Webinar: Health Care Access Following the Election

EverThrive Illinois and the Shriver Center on Policy Law

EverThrive Illinois and the Shriver Center on Policy Law are hosting a webinar on Defending Health Access in Illinois: The ACA and Medicaid Post-Election. The webinar will be held on Monday, December 12 from 2-3pm and will discuss potential threats to the ACA and Medicaid and opportunities to take action and defend health access in Illinois. Register here

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ICAAP's Free Web-based Obesity Education Offerings

ICAAP's Obesity Prevention Initiatives offers an array of web-based education free of charge on ICAAP's new online learning platform in the course catalog under Obesity Prevention. Click here to access a flyer with more information about ICAAP's obesity-related education offerings. The following courses are included:

• Nutrition for Obesity Prevention and Treatment
• Physical Activity Guidelines and Counseling for Children and Adolescents
• Evaluation and Management of Hypertension in Children
• Evaluation and Management of Hyperlipidemia in Children
• Understanding and Assessing Psychosocial Factors Associated with Childhood Obesity
• Connecting Patients to Community Resources

For more information, or for assistance navigating resources and finding resources for patients, please contact Anna Carvlin, Manager, Obesity Prevention Initiatives, at 312/733-1026 x214 or acarvlin@illinoisaap.com. ICAAP obesity-related education is funded by grants from the Otho S.A. Sprague Memorial Institute and the Illinois Department of Healthcare and Family Services.

 

 

Children’s Health: Options for Continued Coverage

For almost 20 years, CHIP has been an essential program providing low- to moderate-income children and pregnant women with appropriate, affordable coverage that with Medicaid has drastically reduced the number of uninsured children nationwide. The coming months will be an important time period for children’s coverage because without Congressional action federal funding for CHIP is not guaranteed beyond September 2017. Many state Medicaid and CHIP officials are already beginning to consider what options may be available to their states if funding for CHIP is delayed or not extended.  With support from the David and Lucile Packard Foundation, NASHP has developed a number of resources that highlight states’ CHIP programs and some of the current policy questions that may be useful as state and federal policymakers consider what the future holds for children’s coverage.    NEW! 2016 CHIP State Fact Sheets Released With help from the American Academy of Pediatrics (AAP), NASHP is releasing 2016 CHIP fact sheets that provide up-to-date information about CHIP for each state, including data on enrollment, participation rates, eligibility levels, benefits, cost sharing requirements, and other key program characteristics. A Closer Look at Policy Options Our recently released Potential Options and Policy Questions for Improving Exchange Coverage for Children that examines ways for improving exchange coverage for children in terms of both affordability and pediatric benefit adequacy, which builds upon the policy options identified in this previous NASHP brief. A Timeline if Federal CHIP Funding Ends This CHIP timeline based on input from state CHIP officials that outlines key budgetary, statutory, and programmatic issues and changes that states with separate CHIP programs would need to consider and/or implement if future federal funding for CHIP remains uncertain.

 

New MOC Project: Identification and Management of Psychosocial Stressors in Children with Overweight and Obesity

Body mass index reduction in children with overweight and obesity can be challenging. Toxic stress, such as adverse childhood experiences, unmet social needs, and psychiatric disorders, may represent an important reason why pediatric obesity is so difficult to treat. Learn how to address these issues in your practice with ICAAP's upcoming MOC activity "Identification and Management of Psychosocial Stressors in Children with Overweight and Obesity." Participants will learn about the cyclical connection between toxic stress and obesity as well as practical tips on how to screen, counsel, and refer for one focused psychosocial stressor of their choice. Additionally, pediatricians can request individualized assistance from ICAAP staff to identify community resources near their practice that can address the psychosocial stressor that they have chosen. The collaborative project is slated to being in January 2017. To register or for more information, please contact Mary Elsner, Director of Obesity Prevention Initiatives, at 312/733-1026 x 237 or melsner@illinoisaap.com.
This activity is funded by a grant from the Illinois Department of Healthcare and Family Services and the Otho S. A. Sprague Memorial Institute.

FluMist Not Recommended For 2016-2017 Flu Season

A friendly reminder from the Centers of Disease Control and Prevention (CDC) to not use FluMist, the nasal spray flu vaccine, this influenza season. However, to the Advisory Committee on Immunization Practices (ACIP) continues to recommend the annual flu shot for the season. To read more about the recommendations, please visit CDC website.

ICAAP Receives Award from Illinois Academy of Family Physicians (IAFP)

IAFP President Alvia Siddiqi, MD presented ICAAP with the President's Award at the 2016 IAFP Annual Meeting. ICAAP and IAFP have partnered for years on education and advocacy with the shared goal of providing the best possible health care for Illinois children. Recent efforts include working with IDPH and the Medicaid MCOs around changes to the VFC program, childhood obesity prevention, tobacco prevention and cessation, and immunizations for children. ICAAP is grateful for the award and the continued partnership with IAFP.

New evidence-based publications from AHRQ can help clinicians, patients and their families make informed decisions about treating low back pain, a condition that affects eight out of 10 people at least once in their lifetimes. Noninvasive Treatments for Low Back Pain: Current State of the Evidence is a publication for clinicians that summarizes the benefits and harms of noninvasive treatments for acute, subacute and chronic low back pain. The publication summarizes findings in an AHRQ-funded systematic review that examined interventions including exercise, medications, acupuncture and superficial heat. The publication also evaluates the strength of evidence for each finding. Also available is a new continuing education module based on the evidence review, as well as a plain-language publication for patients, Noninvasive Treatments for Low Back Pain – A Summary of the Research for Adults.

2017 PQRS Results: Submit an Informal Review by Nov. 30

In 2017, CMS will apply a downward payment adjustment to those who did not satisfactorily report for the
Physician Quality Reporting System (PQRS) in 2015 including:

• Individual eligible professionals
• Comprehensive Primary Care practice sites
• PQRS group practices
• Accountable Care Organizations

If you believe you have been incorrectly assessed the 2017 PQRS payment adjustment, submit an informal review through Nov. 30, 2016:

• See  2015 PQRS: 2017 PQRS Negative Payment Adjustment - Informal Review Made Simple 
• All informal review requestors will be notified via email of a final decision by CMS within 90 days of the original request for an informal review

2015 PQRS feedback reports are available:

• Quick Reference Guide for Accessing 2015 PQRS Feedback Reports 
• 2015 PQRS Feedback Report User Guide 

For more information, visit the  Analysis and Payment webpage. For questions about the informal review process, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715-6222) or Qnetsupport@hcqis.org 



 

CMS Hosts MIPS Overview Webinar Tuesday, Nov. 29

CMS Hosts MIPS Overview Webinar Tuesday, Nov. 29

The Centers for Medicare & Medicaid Services (CMS) invites you to join a webinar Tuesday, Nov. 29, from 1:30-3 PM (ET) on the Merit-based Incentive Payment System (MIPS). Participants will gain more information on how to participate and will learn about flexible participation options for the transitional year (commonly referred to as "Pick Your Pace"). REGISTER NOW! 

                                                 

Space for this webinar is limited. After you register, you will receive an email message with a webinar link. The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.

Submit a Formal Comment: CMS encourages the public to submit comments on the MACRA final rule. Comments are due on Dec. 19, 2016, and can be submitted in several ways, including: Electronically via  https://www.regulations.gov/; By regular mail; By express or overnight mail;

By hand or courier. For more information about the Quality Payment Program, visit qpp.cms.gov.  


 

New AHRQ Summaries for Treating Low Back Pain

 

New AHRQ Summaries for Treating Low Back Pain

New evidence-based publications from AHRQ can help clinicians, patients and their families make informed decisions about treating low back pain, a condition that affects eight out of 10 people at least once in their lifetimes. Noninvasive Treatments for Low Back Pain: Current State of the Evidence is a publication for clinicians that summarizes the benefits and harms of noninvasive treatments for acute, subacute and chronic low back pain. The publication summarizes findings in an AHRQ-funded systematic review that examined interventions including exercise, medications, acupuncture and superficial heat. The publication also evaluates the strength of evidence for each finding. Also available is a new continuing education module based on the evidence review, as well as a plain-language publication for patients, Noninvasive Treatments for Low Back Pain – A Summary of the Research for Adults.

 

 

 

Webinar Registration: Interplay of Hepatitis C Virus Infection with Liver and Kidney Disease

Webinar Program: Date/Time Wednesday, December 14, 2016 12:00 PM - 1:00 PM Eastern Time Who Should Attend  People diagnosed with Hep C or at high risk for getting Hep C – like those with chronic kidney disease – will benefit from learning about the interplay between hepatitis C infection and liver and kidney disease. Webinar Overview  Most people know that Hep C affects the liver. But did you know that Hep C is also an important issue for people with kidney disease? Learn about the hepatitis C virus (HCV), its relationship to liver and kidney disease, current HCV treatment options, and issues surrounding HCV infection and transplantation. Hear from two nationally-recognized experts in their field – a hepatologist (physician specializing in liver disease) and a nephrologist (physician specializing in kidney disease) – who have a particular interest in the impact of HCV infection on their patients. Both speakers will be available for a live question and answer session following their presentation.

Registration  To register, please click here. And be sure to look at the HepC123.org information center, a comprehensive resource dealing with everything from risk factors and diagnosis to treatment and financial assistance. We look forward to your participation.

IL RURAL HEALTH ASSOCIATION OFFERS FREE STUDENT MEMBESHIPS in CONJUNTION with NATIONAL RURAL HEALTH DAY

For Immediate Release       November 17, 2016

Springfield, IL - To kick off National Rural Health Day, the Illinois Rural Health Association wants to draw attention to the critical shortage of healthcare providers and billing specialists in rural areas and is offering free 12 month memberships to college and graduate students interested in healthcare, public health and medical billing and coding professions, who join by December 16^th.  

To join, simply go to www.ilruralheath.com and select the "student" membership category.  Membership will entitle you to stay abreast of the latest rural health news and be invited to our webinars, regional educational and legislative forums as well as our Annual Educational Conference which is being held August 9-10th in Champaign, Illinois.

First organized in 1989, the Illinois Rural Health Association (IRHA) is a collaborative association of medical schools, hospitals, Rural Health Clinics, health departments, practitioners, students and public officials, whose mission is to strengthen health systems for rural residents and communities through advocacy, education, networking, leadership, and scholarships.

Contact: Margaret Vaughn, Executive Director

 

IL Rural Health Association
9211 Waterfall Glen Blvd.
Darien, IL 60561
217-280-0206

            

www.ilruralhealth.org
staff@ilruralhealth.org

IRHA to Host MARCA & MIPS Medicare Webinar

 

Monday, November 21
11:30 A.M. to 1:00 P.M.

MACRA, MIPS, and What to do!?!
This webinar presented by Charles James of North American Healthcare Healthcare Management Services, will provide an overview of the new Medicare Incentive-based Payment System.  We will discuss:

Program and associated time-frames
Eligible Professionals
How to prepare your practice
What is the effect on RHCs?

Register here.

ICAAP: 2016 Presidential Election

Following the election, the AAP and ICAAP remain committed to all children, all families, and all pediatricians and will continue to work to help children and support the health care providers that care for them. Please see the AAP's Blueprint for Children: How the Next President Can Build a Foundation for a Healthy Future to review policy recommendations that would put children and families at the center of policy. The Blueprint was created to provide an administrative and legislative agenda for all children and to guide the US President on issues impacting children's health and well-being, including poverty, education, early childhood development, and building strong communities. The AAP and ICAAP are focused on ensuring that the US is a leading nation for children. Please view AAP President Benard Dreyer’s recent statement for more information and AAP priorities.

Additionally, the AAP provided guidance for pediatricians to provide if parents have asked how to address the negative campaign, the election and results, and the ongoing news stories related to the election and protests. Pediatricians should encourage parents to talk to their children, listen to their questions, and engage in activities that express their values.

IAFP Webinar: Population Health Management for Smoking Cessation in Low Income Smokers

The Illinois Academy of Family Physicians is hosting a webinar in conjunction with the American Cancer Society's Great American Smokeout on Wednesday, November 16 from 12-1pm. Population Health Management for Smoking Cessation in Low Income Smokers will be presented by Brian Hitsman, PhD and Timothy Long, MD. At the end of the session, participants will be able to:

• Recognize the problem of cigarette smoking among socioeconomically disadvantaged populations in Illinois and across the United States.
• Describe progress that has been made in addressing smoking in primary care settings, including safety net community health centers, and remaining challenges.
• Define population health management for smoking cessation and describe its potential for improving the treatment of smoking/nicotine dependence in primary care patients.
• Describe one experimental approach to population health management for smoking cessation in a safety net community health center in Chicago.

Register now at:  https://attendee.gotowebinar.com/register/7137298690355573250

 

Seeking Physicians For Autism Related Survey

Stanford University School of Medicine

You are invited to participate in a research study on how, when and why primary care providers make referrals to genetic services for their patients with an autism spectrum disorder. Please take 5 minutes to complete an anonymous survey provided by Stanford University School of Medicine that examines practice patterns of physicians taking care of children and families with autism. For more information, contact Jessica Kianmahd at kianmahd@stanford.edu.



 

Registration Closes Soon for ICAAP's MOC Part II Activity

Register Now for ICAAP's MOC Part II self-assessment activity Diagnosis and Management of Pediatric Asthma for primary care providers. The live educational session will be held on Friday, December 2, from 8-11:30 am at the Loyola University Medical Center in Maywood. The activity is approved for 15 hours of CME credit and 20 MOC Part II points by the American Board of Pediatrics. The registration fee is $250 for ICAAP members and $300 for non-members.


Pre-registration is required and space is limited so register now on ICAAP's new LMS. Participants must register and complete the pre-test by November 28. Please create a user account and then enroll in the Diagnosis and Management of Pediatric Asthma course. If you have any questions, please contact Elsie Divinagracia at edivinagracia@illinoisaap.com or Kathy Sanabria at ksanabria@illinoisaap.com. 
 
The Illinois Chapter, American Academy of Pediatrics is accredited by the Illinois State Medical Society (ISMS) to provide continuing medical education for physicians.
The Illinois Chapter, American Academy of Pediatrics designates this live activity for a maximum of 15 AMA PRA Category1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Epinephrine Auto Injector Update to Preferred Drug List (PDL)

To:​	​Participating Pharmacies, Physicians, Dentists, Podiatrists, Hospitals and Optometrists
​Date:	​November 15, 2016
​Re:	​Epinephrine Auto Injector Update to Preferred Drug List (PDL)

 

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This notice informs prescribers and providers that the Department of Healthcare and Family Services (HFS) will move the brand name products, EpiPen and EpiPen Jr to non-preferred status.

Beginning with dates of service on and after December 15, 2016, both medications will be non-preferred and require prior authorization. The EpiPen and EpiPen Jr will only be reimbursable when the prescriber can provide medical justification as to why the generic cannot be used.

The generic Epinephrine 0.3mg Auto-Injector and Epinephrine 0.15mg Auto-Injector will remain available without a prior authorization. 

Prescribers should begin updating the participant’s prescriptions or submitting prior authorization requests where appropriate at this time to ensure a smooth transition to the generic product.

If you have any questions regarding this provider notice, please contact the Bureau of Professional and Ancillary Services Pharmacy Billing Consultant at 877-782-5565.

 

Felicia F. Norwood

Director

Revised Statewide Transition Plan for Home and Community-Based Settings

​To:	​Home and Community Based Service Providers
​Date:	​November 9, 2016
​Re:	​Revised Statewide Transition Plan for Home and Community-Based Settings

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 In January 2014, the Centers for Medicare and Medicaid Services (CMS) published final rules that require all Medicaid HCBS settings to demonstrate the characteristics of a community-based, rather than an institutional, setting. Under the federal rule, settings that do not demonstrate those characteristics cannot participate in Medicaid HCBS programs. Federal CMS requires states to assess their current HCBS settings. Over the past several months hundreds of sites throughout Illinois have had on-site visits to assess compliance with the new federal rule. Those visits are now complete.

If your location had a visit, follow up correspondence will occur from the State Operating Agency that administers your program.  If your location did not have a visit, please remember that the new federal rules will apply to your location and that every HCBS setting is required to maintain compliance with the rule. Please review the blank copy of the On Site Assessment Tool that was utilized during recent visits at locations around the state. The questions utilized within that document will be integrated into your future compliance visits with the State of Illinois. It is imperative that your location be compliant with the new federal rule and that when your next accreditation/licensure visit occurs you are able to demonstrate adherence to the new federal rule.

Comments may be submitted by email to HFS.SWTransitionPlan@illinois.gov, or written comments may be mailed to:

The Illinois Department of Healthcare and Family ServicesAttn:  Waiver Management201 South Grand Ave East, FL 2Springfield, IL   62763

 

Felicia F. Norwood

Director

Chapter D-200, Handbook for Providers of Encounter Clinic Services - Vaccination Billing Instructions

  





             

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​To:	​Federally Qualified Health Centers (FQHCs), Encounter Rate Clinics (ERCs), and Rural Health Clinics (RHCs)
​Date:	​November 9, 2016
​Re:	​Chapter D-200, Handbook for Providers of Encounter Clinic Services - Vaccination Billing Instructions

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The Department has re-issued the Handbook for Providers of Encounter Clinic Services (pdf) to include changes to the Vaccines for Children (VFC) program.

The Handbook for Providers of Encounter Clinic Services (pdf) Topic D-210.5.4 has been revised to reflect vaccination billing instructions. Also, Appendix 6 has been added to the Encounter Clinic Appendices (pdf).

Questions regarding this notice should be directed to a Medical Assistance Consultant in the Bureau of Professional and Ancillary Services at 1-877-782-5565.

 

Felicia F. Norwood

Director

Chapter K-200, Handbook for Hospice Agencies - Reissue

                 

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​To:	​Enrolled Hospice Agencies
​Date:	November 7, 2016​
​Re:	​Chapter K-200, Handbook for Hospice Agencies - Reissue

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The Department is reissuing the Handbook for Hospice Agencies, Chapter K-200, Policy and Procedures for Hospice Services. Providers are encouraged to review the handbook in its entirety. This handbook, in conjunction with the Handbook for Providers of Medical Services, Chapter 100, General Policy and Procedures, provides information necessary for providers to receive payment from the Department for hospice services.

 

Some updates of particular note:

• The handbook identifies enrollment instructions for the IMPACT system.
• Physician certification requirements have been modified to state if the hospice cannot obtain the written certification of terminal illness within two calendar days after a benefit period begins, it must obtain an oral certification within two calendar days, and the written certification before it submits a claim for payment. Previously there were non-payment ramifications as identified in notices dated April 7, 2014 and July 30, 2014 if the hospice did not get the written certification within eight days after care was initiated.

• Policy has been included regarding the two-tier routine home care payment system and the service intensity add-on payment.

Any questions may be directed to a hospice billing consultant in the Bureau of Hospital and Provider Services at 1-877-782-5565.

 

Felicia F. Norwood

Director

HOSPITAL PROVIDER ASSESSMENT NOTICE

                 

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​To:	​Hospitals
​Date:	​November 4, 2016
​Re:	​HOSPITAL PROVIDER ASSESSMENT NOTICE

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The REVISED November and December 2016 remittance notices reflecting the increases to the inpatient and outpatient hospital provider assessments per Public Act 99-0516 were mailed to hospitals on November 3, 2016. If your hospital prefers an electronic copy, please contact the Provider Assessment Unit at 217-524-7110.