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CMS Issues Updated Regulations

The Centers for Medicare & Medicaid Services (CMS) recently released an interim final rule eliminating the requirement for a Certificate of Medical Necessity signed by the physician to accompany claims for power wheelchairs. Earlier this year Medicare replaced the old "bed or chair confined" standard with criteria related to functional ability.

 

According to CMS administrator Mark B. McClellan, MD, PhD, "This interim final rule is a step in ensuring that people with Medicare have access to appropriate technology to assist them with mobility."

 

New requirements include a professional face-to-face evaluation documented in the patient's record. The documentation must identify the beneficiary's need for assistance with mobility in the home. Strength, range of motion, and a functional needs assessment are part of the required documentation.

 

The ruling also eliminates restrictions on who can prescribe a power scooter and now allows both physicians and treating practitioners (physician assistant, nurse practitioner, or clinical nurse specialist) to prescribe the power wheelchairs or scooters. Before billing Medicare, a supplier is required to obtain a signed and dated written prescription from the physician or treating practitioner who performed the examination, and it must be within 30 days of when the examination was completed.

 

The ruling will become effective for services on or after October 25.

 

For more information, check out the August 26 Federal Register to see the interim final rule at http://a257.g.akamaitech.net/7/257/2422/01jan20051800/edocket.access.gpo.gov/200.

 

A fact sheet is also available at the CMS Web site:http://www.cms.hss.gov/coverage/wheelchairs.asp.

 

Students Experience Firsthand Issues Facing Older Adults

Students enrolled in the Gerontology Program at Purdue University, West Lafayette, Indiana, are learning firsthand many of the issues that arise as one begins to age. The university has formed a partnership with a local retirement center, Westminster Village. Students participating in the Bridge program live in the retirement center along with the residents of the Village. Requirements include the students having at least one meal per day with the residents, participating in weekly activities, and serving on the facilities planning committee. Those who are participating in the program are gaining valuable insight into the health and social issues faced by aging adults. The residents of the retirement center are also benefiting from the program and receive valuable information on health, diet, and exercise from the students. Professor Gerald Hyner is the Director of the Gerontology Program that is part of the Center on Aging and the Life Course.

  
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Free Information on Caring for Older Adults

The American Geriatrics Society (AGS) Foundation for Health in Aging has a Web site dedicated to caring for older adults. The site contains a wealth of information on the subject, including educational information that is available for download and printing from your computer. Information includes a page on "What Is Geriatrics" and discusses the important role a geriatrician can play in the care of older adults. Topics on this page include dealing with depression, how to recognize and treat it, and a link for a Memory Loss Tool Kit. You can find information on managing medications, tips on preventing problems with polypharmacy, and a tool for your patient to use in tracking his/her medications, both over-the-counter and prescription drugs. Fall prevention also is covered, and a number of resources are provided in the form of handouts that can be used in educating patients and family members. One excellent resource found on this Web site is Eldercare at Home, a workbook written by a team of professionals; it provides clear and practical instructions for dealing with issues and problems that arise when caring for older adults. The workbook is available in three formats, including a free online version that can be found at the Web site (the online version does not include illustrations); the complete workbook, including illustrations, can be ordered for $19.95 (plus shipping/handling), and the Eldercare at Home Presentation Package is available for $149.00 and includes a CD-ROM with PowerPoint presentation, a copy of the complete workbook, and handouts for use in training staff, especially volunteers and home health aides.

 

The AGS Foundation is a national nonprofit organization established in 1999 that is devoted to providing information on the special healthcare needs of older adults. For more information visit http://www.healthinaging.org.

 

REFERENCE

 

Houts, P., Alessi, C., Busby-Whitehead, J., Rubenstein, L., & Fordyce, M. Eldercare at home. (2nd ed.). New York: American Geriatrics Society Foundation for Health in Aging.

Spanish Patient Educational Fact Sheet on Cancer

 

The National Institute on Aging has available a cancer fact sheet printed in Spanish. Information included on the sheet identifies symptoms people should watch for and what to do if a symptom is detected. The fact sheet also covers regular tests to have done and a brief description of how each test is performed. Prevention is covered, with identification of various risk factors and information on where to go to obtain additional information on cancer. To print this information from your computer, log on to http://www.niapublications.org; to order copies via telephone, call toll free at 1-800-222-2225. The Spanish version of the publication is "La Realidad del Cancer en Hombres y Mujeres a Partir de los 50 Anos." The publication is also available in English: "Cancer Facts for People over 50."

New Food Guidance System

One Size Doesn't Fit All

 

Recently, Agriculture Secretary Mike Johanns unveiled MyPyramid, which is replacing the Food Guide Pyramid introduced in 1992. Using the MyPyramid symbol emphasizes a more individualized approach to healthy eating and physical activity. The design of the symbol is simple, with a goal of encouraging consumers to make healthier food choices and incorporate activity into their daily life. The U.S. Department of Agriculture incorporates interactive technology on its Web site to make it easier for the user to personalize his/her daily calorie level based on age, gender, and the amount of daily physical activity.

 

Included at the site is a 1-minute animation providing a brief overview of MyPyramid. The viewer also will find a number of printable handouts that can be used by consumers and professionals. Educational materials include food intake patterns identifying what and how much food should be consumed to maintain a healthy body and an educational framework providing recommendations for making food choices that improve the quality of one's diet. The framework is intended for professionals to use in developing educational material for consumers/patients. See http://www.mypyramid.gov.

 

For additional information regarding 2005 Dietary Guidelines for Americans, see http://www.healthierus.gov/dietaryguidelines/.

Kentucky Develops a Universal State-Wide Patient Information Transfer Tool

 

Health Care Excel, the Medicare Quality Improvement Organization for Kentucky and various health-care facilities throughout the state, has developed a standardized transfer form that is applicable across all healthcare settings. The 3-page form is a sort of "mini patient chart" that facilitates the transfer of patient information from acute care settings to home health agencies, to nursing homes, and even ambulance services. Information on the form includes patient demographics, advance directives, current vitals, at-risk information, infection control, allergies, and much more.

 

This universal transfer form sets the standard for the transfer of information across all settings and improves communication among healthcare workers. Vital information is not lost in transit, and the process of transferring patient information becomes more efficient.

 

To obtain a free copy of this form along with an instruction sheet listing definitions that may have multiple interpretations and a PowerPoint presentation providing an overview of the collaboration in developing the tool, log on to http://www.hce.org/atf.html. Send questions to kyhomehealth@hce.org.

Learn the Facts on Medicare's New Coverage for Prescription Drugs

 

Help your patients and family members get ready for Medicare's prescription drug program. Beginning January 1, 2006, Medicare will offer coverage for prescription drugs. Working with Medicare, insurance companies and other private companies will provide this benefit to eligible Medicare beneficiaries.

 

Who is Eligible? Recipients who have Medicare Part A and/or Part B.

 

When to Sign Up? Between November 15, 2005, and May 15, 2006.

 

Limitations: If you sign up by December 31, 2005, your prescription coverage will become effective on January 1, 2006. If you join after December 31, 2005, your coverage will begin the first day of the month after the month you join.

 

Penalty for late entry: By joining the Medicare prescription plan after May 15, 2006, you risk paying a higher monthly premium, unless you have a drug plan already that covers at least as much as the Medicare prescription drug plan does.

 

What does it cost? There will be a monthly premium, approximately $37 per month in 2006 and a yearly deductible of as much as $250. Also included is a co-payment or co-insurance, and the costs will vary depending on the drug plan you choose. If you have limited income, you may qualify for extra help and may not have to pay a premium or deductible.

 

For more information: Look this fall for the handbook "Medicare & You 2006"; log on to http://www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).