============================================================================= Run Date: DEC 15, 2016 Designation: IB*2*563 Package : IB - INTEGRATED BILLING Priority: Mandatory Version : 2 SEQ #532 Status: Released Compliance Date: JAN 14, 2017 ============================================================================= Associated patches: (v)IB*2*199 <<= must be installed BEFORE `IB*2*563' (v)IB*2*247 <<= must be installed BEFORE `IB*2*563' (v)IB*2*308 <<= must be installed BEFORE `IB*2*563' (v)IB*2*341 <<= must be installed BEFORE `IB*2*563' (v)IB*2*454 <<= must be installed BEFORE `IB*2*563' (v)IB*2*524 <<= must be installed BEFORE `IB*2*563' (v)IB*2*545 <<= must be installed BEFORE `IB*2*563' (v)IB*2*552 <<= must be installed BEFORE `IB*2*563' Subject: FIXED MEDICATION COPAYMENT TIERS (FMCT) Category: - Data Dictionary - Routine - Enhancement (Mandatory) Description: ============ This patch will provide enhancements to the Integrated Billing package for Fixed Medication Copayment Tiers (FMTC) project. It supports the redesign and/or enhancement of the current structure of charges for first-party outpatient medication copayments to treat non-service connected conditions. This project brings the Department of Veterans Affairs (VA) into compliance with the Proposed Rule 38 Code of Federal Regulations (CFR) Part 17 Copayments for Medications. Below is a list of all the applications involved in this project along with their patch number: APPLICATION/VERSION PATCH --------------------------------------------------------------- To be released in a host file: National Drug File (NDF) V. 4.0 PSN*4*492 Pharmacy Data Management (PDM) V. 1.0 PSS*1*200 To be released as a host file: Outpatient Pharmacy (OP) V. 7.0 PSO*7*460 Integrated Billing (IB) V. 2.0 IB*2*563 To be released as a standalone forum patch on or about 1/6/2017: Accounts Receivable (AR) V. 4.5 PRCA*4.5*312 This rulemaking eliminates the Medical Consumer Price Index (CPI-P) formula used to calculate future rate increases and establishes the following three classes of medications, identified as Tier 1, Tier 2, and Tier 3, beginning February 27, 2017: Tier 1 = $5 for a 30-day or less supply of a medication; Tier 2 = $8 for a 30-day or less supply of a medication; and Tier 3 = $11 for a 30-day or less supply of a medication. In addition to the rule, Pharmacy Benefits Management (PBM) made the addition of Tier 0 for excluded and exempt products with no copayment. In order to comply with the Federal regulations, modifications are included in these patches to support fixed copayment amounts depending on the class of the medication (Tier 0, Tier 1, Tier 2, or Tier 3). The VA wide Outpatient Medication Copayment Cap per calendar year which was for only Priority Groups 2-6 is being extended to include Priority Groups 7-8. The new Outpatient Medication Copayment Cap effective January 1, 2017 will be $700 for all Priority Groups subject to Outpatient Medication Copayments (2-8). This specific patch contains the following functionality: --------------------------------------------------------- - Rate files will be updated to store tiered copayments and their new rates effective February 27, 2017. To ensure backward compatibility, the old rates are being associated with the default tier of 2. - Medication copayment cap files will be updated to store the new cap that applies to PG 2-8 effective January 1, 2017. - All automated creation of outpatient medication copayments will utilize the new tiered rates based on the drug dispensed and designated in the National Drug File software package. - Manually created copayment charges will now prompt for a prescription date, if on the date entered there are multiple tiers available for rate selection the user will be prompted for the applicable tier. - The option to locally update rate files is being enhanced to support outpatient medication copayment tiers. - Provide support for the Accounts Receivable (AR) package to lookup potential charges on prescriptions that have not yet been released with the potential charge amount based on the prescription tier value. Patch Components ================ Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- INTEGRATED BILLING ACTION (#350) COPAYMENT TIER (#.22) Modified IB ACTION CHARGE (#350.2) COPAYMENT TIER (#.07) New IB COPAY TRANSACTIONS (#354.71) COPAYMENT TIER (#.2) Modified IB COPAY CAPS (#354.75) PRIORITY LEVEL (#.02) Modified 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 New/Modified/Deleted ---------------------- -------------------- N/A Templates Associated: Template Name Type File Name (Number) New/Modified/Deleted ------------- ---- ------------------ -------------------- N/A Additional Information: New Service Requests (NSRs) ---------------------------- Tiered Medication Copayment Structure (#20150208) Patient Safety Issues (PSIs) ----------------------------- N/A Defect Tracking System Ticket(s) & Overview ------------------------------------------- N/A Test Sites: ---------- AMARILLO, TX MARYLAND HCS SHREVEPORT, LA Software and Documentation Retrieval Instructions ------------------------------------------------- Software being released as a host file and/or documentation describing the new functionality introduced by these patches are available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ------------------------------------------------------------------------- N/A Installation Instructions: ========================== This patch may be installed with users on the system although it should be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Pre-Installation Instructions ----------------------------- Please note that this patch is released in conjunction with the following patches and they should be installed in the following order: File Name Contents Retrieval Format ---------------------------- -------- ---------------- FMCT_PSS200_PSN492.KID PSS*1.0*200 ASCII PSN*4.0*492 FMCT_PSO_7_460_IB.KID IB*2.0*563 ASCII PSO*7.0*460 PRCA*4.5*312 KIDS BUILD FORUM ****** PRCA*4.5*312 TO BE RELEASED ON OR ABOUT 1/6/2017 ******** I. OBTAIN PATCHES -------------- A. Obtain the host files: FMCT_PSS200_PSN492.KID which contains the following patches: PSS*1.0*200 PSN*4.0*492 FMCT_PSO_7_460_IB.KID which contains the following patches: IB*2.0*563 PSO*7.0*460 This patch can be obtained from the ANONYMOUS.SOFTWARE directory at one of the OI Field Offices. The preferred method is to retrieve the file using Secure File Transfer Protocol (SFTP) from DOWNLOAD.VISTA.DOMAIN.EXT, which will transmit the file from the first available server. Alternatively, sites may elect to retrieve the file from a specific OI Field Office. OI FIELD OFFICE FTP ADDRESS DIRECTORY --------------- -------------------- ------------------ Albany DOMAIN.EXT Hines DOMAIN.EXT Salt Lake City DOMAIN.EXT Both host files are located in the directory. Use ASCII Mode when downloading the file. B. Obtain the Accounts Receivable patch PRCA*4.5*312 from FORUM. II. START UP KIDS ------------- Start up the Kernel Installation and Distribution System Menu option [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global Select Installation Option: III. LOAD TRANSPORT GLOBAL FOR MULTI-BUILD FMCT_PSS200_PSN492.KID ------------------------------------------------------------- From the Installation menu, select the Load a Distribution option. When prompted for "Enter a Host File:", enter the full directory path where you saved the host file FMCT_PSS200_PSN492.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]FMCT_PSS200_PSN492.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... FCMT PSS PSN BUNDLE 1.0 PSS*1.0*200 PSN*4.0*492 Use INSTALL NAME: FMCT PSS PSN BUNDLE 1.0 to install this Distribution. IV. RUN OPTIONAL INSTALLATION OPTIONS FOR MULTI-BUILD ------------------------------------------------- From the Installation menu, you may select to use the following options (when prompted for the INSTALL NAME, enter FMCT PSS PSN BUNDLE 1.0): A. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as data dictionaries or templates. B. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, data dictionaries, templates, etc.). C. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. V. INSTALL MULTI-BUILD ------------------- This is the step to start the installation of this KIDS patch. This will need to be run for the FMCT PSS PSN BUNDLE 1.0. A. Choose the Install Package(s) option to start the patch install. B. When prompted for the "Select INSTALL NAME:", enter FMCT PSS PSN BUNDLE 1.0. C. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//", enter YES unless your system does this in a TaskMan process. D. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", enter NO. E. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", enter NO. F. When prompted "Device: HOME//", respond with the correct device but do not queue this install. VI. LOAD TRANSPORT GLOBAL FOR MULTI-BUILD FMCT_PSO_7_460_IB.KID ------------------------------------------------------------ From the Installation menu, select the Load a Distribution option. When prompted for "Enter a Host File:", enter the full directory path where you saved the host file FMCT_PSO_7_460_IB.KID (e.g., SYS$SYSDEVICE:[ANONYMOUS]FMCT_PSO_7_460_IB.KID). When prompted for "OK to continue with Load? NO//", enter "YES." The following will display: Loading Distribution... FMCT PSO IB BUNDLE 1.0 IB*2.0*563 PSO*7.0*460 Use INSTALL NAME: FMCT PSO IB BUNDLE 1.0 to install this Distribution. VII. RUN OPTIONAL INSTALLATION OPTIONS FOR MULTI-BUILD ------------------------------------------------- From the Installation menu, you may select to use the following options (when prompted for the INSTALL NAME, enter FMCT PSO IB BUNDLE 1.0): A. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as data dictionaries or templates. B. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, data dictionaries, templates, etc.). C. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. VIII. INSTALL MULTI-BUILD ------------------- This is the step to start the installation of this KIDS patch. This will need to be run for the FMCT PSO IB BUNDLE 1.0. A. Choose the Install Package(s) option to start the patch install. B. When prompted for the "Select INSTALL NAME:", enter FMCT PSO IB BUNDLE 1.0. C. When prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install? YES//", enter YES unless your system does this in a TaskMan process. D. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//", enter NO. E. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//", enter NO. F. When prompted "Device: HOME//", respond with the correct device but do not queue this install. VIX. INSTALL FORUM PATCH PRCA*4.5*312 -------------------------------- This is the step to start the installation of this KIDS patch. This will need to be run for the PRCA*4.5*312. From the Installation menu, you may select to use the following options (when prompted for the INSTALL NAME, enter PRCA*4.5*312): A. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. [Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only]. B. From the Kernel Installation and Distribution System (KIDS) menu, select the Installation menu. C. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter PRCA*4.5*312) 1. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. 2. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, templates, etc.). 3. Verify Checksums in Transport Global - this option will allow you to ensure the integrity of the routines that are in the transport global. 4. Print Transport Global - this option will allow you to view the components of the KIDS build. D. Use the Install Package(s) option and select the package PRCA*4.5*312 E. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. F. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond NO. Post-Installation Instructions ------------------------------ N/A Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 12 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20P563 Before: n/a After: B16845710 **563** Routine Name: IBARX Before: B51922608 After: B52093772 **101,150,156,168,186,237,308,563** Routine Name: IBARX1 Before: B21141555 After: B24612250 **34,101,150,158,156,234,247,563** Routine Name: IBARXMB Before: B19779235 After: B22706384 **156,563** Routine Name: IBARXMC Before: B43974651 After: B44624308 **156,186,237,552,563** Routine Name: IBARXMN Before: B37752322 After: B34322540 **150,158,156,186,308,563** Routine Name: IBARXMQ Before: B14602656 After: B16386930 **150,156,186,199,563** Routine Name: IBAUTL Before: B18551480 After: B24050910 **93,156,347,429,563** Routine Name: IBEBR Before: B23037770 After: B25886623 **34,52,429,524,563** Routine Name: IBEBRH Before: B3352675 After: B3470311 **563** Routine Name: IBECEA0 Before: B11657908 After: B11992930 **167,563** Routine Name: IBECEA2 Before: B18691868 After: B19420959 **57,52,150,176,183,240,563** Routine Name: IBECEA21 Before: B29059334 After: B31240213 **7,57,167,183,202,312,563** Routine Name: IBECEA22 Before: B7518581 After: B7958331 **150,183,563** Routine Name: IBECEA3 Before: B65921657 After: B70707203 **7,57,52,132,150,153,166,156, 167,176,198,188,183,202,240, 312,402,454,563** Routine Name: IBECEAU2 Before: B20399416 After: B28548148 **7,52,153,176,545,563** Routine Name: IBECEAU3 Before: B6694889 After: B7348522 **132,150,167,183,341,563** Routine Name: IBECEAU4 Before: B16312791 After: B16986387 **52,167,183,341,563** Routine Name: IBRXUTL1 Before: B4282694 After: B5197297 **347,563** Routine list of preceding patches: 199, 247, 308, 341, 454, 524, 545, 552 ============================================================================= User Information: Entered By : Date Entered : MAR 08, 2016 Completed By: Date Completed: DEC 15, 2016 Released By : Date Released : DEC 15, 2016 ============================================================================= Packman Mail Message: ===================== No routines included