============================================================================= Run Date: DEC 15, 2011 Designation: IB*2*465 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #426 Status: Released Compliance Date: DEC 28, 2011 ============================================================================= Subject: 2012 RX COPAY THRESHOLDS Category: - Routine Description: ============ Per forthcoming VHA DIRECTIVE 2011-###, new effective rates for Means Test Thresholds, GMT Thresholds, and RX Copay Thresholds will go into effect January 1, 2012. To ensure compliance with the forthcoming VHA Directive, IB*2.0*465 MUST be installed by December 28, 2011. This patch is being released as an Emergency patch together with DG*5.3*848 (2012 Means Test Thresholds) and EAS*1.0*104 (2012 GMT Thresholds) and may be installed out of sequence with respect to other released IB patches. Please Note: We expect the VHA Directive to be titled MEANS TEST AND GEOGRAPHIC-BASED MEANS TEST THRESHOLDS FOR CALENDAR YEAR 2012. In order to provide adequate time for sites to install, Central Business Office has agreed that these patches may be released prior to availability of the actual Directive Number. Every year, the government sets new values for the Medicare deductible and for the pension threshold rates. These values need to be updated in the associated billing files for accurate and legal billing. The purpose of this patch is to assist sites in the entry of the Basic Pension Threshold rates and the Medicare Deductible value for Calendar Year 2012. A post-init routine is included in this patch, which will automate the update of the new Medicare and pension threshold values. The Technical section below contains a list of the new rates, which may also be found in forthcoming VHA DIRECTIVE 2011-###. If a site has already entered the values manually, the record will be overwritten with the national update. The new pension rates for Calendar Year 2012 (with an effective date of 12/1/11) are defined in forthcoming VHA DIRECTIVE 2011-### as: * $ 12,256 for a single veteran without dependents * $ 16,051 for a veteran with 1 dependent * An additional $ 2,093 for each additional dependent beyond 1 dependent And the Medicare deductible rate effective 01/01/2012 is shown as: * The Medicare deductible: $ 1,156. This patch, IB*2.0*465, is one of three VistA 2012 threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*848 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*104 will address the annual updates for the GMT Thresholds. Patch Components ================ Files & Fields Associated: N/A Forms Associated: Form Name File # New/Modified/Deleted --------- ------ -------------------- N/A Mail Groups Associated: Mail Group Name New/Modified/Deleted --------------- -------------------- N/A Options Associated: Option Name Type New/Modified/Deleted ----------- ---- -------------------- N/A Protocols Associated: Protocol Name New/Modified/Deleted ------------- -------------------- N/A Security Keys Associated: Security Key Name ----------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: File #350.2 -- IB ACTION CHARGE is updated with a new record. The values are as follows: .01 KEY = "MEDICARE DEDUCTIBLE" .02 EFFECTIVE DATE = 3120101 (internal form for January 01, 2012) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 1156 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 3111201 (internal form for 12/01/2011) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 12256 .04 BASE RATE WITH 1 DEPENDENT = 16051 .05 BASE RATE WITH 2 DEPENDENTS = 18144 .06 BASE RATE WITH 3 DEPENDENTS = 20237 .07 BASE RATE WITH 4 DEPENDENTS = 22330 .08 BASE RATE WITH 5 DEPENDENTS = 24423 .09 BASE RATE WITH 6 DEPENDENTS = 26516 .1 BASE RATE WITH 7 DEPENDENTS = 28609 .11 BASE RATE WITH 8 DEPENDENTS = 30702 .12 ADDITIONAL DEPENDENT AMOUNT = 2093 SOFTWARE RETRIEVAL ------------------ The software for this patch is not being distributed through the National Patch Module. This patch is being distributed as part of a host file. The host file will contain the following three KIDS builds: Host file name: DG_53_P848.KID Builds: DG*5.3*848 EAS*1.0*104 IB*2.0*465 Sites may retrieve the software directly using File Transfer Protocol (FTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany : ftp.fo-albany.med.va.gov Hines : ftp.fo-hines.med.va.gov Salt Lake City : ftp.fo-slc.med.va.gov First Available Server : download.vista.med.va.gov The following file will be available: File Name Description --------- ----------- DG_53_P848.KID Host File containing KIDS software distribution Note: Use ASCII mode when transferring the .KID file. New Service Requests (NSRs) ---------------------------- N/A Patient Safety Issues (PSIs) ----------------------------- N/A Remedy Ticket(s) & Overview --------------------------- N/A Test Sites: ---------- Chillicothe, OH VAMC (Medium) New York Harbor HCS (Large/Integrated) VISN 2 Upstate New York HCS (Large/Integrated) Documentation Retrieval Instructions ------------------------------------ N/A Patch Installation: Pre/Post Installation Overview ------------------------------ The IB20E465 pre-init routine will provide prompting during the patch install and may be deleted after installation. The IB20P465 post-install routine will update the following files. IB20P465 may be deleted after installation. IB ACTION CHARGE (#350.2) BILLING EXEMPTIONS (#354.1) BILLING THRESHOLDS (#354.3) Installation Instructions ------------------------- The components sent with this patch IB*2.0*465 have been included in the HOST File DG_53_P848.KID. Please follow the instructions listed in the INSTALLATION INSTRUCTIONS section of the patch description for patch DG*5.3*848. In the DG patch description, please make special note of installation instruction #4b and post-installation instruction #2. They concern a report that the installer may need to print in order for the patches to install. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20E465 Before: n/a After: B2238582 **465** Routine Name: IB20P465 Before: n/a After: B34798017 **465** ============================================================================= User Information: Entered By : MOORE,TERRY D Date Entered : OCT 06, 2011 Completed By: RUDINGER,NANCY L. Date Completed: DEC 15, 2011 Released By : POST,HELEN Date Released : DEC 15, 2011 ============================================================================= Packman Mail Message: ===================== No routines included