============================================================================= Run Date: DEC 05, 2019 Designation: IVM*2*183 Package : IVM - INCOME VERIFICATION MATCH Priority: Mandatory Version : 2 SEQ #152 Status: Released Compliance Date: JAN 05, 2020 ============================================================================= Associated patches: (v)IVM*2*115 <<= must be installed BEFORE `IVM*2*183' (v)IVM*2*149 <<= must be installed BEFORE `IVM*2*183' Subject: MEANS TEST ACCEPTANCE RULE UPDATES FOR MOH AND VFA Category: - Routine - Enhancement (Mandatory) Description: ============ Patch IVM*2.0*183 is being released to support the enhancements for the Enterprise Health Benefits Determination (EHBD) program that focuses on updates for the Enrollment System Modernization (ESM) Phase 2 project. IVM*2.0*183 is being released with DG*5.3*972 in Host File DG_53_P972.KID. Patch IVM*2.0*183 is also being released in support of the Enrollment System (ES) 5.5 and 5.7 releases. Refer to Informational Patches EAS*1*173 and EAS*1*180 (Enrollment Application System) for additional detail regarding the ES releases. IMPORTANT ------------------------------------------------------------------------ The following patches are being released concurrently and should be installed in the following order: 1. Veterans Health Information System and Technology Architecture (VistA) Registration, Eligibility, & Enrollment (REE) Registration (DG) patch DG*5.3*972, released with Income Verification Match (IVM) patch IVM*2.0*183 in Host File DG_53_P972.KID, ensures Veterans awarded Medal of Honor are placed in Priority Group 1 and are exempt from copayments for health care and medications. 2. Patch IVM*2.0*183, released with DG*5.3*972 in Host File DG_53_P972.KID, modifies how VistA determines if an income test is the active current test per Veteran's Financial Assessment (VFA) rules and adds a condition that Medal of Honor recipients are not subject to income testing. 3. Patch EAS*1.0*174 ensures VistA users can exempt Veterans awarded Medal of Honor from Long Term Care (LTC) copayments and LTC income testing. 4. Integrated Billing (IB) patch IB*2.0*627 will need to be installed directly after EAS*1.0*174 as the full functionality of Medal of Honor will not be apparent until IB*2.0*627 is installed. ------------------------------------------------------------------------ When a site receives an income test update from the Health Eligibility Center (HEC) (Health Level 7 (HL7) ORU/ORF-Z10 message type), a number of checks are completed on the incoming data before allowing that information to update the site's database. One of the checks is to determine whether the test is a current income test. If an incoming test date is more than 365 days old, the system rejects and does not upload the test if the status is Means Test (MT) Copay Exempt (MT COPAY EXEMPT) or Geographic Means Test (GMT) Copay Required (GMT COPAY REQUIRED). IVM*2.0*183 modifies how VistA determines if an income test is the active current test per Veteran's Financial Assessment (VFA) rules. Subject to existing criteria, it will also consider the following as current income tests and upload the MT: The received income test has an MT Date greater than or equal to one year prior to the VFA Start Date (VFA Start Date = 1/1/2013), and the MT status is either MT COPAY EXEMPT or GMT COPAY REQUIRED. Note: Rules that determine whether the site has a more current income test and whether the test is active or inactive have not been modified, and may result in rejection of the income test. For example, if there is a 2017 income test on file at the site, and a 2015 income test is received from ES, the incoming test is not a current test, so it will be rejected and will not upload. VistA users can view the accepted MT in the View a Past Means Test [DG MEANS TEST VIEW TEST] option. Because the test has been accepted, the user will not see messages such as "MEANS TEST REQUIRED" in these scenarios. An MT will be accepted from the ES when an HL7 ORU/ORF-Z10 message is received at correlated sites using VFA rules to determine if the MT is a current active test. The following criteria are added to that determination: a. The MT Date is greater than or equal to one year prior to the VFA Start Date, the patient is subject to Means Testing, and the patient's MT status is MT COPAY EXEMPT. OR b. The MT Date is greater than or equal to one year prior to the VFA Start Date, the patient is subject to Means Testing, the patient's MT status is GMT COPAY REQUIRED, and the patient has agreed to pay the deductible(s). When ES sends an HL7 ORU/ORF-Z10 message containing the ZMT segment to VistA sites where the Veteran is known, the system will accept and process the income test when the above conditions exist. Previously rejected Z10 messages can also be resent and processed per the above criteria. Integration Control Registration (ICR) 7088 ($$OLDMTPF^DGMTU4(TESTDATE)) is added to determine if annual means test date is more than 1 year old. ICR 7088 NAME: DGMTU4 - Annual means test date determination CUSTODIAL PACKAGE: REGISTRATION SUBSCRIBING PACKAGE: INCOME VERIFICATION MATCH USAGE: Controlled Subscri ENTERED: JUL 11,2019 An MT received from ES in an HL7 ORU/ORF-Z10 message may not be appropriate for certain patients and may be rejected. Some examples of inappropriate MTs are those for Veterans who are deceased, or those not subject to income testing such as Purple Heart recipients and the catastrophically disabled. Patch IVM*2.0*183 adds a further condition: Medal of Honor recipients. In these cases, the MT is rejected and VistA returns the message "Means Test upload not appropriate for current patient". Note: Registration patch DG*5.3*972 used the existing structure of the HL7 VA-Specific Military History Segment (ZMH) in VistA to send three new Medal of Honor (MOH) data elements. These updates allow filing of MOH data when sent by ES. The ZMH tables in the IVM Technical Manual are updated to include MOH data elements (CURRENT MOH INDICATOR (#.541), MOH AWARD DATE (#.542), and MOH STATUS DATE (#.543) in the PATIENT file (#2)) in the existing fields. Patch Components: ----------------- Files & Fields Associated: File Name (Number) Field Name (Number) New/Modified/Deleted ------------------ ------------------- -------------------- 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 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: N/A Problem: -------- N/A Resolution: ----------- N/A Test Sites: ----------- Birmingham VA Medical Center, Birmingham, AL VA Eastern Colorado Health Care System (ECHCS), Aurora, CO James A. Haley Veterans' Hospital, Tampa, FL Software and Documentation Retrieval Instructions: ---------------------------------------------------- Documentation describing the new functionality and/or a Host File containing a build may be included in this release. 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 can also be found on the VA Software Documentation Library at: https://www.domain.ext/vdl/ Documentation Title File Name SFTP Mode -------------------------------------------------------------------------- DG_53_P972.KID Release Notes DG_5_3_P972_RN.PDF (binary) IVM Technical Manual IVM_2_TM.PDF (binary) Host File Name FTP Mode --------------------------------------------------------------------- DG_53_P972.KID (ASCII) Patch Installation: ------------------- Pre/Post Installation Overview: ------------------------------- See the IMPORTANT note in the Description section - full functionality of Medal of Honor will not be apparent until Host File DG_53_P972.KID (DG*5.3*972 and IVM*2.0*183), patch EAS*1.0*174, and patch IB*2.0*627 are all installed. Pre-Installation Instructions: ------------------------------ N/A Installation Instructions: -------------------------- Please see the Patch Description for patch DG*5.3*972 for installation instructions. Post-Installation Instructions: ------------------------------- N/A Back-Out/Roll Back Plan: ------------------------ Please see the Patch Description for patch DG*5.3*972 for the Back-out/Roll Back Plan. Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;INCOME VERIFICATION MATCH;**[Patch List]**;21-OCT-94;Build 30 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: IVMCM Before: B80339401 After: B86738445 **12,17,28,41,44,53,34,49,59, 55,63,77,74,123,115,183** Routine Name: IVMUFNC5 Before: B8601879 After: B18584748 **55,109,149,183** Routine list of preceding patches: 115, 149 ============================================================================= User Information: Entered By : Date Entered : MAY 08, 2019 Completed By: Date Completed: DEC 05, 2019 Released By : Date Released : DEC 05, 2019 ============================================================================= Packman Mail Message: ===================== No routines included