============================================================================= Run Date: DEC 20, 2012 Designation: IB*2*485 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #443 Status: Released Compliance Date: DEC 31, 2012 ============================================================================= Subject: 2013 RX COPAY THRESHOLDS Category: - Routine - Informational Description: ============ Per VHA FACT SHEET titled MEANS TEST, GEOGRAPHIC-BASED MEANS TEST AND PENSION THRESHOLDS FOR CALENDAR YEAR 2013, this patch MUST be installed before January 1, 2013. The patch is being released as an Emergency patch together with DG*5.3*860 (2013 Means Test Thresholds) and EAS*1.0*108 (2013 GMT Thresholds) and may be installed out of sequence with respect to other released IB patches. 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 2013. 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 VHA FACT SHEET titled MEANS TEST, GEOGRAPHIC-BASED MEANS TEST AND PENSION THRESHOLDS FOR CALENDAR YEAR 2013. 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 2013 (with an effective date of 12/1/12) are defined in VHA FACT SHEET titled MEANS TEST, GEOGRAPHIC- BASED MEANS TEST AND PENSION THRESHOLDS FOR CALENDAR YEAR 2013 as: * $ 12,465 for a single veteran without dependents * $ 16,324 for a veteran with 1 dependent * An additional $ 2,129 for each additional dependent beyond 1 dependent And the Medicare deductible rate effective 01/01/2013 is shown as: * The Medicare deductible: $ 1,184. This patch, IB*2.0*485, is one of three VistA 2013 threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*860 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*108 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 = 3130101 (internal form for January 01, 2013) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 1184 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 3121201 (internal form for 12/01/2012) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 12465 .04 BASE RATE WITH 1 DEPENDENT = 16324 .05 BASE RATE WITH 2 DEPENDENTS = 18453 .06 BASE RATE WITH 3 DEPENDENTS = 20582 .07 BASE RATE WITH 4 DEPENDENTS = 22711 .08 BASE RATE WITH 5 DEPENDENTS = 24840 .09 BASE RATE WITH 6 DEPENDENTS = 26969 .1 BASE RATE WITH 7 DEPENDENTS = 29098 .11 BASE RATE WITH 8 DEPENDENTS = 31227 .12 ADDITIONAL DEPENDENT AMOUNT = 2129 SOFTWARE RETRIEVAL ------------------ The software for this patch is not being distributed through the National Patch Module. This patch is being distributed as a host file. The host file will contain the following three KIDS builds: Host file name: DG_53_P860.KID Builds: DG*5.3*860 EAS*1.0*108 IB*2.0*485 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_P860.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: ---------- VISN 2 Chillicothe, OH VAMC Puget Sound HCS Documentation Retrieval Instructions ------------------------------------ N/A Patch Installation: Pre/Post Installation Overview ------------------------------ The IB20E485 pre-init routine will provide prompting during the patch install and may be deleted after install. The IB20P485 post-install routine will update the following files and may be deleted after install. IB ACTION CHARGE (#350.2) BILLING EXEMPTIONS (#354.1) BILLING THRESHOLDS (#354.3) Installation Instructions ------------------------- The components sent with this patch IB*2.0*485 have been included in the HOST File DG_53_P860.KID. Please follow the instructions listed in the INSTALLATION INSTRUCTIONS section of the patch description for patch DG*5.3*860. Pre-Installation Instructions ----------------------------- NOTE: during the installation, please bear in mind items below. 1. 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 installer will be prompted to UPDATE AND PRINT the exemptions report since the exemption status may change due to the new rates. Press to accept the default value of Update & Print. At the DEVICE prompt you must enter a print device. An entry is required and the HOME device is not allowed; neither is the p-Message device (this will abort the install). You MUST choose a valid printer. You need not queue the report since the patch will do so automatically. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20E485 Before: n/a After: B2238685 **485** Routine Name: IB20P485 Before: n/a After: B34807557 **485** ============================================================================= User Information: Entered By : CROSSMAN,PAM Date Entered : OCT 04, 2012 Completed By: MOORE,TERRY D Date Completed: DEC 17, 2012 Released By : POST,HELEN Date Released : DEC 20, 2012 ============================================================================= Packman Mail Message: ===================== No routines included