Risk Adjustment User Group July 2008

Welcome to the July User Group Introduction Payment Process Operations Update Data Validation Technical Assistance Update Questions and Answers Closing

INTRODUCTION

INTRODUCTION User Group Process All attendees must pre-register It is only necessary to register once Retain unique PIN for all sessions Session will last for one hour Session slides will be available by the Tuesday before the session Panel will answer questions during the Q&A portion of the session

INTRODUCTION The 2008 monthly Risk Adjustment User Group Q & A and Notes documents are posted at the CSSC Operations website. Please continue to review the website for updates to this information. www.csscoperations.com/new/usergroup/usergroupinfo.html

PAYMENT PROCESS

PAYMENT PROCESS (PART A-ONLY OPTION) Effective for 2006 payments, organizations may elect to have CMS determine payments for all “Part A-only” enrollees using either new enrollee factors or full risk adjustment factors. Plans may not elect to move some eligible “Part A-only” enrollees into full risk adjustment, while retaining others as new enrollees. Once elected, this option will remain turned “on” until CMS is otherwise notified prior to August 31st of any successive year. This option is applied during reconciliation for a payment year only (i.e., it will not be applied prospectively). Plans interested in this option must contact henry.thomas@cms.hhs.gov by August 31st.

PAYMENT PROCESS (PART A-ONLY OPTION TABLE) Beneficiary entitled under Part A Beneficiary enrolled in Part B 0 – 11 months >= 12 months New enrollee factors New enrollee of full risk factors Full risk factors

DATA VALIDATION

DATA VALIDATION Calendar Year 2007 Calendar Year 2006

OPERATIONS UPDATES

Connecting to the FERAS OPERATIONS Connecting to the FERAS To establish an IP connection with the FERAS, you must be connected to the Medicare Data Communications Network (MDCN), which is provided by AT&T Global Network Services. The MDCN is the secure network linking the Risk Adjustment data processing entities. If you are not connected to the MDCN, please contact AT&T at 1-800-905-2069.

OPERATIONS All submitters with IP network access have been authorized to connect to the FERAS. In order to submit claims to the FERAS via the MDCN, you must be enrolled with the CSSC Operations. If you are not enrolled, please contact the CSSC Operations Help Line at (877) 534-2772. Once enrolled with the CSSC, to submit and retrieve data electronically, you will receive a Submitter ID and a password.

TECHNICAL ASSISTANCE UPDATES

TECHNICAL ASSISTANCE UPDATES 2008 Monthly Technical Assistance Sessions Enrollment & Payment Session July 30th Due to Regional Technical Assistance Sessions, the August Monthly Technical Assistance Session is canceled Register today at www.tarsc.info

REGIONAL TECHNICAL ASSISTANCE SESSIONS Limited Availability…Register Soon! CHICAGO, IL August 11 – August 14 LAS VEGAS, NV registration is closed NEW ORLEANS, LA September 9 – September 10

TECHNICAL ASSISTANCE UPDATES *For detailed information and to register online log on to www.tarsc.info Technical Assistance Registration Service Center

QUESTIONS & ANSWERS

CLOSING

RESOURCES Sean Creighton (Director, Division Risk Adjustment Operations) sean.creighton@cms.hhs.gov Henry Thomas (Training, Project Officer) henry.thomas@cms.hhs.gov Lateefah Hughes (Data Validation, Team Lead) lateefah.hughes@cms.hhs.gov Louis Johnson (FERAS,GTL) louis.johnson@cms.hhs.gov Chanda McNeal (Payment Issues) raf_payment_questions@cms.hhs.gov LTC www.tarsc.info CSSC www.csscoperations.com