Health Insurance Marketplace: 10 Things to Tell Your Patients

1.  If you don’t already have health coverage, the Health Insurance Marketplace is a new way to find and buy health coverage that fits your budget and meets your needs.

2.  Open Enrollment starts October 1, 2013, and ends on March 31, 2014. Plans and prices will be available then. Coverage starts as soon as January 1, 2014.

3.  Not only can you view and compare health insurance options online, but with one simple application, you can have those options tailored to your personal situation and find out if you might be eligible, based on your income, for financial assistance to lower your costs.

4.  The same application will let you find out if you and your family members might qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).

5.  The information is all available online, but you can apply 4 ways: online, by phone, by mail, or in-person with the help of a trained assister or navigator.

6.  Each health plan will generally offer comprehensive coverage, including a core set of essential health benefits like doctor visits, preventive care, maternity care, hospitalization, prescription drugs, and more.

7.  No matter where you live, there will be a Marketplace in your state, offering plans from private companies where you’ll be able to compare your health coverage options based on price, benefits, quality, and other features important to you before you make a choice.

8.  Health insurance companies selling plans through the Marketplace can’t deny you coverage or charge you more due to pre-existing health conditions, and they can’t charge women and men different premiums based on their gender.

9.  Marketplaces will be operated by your state, the federal government, or a partnership of the two, but each Marketplace will give you the same access to all of your Marketplace coverage options.

10. For more information, visit HealthCare.gov. Or, call the Health Insurance Marketplace Call Center at 1-800-318-2596, 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325.

How FQHCs Can Compete within the NSHC Jobs Center

Since November 1 is the deadline to apply to be an National Health Service Corps Site, many new and  updated applications will come in from applicants who compete with FQHCs for NHSC clinicians.  Health centers are auto-approved with NO expiration date.  Auto-approval means that some data from BPHC is transferred to the NSHC system.  Given that others will be updating their information, now is the time for every health center to assure they have the following in the NHSC Jobs Center:

1.  An exciting site profile that will attract clinician interest

2.  All current eligible vacancies listed

3.  The correct person for applicants to contact

If you have any questions, contact Donald Weaver, M.D., Associate Medical Officer, NACHC, Ph. 301-347-0400 ext. 2069, or dweaver@nachc.com .

Medicaid ICD-10 Implementation Project October 2013 Update

Nebraska Medicaid Clarifications and Additional Information

1.  Dual Processing: When “dual processing” is discussed, there seem to be several interpretations. Dual processing for Nebraska Medicaid means that both ICD-9 and ICD-10 codes will be accepted on and after 10-1-2014, but only if submitted as follows:

·  ICD-9 will only be accepted for processing if the dates of service are before 10-1-2014.

·  ICD-10 will only be accepted for processing if the dates of service (“to” date or discharge date) are on or after 10-1-2014.

2.  ICD-10 Code Books: If you have not done so already, order ICD-10 Code Books now. Some publishers report printing backlogs. Nebraska Medicaid cannot supply the code books or recommend a publisher.

3.  Claim submission timeline: There has been a change to the claim submission timeline that will impact all providers. The timeline changed from one year after the date of service to 6 months, one-half the previous time allowed. Effective September 1, 2013, claims with dates of service September 1, 2013, or later, must be submitted within six (6) months of the date of service.  Claims submitted after the submission time has elapsed, will be rejected/denied.  Providers will begin to see this impact by March, 2014. Certain exceptions are outlined in regulation 471 NAC 3-002.01A at Payment for Medicaid Services.

4.  Nebraska ICD-Collaborative: The collaborative is a partnership of Nebraska individuals and organizations working together to facilitate communication, collaboration and information sharing among ICD-10 stakeholders to assist with the transition to and successful implementation of ICD-10 CM and ICD-10 PCS. Please visit the website at: http://www.nebraskaicd10.org/ . The website includes links to resources and events, such as available training sessions.

Resources- Check out the Nebraska Health Information Management Association website at: http://www.nhima.org for some training opportunities in Nebraska.

The Nebraska Medicaid ICD-10 Project website also has a number of Frequently Asked Questions at http://dhhs.ne.gov/medicaid/Pages/ICD-10.aspx .

The Centers for Medicare & Medicaid Services (CMS) has resources to help prepare for a smooth transition. Visit www.cms.gov/ICD10 to find out more.

Questions?

Please submit questions about this bulletin or about ICD-10 to DHHS.ICD-10Implementation@nebraska.gov.

The Nebraska Medicaid ICD-10 Project website also has a number of Frequently Asked Questions at http://dhhs.ne.gov/medicaid/Pages/ICD-10.aspx .

The Centers for Medicare & Medicaid Services (CMS) website has published a list of Frequently Asked Questions at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10FAQs2013.pdf

 

 

.

Assessing the Potential Impact of the ACA on Uninsured Community Health Center Patients: A Nationwide and State-by-State Analysis – Report

George Washington University School of Public Health offers this research analysis of the effect of the ACA in states choosing whether or not to expand Medicaid.  The report is available here:  Report from George Washington University School of Public Health

Kaiser Health News comments on the revenue lost to CHCs in states not expanding Medicaid.

 

Success Stories on Getting Affordable Health Insurance

HHS Secretary Kathleen Sebelius shares that more people are applying and getting covered every day, and she often hears how the Marketplace has helped them.  It’s one of the best parts of her job.  Here are some of their stories:

  • Last week while on the road in Ohio, she met Keith Deaton, a Cincinnati realtor. Because of a preexisting condition, Keith has struggled to find health insurance that meets his family’s budget.  When Secretary Sebelius spoke with him, he told her how excited he was to be able to shop for a plan that’s a better fit for him and his family.
  • Daniel, a student from Florida, was able to find high quality insurance for $70 dollars a month through HealthCare.gov.  Affordable coverage is critical to students like Daniel who have to protect their health on a limited budget.

You can read more stories like these on the new page: http://www.hhs.gov/healthcare/

You can also ask your patients to share their story using #GetCovered on FacebookTwitter, and Pinterest.

Robert Wood Johnson Foundation Announces Executive Nurse Fellowship

The Robert Wood Johnson Foundation Executive Nurse Fellows (ENF) program is a three-year advanced leadership program for nurses who aspire to lead and shape health care locally and nationally. Fellows strengthen and improve their leadership abilities related to improving health and health care.

The program will award up to 20 fellowships for the 2014 cohort. Each award will be up to $35,000 for each fellow over three years.

The application deadline is January 14, 2014, at 3:00 pm ET.

Find detailed information here.

O&E Quarterly Progress Reports are due October 24, 2013

Keshia Bradford, Director of Outreach & Enrollment, reminds all health center Outreach & Enrollment staff that Quarterly Progress Reports are due on Thursday, October 24, 2013.

Contact Keshia at kbradford@hcanebraska.org or 402-933-3519 if you have any questions.

Outreach & Enrollment

Outreach & Enrollment.  Just two words but now so much more meaningful.  From just going out into the community, Outreach now means a tireless effort to help individuals who may qualify for affordable health insurance, possibly for the very first time.  From just getting enrolled to enter a sport or a school, Enrollment now means peace of mind for thousands of Nebraskans who will get new help with medical expenses at a price they can afford.  For those of us working in Outreach & Enrollment from Community Health Centers, it means reaching people of various ages, ethnicities, and educational backgrounds for the common goal of enrolling in health insurance.

This is why I am here.  I am excited to be a part of this historic effort to increase access to health care and the insurance that helps pay for it.  I have always wanted to help others and I am able to do so by providing Outreach & Enrollment assistance to health centers throughout the state of Nebraska.  How awesome is that?  Pretty awesome.  I am fortunate enough to meet and work with people at our health centers who see the challenges they are up against.  They do not back down, standing for what they believe is right for the people they serve.  Kudos to you, health centers!

The other day, I was asked to do a Health Insurance Marketplace presentation on a Sunday afternoon to a group of refugee women.  The address I was given led me to a tiny Asian grocery store.  Within a few minutes I was given delicious Thailand coffee.  (By far the best coffee I have had.  I really like my coffee creamy.  Anyway, trust me, it was good coffee.)  I soon learned that their meeting place changed every time they met because they did not have a designated spot.  I saw how committed these women were because they are starting an organization unlike any other in Omaha in order to take the information from my health care reform talk to their populations.  I began my presentation and the time flew.  The conversations around the table were great.  I was able to give them many resources which they, in turn, will provide to their diverse refugee groups.  These women are committed to spreading the word that health insurance may be available to help their own communities in need.  Again, how awesome is that?  People taking the initiative to help educate others.

Do these women inspire you?  Here’s what you can do to help:

Please contact me if you have health care reform questions.  I would love to help you get the information you need.

Your Partner for Health Care Access,

Keshia Bradford

Director of Outreach & Enrollment

kbradford@HCANebraska.org

 

Managing Ambulatory Health Care I: A Program for Physicians in Community Health Care (MAHC I)

Description: Paging all health center physicians! Go beyond the basics of being a new medical director in a FQHC. Apply for MAHC I and learn skills that are essential in the community health center environment, including but not limited to:

  • Financial management: learn to read income statements and balance sheets and improve your ability to participate in financial discussions
  • The enhanced role of the medical director: learn essential strategies to increase your influence as a physician manager in the health center
  • Clinical operations: develop an understanding of options to help improve a number of common operational issues faced by community health centers

Upcoming MAHC I Courses

November 4-7, 2013—Myrtle Beach, South Carolina
Learn more about this training.
Brought to you by NACHC and the South Carolina Primary Health Care Association (SCPHCA)

Save the date -Registration Opens Soon! February 17-20, 2014—Austin, Texas
Brought to you by NACHC and the Migrant Clinicians Network (MCN)

New AHRQ Toolkit Helps Make Care Safer for Patients in Medical Offices

A toolkit to help doctors, nurses and medical office staff improve their processes for tracking, reporting and following up with patients after medical laboratory tests was released today by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ). The toolkit is part of the agency’s effort to make care safer for patients in all settings.

Approximately 40 percent of primary care office visits involve some type of diagnostic medical test, such as a urine sample or blood test, provided on site or at a laboratory. However, if test results are lost, incorrect or incomplete, the wrong treatment may be prescribed and patient harm can occur.

This new toolkit is designed to improve safety in office-based settings by giving doctors and their staff a practical, easy-to-use resource to help manage their lab test results and patient follow-up.

Improving Your Office Testing Process: Toolkit for Rapid-Cycle Patient Safety and Quality Improvement (http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/ambulatory-care/office-testing-toolkit/) offers step-by-step instructions on how to evaluate an office testing process, identify areas where improvement is needed and address those areas. Practical tools are included that can be used to assess office readiness, plan activities, engage patients, audit efforts and incorporate electronic health records. The toolkit also includes a template for practices to ensure that laboratory test results are communicated effectively to patients in English or Spanish.

To order a free copy of  Improving Your Office Testing Process: Toolkit for Rapid-Cycle Patient Safety and Quality Improvement, contact the AHRQ Clearinghouse at 800-358-9295 or Email AHRQpubs@ahrq.hhs.gov and ask for publication number 13-0035.