============================================================================= Run Date: DEC 21, 2009 Designation: IB*2*425 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #392 Status: Released Compliance Date: DEC 31, 2009 ============================================================================= Subject: 2010 RX COPAY THRESHOLDS Category: - Routine Description: ============ Per forthcoming VHA DIRECTIVE 2009-### (# to be assigned upon publication) - This patch MUST be installed before January 1, 2010. The patch is being released as an Emergency patch together with DG*5.3*818 (2010 Means Test Thresholds) and EAS*1.0*98 (2010 GMT Thresholds) and may be installed out of sequence with respect to other released Integrated Billing (IB) patches. Please Note: We expect the VHA Directive to be titled MEANS TEST AND GEOGRAPHIC-BASED MEANS TEST THRESHOLDS FOR CALENDAR YEAR 2010. 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 2010. 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 2009-###. 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 2010 (with an effective date of 12/1/09) are defined in forthcoming VHA Directive 2009-### as: * $ 11,830 for a single veteran without dependents * $ 15,493 for a veteran with 1 dependent * An additional $ 2,020 for each additional dependent beyond 1 dependent And the Medicare deductible rate effective 01/01/2010 is shown as: * The Medicare deductible: $ 1,068. This patch, IB*2.0*425, is one of three VistA 2010 Threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*818 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*98 will address the annual updates for the GMT Thresholds. Please Note: This year, only the GMT Threshold dollar amounts will be increasing from a year ago. All other dollar amounts and rates will remain the same as the corresponding figures from last year. Patches for the Registration and Integrated Billing packages are still needed in order to link the figures to Calendar Year 2010/Income Year 2009. TECHNICAL: ========== File #350.2 -- IB ACTION CHARGE is updated with a new record. The values are as follows: .01 KEY = "MEDICARE DEDUCTIBLE" .02 EFFECTIVE DATE = 3100101 (internal form for January 01, 2010) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 1068 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 3091201 (internal form for 12/01/2009) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 11830 .04 BASE RATE WITH 1 DEPENDENT = 15493 .05 BASE RATE WITH 2 DEPENDENTS = 17513 .06 BASE RATE WITH 3 DEPENDENTS = 19533 .07 BASE RATE WITH 4 DEPENDENTS = 21553 .08 BASE RATE WITH 5 DEPENDENTS = 23573 .09 BASE RATE WITH 6 DEPENDENTS = 25593 .1 BASE RATE WITH 7 DEPENDENTS = 27613 .11 BASE RATE WITH 8 DEPENDENTS = 29633 .12 ADDITIONAL DEPENDENT AMOUNT = 2020 SOFTWARE RETRIEVAL ================== The software is not being distributed through the National Patch Module. It is being distributed as a host file which will contain the following three KIDS builds: Host file name: DG_53_P818.KID Builds: DG*5.3*818 EAS*1.0*98 IB*2.0*425 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_P818.KID Host File containing KIDS software distribution Note: Use ASCII mode when transferring the .KID file. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following NOIS/Remedy ticket(s): --------------------------------------------------------- There are no NOIS/Remedy tickets associated with this patch. TEST SITES: =========== Charleston VAMC (Medium) Birmingham VAMC (Large) Upstate NY HCS (Integrated) Puget Sound HCS (Integrated) ================ INSTALLATION INSTRUCTIONS ================= The components sent with this patch, IB*2.0*425, have been included in the host file DG_53_P818.KID. Please follow the instructions listed in the Installation Instructions section of the patch description for patch DG*5.3*818. During installation, the BILLING EXEMPTIONS file (#354.1) will be checked for medication co-payment exemptions based on prior thresholds. If there are some, the "Exemptions Based on Prior Year Thresholds" report may be generated. Steps 4b and 6 in the Installation Instructions pertain to this report. Following is a list of the routines included in the IB patch. The second line of each of these routine(s) will look like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;[Build #] Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20E425 Before: n/a After: B2239161 **425** Routine Name: IB20P425 Before: n/a After: B34800761 **425** ============================================================================= User Information: Entered By : DESMOND,LINDA Date Entered : OCT 22, 2009 Completed By: RUDINGER,NANCY L. Date Completed: DEC 18, 2009 Released By : HARRIS,ANGELA Date Released : DEC 21, 2009 ============================================================================= Packman Mail Message: ===================== No routines included