As you are aware, the sequestration began on April 1, 2013.  Here are some frequently asked questions and answers regarding the sequestration.  

Sequestration Questions and Answers

Question:

Does the two percent payment reduction under sequestration apply to the payment rates reflected in Medicare fee-for-service fee schedules or does it only apply to the final payment amounts?

Answer:

Payment adjustments required under sequestration are applied to all claims after determining the Medicare payment including application of the current fee schedule, coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments. All fee schedules, Pricers, etc., are unchanged by sequestration; it’s only the final payment amount that is reduced.

Question:

How is the two percent payment reduction under sequestration identified on the electronic remittance advice (ERA) and the standard paper remittance (SPR)?

Answer:

Claim adjustment reason code (CARC) 223 is used to report the sequestration reduction on the ERA and SPR.

Question:

What is the verbiage for CARC 223?

Answer:

'Adjustment code for mandated Federal, State or local law/regulation that is not already covered by another code and is mandated before a new code can be created.'

Question:

Will the two percent reduction be reported on the remittance advice in a separate field?

Answer:

For institutional Part A claims, the adjustment is reported on the remittance advice at the claim level. For Part B physician/practitioner, supplier, and institutional provider outpatient claims, the adjustment is reported at the line level.

Question:

How will the payments be calculated on the claims?

Answer:

The reduction is taken from the calculated payment amount, after the approved amount is determined and the deductible and coinsurance are applied.

Question:
How are unassigned claims affected by the two percent reduction under sequestration?

Answer:

Though beneficiary payments toward deductibles and coinsurance are not subject to the two percent payment reduction, Medicare’s payment to beneficiaries for unassigned claims is subject to the two percent reduction. The non-participating physician who bills on an unassigned basis collects his/her full payment from the beneficiary, and Medicare reimburses the beneficiary the Medicare portion (e.g., 80 percent of the reduced fee schedule amount. Note: The 'reduced fee schedule' refers to the fact that Medicare’s approved amount for claims from non-participating physicians/practitioners is 95 percent of the full fee schedule amount). This reimbursed amount to the beneficiary would be subject to the two percent sequester reduction just like payments to physicians on assigned claims. Both are claims payments, just to different parties. If the Limiting Charge applies to the service rendered, physicians/practitioners cannot collect more than the Limiting Charge amount from the beneficiary.

We encourage physicians, practitioners, and suppliers who bill unassigned claims to discuss with their Medicare patients the impact of the sequestration reductions to Medicare payments.

Question:

Is this reduction based on the date of service or date of receipt?

Answer:

In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will incur a two percent reduction in Medicare payment. Claims for durable medical equipment (DME), prosthetics, orthotics, and supplies, including claims under the DME Competitive Bidding Program, will be reduced by two percent based upon whether the date-of-service, or the start date for rental equipment or multi-day supplies, is on or after April 1, 2013. 

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(information from CMS)

Medicare Adantage Plan Payments to be Boosted

On April 1, 2013, CMS announced that it plans to boost payments to Medicare Advantage plans by 3.3% next year.  This will likely spare thousands of beneficiaries from disruptive coverage shifts by keeping private plans from dropping coverage. Back in February, CMS had announced that it proposed cutting Medicare Advantage  pay by 2.2%.

CMS cited public comments as part of the reason behind the change. After the announcement was made about the original cuts,  Medicare Advantage plans had threatened to reduce their participation in the program.

In other changes that were finalized, enrollees will need to consent to each prescription delivery in order for them to be shipped, in order to reduce costs from unwanted prescriptions.
 
Interest in Medicare Advantage plans and their benefits continues to grow.  Since passage of the Affordable Care Act, according to CMS, enrollment in Medicare Advantage plans has increased by 25%.


CMS Is Now Accepting 2014 ePrescribing Hardship Requests to Avoid Penalties

Physicians will receive a 2 percent penalty in 2014 if they do not meet the requirements of the Medicare ePrescribing (eRx) program this year, meet one of the limited exemption categories, or obtain approval for a hardship exemption.

From March 1 through June 30, 2013, CMS has re-opened the Quality Reporting Communication Support Page to allow physicians to request a hardship exemption for 2014.

Physicians who do not meet one of the exemption or hardship categories must: (1) report the eRx measure via claims (10 eRx events for individual physicians and larger numbers for groups using GPRO); or (2) register for the meaningful use (MU) of electronic health records (EHR) incentive program by June 30, 2013; or (3) achieve MU under the EHR Incentive Program during one of the reporting periods needed to avoid an eRx penalty in 2014.

For additional information on the 2014 eRx penalties and how to
avoid them, review CMS’ 2014 eRx Payment Adjustment Fact Sheet on the cms website, www.cms.gov. 

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(information provided by Palmetto)

EDI Enrollment Status Online Request Form

Palmetto GBA now offers an online process to request the status of the processing of your EDI Enrollment forms. The linked online form can be used to request status information for any one of the following EDI enrollment options:

• EDI Enrollment Tracking

• EDI Enrollment Agreement

• Claims Submission Enrollment

• Electronic Remittance Linkage

EDI Enrollment Tracking

The Palmetto GBA EDI Operations Department will send a tracking number via email once your EDI Enrollment request has been received.

To request a status update of your EDI Enrollment form, please click on the link from your email. Enter your Tracking Number and you will immediately receive status information regarding your EDI request. The EDI Enrollment Tracking Comments Chart is a listing of all enrollment approval and rejection messages. If your forms were rejected, please correct and resubmit.

EDI Enrollment Agreement

To complete the Enrollment Agreement portion, enter the PTAN (Provider ID) on the form and it will return an enrollment date for this PTAN (Provider ID) if this provider is enrolled with EDI.

Claims Submission Enrollment

To complete the Claims Submission portion, enter the PTAN (Provider ID) and the Submitter ID on the form and it will return an enrollment date for claims submission linkage. Note: The Claims Submission Date is an approximation of the date that the Submitter ID and PTAN (Provider ID) were linked for claims submission. This date may actually have occurred prior to the date listed. If Submitters are able to currently submit for this PTAN (Provider ID), please continue to do so.
 
Electronic Remittance Linkage

To complete the Electronic Remittance Linkage, enter the PTAN (Provider ID) and the Submitter ID/Receiver ID on the form and it will return an enrollment date for electronic remittance linkage. Note: This linkage can only occur for one Submitter ID/Receiver ID.

A PTAN(Provider ID) cannot have multiple linkages for electronic remittances.
To request a status update for these items,click on the link and select the appropriate option. The above statuses are only produced if paperwork has been submitted for a PTAN (Provider ID) to the Palmetto GBA EDI Operations department and 20 business days has elapsed for processing of the request. Please allow 48 hours for enrollment completion before submitting claims or retrieving remittances.

If you are a J1 or J11, Part A or Part B Palmetto submitter and have a question about your status or do not receive a response about your status, please email Medicare.EDI@PalmettoGBA.com.
 

April 2013 Quarterly System Release: Claim Hold

The Centers for Medicare & Medicaid Services (CMS) has identified technical issues with certain parts of the April 2013 quarterly systems release. For claims with dates of service or 'Through Dates' on or after April 1, 2013, the issues affect

(1) all Home Health final claims,
(2) outpatient Critical Access Hospital (CAH) and Rural Health Clinic (RHC) claims where dollars have been applied to the beneficiary deductible and
(3) the remittance advice summary payment amount for Medicare Advantage inpatient prospective payment system (IPPS) claims with indirect medical education (IME).

In addition, for claims pending with or received by the Medicare claims administration contractors on or after April 1, 2013, the issues affect

(1) all claims for assistant-at-surgery services and
(2) all Ambulatory Surgical Center claims.

As a result of these issues, CMS has instructed its Medicare claims administration contractors to hold all of these specific claim types until April 14, 2013, when system fixes are expected to be implemented.

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(information supplied by HHS)

Health and Human Services (HHS) Secretary Kathleen Sebelius announced on March 29, 2013, a final rule with a request for comments that provides, effective January 1, 2014, that the federal government will pay 100 percent of the cost of certain newly eligible adult Medicaid beneficiaries.  These payments will be in effect through 2016, phasing down to a permanent 90 percent matching rate by 2020.  The Affordable Care Act authorizes states to expand Medicaid to adult Americans under age 65 with income of up to 133 percent of the federal poverty level (approximately $15,000 for a single adult in 2012) and provides unprecedented federal funding for these states.

“This is a great deal for states and great news for Americans,” HHS Secretary Kathleen Sebelius said. “Thanks to the Affordable Care Act, more Americans will have access to health coverage and the federal government will cover a vast majority of the cost.  Treating people who don’t have insurance coverage raises health care costs for hospitals, people with insurance, and state budgets.”

The final rule provides important information to states that expand Medicaid.  It describes the simple and accurate method states will use to claim the matching rate that is available for Medicaid expenditures of individuals with incomes up to 133 percent of poverty and who are defined as “newly eligible” and are enrolled in the new eligibility group.  The system is set up to make eligibility determinations as simple and accurate as possible for state programs.

Under the Affordable Care Act, states that cover the new adult group in Medicaid will have 100 percent of the costs of newly eligible Americans paid for by the federal government in 2014, 2015, and 2016. The federal government’s contribution is then phased-down gradually to 90 percent by 2020, and remains there permanently.  For states that had coverage expansions in effect prior to enactment of the Affordable Care Act, the rule also provides information about the availability of an increased FMAP for certain adults who are not newly eligible.
 
The rule builds on several years of work that HHS has done to support and provide flexibility to states’ Medicaid programs ahead of the 2014 expansion, including:

•90 percent matching rate for states to improve eligibility and enrollment systems;
•More resources and flexibility for states to test innovative ways of delivering care through Medicaid;
•More collaboration with states on audits that track down fraud; and
•Specifically outlining ways states can make Medicaid improvements without going through a waiver process.
 
For more information on the improvements made to Medicaid, please visit: http://www.medicaid.gov/State-Resource-Center/Events-and-Announcements/Downloads/MMF_Jan-Dec-2012_FINAL.PDF
 
For the full text the final rule, please go to http://www.ofr.gov/inspection.aspx

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Effective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will turn on the Phase 2 denial edits. This means that Medicare will deny claims for services or supplies that require an ordering/referring provider to be identified and that provider is not identified, is not in Medicare's enrollment records, or is not of a specialty type that may order/refer the service/item being billed.

The Affordable Care Act, Section 6405, “Physicians Who Order Items or Services are Required to be Medicare Enrolled Physicians or Eligible Professionals,” requires physicians or other eligible professionals to be enrolled in the Medicare Program to order or refer items or services for Medicare beneficiaries. Some physicians or other eligible professionals do not and will not send claims to a Medicare contractor for the services they furnish and therefore may not be enrolled in the Medicare program. Also, effective January 1, 1992, a physician or supplier that bills Medicare for a service or item must show the name and unique identifier of the attending physician on the claim if that service or item was the result of an order or referral. Effective May 23, 2008, the unique identifier was determined to be the National Provider Identifier (NPI). The Centers for Medicare & Medicaid Services (CMS) has implemented edits on ordering and referring providers when they are required to be identified in Part B, DME, and Part A HHA claims from Medicare providers or suppliers who furnished items or services as a result of orders or referrals.

This means that starting May 1, Medicare will deny claims for Medicare-covered services ordered/referred by a physician for durable medical equipment, prosthesis, orthotics and services (DMEPOS), clinical lab, radiology services and certification of home health if the physician does not have a Medicare profile in the Medicare enrollment system, PECOS.

The Centers for Medicare & Medicaid Services (CMS) says physicians who order such services and are not enrolled should do so immediately, or the applications may not be processed before May 1.  Physicians may register by using the internet based Provider Enrollment, Chain and Ownership System (PECOS) or by completing the paper enrollment form (CMS-8550). 

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(information provided by Humana)

Health care providers are REQUIRED to complete Compliance Certification! The Centers for Medicare & Medicaid Services (CMS) requires that all Humana business partners, including health care providers, complete required compliance training and certifications.

Health care providers can complete this information online via Humana’s secure Compliance website, which requires internet access. To access the website, health care providers must be registered on Humana.com or Availity.com. Detailed instructions and additional information on completing these requirements, including registration, are available here. While health care providers are encouraged to complete the compliance requirements within 30 days of notification, these requirements must be completed no later than December 31, 2013.

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(information provided by Cigna)

Cigna to Have Single Appeal Reviews

 Cigna has historically offered second-level appeals to health care professionals who were not satisfied with the resolution of a first-level review. Beginning July 1, 2013, Cigna will no longer offer second-level appeals. All appeals will follow a thorough single appeal review process and will be completed within 60 days. This change establishes a consistent approach for health care professionals across Cigna’s network.

As a reminder, all appeals should be initiated in writing within 180 calendar days of the date of the initial payment or denial decision. If the appeal relates to a payment that we adjusted, the appeal should be initiated within 180 calendar days of the date of the last payment adjustment.

Health care professionals should submit all appeal requests on a “Request for Provider Payment Review Form,” which can also be found on the Cigna for Health Care Professionals website (CignaforHCP.com > Resources > Forms Center > Medical Forms). This form will help Cigna understand the circumstances around your appeal request in order to conduct that thorough review.

For additional information on how to submit an appeal, please review the Claim Adjustment & Appeals Guidelines on the Cigna for Health Care Professionals website (CignaforHCP.com > Resources > Clinical Reimbursement Policies and Payment Policies > Claims Appeals Policies and Procedures > Appeal Policy and Procedures).
 

Cigna’s Network News Going All Digital

Beginning with the July issue, Cigna’s Network News newsletter will become an all-digital publication.  It’s easy to sign up for the newsletter.  If you’re registered to use the Cigna for Health Care Professionals website, log into CignaforHCP.com/My Profile. Review your email address to ensure it is correct and you will automatically receive Network News via email.

You may also sign up by emailing Cigna ---NetworkNewEditor@Cigna.com or via faxing to Cigna at 1-646-467-5697.  You must include the following information with your fax or email:

•  Cigna Provider Id or TIN
•  Email address (can be multiple addresses per Provider ID or TIN)
•  Name and job title for each email address provided
•  Practice type (physician, hospital or anciallry)
•  Primary address (city, state, zip)

Anyone in the physician’s office may receive Network News via email.   

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The WVSMA is pleased to bring two special classes for physicians, office administrators and staff.

Through our exclusive partnership with Practice Management Institute (PMI), we are bringing two new and often requested offerings to you---"Chart Auditing for Physician Services" and "HIPAA Compliance in the Medical Practice". Classes will be provided in three different locations throughout West Virginia so you will be able to access a class more easily.

For the first time, we are pleased to announce that Category 1 CME credit is available for physicians who take the "Chart Auditing for Physician Services" course. Additional information regarding the CME credit may be found on the WVSMA’s website, wvsma.org.

PMI certified professionals may receive 3 CEUs for each class session (total of 6 for a full day of classes). This is a wonderful opportunity for you to gain valuable knowledge in your choice of three locations. You may choose to attend one class or the full day in your choice of location. We want to make it as convenient as possible for you!

Classes will be offered on Thursday, April 25, 2013 in Charleston, Friday, April 26, 2013 in Huntington, and Thursday, May 2, 2013, in Morgantown. Additional information, including classroom locations and times may be found on the WVSMA website, www.wvsma.org.

You may register on the WVSMA’s website by faxing the registration form to (304) 925-0345. You may register for either class ($199/session) or for the entire day. WVSMA members and PMI certified professionals receive a special discounted rate.

If you have any questions, please feel free to contact Barbara Good (barbara@wvsma.org).

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Register today for Practice Management Institute’s (PMI) National Conference in May in New Orleans!   Participants may choose from three distinct “tracks’ to study, or mix and match sessions.   The conference is a great way to obtain the most up to date information for your medical practice. 

West Virginia has been well represented at the conference for the past two years.  If you are interested in attending, please contact Barbara Good or view the information on PMI’s website, www.pmimd.com.

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Human Infections with Novel Influenza A (H7N9) Viruses
(This is an official CDC Advisory)

Summary and Background

As of April 4, 2013, Chinese public health officials have reported 14 cases of human infection with a novel avian influenza A (H7N9) virus from four different provinces in China. All patients were hospitalized with severe respiratory illness, and six persons have died. These are the first human infections identified with an avian influenza A (H7N9) virus infection. Six cases are from Shanghai, one is from Anhui Province, four are from Jiangsu Province, and three are from Zhejiang Province. Thirteen cases are in adults aged 27 through 87 years, and one case is in a child aged 4 years; all cases had illness onset from February 19 through March 31, 2013. No person-to-person transmission or epidemiologic link between any of the cases has been identified. We are aware of reports of possible sources of infection but these have not been confirmed. We are investigating and will provide that information when it is available.

Preliminary functional data of the isolated viruses from the first 3 cases suggest that they are likely susceptible to neuraminidase inhibitors. Investigations by Chinese public health officials are ongoing.

These cases are a reminder that novel A influenza viruses can infect and cause severe respiratory illness in humans. Novel influenza A viruses are influenza viruses that are different from currently circulating human influenza A virus subtypes and include influenza viruses from predominantly avian and swine origin. In recent years, human infections with highly pathogenic avian influenza A (H5N1) virus in several Asian countries and Egypt, highly pathogenic avian influenza A (H7N3) virus in Mexico, and variant influenza A (H3N2)v viruses in the United States have been reported

(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6136a4.htm, http://www.who.int/influenza/human_animal_interface/EN_GIP_20130312CumulativeNumberH5N1cases.pdf, http://emergency.cdc.gov/HAN/han00325.asp).

The clinical presentation of human infection with avian influenza A viruses varies considerably--from mild illness, including conjunctivitis, fever, and cough, to severe illness, including fulminant pneumonia leading to death in cases of H5N1 and in these recent cases of H7N9 virus infections. To date there has been no evidence of person-to-person transmission of influenza A (H7N9) viruses.

At this time, no cases of human infection with avian influenza A (H7N9) viruses have been detected in the United States. Rapid detection and characterization of novel influenza viruses remain a critical component of national efforts to prevent further cases, evaluate clinical illness associated with them, and assess any ability for these viruses to spread among humans. As a result, clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even outside of the typical influenza season.

Clinicians should consider the possibility of novel influenza A (H7N9) virus infection in persons with respiratory illness and an appropriate travel or exposure history. Although the majority of novel influenza A (H7N9) cases have resulted in severe respiratory illness in adults, infection with this virus may cause mild illness in some and may cause illness in children as well. When performing influenza diagnostic testing in patients with respiratory illness for whom an etiology has not been confirmed, clinicians may identify human cases of avian influenza A virus infection or new cases of variant influenza in the United States. Patients with novel influenza A (H7N9) virus infections should have a positive test result for influenza A virus via reverse-transcription polymerase chain reaction (RT-PCR) testing but be unsubtypeable.

Suspected infections with novel influenza A (H7N9) viruses in the United States should be reported to CDC within 24 hours of initial detection, and state health departments should notify CDC promptly of all patients under investigation for possible novel influenza A virus infection.

Interim Recommendations for Clinicians and State and Local Health Departments

Case Investigation and Testing

Patients with illness compatible with influenza who also meet either of the exposure criteria below should be candidates for RT-PCR testing for influenza. Decisions about diagnostic testing for influenza using RT-PCR should be made using available clinical and epidemiologic information, and additional persons in whom clinicians suspect influenza A (H7N9) virus infection may also be tested.

Patients with recent travel to countries where human cases of novel influenza A (H7N9) virus infection have recently been detected, especially if there was recent direct or close contact with animals (such as wild birds, poultry, or pigs) or where influenza A (H7N9) viruses are known to be circulating in animals. Currently, China is the only country that has recently reported novel influenza A (H7N9) human cases.
Patients who have had recent contact with confirmed human cases of infection with novel influenza A (H7N9) virus.

Clinicians should obtain a nasopharyngeal swab or aspirate from these patients, place the swab or aspirate in viral transport medium, and contact their state or local health department to arrange transport and request a timely diagnosis at a state public health laboratory or CDC. For additional guidance on diagnostic testing of patients under investigation for novel influenza A (H7N9) virus infection, please see Interim Guidance for Laboratory Testing of Persons with Suspected Infection with Highly Pathogenic Avian Influenza A (H5N1) Virus in the United States at http://www.cdc.gov/flu/avianflu/guidance-labtesting.htm.

If infection with influenza A (H7N9) virus is suspected based on current clinical and epidemiological screening criteria recommended by public health authorities, specimens should be collected with appropriate infection control precautions for novel virulent influenza viruses and sent to the state or local health department for testing. Viral culture should not be attempted in these cases.

All unsubtypeable influenza A virus specimens should be submitted to CDC immediately for additional diagnostic testing. At this time, confirmatory testing for avian influenza A (H7N9) will be conducted at CDC.

Commercially available rapid influenza diagnostic tests (RIDTs) may not detect avian or variant influenza A viruses in respiratory specimens. Therefore, a negative rapid influenza diagnostic test result does not exclude infection with influenza viruses. In addition, a positive test result for influenza A cannot confirm variant or avian influenza virus infection because these tests cannot distinguish between influenza A virus subtypes (they do not differentiate between human influenza A viruses and avian or variant viruses). Therefore, when RIDTs are positive for influenza A and there is concern for novel influenza A virus infection, respiratory specimens should be collected and sent for RT-PCR testing at a state public health laboratory. Clinical treatment decisions should not be made on the basis of a negative rapid influenza diagnostic test result since the test has only moderate sensitivity.

Infection Control

Clinicians should be aware of appropriate infection control guidelines for patients under investigation for infection with novel influenza A viruses. Because it has been shown to cause severe respiratory illness in cases identified so far, healthcare personnel (HCP) caring for patients under investigation for novel influenza A (H7N9) virus infection should adhere to Standard Precautions plus Droplet, Contact, and Airborne Precautions, including eye protection, until more is known about the transmission characteristics of the A (H7N9) virus.

All clusters of respiratory illness in HCP caring for patients with severe acute respiratory illness should be investigated.

Treatment

For persons hospitalized with suspected influenza, including suspected novel H7N9 virus infection, clinicians should start empiric treatment with influenza antiviral medications (oral oseltamivir or inhaled zanamivir) as soon as possible, without waiting for laboratory confirmation.

For high-risk persons (persons <5 years of age, ≥65 years of age, and those with certain underlying medical conditions) with suspected influenza of any severity , including suspected novel H7N9 virus infection, clinicians should start empiric treatment with influenza antiviral medications (oral oseltamivir or inhaled zanamivir) as soon as possible, without waiting for laboratory confirmation.

Antiviral treatment is most effective when started as soon as possible after influenza illness onset. Early initiation of treatment provides a more optimal clinical response, although treatment of moderate, severe, or progressive disease begun after 48 hours of symptoms may still provide benefit.

For More Information

World Health Organization (WHO) “H7N9 avian influenza human infections in China” is available at http://www.who.int/csr/don/2013_04_01/en/index.html.
CDC avian influenza A (H7N9) information page is available at http://www.cdc.gov/flu/avianflu/h7n9-virus.htm.
WHO “Frequently Asked Questions on human infection with A (H7N9) virus, China” is available at http://www.who.int/influenza/human_animal_interface/faq_H7N9/en/index.html.
The Chinese Center for Disease Control and Prevention “Questions and Answers about human infection with A(H7N9) avian influenza virus" is available at http://www.chinacdc.cn/en/ne/201303/t20130331_79282.html.
CDC general information about avian influenza viruses and how they spread is available at http://www.cdc.gov/flu/avianflu/avian-in-humans.htm .
CDC “Interim Guidance on Case Definitions to be Used for Investigations of Influenza A (H3N2) Variant Virus Cases” for state and local health departments is available at http://www.cdc.gov/flu/swineflu/case-definitions.htm.
CDC “Prevention Strategies for Seasonal and Influenza A (H3N2)v in Health Care Settings” is available at http://www.cdc.gov/flu/swineflu/prevention-strategies.htm.
CDC “Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspected Influenza A (H3N2)v Virus Infection” for public health professionals is available at http://www.cdc.gov/flu/swineflu/h3n2v-testing.htm.
CDC “Interim Guidance for Enhanced Influenza Surveillance: Additional Specimen Collection for Detection of Influenza A (H3N2) Variant Virus Infections” for state and local health departments is available at http://www.cdc.gov/flu/swineflu/h3n2v-surveillance.htm.
National Association of State Public Health Veterinarians “Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011” is available as the first bulleted item at http://nasphv.org/documentsCompendiumAnimals.html .

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

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• • Sequestration Update
• • Medicare Update
• • Palmetto GBA Updates
• • HHS Finalizes Rule Guaranteeing 100% Fundin for New Medicaid Beneficiaries
• • Medicare PECOS Update Denials Will Begin May 1, 2013
• • UnitedHealthcare and WVSMA Meeting
• • 2013 Humana Provider Compliance Certification
• • Cigna Update
• • WVSMA Offers Special Classes for Physicians and Staff!
• • PMI National Conference Information
• • Human Infections with Novel Influenza A (H7N9) Viruses