============================================================================= Run Date: DEC 28, 2005 Designation: IB*2*331 Package : IB - INTEGRATED BILLING Priority: EMERGENCY Version : 2 SEQ #294 Status: Released Compliance Date: DEC 31, 2005 ============================================================================= Subject: 2006 RX COPAY THRESHOLDS Category: - Routine Description: ============ NOTE: The Health Eligibility Center (HEC) will install Patch IVMB*2.0*867 before January 1, 2006. Per VHA DIRECTIVE 2005-064 - This patch MUST be installed before January 1, 2006. The patch is being released as an emergency patch (together wih DG*5.3*686 and EAS*1.0*69) 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 2006. 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 Directive 2005-064. 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 (CY) 2006 (with an effective date of 12/1/05) are defined in VHA Directive 2005-064, dated December 22, 2005 as: * $ 10,579 for a single veteran without dependents * $ 13,855 for a veteran with 1 dependent * An additional $ 1,806 for each additional dependent beyond 1 dependent And the Medicare deductible rate effective 01/01/2006 is shown as: * The Medicare deductible: $ 952. This patch, IB*2.0*331 is one of three VistA 2006 threshold patches. It addresses the annual updates for the Pharmacy Copay Thresholds. Patch DG*5.3*686 will update the thresholds for the Means Tests and the Maximum Annual Pension Rate. Patch EAS*1.0*69 will address the annual updates for the GMT Thresholds. 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 = 3060101 (internal form for January 01, 2006) .03 IB TRANSACTION TYPE = pointer to "MEDICARE DEDUCTIBLE" in file #350.1 .04 UNIT CHARGE, FIXED = 952 ========== File #354.3 -- BILLING THRESHOLDS is updated with a new record. The values are as follows: .01 DATE = 3051201 (internal form for 12/01/2005) .02 TYPE = 1 (for BASIC PENSION) .03 BASE RATE FOR VETERAN = 10579 .04 BASE RATE WITH 1 DEPENDENT = 13855 .05 BASE RATE WITH 2 DEPENDENTS = 15661 .06 BASE RATE WITH 3 DEPENDENTS = 17467 .07 BASE RATE WITH 4 DEPENDENTS = 19273 .08 BASE RATE WITH 5 DEPENDENTS = 21079 .09 BASE RATE WITH 6 DEPENDENTS = 22885 .1 BASE RATE WITH 7 DEPENDENTS = 24691 .11 BASE RATE WITH 8 DEPENDENTS = 26497 .12 ADDITIONAL DEPENDENT AMOUNT = 1806 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_P686.KID Builds: DG*5.3*686 EAS*1.0*69 IB*2.0*331 Sites may retrieve the software directly using 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_P686.KID Host File containing KIDS software distribution Note: Use ASCII mode when transferring the .KID file. This patch addresses the following New Service Request (NSR): ------------------------------------------------------------- There is no NSR associated with this patch. This patch addresses the following NOIS/Remedy ticket(s): --------------------------------------------------------- There are no NOIS/Remedy tickets associated with this patch. TEST SITES: =========== Bronx VAMC Puget Sound HCS West LA VAMC ================INSTALLATION INSTRUCTIONS ================= The components sent with this patch IB*2.0*331 have been included in the HOST File DG_53_P686.KID. Please follow the instructions listed in the INSTALLATION INSTRUCTIONS section of the patch description for patch DG*5.3*686. NOTE: during the installation, please bear in mind items 2 and 3 below. 1. COMPONENTS SENT WITH PATCH -------------------------- The following is a list of the routine(s) included in this patch. The second line of each of these routine(s) will look like: ;;2.0;INTEGRATED BILLING;**[PATCH LIST]**;21-MAR-94 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== =========== IB20E331 N/A 1642749 331 IB20P331 N/A 13928890 331 Total number of new routines - 2 2. 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. 3. Routines IB20E331 and IB20P331 may be deleted after successful installation of this patch. Routine Information: ==================== Routine Name: IB20E331 Routine Name: IB20P331 ============================================================================= User Information: Entered By : HUA,PATRICK Date Entered : NOV 03, 2005 Completed By: MULLER,RICHARD Date Completed: DEC 28, 2005 Released By : GANUS,MAUNETTE Date Released : DEC 28, 2005 ============================================================================= Packman Mail Message: ===================== No routines included