============================================================================= Run Date: DEC 29, 2014 Designation: IB*2*540 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #485 Status: Released Compliance Date: DEC 31, 2014 ============================================================================= Subject: 2015 RX COPAY THRESHOLDS Category: - Routine - Informational Description: ============ ************************************************************************** * Per VHA FACT SHEET titled MEANS TEST AND GEOGRAPHIC-BASED MEANS TEST * * AND MAXIMUM ANNUAL RATES OF PENSION FOR CALENDAR YEAR 2015, this * * patch MUST be installed before January 1, 2015. The patch is being * * released as an Emergency patch together with DG*5.3*910 (2015 Means * * Test Thresholds) and EAS*1.0*125 (2015 GMT Thresholds) and may be * * installed out of sequence with respect to other released IB patches. * ************************************************************************** This patch, IB*2.0*540, is one of three VistA 2015 threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*910 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*125 will address the annual updates for the GMT Thresholds. ASSOCIATED REMEDY TICKETS: ========================== 1. INC000001086741 Integrated Billing - Other: PARTICIPATING TEST SITES: ========================= REMEDY OVERVIEW: ================ 1. INC000001086741 Integrated Billing - Other: PROBLEM: -------- 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 2015. RESOLUTION: ----------- 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 AND GEOGRAPHIC-BASED MEANS TEST AND MAXIMUM ANNUAL RATES OF PENSION FOR CALENDAR YEAR 2015. 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 2015 (with an effective date of 12/1/14) are defined in VHA FACT SHEET titled MEANS TEST AND GEOGRAPHIC- BASED MEANS TEST AND MAXIMUM ANNUAL RATES OF PENSION FOR CALENDAR YEAR 2015 as: * $ 12,868 for a single veteran without dependents * $ 16,851 for a veteran with 1 dependent * An additional $ 2,198 for each additional dependent beyond 1 dependent Medicare deductible rate effective 01/01/2015 is shown as: * The Medicare deductible: $ 1,260. 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 = 3150101 (internal form for January 01, 2014) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 1260 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 311201 (internal form for 12/01/2013) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 12868 .04 BASE RATE WITH 1 DEPENDENT = 16851 .05 BASE RATE WITH 2 DEPENDENTS = 19049 .06 BASE RATE WITH 3 DEPENDENTS = 21247 .07 BASE RATE WITH 4 DEPENDENTS = 23445 .08 BASE RATE WITH 5 DEPENDENTS = 25643 .09 BASE RATE WITH 6 DEPENDENTS = 27841 .1 BASE RATE WITH 7 DEPENDENTS = 30039 .11 BASE RATE WITH 8 DEPENDENTS = 32237 .12 ADDITIONAL DEPENDENT AMOUNT = 2198 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_P910.KID Builds: DG*5.3*910 EAS*1.0*125 IB*2.0*540 Sites may retrieve the software directly using File Transfer Protocol (FTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: ftp.domain.ext Hines: ftp.domain.ext Salt Lake City: ftp.domain.ext First Available Server: download.vista.domain.ext The following file will be available: File Name Description --------- ----------- DG_53_P910.KID Host File containing KIDS software distribution Note: Use ASCII mode when transferring the .KID file. Pre/Post Installation Overview ------------------------------ The IB20E540 pre-init routine will provide prompting during the patch install and may be deleted after install. The IB20P540 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 IB*2.0*540 patch have been included in the HOST File DG_53_P910.KID. Please follow the instructions listed in the INSTALLATION INSTRUCTIONS section of the patch description for patch DG*5.3*910. NOTE: Please bear in mind items below for install. 1. During installation, the BILLING EXEMPTIONS file (#354.1) will be checked for medication co-payment exemptions based on prior thresholds. If they exist, 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 valid print device. An entry is required and the HOME device is not allowed; neither are the P-Message device or Spooler 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 second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20E540 Before: n/a After: B2238789 **540** Routine Name: IB20P540 Before: n/a After: B35636879 **540** ============================================================================= User Information: Entered By : Date Entered : NOV 24, 2014 Completed By: Date Completed: DEC 19, 2014 Released By : Date Released : DEC 29, 2014 ============================================================================= Packman Mail Message: ===================== No routines included