CMS Releases Transmittal to Implement 90 day Recertification Rule 

The Centers for Medicare & Medicaid Services (CMS) released Transmittal 88/Change Request 5921 to implement the new regulations discussed in the Federal Register on November 27, 2007, concerning outpatient therapy services including personnel qualifications and the timing of recertification of plans of care.     

CMS requires through regulations at 42 C.F.R. § 424.24 to permit a plan of care to cover therapy services for up to 90 days. Recertification will be required for therapy services provided beyond 90 days. AOTA strongly supported this positive change from the previous 30-day recertification requirement, which allows for variation among patients’ needs and puts decision-making back in the hands of the treating physician, in coordination with the occupational therapy practitioner.   This transmittal requires contractors to implement the regulations effective January 1, 2008. 

Transmittal 88 is available on the CMS website at: http://www.cms.hhs.gov/transmittals/downloads/R88BP.pdf

 

 

http://health.usnews.com/usnews/health/healthday/080207/report-shows-dangerous-chemical-can-leach-from-baby-bottles.htm

 

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The TV Show “Extreme makeover, Home Edition” features a house in Massachusetts made over for a traumatic brain injury patient.  Work was done by a team of volunteers headed by a group of  OT’s.  The show airs on May 11 8pm

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2008 Physician Quality Reporting Initiative (PQRI)

National Provider Conference Call with Question & Answer Session

  The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the second in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EDT, on Wednesday, April 30, 2008.

 The Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) was enacted on December 29, 2007. MMSEA authorizes CMS to make PQRI incentive payments for satisfactorily reporting quality measures data in 2008.

 MMSEA also provides professionals greater flexibility for participating in the 2008 PQRI by authorizing CMS to establish alternative reporting criteria and alternative reporting periods for the reporting of measures groups and for the submission of data on PQRI quality measures through clinical data registries. 

 In 2008, eligible professionals may earn an incentive payment of 1.5 percent of  their total allowed charges for physician fee schedule  covered professional services furnished during the respective alternative reporting periods based on data submitted via these mechanisms.  While TRHCA established a cap on incentive payments for 2007, based on an average per measure payment amount, there is no cap on incentive payments under MMSEA for 2008 and 2009.

 These provisions provide increased opportunities for eligible professionals to report PQRI quality measures and the possibility to earn incentive payments for satisfactory reporting. This call will provide an overview of these new flexibilities.   

 A PowerPoint slide presentation will be posted to the PQRI webpage at, http://www.cms.hhs.gov/PQRI/30_EducationalResources.asp#TopOfPage, on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, Dr. Daniel Green and Rachel Nelson. Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.

 NOTE: We are pleased to announce that CMS will be offering continuing education units (CEUs) for eligible participants; the agenda and details on how to register to obtain CEUs for this call is forthcoming.

 Conference call details:

 Date:                           April 30, 2008

Conference Title:      2008 Physician Quality Reporting Initiative National Provider Call

Time:                          1:30-3:30 p.m. EDT

 In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data.  This registration is solely to reserve a phone line, NOT to allow participation.  If you cannot attend the call, replay information is available below.

 Registration will close at 1:30 p.m. EDT on April 29, 2008, or when available space has been filled.  No exceptions will be made, so please be sure to register prior to this time.

 To register for the call participants need to go to:

http://www2.eventsvc.com/palmettogba/event/2f7d0cda539b41 dfb0fa57ad119b2ba9

 Fill in all required data. 

 Verify your time zone is displayed correctly the drop down box.

 Click "Register".

 You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter.   Note: Please print and save this page, in the event that your server blocks the confirmation emails.  If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.

 For those of you who will be unable to attend, a replay option will be available shortly following the end of the call.  This replay will be accessible from 3:30 p.m. EDT 4/30/2008 until 11:59 p.m. EDT 5/07/2008.  The call in data for the replay is (800) 642-1687 and the passcode is 42860144.

 If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.

 Valerie A. Haugen, Director
Division of Provider Information Planning & Development
Provider Communications Group, CMS
(410) 786-6690
Valerie.Haugen@cms.hhs.gov

Visit the Medicare Learning Network  ~ it’s free!

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Grants:

The four grants reviewed in this Alert are from two Federal Agencies and one private organization.

Up to $14.5 million in public funds will be made available in up to 36 awards, with the maximum amount ranging from $300,000 to $2.000,000 per award. Up to $9 million will be awarded by the Harry and Jeanette Weinberg Foundation in up to 20 awards, with amounts ranging from $300,000 to $900,000 per award.

Funds will be utilized to:

1) facilitate collaboration and the exchange of information related to substance abuse and mental health within the network of Historically Black Colleges and Universities;

2) expand and strengthen substance abuse and mental health services to homeless individuals;

3) promote holistic studies of trauma spectrum disorders in servicemembers; and

4) increase support for family and informal caregivers who assist older adults living in the community.

Public founding is available thru the Department of Health and Human Services (Substance Abuse and Mental Health Services Administration), and the U.S. Army Medical Research Acquisition Activity’s Defense Center of Excellence (DCoE) for Psychological Health (PH) and Traumatic Brain Injury (TBI).  These grants may provide opportunities to develop and enhance your strategies for program sustainability. Decide if they are compatible with your TBI program, and share them with your partners working to improve outcomes for individuals with TBI.

Scroll down to find further details on the grants summarized (and numbered) above.

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PUBLIC FUNDING

1)  Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services Cooperative Agreement for the Historically Black Colleges and Universities Center for Excellence in Substance Abuse and Mental Health (Short Title: HBCU – Center for Excellence) CFDA No.: 93.243.  Grants.gov Funding Opportunity Number: TI-08-011.  Application Deadline: May 22, 2008.

Purpose: To create a Center for Excellence that will continue the effort to network the 103 HBCUs throughout the United States and promote workforce development through expanding knowledge of best practices, leadership development and encouraging community partnerships that enhance the participation of African-Americans in the substance abuse treatment and mental health professions. The comprehensive focus of the HBCU – Center for Excellence will simultaneously expand service capacity on campuses and in other treatment venues.

Eligible Applicants: Any of the 103 nationally recognized HBCUs, or a consortium of HBCUs with a lead college/university as the applicant.  Estimated Available Funds: $500,000.  Maximum Award Size: $500,000.  Estimated Number of Awards: 1.  Project Period: Up to 3 years. For more information, contact: Shannon Taitt Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road, Room 5-1037 Rockville, MD 20857 Telephone: 240-276-1691.  Email: Shannon.Taitt@samhsa.hhs.gov or Roslyn Holliday Moore Center for Mental Health Services Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road, Room 6-1077 Rockville, MD 20857 Telephone: 240-276-1825 Email: RoslynHolliday.Moore@samhsa.hhs.gov Or go to: http://www.samhsa.gov/Grants/2008/ti_08_011.aspx

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2) Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services Development of Comprehensive Drug/Alcohol and Mental Health Treatment Systems for Persons Who are Homeless (Short Title: Treatment for Homeless) CFDA No.: 93.243.  Grants.gov Funding Opportunity Number: TI-08-013. Application Deadline: May 29, 2008.

Purpose: To expand and strengthen treatment services for persons who are homeless, who also have substance use disorders, mental disorders, or co- occurring substance use and mental disorders.  SAMHSA will give preference to applicants that:

- Provide integrated primary health, substance abuse, and mental health services to homeless individuals;

- Demonstrate effectiveness in serving runaway, homeless, and street youth;

- Have experience in providing substance abuse and mental health services to homeless individuals;

- Demonstrate experience in providing housing for individuals in treatment for or in recovery from mental illness or substance abuse; and/or

- Demonstrate effectiveness in serving homeless veterans.

Eligible Applicants: Public and private nonprofit entities, including local governments, Federally recognized American Indian/Alaska Native tribes and tribal organizations, urban Indian organizations, public or private universities and colleges; and community- and faith-based organizations.  Estimated Available Funds: Up to $10 million.

Maximum Award Size: $400,000 per year.

Estimated Number of Awards: Treatment for Homeless - General: Up to 13 Treatment for Homeless - Services: Up to 12.

Project Period: Up to five years.  For more information, contact: Joanne Gampel, M.A. Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road Room 5-1058 Rockville, MD 20857 Telephone: 240-276-2895 Email: joanne.gampel@samhsa.hhs.gov Or go to: http://www.samhsa.gov/Grants/2008/ti_08_013.aspx

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3)  U.S. Army Medical Research Acquisition Activity (USAMRAA) The Defense Center of Excellence (DCoE) for Psychological Health (PH) and Traumatic Brain Injury (TBI) Call for Proposals: Military Psychological Health Research – Complementary and Alternative Strategies (CAM) CFDA No.: 12.420.  Grants.gov Funding Opportunity Number: W81XWH-08-PH-TBI. Deadline for required Letter of Intent: April 15, 2008, 5:00 p.m. EDT. Application Deadline: May 15, 2008, 11:59 p.m. EDT.  Purpose: To instigate studies that will lead to a better understanding of the current use of CAM therapies by service-members, and to explore approaches that may be particularly effective in both protecting and treating the injured service-member. The Department of Defense is dedicated to supporting evidence-based approaches to medical treatment and wants to support the use of alternative therapies if they are proven efficacious.

Specific aims of this call for proposals focus on a holistic approach for trauma spectrum disorders, including patients with TBI and/or post traumatic stress disorder (PTSD), depression, anxiety, and/or substance dependence/abuse. Eligible Applicants: Any organization with the ability to carry out scientific investigations, and is capable of addressing the unique focus and goals of the program.  Funding: Two types of proposals will be considered. Individual research proposals containing preliminary data are expected to average $200,000 per year for up to four years of support; no proposal award will exceed $1 million in total funding (including indirect costs). Seedling grants proposing innovative but testable hypotheses without preliminary data, will be considered for $300,000 in total funding (including indirect costs), with research to be completed within 18 months. A total of approximately $4,000,000 is available for the portfolio of projects to be funded. For more information, contact:  Russell Shilling Telephone: 703-696-9460 Fax: 703696-9478 Email: Russell.shilling@tma.osd.mil Or go to: http://tinyurl.com/4ufdoa to download the full announcement.

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PRIVATE FUNDING

4)  The Harry and Jeanette Weinberg Foundation Family and Informal Caregiver Support Program The Foundation believes that the best solutions for improving long-term care and supportive services for older adults living in the community must include their family and informal caregivers, as well as the active engagement of older adults and other community members and assets.  This Program provides support to innovative and/or evidence-based community initiatives or projects that help family and informal caregivers assist low and moderate income, community dwelling older adults in maintaining their independence and quality of life.  Deadline for required Letter of Inquiry (LOI): June 12, 2008, 5 PM EST.  Successful LOI applicants will be notified by August 1, 2008, and will have until October 7 to submit a Full Proposal. Grants will be announced in early February 2009.  Estimated Available Funds: Up to $9 million over three years will support from 12 to 20 community-based Projects with grants ranging from $100,000 to $300,000 per year (for a total of $300,000 to $900,000 for each grant recipient from March 2009 through February 2012).  Eligible Applicants: Non-profit 501(c)(3) organizations, including aging and human service agencies, faith-based and other community-based organizations, tribal organizations, and units of local government.  NOTE: Two free Informational Phone Conferences will take place – the first on Wednesday, April 30, 2008, between 3 PM and 3:25 PM EST, the second on Thursday, May 8, 2008, between 1 PM and 1:25 PM EST.

FOR FURTHER INFORMATION

For more information, contact:  The Harry and Jeanette Weinberg Foundation  7 Park Center Court Owings Mills, MD 21117  Phone: 410-654-8500 Fax: 410-654-4900  Email: CaregivingRFP@theweinbergfoundation.org Or go to: http://www.hjweinbergfoundation.org/subPages/grantmaking/rfp.htm

 

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(posted 04/15/2008)

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Senate Introduces Bill to Stop Medicaid Cuts

NJHA is asking members to urge New Jersey ’s senators to support S. 2819, the Economic Recovery in Health Care Act. The bill, introduced by Sens. Jay Rockefeller (D-W. Va. ), Olympia Snowe (R-Maine) and Ted Kennedy (D-Mass.), would delay by one year Medicaid rules expected to strip billions of dollars in funding from the program.

The Senate measure is similar to another bill supported by NJHA, H.R. 5613, the Protecting the Medicaid Safety Net Act. The Senate bill would extend the current moratoria on payments to public providers, graduate medical education, school-based services and rehabilitative services, and halt impending or existing regulations that cut funds for targeted case management, allowable provider taxes, outpatient clinic and hospital services.

In addition, the Senate bill delays implementation of a State Children’s Health Insurance Program directive that would affect access to the program for low-income children, and provides targeted fiscal relief to help states deal with shortfalls in the current economic downturn.

Please urge your lawmakers to support S.2819/H.R.5613.

(posted 04/08/2008) 

 

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Coaching the Comeback -  January 15th, 2008, Article on Occupational Therapy in the New York Times.   Please click here to access the NY Times, then type "Coaching the Comeback" in the search box.

(posted 02/08/08)

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