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News Bulletins 2004 |
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News Bulletins 2004 |
| Topic Index |
| Topic Index |
18 Jun 2004 There is a later article on nutrition.
Patient Education Resources on New NIH website
The National Institutes of Health have recently announced an expanded health information website, http://health.nih.gov, that includes many resources for patient education. The kidney pages are at http://health.nih.gov/search.asp/14. Here are just a few of the many documents on these pages...
Diabetic Kidney Problems http://health.nih.gov/result.asp/191/14
High Blood Pressure http://www.nhlbi.nih.gov/hbp/hbp/intro.htm
Eat Right to Feel Right on Hemodialysis http://kidney.niddk.nih.gov/kudiseases/pubs/eatright
Peritoneal Dialysis http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal
Renal Osteodystrophy http://kidney.niddk.nih.gov/kudiseases/pubs/renalosteodystrophy
The NIH announcement contains a more complete introduction, at http://www.nih.gov/news/pr/jun2004/od-15.htm.TOP OF PAGE BOTTOM OF PAGE
18 Jun 2004 According to the American Academy of Physical Medicine and and Rehabilitation, at http://www.aapmr.org/hpl/pmrprac/CPTonline.htm, "The American Medical Association has announced the introduction of new Category III CPT code 0074T for reporting online consultations between physicians and patients. The code descriptor is: 'online evaluation & management service, per encounter, provided by a physician, using the Internet or similar electronic communications network, in response to a patient’s request; established patient.' While Medicare will begin using the code on July 1, 2004, it will not reimburse physicians who report the code since it is intended to be a tracking code. Category III codes are temporary codes to be used for data collection for emerging technology, services, and procedures. Private insurers will reimburse code 0074T on a limited basis. It is recommended that physicians check with individual insurers to determine if online consultations will be a covered service." The AMA announcement has more detail about Category III and code 0074T, at http://www.ama-assn.org/ama/pub/article/3885-4897.html.
New CPT-III Code for Online ConsultationsTOP OF PAGE BOTTOM OF PAGE
18 Jun 2004 The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has implemented their 2004 National Patient Safety Goals. As part of this effort to reduce medication errors, JCAHO has created a list of abbreviations, symbols and dose designations which have contributed to medication errors. The Institute for Safe Medication Practices keeps their own extended version of this list, and a nicely-formatted copy can be found at http://www.ismp.org/PDF/ErrorProne.pdf. The official JCAHO list, at http://www.jcaho.com/accredited+organizations/patient+safety/04+npsg/04_faqs.htm#dangerous, is much smaller. A tidier compilation of JCAHO's list can be found at http://www.nwrenalnetwork.org/news/abbrevs.doc. JCAHO has also published a list of "tips" for implementing change, at http://www.jcaho.com/accredited+organizations/patient+safety/04+npsg/tips.htm.
Error-Free AbbreviationsTOP OF PAGE BOTTOM OF PAGE
17 Jun 2004 The Centers for Disease Control have a new Draft Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2004. It's intended for review and comment only, and is not ready for implementation of policy or procedure. You can comment till 13 August. Details at http://www.cdc.gov/ncidod/hip/isoguide.htm.
New Draft CDC Guideline on IsolationTOP OF PAGE BOTTOM OF PAGE
10 Jun 2004 American Medical News has published an article describing the National Vascular Access Improvement Initiative or Fistula First Project. It begins,
CMS Initiative to Increase Fistula Use"Medicare is trying to fundamentally change the standard of care for patients with end-stage renal disease, and it is reaching out o primary care physicians and specialists for help.The article, "Medicare hopes to boost better option for dialysis" can be found at http://www.ama-assn.org/amednews/2004/05/17/gvsb0517.htm. You can also find more information and useful hyperlinks below.
"The motivation for the initiative is both to improve the quality of patient care and to save Medicare money. The effort could have an enormous impact. About 270,000 Medicare beneficiaries currently receive dialysis treatment, and the number is expected to double by 2010. Because ESRD patients automatically qualify for Medicare, the program bears the brunt of dialysis costs.
"The plan, announced in April by the Centers for Medicare & Medicaid Services, focuses on the way doctors establish vascular access for dialysis patients. Most U.S. surgeons opt to use arteriovenous grafts or hemodialysis catheters, even though AV fistulas are typically a clinically superior method.
"In the United Kingdom and Japan, where budgetary pressures forced physicians to turn to fistulas long ago, grafts are more the exception than the rule. But in the United States, fewer than a third of Medicare dialysis patients have an AV fistula."TOP OF PAGE BOTTOM OF PAGE
4 Jun 2004 BONENT (Board of Nephrology Examiners - Nursing and Technology, Inc.) has created a web-based practice examination to augment a candidate’s preparation for taking the Certified Hemodialysis Technologist/Technician (CHT) examination. The current BONENT Update newsletter, at http://www.goamp.com/bonent/MS_PDF/news_letter.pdf, contains all the details. The tentative launch date is 1 July 2004. For updates and to access the new practice exam when it's ready, visit the BONENT website at http://www.goamp.com/BONENT. To download a flyer for posting, click on http://www.nwrenalnetwork.org/news/BONENTPracticeExam.doc, then choose "File" and "Save As" from the menus at the top of the screen, and save it as a Word Document.
BONENT Web-Based CHT Practice ExamTOP OF PAGE BOTTOM OF PAGE
4 Jun 2004 Just a reminder; this is the last month that non-HIPAA-compliant Medicare claims will be paid on a timely basis. Starting in July, payment for non-HIPAA-compliant claims will be delayed two weeks. Details are at http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM2981.pdf and http://www.ama-assn.org/amednews/2004/05/17/gvl10517.htm.
Coding Compliance Deadlines for HIPAA, ICD-9-CM, CPT, HCPCS
AMA Press points out that another provision of HIPAA requires CMS to eliminate their 90-day grace period for the use of out-of-date billing codes. ICD-9-CM-2005 codes take effect 1 October 2004. CPT and HCPCS Level II 2005 codes take effect 1 January 2005. After those dates, claims with obsolete codes will be rejected. AMA Press offers updated code books at http://unity.ama-assn.org/UM/T.asp?A40.586.1527.1.209045.
For earlier HIPAA bulletins, see below.TOP OF PAGE BOTTOM OF PAGE
4 Jun 2004 There is a later bulletin on this topic.
NIH National Kidney Disease Education Program
The National Institutes of Health have instituted a National Kidney Disease Education Program (NKDEP) and with it a "You Have The Power To Prevent Kidney Disease" campaign. The program and campaign are aimed at preventing or delaying the onset of ESRD. Please look over the posters at http://www.nwrenalnetwork.org/news/primary.htm and http://www.nwrenalnetwork.org/news/prevent.htm, and the NKDEP website at http://www.nkdep.nih.gov, to see if they have anything to contribute to your life or your practice, and if you have any means to help spread the word.TOP OF PAGE BOTTOM OF PAGE
3 Jun 2004 The FDA has issued a class I recall for Arjo MINSTREL patient lift models HMB001-US and HMB002-US because of problems that could result in a patient falling to the ground. Full details are at http://www.fda.gov/cdrh/recalls/recall-043004.html.
Arjo Minstrel Patient Lift Class I RecallTOP OF PAGE BOTTOM OF PAGE
3 Jun 2004 This notice has been revised - see 9 July 2004.
2004 Dialysis Facility Reports
The 2004 Dialysis Facility Reports (DFRs), which compute standardized mortality and hospitalization ratios for each facility, along with comparisons of facility adequacy and hematocrit averages to Network and national averages, plus other measures, are due in August. These reports are prepared from billing data by the University of Michigan Kidney Epiodemiology and Cost Center and the Colorado Foundation for Medical Care. The current schedule looks like this...August - Network receives reports and mails them to facilitiesFacilities may use the September comment procedure to petition CMS to delete information which the facility believes to be inaccurate or inappropriate from the DFC website. Instructions for this process will be mailed with the reports.
September - facilities review reports and register comments at http://www.cfmc.org/esrddata before 30 September
October - copies of the DFRs and facility comments are sent to state survey agencies
November - selected information from the reports is posted on the Dialysis Facility Compare (DFC) website for access by the general publicTOP OF PAGE BOTTOM OF PAGE
3 Jun 2004 The next CMS "Open Door Forum," on ESRD and Clinical Labs, will be tomorrow, Friday 4 June, at 11am in Washington, Oregon and northern Idaho, noon in Montana and southern Idaho, 10am in Alaska. You can dial in live at 1-800-837-1935, using Conference ID #4345691, and/or listen to a recording of the Forum on Monday, Tuesday and Wednesday of next week (7-9 June) at 1-800-642-1687, also using Conference ID #4345691. On their website, CMS says about these Forums, "CMS desires to better hear and interact with those beneficiaries, providers, and other stakeholders interested in the delivery of quality healthcare for our nation's seniors and beneficiaries with disabilities. This increased emphasis on responsiveness is captured through an ongoing series of 'Open Door Forums' that provide a dialogue about both the many individual service areas and beneficiary needs within CMS." Minutes from the March ESRD Open Door Forum are at http://www.nwrenalnetwork.org/news/OpenDoorESRDMar04.htm.
Next CMS Open Door Forum on 4 JuneTOP OF PAGE BOTTOM OF PAGE
3 Jun 2004 CMS has placed in the Federal Register a notice to establish, and request members to participate on, an Advisory Board for the Demonstration of a Bundled Case-Mix Adjusted Payment System for ESRD Services. The Board was mandated by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Board will provide advice and recommendations with respect to the establishment and operation of a demonstration project of the use of a fully case-mix adjusted payment system for ESRD services. Board membership will consist of representatives from patient organizations, individuals with expertise in ESRD dialysis services, the Medicare Payment Advisory Commission, the National Institutes of Health, Network Organizations, Medicare contractors to monitor quality of care, and providers of dialysis services. Nominations for membership will be considered if they are received by 2 July 2004. You can link to the complete Federal Register notice from http://www.renalweb.com/ubb/Forum15/HTML/000571.html.
Bundled Case-Mix-Adjusted ESRD PaymentsTOP OF PAGE BOTTOM OF PAGE
28 May 2004 CMS will have an Open Door Forum next Tuesday morning on the topic of guidelines for providing discounted health care services to uninsured and underinsured patients. A recording of this meeting will be available from noon Tuesday 1 June till noon Saturday 5 June, at 800-642-1687, conference ID #7720393. Information and schedules for CMS Open Door Forums are available at http://www.cms.hhs.gov/opendoor/.
CMS Forum on Uninsured and Underinsured PatientsTOP OF PAGE BOTTOM OF PAGE
21 May 2004 From MedWatch - The FDA Safety Information and Adverse Event Reporting Program: The FDA and Medtronic, Inc. have notified healthcare professionals of a Class I recall of Paradigm Quick-Set Plus Insulin Administration Sets, models MMT-359S6, MMT-359S9, MMT-359L6 and MMT-359L9, because of problems with bending of the infusion set's cannula or unintentional disconnection of the set at the insertion site that can interrupt insulin flow to diabetics who use them. These problems have resulted in a number of serious injuries, including some hospitalizations. You can find more information, including links to the FDA/CDRH recall notice and Medtronic press release, at http://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#paradigm. You can subscribe to MedWatch directly at http://www.fda.gov/medwatch.
Quick-Set Plus Infusion Set RecallTOP OF PAGE BOTTOM OF PAGE
21 May 2004 CMS's sister division, the HHS Office for Civil Rights (OCR), is responsible for implementation of the HIPAA Privacy Rule. OCR has created an email list to distribute announcements, notices of available resources, and other educational information about the HIPAA Privacy Rule. You may subscribe at http://list.nih.gov/cgi-bin/wa?SUBED1=ocr-privacy-list&A=1 or go to http://list.nih.gov/ and under "Browse" select "O" then "OCR-PRIVACY-LIST". OCR's HIPAA website, http://www.hhs.gov/ocr/hipaa/, contains a wide range of helpful guidance about the Privacy Rule and related issues. OCR updates this website frequently with material such as the letter to healthcare providers at http://www.hhs.gov/ocr/Healthcare-Provider-letter.pdf, which debunks popular myths about the Privacy Rule. There are also earlier news bulletins about HIPAA.
HIPAA Privacy Rule BulletinsTOP OF PAGE BOTTOM OF PAGE
10 May 2004 On 8 January 2004 CMS published the final rule for the 2004 physisican fee schedule in the Federal Register. The 2004 physician conversion factor was increased by 1.5% to $37.3374. For adult dialysis patients, the new fee schedule for nephrologists is $303 per month for 4 or more visits (16% increase), $252 per month for 2 to 3 visits (4% reduction), $201 per month for 1 visit (23% reduction), and $252 per month for home dialysis (4% reduction). On 6 May 2004 the Renal Physicians Association (RPA) released its recommendations on refining dialysis G-code methodology for physicians. The three page letter (http://www.renalmd.org/downloads/MCP_Additional_Issues_Document_April_28.pdf) is from RPA President James Weiss MD to Stephen M. Phillips, Director of the Division of Practitioner Services, Center for Medicare Management. [Summary by RenalWEB, 7 May 2004]
Nephrologist Fee ChangesTOP OF PAGE BOTTOM OF PAGE
6 May 2004 A new CMS website, http://www.cms.hhs.gov/medlearn/drugcard.asp, lists many "Medicare-Approved Drug Discount Cards and Transitional Assistance Program" resources that are available to health care professionals, pharmacy professionals, and patients. These include websites, posters, and brochures that you can either download and copy for your patients, or order in hardcopy directly from Medicare.
Drug Discount CardsTOP OF PAGE BOTTOM OF PAGE
10 May 2004 There is a later article on this topic.
CAHPS Survey on Patient Experience of Care
At http://www.cms.hhs.gov/esrd/3a.asp, CMS describes a survey on Patient Experience of Care, which they expect to pilot this summer, and have available in early 2005. Patient satisfaction survey results were part of the additional information requested by participants in the Dialysis Facility Compare evaluation. CAHPS stands for Consumer Assessment of Health Plans. You can review the draft survey at http://www.cms.hhs.gov/regulations/pra/ (see the "January 30, 2004" item). CMS has set up an email address to receive comments on the survey, ESRDCAHPS@cms.hhs.gov.TOP OF PAGE BOTTOM OF PAGE
10 May 2004 The Dialysis Facility Compare ("DFC") website (http://www.medicare.gov/Dialysis/Home.asp) has been evaluated by the Research Triangle Insitute, and their 200-page final report is available at http://www.cms.hhs.gov/esrd/DFCFinalReport04-2004.pdf. The 15-page executive summary at the beginning makes good reading - for instance, "All groups of respondents [ie, patients, family, professionals] were concerned about facilities that showed quality data as 'Not Available'... participants generally believed that those facilities were 'hiding something.' " Participants were not initially familiar with DFC, but once they were introduced to it, they were very happy to have access to the information, and wanted more. While they would prefer recent information, they were not concerned about the vintage of the data currently in DFC. PD patients wanted a parallel resource.
Dialysis Facility Compare EvaluationTOP OF PAGE BOTTOM OF PAGE
28 Apr 2004 The Northwest Kidney Centers, the Washington State Association of Black Health Care Professionals, and the University of Washington School of Medicine are presenting this year's African American Kidney Health Conference in Seattle on Saturday May 1st, from 10am to 2:30pm. Look for details at http://www.nwrenalnetwork.org/aakhc.htm. The conference is free, and the program will appeal to all kidney patients and family members, anyone who is at risk for kidney disease, and anyone who wants to find out how to maintain the health of their kidneys. People of color and folks who have diabetes or high blood pressure are especially encouraged to attend.
Kidney Health Conference 1 MayTOP OF PAGE BOTTOM OF PAGE
27 Apr 2004 The Forum of ESRD Networks has forwarded to us a copy of a memo from HHS Secretary Tommy Thompson to Representative Pete Stark, in which Secretary Thompson says, "I am optimistic that the ESRD notice of proposed rulemaking (NPRM) will be published soon" for revision of the ESRD Conditions for Coverage. The NPRM initiates the 60-day public comment period. He says they "anticipate a large number of public comments." We've put a copy of the memo on our website at http://www.nwrenalnetwork.org/ccthompsonstark.pdf.
Conditions for CoverageTOP OF PAGE BOTTOM OF PAGE
20 Apr 2004 On 30 April 2004, the National Consensus Project for Quality Palliative Care ("NCP," http://www.nationalconsensusproject.org/) will release its Clinical Practice Guidelines for Quality Palliative Care. Further information can be found at http://www.nwrenalnetwork.org/ncp.htm. We've put a couple of letters there which stress the utility and importance of the Guidelines, as well as a newsletter article which you can reprint in your own publications.
Clinical Practice Guidelines for Quality Palliative CareTOP OF PAGE BOTTOM OF PAGE
20 Apr 2004 The AAKP (American Association of Kidney Patients) has announced a new monthly electronic newsletter called “Kidney Transplant Today." Starting in July, AAKP will electronically transmit the newsletter on the first Tuesday of each month. It will feature news about transplants, advances in medications, developments in research, new programs and materials, and much more. “AAKP believes strongly that patient education leads to better outcomes and improved communication with members of the healthcare team,” AAKP Executive Director Kris Robinson comments. “Timely and appropriate information can help patients make educated decisions about their treatment options.” To subscribe send your name and e-mail address to info@aakp.org, with “Kidney Transplant Today” in the subject line. AAKP is a voluntary, patient organization, which for 35 years has been dedicated to helping renal patients and their families deal with the physical, emotional, and social impact of kidney disease. The programs offered by AAKP aim to inform and inspire patients and their families to better understand their condition, adjust more readily to their circumstances and assume more normal, productive lives. http://www.aakp.org.
New AAKP Transplant NewsletterTOP OF PAGE BOTTOM OF PAGE
20 Apr 2004 CMS has developed a new HIPAA (Health Insurance Portability and Accountability Act) educational article titled "Medicare Providers: Their Vendors, Clearinghouses, or Other Third Party Billers, and the HIPAA/Medicare Contingency Plan." What it says is that a provider is responsible to assure that their third-party billing agent, if any, is HIPAA compliant. You can read this 3-page Medlearn Matters article at http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/SE0414.pdf. See also our earlier bulletin on HIPAA Compliance.
HIPAA Compliance of 3rd-Party Billing AgentsTOP OF PAGE BOTTOM OF PAGE
16 Apr 2004 Results from the 2003 Clinical Performance Measures Project are out. This Network's performance is summarized on our CPM stats page, and a PDF of the national 2003 Annual Report is at http://www.cms.hhs.gov/esrd/1f.pdf. This is a 100-page PDF - click the link just before your coffee break, so it'll be ready when you get back. When the the printer finishes them in a few weeks, hard copies of this Annual Report will be distributed to all facilities.
CPM 2003 and 2004
The Annual Report includes a handy "Outcome Comparison Tool" which you can use to compare your facility's performance to that of the US and the Network. We've asked for a separate electronic copy of this tool so we can enter the Network's numbers on it and distribute it for your use.
As of December 2002, this Network led the pack in percentage of patients dialyzing through fistulas, at 46%. However, the percentage of Network patients dialyzing via catheter increased from 19% to 24% between December 2001 and December 2002. If first-year mortality for patients using catheters is 70% higher than for patients using fistulas, as reported by Xue et al in the November 2003 AJKD, it doesn't take many catheters to negate the positive effects of converting patients to fistulas.
The percentage of patients with Kt/V 1.2 and above held steady at 92%, third best in the country behind Texas and New England. The percentage of patients with URR greater than or equal to 65% continued its steady climb, now up to 89%.
The percentage of patients with hemoglobin 11 or higher crept up to 80% from 2001's 79% - fourth highest in the country behind Illinois, Texas, and Northern California. With only 73% of our patients having transferrin saturation at or above 20%, however, we're well below the 80% national average, and the lowest Network in this measure. At 92% we equal the national average in percentage of patients with ferritin at or above 100 ng/mL.
And need we - or must we - mention serum albumin? This Network is still dead last, at 25% of patients at or above 4.0 (BCG) or 3.7 (BCP). The next lowest Network (in the Heartland) is at 30%, and the highest (Illinois) at 45%.
We know you're eagerly awaiting forms for the 2004 CPM sample, and we plan to distribute those by the end of April. The due date for completing and returning them to the Network is 30 June. We don't know yet if that date will slide a week or so because of the delay getting the forms printed and distributed.TOP OF PAGE BOTTOM OF PAGE
15 Apr 2004 The National Library of Medicine has collected numerous Spanish-language weblinks concerning dialysis on its Medline Plus website at http://www.nlm.nih.gov/medlineplus/spanish/dialysis.html. See also our bulletin on the Free CKD Help Line in Spanish.
Spanish-Language Resources for Patient EducationTOP OF PAGE BOTTOM OF PAGE
15 Apr 2004 The mission of the federal ESRD program includes encouraging patients to participate in vocational rehabilitation programs. Each of the states in our Network has a "voc-rehab" office, which may be useful as a resource. The State Vocational Rehabilitation Offices and their phone numbers and websites are,
State Vocational Rehabilitation Offices
for Alaska: 800-478-2815 (in-state use only) or 907-465-2814, http://www.labor.state.ak.us/dvr/disable.htm;
for Idaho: 208-334-3390, http://www2.state.id.us/idvr/idvrhome.htm;
for Montana: 877-296-1197 or 406-444-2590, http://www.dphhs.state.mt.us/dsd/govt_programs/vrp;
for Oregon: 877-277-0513 or 503-945-5880, http://www.dhs.state.or.us/vr; and
for Washington: 800-637-5627 or 360-438-8000, http://www1.dshs.wa.gov/dvr.TOP OF PAGE BOTTOM OF PAGE
14 Apr 2004 There is a later bulletin on this topic.
Printed Life Options Kidney School Modules
Free Print Versions of Life Options Kidney School(TM) Modules Now Available for Download
In response to community requests, Life Options announces free print versions of its online Kidney School modules (http://www.KidneySchool.org). The introduction and first eight modules are now available to download from the Kidney School table of contents as PDF files, with remaining modules in production. These print documents will allow people without Internet access to benefit from the research-based information in Kidney School.
The purpose of Kidney School is to inspire, motivate, and empower people with chronic kidney disease (stages 3 to 5) to take an active role in their healthcare--and improve their chances to live long and live well. More than 130,000 users have visited the self-paced kidney learning center since its launch in March, 2002; an average of 6,000 visitors per month.
Life Options developed the PDF documents with all of the original content featured in the online version of Kidney School, minus the interactive components and the certificate of completion. The print versions feature a post-test, lively content, graphics, photos, and patient quotes. A multidisciplinary panel of Life Options Rehabilitation Advisory Council members and patients and professionals from the renal community reviewed all Kidney School content.
Life Options is administered by the Medical Education Institute, Inc. of Madison, WI, and supported by Amgen Inc. For free, research-based materials or more information about how to live long and live well with kidney disease, please visit the award-winning Life Options website at http://www.lifeoptions.org, call (800) 468-7777, or e-mail lifeoptions@MEIresearch.org. See also our earlier bulletin on Kidney School CE Credits and our later bulletin on the Nutrition Module.TOP OF PAGE BOTTOM OF PAGE
14 Apr 2004 The national Fistual First website is now live, at http://www.qualityhealthcare.org/IHI/topics/ESRD/VascularAccess. It organizes an impressive list of resources for both professional staff and patients. CMS has issued a press release describing the Fistula First project, http://www.cms.hhs.gov/media/press/release.asp?Counter=1007. The effort to increase fistula use involves not just dialysis professionals and patients, but also patients with pre-ESRD kidney disease and the professionals who treat them, including primary care physicians. If you can help reach these patients and professionals, please give them a copy of this press release. A recent article in the American Journal of Kidney Disease (Xue et al, v.42 #5, November 2003, pp.1013-19) reported that elderly incident hemodialysis patients with catheters had first-year mortality 70% higher than those with fistulas, and those with grafts had first-year mortality 16% higher than those with fistulas. Many of the tools mentioned in the press release and the national website can be found on our Fistula First webpage.
National Fistula First Website and CMS Press ReleaseTOP OF PAGE BOTTOM OF PAGE
31 Mar 2004 Facility Data Coordinators have traditionally kept this Network informed of changes in patient status via a Monthly Status Report ("MSR"). The Centers for Medicare and Medicaid Services ("CMS") has now instructed all Networks and all facilities to use the new Patient Activity Report ("PAR") to collect information about patient additions, losses, and census-neutral events. Shifting to the format of this PAR is mandatory, and its use will be standard across the country. This will provide necessary consistency to the national patient tracking process. Effective with reporting of April 2004 data, the PAR will replace the MSR. We are requesting all facilities to begin using the PAR starting with events for April. The PAR still has a due date of the 10th of the following month. This means each facility's first PAR is due May 10, 2004. The PAR form and instructions have been mailed to all Network 16 Data Coordinators. Though electronic submission of completed forms is not enabled, you may download a copy of the form at http://www.nwrenalnetwork.org/par.xls (after clicking this link, click on "File" in the upper left hand corner of the screen, click on "Save As" in the dropdown menu, and specify a folder on your computer to receive the MSExcel spreadsheet). Instructions for using the PAR can be found at http://www.nwrenalnetwork.org/parinstructions.htm. There is a later bulletin on this topic.
New Patient Activity Report for Monthly EventsTOP OF PAGE BOTTOM OF PAGE
31 Mar 2004 The Centers for Medicare & Medicaid Services ("CMS") today issued the second phase of its final regulations addressing physician referrals to entities with which they have a financial relationship. This interim final regulation will protect beneficiaries and taxpayers from abusive referral patterns, while providing straightforward rules for physicians and providers to comply with the law. This rule is on display at the Federal Register and was published March 26, 2004 and effective July 26, 2004. Comment period ends June 24, 2004. See the CMS Press Release for details of the announcement, and a summary of the history of the process.
CMS Physician Self-Referral RuleTOP OF PAGE BOTTOM OF PAGE
17 Mar 2004 The latest issue of Consumer News, our patient newsletter, is hot off the press, and can be found at http://www.nwrenalnetwork.org/cnews304.pdf. We are printing a full supply of hard copies, which we will send to each facility in early April, for distribution directly to each patient.
New Patient NewsletterTOP OF PAGE BOTTOM OF PAGE
17 Mar 2004 AMERICAN KIDNEY FUND OFFERS SPANISH TOLL-FREE HELP LINE. The American Kidney Fund has announced a new toll-free help line for Spanish speaking callers who need information about chronic kidney disease (CKD). According to the Fund, Hispanic Americans have nearly twice the risk of kidney disease as non-Hispanic Caucasians. In fact, one out of every eight people with kidney failure in the U.S. is Hispanic. The Fund is helping to address the high incidence of CKD among Hispanic Americans by raising awareness of the disease. The Spanish Help Line is available by calling (866)-300-2900. For more information, please visit http://www.akfinc.org/SearchAKF.htm, search on "Help Line" and then select "AKF Helpline."
Free CKD Help Line in SpanishTOP OF PAGE BOTTOM OF PAGE
8 Mar 2004 Effective 1 July 2004, Medicare is modifying its Health Insurance Portability and Accountability Act (HIPAA) contingency plan. The modification continues to allow submission of non-compliant electronic claims. However, the payment of electronic claims that are not HIPAA compliant will take thirteen additional days. Full details are at http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM2981.pdf. There are also earlier news bulletins about HIPAA.
HIPAA ComplianceTOP OF PAGE BOTTOM OF PAGE
8 Mar 2004 The Food and Drug Administration (FDA) has announced that Moving Solutions, Inc., of Downers Grove, Ill., is recalling its patient lifts because of a faulty design. Excessive wear of the main bolt, which secures the lift arm to the main frame of the patient lift, will cause the bolt to break, which will cause the patient to fall. The lift arm may also fall on the patient, which could result in serious injury, even death. Facilities and individuals should stop using these lifts until the problem is corrected. The recall involves all FAABORG model battery operated patient lifts distributed by Moving Solutions, because the lift arm is interchangeable between all models of FAABORG patient lifts. FAABORG, located in Denmark, is the manufacturer. Moving Solutions is the initial U.S. distributor; however there may be other distributors. FDA is monitoring the firm's action, which constitutes a Class I recall, to make sure that all facilities which use these lifts are adequately notified of the problem and to make sure that no more products are distributed. A class I recall is the most serious type of recall, used in situations where there is a reasonable probability that use of the product will cause serious injury or death. Full details are at http://www.fda.gov/bbs/topics/news/2004/NEW01032.html.
Moving Solutions / FAABORG Patient Lift RecallTOP OF PAGE BOTTOM OF PAGE
8 Mar 2004 Nurses and other health care professionals can now earn continuing education credits by going to Kidney School on-line at http://www.kidneyschool.org. Available 24 hours a day, Kidney School is a web-based, interactive learning center designed to provide practical information about how people with chronic kidney disease can live long and well. Kidney School consists of 16 modules addressing a wide range of topics from treatment options to lab tests. A multidisciplinary panel of experts from the Life Options Rehabilitation Advisory Council (LORAC) reviews all Kidney School content. Since the first modules went "live" in March 2002, patients and professionals alike have welcomed this source of information about kidney disease. Life Options now has a pilot program of CE credits for Kidney School. At this time, continuing education credits can be earned for Kidney School Modules 1 & 2, which cover basic information about the causes of chronic kidney disease, and treatment options. Professionals who want to earn CE credit can register, take and score a post test, and print out a CE certificate - all online. The fee, $20.00 for 2 contact hours, will be used to support ongoing updates and revisions of Kidney School. This continuing education activity was approved by the Wisconsin Nurses Association Continuing Education Approval Program Committee, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Kidney School is an educational project of Life Options, which is sponsored by an unrestricted educational grant from Amgen Inc. and administered by the non-profit Medical Education Institute. Life Options is a program of research and research-based educational materials. Life Options and Kidney School content are entirely independent of and not influenced by its corporate sponsor(s). For more information about Kidney School, Kidney School CE credits, or Life Options, visit the Life Options website at http://www.lifeoptions.org or the Kidney School website at http://www.kidneyschool.org.
Continuing Education Credits for Life Options Kidney SchoolTOP OF PAGE BOTTOM OF PAGE
2 Mar 2004 The Washington-Oregon Transplant Games team meeting has been changed to Friday, March 19th at 6:30 PM at Life Center Northwest's office in Bellevue. If you are, or if you know, a transplant recipient who is thinking about competing in the 2004 Transplant Games, please consider attending this meeting, and help us spread the word. This meeting is the first in our area this year, and everyone is welcome. Even if you aren't sure if you'd like to participate, but would like to find out more, please attend. A representative from National Kidney Foundation of Oregon and Washington will be there to tell us what to expect and answer our questions. Also, we will watch a video about the transplant games for those of us who have never been to them before. An athlete will be present to talk about the games and registration and fundraising issues will also be addressed. LOCATION: Life Center Northwest, 1407 116th Ave NE Suite E-210, Bellevue, WA 98004. DATE & TIME: Friday, March 19, 2004, Starting at 6:30 PM. MORE INFORMATION: Syrenka L. Slettebak, Community Education & Volunteer Program Coordinator, Northwest Kidney Centers, (206) 292-2771 ext. 5355, or syrenka@nwkidney.org.
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Patients' Rights and Responsibilities - NKF and Kidney School
27 Feb 2004 The Life Options program has announced a new Patient Rights and Responsibilities module for its Kidney School, at http://www.KidneySchool.org. As key team members, patients have important rights related to their healthcare - and important responsibilities, as well. This new module of Kidney School focuses on three main areas of rights and responsibilities: information-seeking, taking part in care, and being treated with respect and dignity. Information on how to handle conflicts with healthcare providers and decision-making about end-of-life issues is also featured. "Patients who are fully informed of their rights as well as their responsibilities are more likely to be active partners with their caregivers," says Life Options Rehabilitation Advisory Council (LORAC) member and Kidney School reviewer Beth Witten, MSW, ACSW, LSCSW. "Good communication and quality care help to assure that patients are healthier and live longer." Life Options developed this module with all of the expected features of Kidney School: a pretest/posttest; lively content; pop-ups, graphics, photos, and patient quotes; an evaluation; and a certificate of completion. As always, a multidisciplinary panel of LORAC members and patients and professionals from the renal community reviewed the module.
The purpose of Kidney School is to inspire, motivate, and empower people with chronic kidney disease (stages 3 to 5) to take an active role in their care - and improve their chances to live long and live well. More than 130,000 users have visited the self-paced kidney learning center since its launch in March 2002, an average of 6,000 visitors per month. Life Options is administered by the Medical Education Institute of Madison WI, and supported by Amgen. Life Options' free, research-based educational materials for patients and professionals are available from the award-winning Life Options website at http://www.lifeoptions.org. For more information, contact the Life Options Resource Center at (800) 468-7777 or lifeoptions@MEIresearch.org.
29 Jan 2004 The National Kidney Foundation Patient & Family Council has just released the booklet Dialysis Patients' Bill of Rights and Responsibilities. It outlines the rights of dialysis patients on topics such as treatment options, access to information, and counseling. It also addresses the responsibilities patients have to their dialysis facility, health care staff and fellow patients. Created in collaboration with NKF professional councils and several peer organization including the Centers for Medicare and Medicaid Services (CMS) and the End Stage Renal Disease (ESRD) Networks, the booklet serves as a comprehensive, unbiased guide for dialysis patients everywhere. NKF recommends that patients, family members and members of the health care team read Dialysis Patients' Bill of Rights and Responsibilities. Download a free copy at the Patient and Family Councils' web site, www.nkfkidneypatients.org. To order copies for your patients, contact Crystal Tucker at 800-622-9010.TOP OF PAGE BOTTOM OF PAGE
27 Feb 2004 Summaries of Upcoming New Benefits in Medicare as a result of the Medicare Modernization Act of 2003 can be found at http://www.nwrenalnetwork.org/UpcomingMedicareBenefitsEnglish.pdf (English) and http://www.nwrenalnetwork.org/NuevosBeneficiosMedicareSpanish.pdf (Spanish). CMS is now also publishing a web page that archives daily fact sheets related to the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The fact sheets featured on the page offer analysis of a wide range of subjects that derive from the Act. This "Medicare Issue of the Day" page is located at: http://www.cms.hhs.gov/medicarereform/issueoftheday/. Most of the documents are in PDF format. Acrobat PDF reader software can be downloaded from the same page.
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18 Feb 2004 The Centers for Disease Control will not be conducting a National Surveillance of Dialysis-Associated Diseases Survey for calendar year 2003. ESRD Networks across the country proposed a collaborative effort to capture some of the key data covered by this Survey, but the proposal was denied because neither CDC nor CMS believed there was a serious enough problem to warrant the data collection, because less than half of the Networks conduct infection control or Hepatitis B/Hepatitis C projects, and because vascular access data is being collected through the Fistula First project.
No 2003 CDC SurveyTOP OF PAGE BOTTOM OF PAGE
18 Feb 2004 Dr. Prabir Roy-Chaudhury is leading a timely symposium on hemodialysis vascular access, sponsored by the University of Cincinnati College of Medicine Department of Surgery and the Kidney Foundation of Greater Cincinnati. It will be held March 19-20 in Cincinnati, Ohio. The program is described at http://www.nwrenalnetwork.org/CincinnatiVASymposium2004.pdf. If your travels take you in this direction, consider an educational detour! We are in the process of designing educational outreach on the same theme, to continue to build upon the successful foundation laid by our "Back to the Basics" program to increase the use of native fistulas in hemodialysis patients. See our Fistula First page for more information.
Vascular Access Symposium
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12 Feb 2004 The current issue of the Diabetes In Control Newsletter, http://www.diabetesincontrol.com/issue194/Issue194.pdf, references a number of well-done educational brochures for diabetic patients from the Diabetic Research and Wellness Foundation, on
Free Diabetes Newsletter and Patient Education Brochureshey can be downloaded free from http://www.diabeteswellness.net/, or ordered in bulk for the cost of shipping (see the same website for ordering information). You can review past issues of the free Diabetes In Control Newsletter at http://www.diabetesincontrol.com/newsarchive.shtml and subscribe at http://www.diabetesincontrol.com/subscribe.shtml. The Newsletter is weekly.Looking After Your Feet
Impotence and What You Should Know
Managing Diabetes When You Are Ill
Some Answers To Your Questions
Looking After Your Eyes
Injecting Insulin - Sites and Swelling
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12 Feb 2004 This is an ad, but it looks useful... "HIPAA: Here today...here tomorrow. After all the hoopla surrounding last year's Privacy and Transaction laws, we bet you thought HIPAA had hit the highway for good. Additional HIPAA deadlines are fast approaching; and ultimately, noncompliance will be answered with nonpayment. AMA Press has the resources to get you back on the HIPAA track. To learn more about upcoming HIPAA deadlines and AMA Press HIPAA publications, visit http://www.amapress.com. To receive future AMA Press newsletters in HTML format, please send a new e-mail message to subscribe-AMA.Press.HTML@unity.ama-assn.org. No subject or other message is necessary." There are also earlier news bulletins about HIPAA.
AMA Book on HIPAA Coding
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29 Jan 2004 Assessment and Management of Adult Obesity: Case Studies in Disease Prevention and Health Promotion - Roadmaps for Clinical Practice consists of 10 booklets that offer practical recommendations for addressing adult obesity in the primary care setting. The primer offers practical advice on: evaluating patients for current and potential health risks related to weight - beginning with a measure of the body mass index (BMI); understanding medication and surgical options; improving communication and counseling; and making office environments more accomodating to obese patients. The booklets were produced with support from the Robert Wood Johnson Foundation, and developed in collaboration with the U.S. Department of Health and Human Services. The 10 booklets are available for download in PDF format at
New AMA Obesity Primer
http://www.ama-assn.org/ama/pub/category/print/10931.html. Clinical Tools and Patient Handouts, which appear throughout the booklets, are also available separately. CME credit is available. The primer is also available in print or on CD-ROM and is free of charge, from Order Department / American Medical Association / P.O. Box 930876 / Atlanta GA 31193-0876, or fax to 312-464-5600. Please refer to product order number NC426203. 800-262-3211 (AMA members); 800-621-8335 (nonmembers).
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27 Jan 2004 The application form for recertification as a Certified Nephrology Nurse (CNN), Certified Dialysis Nurse (CDN) and Certified Clinical Hemodialysis Technician (CCHT) by the Nephrology Nursing Certification Commission ("NNCC") will change this Spring. The new form is scheduled to be available at http://www.nncc-exam.org/recert/default.htm in April. If your ANNA Chapter or ESRD Facility hosts CNN/CDN/CCHT exams, a new hosting criteria will go into effect in mid-May. You can get the new form and criteria at http://www.nncc-exam.org/sites/host/hostappl.pdf.
CNN/CDN/CCHT Exam Changes
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16 Jan 2004 Our sincere thanks to all candidates who participated in our Board of Directors election process. We are pleased to announce that voting members of Northwest Renal Network have elected the following Board of Directors for the term 1/1/2004 - 12/31/2005. Officers: Margaret Eddy, MD - Chair (MT); Jean Stevens, RN, MBA - Vice-Chair (AK); John Stivelman, MD - Secretary/Treasurer (WA). General Members: Micheal J. Adcox, MD (Medical Review Board Chair) (ID); Jackie Chandler, RN, CNN (OR); Miriam Cressman, RN, CNN (WA); Troyce Crucchiola (Informed Consumer) (OR); Peter B. Hulman, MD (AK); Gwendolyn Pincomb, MD, PhD (MT).
Board of Directors Election Results
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15 Jan 2004 MedWatch - The FDA Safety Information and Adverse Event Reporting Program: Ortho-Clinical Diagnostics Inc. and FDA notified healthcare professionals of reports of increased initial reactive (IR) and repeat reactive (RR) rates obtained with the Antibody to HBsAg ELISA Test System 3 donor screening assay, with false repeat reactive results being confirmed using the Antibody to HBsAg ELISA Test System 3 Confirmatory Test. Ortho is currently examining available information as to the causes of these events. The letter recommended measures to mitigate problems with the donor screening assay, and provided changes made to the instructions for use of the Antibody to HBsAg ELISA Test System 3 Confirmatory Test kit. Read the 2004 MedWatch safety summary, including a link to the Ortho letter, at: http://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#elisa. You can learn more about MedWatch and subscribe/unsubscribe to the e-list at the MedWatch homepage, http://www.fda.gov/medwatch or by going directly to http://list.nih.gov/cgi-bin/wa?SUBED1=medwatch&A=1.
Antibody to HBsAg ELISA Test System 3
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15 Jan 2004 The National Healthcare Quality Report, developed by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, represents the first national comprehensive effort to measure the quality of health care in America. The report includes a broad set of performance measures that can serve as baseline views of the quality of health care. The report presents data on the quality of services for seven clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, HIV and AIDS, mental health, and respiratory disease. For the information reported on ESRD and chronic kidney disease, please see http://www.qualitytools.ahrq.gov/qualityreport/documents/J%20ESRD%20121103qg.pdf.
AHRQ Reports
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9 Jan 2004 HHS ANNOUNCES IMMEDIATE STEPS TO MAKE MEDICARE-APPROVED DRUG DISCOUNT CARD PROGRAMS AVAILABLE THIS SPRING
Medicare-Approved Drug Discount Cards
The U.S. Department of Health and Human Services (HHS) Secretary Tommy G. Thompson announced an interim final regulation for the Medicare Prescription Drug Discount Card Program, designed to help people who are covered by Medicare with the cost of prescription drugs. Individuals will be able to enroll in a Medicare approved prescription drug discount program beginning in spring of 2004.
The regulation outlining the new drug discount card program is the first action resulting from the Medicare Prescription Drug, Improvement and Modernization Act of 2003. While the drug discount benefit will be available next spring, the more significant provision of the law creating new Medicare drug coverage available to all Medicare beneficiaries will take effect in 2006.
Seniors and individuals with disabilities will be able to use these cards to garner savings of about 10 to 15 percent on their total drug costs, with savings of up to 25 percent or more on individual prescriptions. All Medicare beneficiaries, except those who already have Medicaid outpatient drug coverage, will be able to enroll in Medicare approved drug discount card programs, with benefits beginning in June, and may continue until the Medicare prescription drug benefit is implemented in 2006.
A key part of the Medicare-approved prescription drug discount card program is a subsidy of up to $600 a year for eligible low-income beneficiaries. Individuals whose income is less than $12,124 each year or married couples whose income is less than $16,363 may qualify for this special help. In addition, Medicare will cover the cost of the enrollment fee for these low-income cardholders. The Medicare-approved prescription drug discount card will be administered by the Centers for Medicare & Medicaid Services (CMS), the HHS agency that runs both programs.
Medicare beneficiaries will have a choice of at least two Medicare-approved cards, but be allowed to enroll in only one drug card program at a time. The cost of enrollment can be no more than $30 annually. Beneficiaries can change cards during an open enrollment period prior to 2005 or under special circumstances. Beginning in 2006, all people with Medicare will have access to a voluntary prescription drug benefit.
Beneficiaries will be able to get information about how the discount drug card program operates, who can qualify and how to join, as well as some comparative information on card sponsors in the spring at www.medicare.gov and 1-800 MEDICARE (1-800-633-4227) TTY/TDD: 1-877-486-2048.
At www.medicare.gov, beneficiaries will find a price comparison Web site that can help them compare negotiated prices, fees, and other card program features from card to card. The negotiated prices displayed will be a drug's maximum price for an approved sponsor's service area. Actual prices may vary, but will not be more than the posted prices. Customer service representatives at 1-800-MEDICARE will be able to help answer questions about the program, walk-through the price comparison Web site, and refer to appropriate sponsor or other resources (such as, make appropriate referrals for eligibility determination or to their State Pharmacy Assistance Program).
Medicare will contract with private companies to offer the new discount cards. Any non-governmental organization that meets all of the qualifications can receive a Medicare endorsement. Organizations will need to complete a detailed application concerning their qualifications and the design of their proposed drug discount card program. CMS will ask for applications several days following the publication of the interim final rule. This posting will be found at www.cms.hhs.gov/discountdrugs. A separate solicitation will be posted for certain Medicare managed care contractors on this site, as well as on the health plans pages at www.cms.hhs.gov/healthplans.
The regulation requires drug card sponsors to pass through savings in the form of price concessions to beneficiaries and publish the prices for the prescription drugs their cards will cover. Medicare will also provide card sponsor program information so that beneficiaries can choose the discount card program that best meets their individual needs. It is expected that the Medicare-approved discount drug cards will be available through a variety of sources, including pharmaceutical benefit managers, insurers, retail pharmacies, and Medicare Plus Choice plans. To be Medicare approved, a drug discount card program must include an extensive retail pharmacy network; no mail-order only programs will be allowed. Information about the participation process for interested organizations is available at www.cms.gov.
Information provided by the Department of Health and Human Services Weekly Report, December 15-21, 2003 and at www.hhs.gov/news/newsletter/weekly.
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9 Jan 2004 Beginning January 1, 2004, Medicare ESRD providers and suppliers are to use HCPCS code Q4054 for darbepoetin alfa, and new replacement code Q4055 for epoetin alfa. The previous Q codes for epoetin alfa have been deleted. More details concerning this issue can be found in Change Request 2963. CMS will be issuing a more detailed article regarding this coding change in the very near future. The article will be distributed via Medicare contractor newsletters, CMS listservs, and other electronic notification vehicles. If you have any questions, please contact Lynn Merritt-Nixon at (410) 786-4652 or Lmerrittnixon@cms.hhs.gov.
New EPO Q Codes
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Page updated March 7, 2008