DCH-i [Vol. 3, no. 1 (Nov. 2013)]

November 2013 Volume 3, Issue 1

ACA Provider Rate Increase Payments Began November 1

Providers who have attested to their eligibility for the mandated ACA Provider Rate Increase will begin receiving their increased payments soon. The Georgia Department of Community Health (DCH) began processing the increased payments on Friday, November 1.
Providers who attested on or before August 31, 2013, will receive retroactive payments from January 1, 2013, in subsequent payment cycles. Those who attest on September 1, 2013, or after will receive the increased payments from the first of the month in which they attest. The Provider Rate Increase is applicable for two years, from January 1, 2013, through December 31, 2014.

Follow Us!

Currently there is no backlog of attestation approvals. However, approximately 500 providers have not yet been approved because of incomplete documentation. These providers must provide the outstanding documentation by November 30, 2013. To determine your attestation status, please visit the Georgia Medicaid Management Information System (GAMMIS) at www.mmis.georgia.gov or email EnrollmentACARateIncrease@dch.ga.gov.
Register Now for November 21 Medicaid Fair in Dalton
Registration is open for the 2013 Fall Medicaid Fair to be held in Dalton on Thursday, November 21. The day-long session will include presentations, panel discussions and an opportunity to talk one-on-one with various exhibitors about claims issues and other topics. More information? Register here.
On the Road to ICD-10: A Checklist
Avoiding the Trials and Tribulations of Transitioning to ICD-10

In This Issue
Provider Rate Increase Begins November 1
Register for November Medicaid Fair
On the Road to ICD-10
National Rural Health Day
News for Providers -Revalidation, Application Fees
Provider Update: OPR Edits Begin
GaHIN Launches Newsletter
CIO Roundtable November 11id Pediatric Boot Camp
EHR Incentives
September, October Board Actions

If you had to travel to a new destination, wouldn't you do some planning to prepare for that trip? Probably. Now what if that trip involved your livelihood -- and being able to pay your bills. Wouldn't you get serious about your trip planning? Most assuredly.
The new destination is ICD-10 and it is replacing the old familiar ICD-9 that you know so well. (A reminder: All HIPAA-covered health care provider entities -- along with payers, vendors and their business associates -- will be required by the federal government to start using ICD-10 code sets for services rendered on and after October 1, 2014.) To help you get started, take a look at this checklist.
Your ICD-10 Road Map should include...
An understanding of what ICD-10 is and why it matters
A working knowledge of ICD-10's risks and rewards (Hint: Be sure to include a Risk Mitigation component in case your claims are rejected or denied and your cash flow slows or stops.)
A designated "ICD-10 Leader" in your organization and a commitment from your organization's leadership for a successful transition to ICD-10 (Hint: Without this leadership commitment, your transition may suffer.)

About DCH-i
DCH-i is the regular newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important
information to you as physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Our goal is to help create A Healthy Georgia -- together.
Write us at DCH-i@dch.ga.gov.

An assessment of how ICD-10 codes will affect all areas of your office (Hint: We're talking ALL areas: reception, physician offices, exam rooms, nurses' stations, practice manager offices, billing, lab and more.)
The crosswalking (translating/mapping) of your most frequently used ICD-9 codes to ICD-10 codes (Hint: The code mapping could be 1:1 or most likely, 1: many. General Equivalence Mappings (GEMs) and other translator tools can help with this.)

Do you have a question or a comment? Tell us what's on your mind at DCH-i@dch.ga.gov.
About DCH

Updates to your business processes (internally and externally with trading partners) and IT systems (EHRs, billing, practice management) to ensure that both ICD-9 and ICD-10 codes can be accommodated during the transition (Hint: Consider your budget for all related expenses in these areas.)

Various levels of ICD-10 training for coders, billers, physicians and others (Hint: Online live and on-demand; live-group and 1:1 training courses are available. Some training is free and some is cost-based.)
Early use of ICD-10 codes as practice in your charting/documentation to aid your training (Hint: ICD-10 does require more documentation and greater specificity than ever before. But, it should not change the way you deliver patient care.)
An internal and external testing plan for your ICD-10 readiness with your payers and trading partners. (Hint: DCH and Georgia Medicaid will begin testing with Trading Partners in late Q4 of 2013 and with Providers in Q1 of 2014. That's just around the corner.)
Learning during testing will help to fine tune what your people know about ICD-10, how the ICD-10 processes can be improved, and the edits within the systems where ICD-10 is used.
For more information about ICD-10 Transition Readiness with Georgia Medicaid, visit www.dch.georgia.gov/icd-10. If you have an ICD-10 question, email us at icd10project@dch.ga.gov. To sign up for an upcoming webinar or to view previous ICD-10 webinars, visit www.dch.georgia.gov/it-events.
Celebrate National Rural Health Day on November 21

Through effective planning, purchasing and oversight, the
Department of Community Health (DCH) provides
access to affordable, quality health care to millions of
Georgians, including some of the state's most vulnerable and underserved populations.
DCH is responsible for Medicaid and PeachCare for
Kids, the State Health Benefit Plan, Healthcare Facility Regulation and
Health Information Technology in Georgia.
Clyde L. Reese III is the DCH Commissioner.
We are dedicated to A Healthy Georgia. www.dch.georgia.gov

More than 2 million Georgians count on the services of physicians, hospitals and health care providers who deliver critical health services in rural Georgia. The Georgia Department of Community Health's (DCH) State Office of Rural Health (SORH) serves Georgia's 109 counties that have populations of less than 35,000.
Throughout the state, there are 63 hospitals located in rural counties; 31 of these are Critical Access Hospitals. Twenty-seven Federally Qualified Health Centers provide 180 access points for health care.
Georgia is joining the nation to celebrate the third annual Rural Health Day on Thursday, November 21. The commemoration will recognize the contributions of physicians, hospitals and other health care providers who deliver health care to hundreds of thousands of underserved people in rural areas of the nation. The program is being sponsored by the National Organization of State Offices of Rural Health.
News for Providers: Revalidation, Application Fees Begin
Soon, DCH will implement two requirements of the Affordable Care Act (ACA) -- Revalidation of Enrollment (Revalidation) and Application Fees.
Revalidation is applicable to all providers at all service locations. Application fees will affect only certain facility types, not individual practitioners. Both ACA requirements were enacted into law to help reduce fraud, waste and abuse of the Medicaid program. Also, the ACA requires that Revalidation be conducted every five years. Application fees will be collected at initial enrollment and at revalidation or every five years.
DCH will post a detailed Frequently Asked Questions document soon on our website under Provider News.
Providers Must Use Individual NPI for OPR Enrollment; Pharmacy OPR Claims Edits Have Begun
The Affordable Care Act now requires that Ordering, Prescribing and Referring (OPR) physicians be enrolled in Medicaid, even if the OPR provider is not filing claims. OPR providers should access
the Georgia Medicaid Management Information System (GAMMIS) website at www.mmis.georgia.gov to register.
During the enrollment process, individual practitioner applicants have the option to list both their Individual and/or Organizational NPI numbers on the enrollment application. If the enrolling provider orders, prescribes or refers services for Medicaid members, the individual practitioner's NPI must be listed on the claim, not an organizational NPI.
Additionally, editing for OPR Pharmacy claims began on October 1, 2013. Claims without the OPR provider's individual NPI will be denied.
Editing for other OPR claims will begin soon.
For complete information, read the Frequently Asked Questions on the DCH website.

Editor-in-Chief Pamela A. Keene
Circulation Janice Abrams
Director of Communications and Legislative Affairs Lisa Marie Shekell
Associate Director of Communications Peg Woodruff
DCH Mission
We will provide Georgians with access to affordable quality health care through effective planning, purchasing
and oversight.
We are dedicated to A Healthy Georgia.

Georgia Health Information Network Launches Newsletter
The first edition of GaHIN News, the Georgia Health Information Network (GaHIN, pronounced GEE-hen) newsletter, is now available. Each month, GaHIN will provide news and information about the latest updates to the GaHIN collaborative, industry news of interest, and the latest events in Georgia's health IT community. It will also introduce readers to GaHIN members and stakeholders, who are fostering a healthier Georgia through the use and exchange of electronic health information. For more information visit the GaHIN.org website.

Attention CIOs: Roundtable Forum About the Georgia Health Information Network (GaHIN)
On Monday, November 11, the Institute for Healthcare Information Technology is hosting a roundtable discussion for Chief Information Officers at 4 p.m. at the Metro Atlanta Chamber Rotunda. The topics? The Georgia Health Information Network (GaHIN) and the opportunities for the electronic exchange of health information in Georgia.
Highlighted speakers include Kelly Gonzalez, chief, Division of Health IT, State Health IT Coordinator, Georgia Department of Community Health; and Dennis White, chairman of GaHIN and Chief Executive Officer for Alliant/GMCF.
At this program you will:
Learn about the products, service offerings and benefits of joining the statewide health information network
Identify the different options for connecting to GaHIN
Learn how participating in GaHIN will help your organization meet Meaningful Use Requirements
Following the Forum, you are invited to attend the Health IT Leadership Summit VIP Reception on the Chamber's Rooftop. Attendees will receive a complimentary invitation to attend the 2013 Health IT Leadership Summit on November 12, 2013, at the FOX Theater.
Attendance is strictly limited to CIOs and is offered at no cost. To register, email cbareis@mmmlaw.com.

Nearly $160 Million Paid in EHR Incentives
Georgia's Medicaid Electronic Health Record (EHR) Incentive Program has issued nearly $160 million in payments of federal funds to eligible providers through October 19, 2013. The program was launched on September 5, 2011.

Board Actions
The Board of Community Health took the following action at its Thursday, September 12, meeting:
PUBLIC NOTICE: GAPP Medically Fragile Daycare -- Final Approval
The Board of Community Health took the following actions at its Thursday, October 10, meeting:
PUBLIC NOTICE: Medical Coordination Program for the Aged, Blind and Disabled Population State Plan Amendment -- Initial Adoption
Medical Coordination Program for the Aged, Blind and Disabled Population State Plan Amendment
PUBLIC NOTICE: Georgia Hospice Program and Pediatric Concurrent Care -- Initial Adoption
The next meeting of the Board of Community Health is scheduled for Thursday, November 14, at 10:30 a.m. in the 5th Floor Board Room at 2 Peachtree Street, Atlanta.