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Bi-Monthly Letter to SHIBA Sponsors, Coordinators & Volunteers

January 11, 2001

Dear Sponsors/Coordinators/Volunteers:

Happy New Year! We want to welcome Von Ledbetter as our new Public Service Representative for SHIBA. It is our plan to train all SHIBA volunteers on "Surfing the net" to become more familiar with SHIBA and the Medicare web site. Von will be organizing and conducting this training, and she will be contacting each of the sponsors to coordinate training sessions. Von also provides back up support, data entry and phone coverage. She inputs the Record of Assistance information that is used for statistical information when applying for HCFA grant approval and completing semi-annual reports. Von also returns phone messages from the toll free line. Welcome to the SHIBA family Von!

We are currently working on the "2001 Oregon Consumer Guide to Medicare Supplement Insurance and Managed Care Organizations (MCOs)" and the "Oregon Long-Term Care Insurance: Companies and Consumer Tips" book. We are making some changes to the format of the Consumer Guide in the Medicare + Choice section, and updating the flow of the Standard Medigap Plan section. We hope to have the Long-Term Care brochure ready by early February and the Consumer Guide by March 1st. Thank you to those of you who have provided valuable input. We will be sending copies to each of the sponsor locations as soon as they are completed.

We are in the beginning stages of updating our SHIBA web site. Some of you have offered your input, which is much appreciated. As you are browsing the Internet, if you see something you like or don't like, would you jot it down and drop us a note. We want to create a useful tool for you and the Medicare beneficiaries. One thing we want to keep in mind as we are updating our SHIBA web site and for other e-mail communications for confidentiality purposes; please do not send social security numbers or Medicare numbers via electronic mail. If you have an issue that we can not generically solve without an identification number, please call us directly for help at any time.

Facts from www.medicare.gov show Internet access among Medicare beneficiaries increasing dramatically from 1997 to 1999, from 6.8% to 21.3%. Senior Citizens are the fastest growing sector of the online audience.

Medicare updates.

Premiums, Deductibles and Co-insurance for 2001.

Enclosed is an updated SHIBA flyer listing Part A and Part B rates.

Advance Beneficiary Notices (ABN)

The new ABN's are part of the HCFA Beneficiary Notices Initiative. They are designed to be more user friendly. Part B ABN's advise beneficiaries, before items or services are actually furnished, that Medicare is likely to deny payment for them. Because of this beneficiaries are able to make better informed decisions about receiving items or services for which they may have an out of pocket expense, they can be more involved in health care treatment decisions.

General Enrollment Period

Just a reminder that this is the general enrollment period for Medicare Part B. General enrollment is January 1st - March 31st of each year.

Changes to www.medicare.gov

November 15, two new databases were released including a Prescription Drug Assistance Program database (PDAP) and a Participating Physician Directory (PPD). PDAP provides users with information on Medigap plans and managed care plans that provide various prescription options. PPD allows users to search for Medicare participating physicians by specialty and location. The PDAP provides the following information:

  1. Prescription drug coverage
  2. State government pharmacy assistance programs
  3. Programs offered by pharmaceutical companies
  4. Community-based programs
  5. Programs that offer prescription drug coverage for particular diseases or conditions

Outpatient Prospective Payment System (OPPS) Under the outpatient prospective payment system, hospitals and community mental health centers are paid a set amount of money (called the payment rate) to give some outpatient services to Medicare patients. The payment rate is the total payment that a hospital or community mental health center gets when they give outpatient services to Medicare patients. You may access the HCFA web site at http://www.hcfa.gov/medlearn/refopps.htm for more information. We have also enclosed Your Guide to the Outpatient Prospective Payment System.

HCFA has requested that we track calls or concerns related to the OPPS, we will be asking you for this information for tracking purposes. Suggested format also attached. Thank you for your assistance.

Nursing Home Care

Enclosed is an all in one guide book from Consumers' Union offering new tools for finding nursing home care.

Reminder:

We would like to continue with the practice of giving throughout the year. If you have any outstanding Records of Assistance forms, please send them in as soon as possible. Our reporting period ends March 15th. All RoA's for this reporting period must be input into the database prior to March 15th. We would also like to provide a portion of the newsletter for volunteer/coordinator recognition. If you know of someone that you would like recognized, please let us know. We would like to publicly recognize our team members.

Sincerely,

Margaret L. Scott
SHIBA Field
(503) 947-7263 or 1-800-722-4134
E-mail: margaret.l.scott@state.or.us

Terri Hays Officer
SHIBA Field Officer
503-947-7250 or 1-800-722-4134
E-mail: teresa.hays@state.or.us

Von Ledbetter
Public Service Representative
503-947-7268 1-800-722-4134
E-mail: von.m.ledbetter@state.or.us

Check off for agenda items:

Medicare updates

_____ Advance Beneficiary Notices (ABN)
_____ General Enrollment Period
_____ Changes to www.medicare.gov
_____ Outpatient Prospective Payment System (OPPS)

Enclosed Literature
_____ Consumers Union Report
_____ Draft Text for Inquiry HCFA OPPS survey
_____ Sample Prospective Payment Systems work sheet

Literature to follow under separate mailing

_____ Medicare calendars
_____ updated SHIBA Free Help brochures

Just for fun word search

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