============================================================================= Run Date: DEC 27, 2018 Designation: IB*2*635 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #576 Status: Released Compliance Date: DEC 31, 2018 ============================================================================= Associated patches: (v)IB*2*611 <<= must be installed BEFORE `IB*2*635' Subject: 2019 RX COPAY THRESHOLDS Category: - Routine Description: ============ ************************************************************************** * Per VHA FACT SHEET titled MEANS TEST AND GEOGRAPHIC-BASED MEANS TEST * * AND MAXIMUM ANNUAL RATES OF PENSION FOR CALENDAR YEAR 2019, this * * patch MUST be installed AS SOON AS POSSIBLE. The patch is being * * released as a combined build together with DG*5.3*973 (2019 Means * * Test Thresholds) and EAS*1.0*170 (2019 GMT Thresholds) and may be * * installed out of sequence with respect to other released IB patches. * ************************************************************************** This patch, IB*2.0*635, is one of three VistA 2019 threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*973 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*170 will address the annual updates for the GMT Thresholds. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- N/A Forms Associated: Form Name File Number 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 Remote Procedures Associated: Remote Procedure Name New/Modified/Deleted --------------------- -------------------- N/A Parameter Definitions Associated: Parameter Name New/Modified/Deleted -------------- -------------------- N/A Additional Information: ----------------------- New Service Requests (NSRs): N/A Patient Safety Issues (PSIs): N/A Defect Tracking System Ticket(s) & Overview: ============================================ 1. INC2776938 - 2019 RX COPAY THRESHOLDS Problem: -------- Each 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 2019. Resolution: ----------- Post Install routine IB20P635, 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 2019. 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 2019 (with an effective date of 12/1/18) are defined in VHA FACT SHEET titled MEANS TEST AND GEOGRAPHIC- BASED MEANS TEST AND MAXIMUM ANNUAL RATES OF PENSION FOR CALENDAR YEAR 2019 as: * $ 13,535 for a single veteran without dependents * $ 17,724 for a veteran with 1 dependent * An additional $ 2,313 for each additional dependent beyond 1 dependent Medicare deductible rate effective 01/01/2019 is shown as: * The Medicare deductible: $ 1,364. 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 = 3190101 (internal form for January 01, 2019) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 1364 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 3181201 (internal form for 12/01/2018) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 13535 .04 BASE RATE WITH 1 DEPENDENT = 17724 .05 BASE RATE WITH 2 DEPENDENTS = 20037 .06 BASE RATE WITH 3 DEPENDENTS = 22350 .07 BASE RATE WITH 4 DEPENDENTS = 24663 .08 BASE RATE WITH 5 DEPENDENTS = 26976 .09 BASE RATE WITH 6 DEPENDENTS = 29289 .1 BASE RATE WITH 7 DEPENDENTS = 31602 .11 BASE RATE WITH 8 DEPENDENTS = 33915 .12 ADDITIONAL DEPENDENT AMOUNT = 2313 Test Sites: ----------- Manchester VAMC West Palm Beach VAMC Software and Documentation Retrieval Instructions: -------------------------------------------------- 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_973.KID Builds: DG*5.3*973 EAS*1.0*170 IB*2.0*635 The preferred method is to retrieve the files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve the 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: Hines: domain.ext Salt Lake City: domain.ext Documentation Title File Name FTP Mode --------------------------------------------------------------------- N/A Host File Name FTP Mode --------------------------------------------------------------------- DG_53_973.KID Ascii Patch Installation: ------------------- Pre/Post Installation Overview: Pre-Installation Instructions: The IB20E635 pre-init routine will provide prompting during the patch install and may be deleted after install. The IB20P635 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*635 patch have been included in the HOST File DG_53_973.KID. Please follow the instructions listed in the INSTALLATION INSTRUCTIONS section of the patch description for patch DG*5.3*973. 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. Post-Installation Instructions: Please see patch DG*5.3*973 for Back-Out plan. Back-Out/Roll Back Plan: ------------------------ Please see patch DG*5.3*973 for Back-Out plan. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INTEGRATED BILLING;**[Patch List]**;21-MAR-94;Build 6 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IB20E635 Before: n/a After: B2474662 **635** Routine Name: IB20P635 Before: n/a After: B34594561 **635** ============================================================================= User Information: Entered By : Date Entered : OCT 17, 2018 Completed By: Date Completed: DEC 27, 2018 Released By : Date Released : DEC 27, 2018 ============================================================================= Packman Mail Message: ===================== No routines included