




TENNCARE AWARDS FULL-FINANCIAL RISK MANAGED CARE
CONTRACTS IN EAST AND WEST REGIONS
MEDICAL AND BEHAVIORAL HEALTH INTEGRATION COMPLETE STATEWIDE
NASHVILLE, Tenn.— The TennCare Bureau announced today that BlueCross BlueShield of Tennessee (BCBST) and UnitedHealth Plan of River Valley, Inc. (United) are the prevailing bidders in both the East and West grand regions of the state for TennCare’s managed care organization (MCO) contracts. TennCare placed the managed care contracts up for competitive bid in January 2008. The Middle region’s competitive bid process was completed last year. ...click here for the press release in full
Sports Physical Rule Change
Beginning with the 2008-2009 school year, full EPSDT/well-child checkups (WCC) will be required for all athletes in 7th and 9th grades. For athletes in 7th and 9th grades, a specific clearance form must be used.
The new clearance form has a check box for documenting completion of the EPSDT/WCC. Forms can be filled starting May 1, 2008.
No specific form is required for the actual EPSDT/WCC but TNAAP has developed a Preparticipation Physical Evaluation/History form and modified the existing 11 to14 year and 15 to 20 year EPSDT/Well child forms to accommodate all the components of the requirements of the EPSDT and Sports Physical.
Children’s Hospital
The Safety Store, which will be the only one of its kind in the South, will offer affordable safety products and education for parents. The store will sell items such as car seats, bicycle helmets, and baby-proofing products like outlet covers and oven guards.
Another component of the Safety Stores is called “Safe Escape.” This will offer families of children with disabilities and special health care needs education, information and equipment to prepare for safe escape during emergencies. Devices such as mats to evacuate wheelchair-bound children and vibrating smoke detectors will be available for hearing impaired children.
“The Safe Escape program is of particular interest to us in light of recent weather-related events,” said Mary Kate Mouser, director of Children’s Health Improvement and Prevention at Children’s Hospital. “Tornadoes have touched down in Middle Tennessee recently and families with special needs children are especially vulnerable in these kinds of emergency situations.”
The store will open in the hospital’s
“The Safety Store is a logical enhancement to education offered at the Children’s Hospital,” Mouser said. “We have been selling child passenger safety seats in our Friends Gift Shop for years and have been looking for a way to expand our product line to other safety items.”
The Safety Store will collaborate with community and hospital entities including: the Metro Nashville Fire Department, the Davidson County Sheriff’s Department, Committee on Pediatric Emergency Care, First Steps of Nashville, and the Children’s Hospital departments of Trauma and Pediatric Emergency Medicine.
This grant was made possible by a $1 million grant awarded to NACHRI by the U.S. Department of Homeland Security under the Federal Emergency Management Agency’s (FEMA) Assistance to Firefighters Grant program.
PEDIATRICIAN$ – EHR GRANT MONIE$
The State of Tennessee is making grant funds available to primary care and pediatric offices state wide to purchase Electronic Health Records (EHR). The Cumberland Pediatric IPA in Nashville was one of several non-profit organizations selected to help in the marketing and management of funds identified for this effort. The IPA can work directly with your practice to determine eligibility and priority to obtain up to $3,500 per physician and up to $6,000 per office site to purchase an EHR system and establish connectivity with the State’s broadband secure network that will enable physicians to prescribe online, send secure messaging among health care providers, share images such as X-rays, MRIs and CT scans and access patient information via portable health records when the system is fully mature. Already, over 160 pediatricians have signed up via the IPA; call 615-936-6052 to learn about the details.
January 2, 2008 - TennCare will require the use of a National Provider Identifier (NPI) number on all claims submitted to TennCare's Managed Care Organizations. MCO claims submitted without an NPI will be denied and must be resubmitted with an NPI before an MCO can pay the claim. Policy Statement.
New Recommendations for Pediatric Health
The AAP and Bright Futures have released the "2008 Recommendations for Pediatric Health," also known as the Periodicity Schedule, outlining the guidelines and priorities - including measurements, screenings, tests, immunizations, developmental/behavioral assessments, oral health and preventative care - at each of the 31 age-based health supervision visits from birth to age 21. The recommendations help ensure continuity of care for all children throughout the U.S. Bright Futures is a project of the AAP funded by the Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB). More information on Bright Futures is available at http://brightfutures.aap.org/web/
1. Temporary deferral of the routine Hib vaccine booster dose administered at 12-15 months of age except for children who are at increased risk for invasive Hib disease.
2. Children at increased risk for invasive Hib disease should continue to receive the recommended booster dose of Hib vaccine at 12-15 months of age. immunocompromising
3. The primary series for all children should be completed on schedule with 2 doses of a PRP-OMP containing Hib conjugate vaccine (PedvaxHIB or Comvax) given at 2 and 4 months of age or 3 doses of a PRP-T containing conjugate vaccine (ActHIB) given at 2, 4 and 6 months of age.
Hib Vaccine Recall - UPDATE!
December 20, 2007 - The recent suspension of production by Merck of PedvaxHIB® and Comvax® and the voluntary recall of certain lots of both vaccines on December 13th have led to a significant disruption in the supply of Haemophilus influenzae type b (Hib) containing vaccines. AAP has been working with the CDC and other stakeholders to develop an interim strategy to best meet the needs of children during the shortage. A CDC Dispatch published provides additional details on the expected shortage and interim recommendations. In brief, recommendations include:
For more information, go to the Centers for Disease Control and Prevention Q and A .
Information for schools, students, and parents on Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA)
In the past, most lethal staph infections occurred in people who were hospitalized or had a chronic illness or weakened immune system. Now, a growing number of otherwise healthy people, many of whom have never been in a hospital, also are developing life-threatening staph infections. Useful information on staph, including how it is spread, treated, and prevented.
Online CME Course on this Topic
SAN FRANCISCO – Two new clinical reports from the AAP will help pediatricians recognize autism spectrum disorders (ASDs) earlier and guide families to effective interventions. Language delays usually prompt parents to raise concerns to their child’s pediatrician – usually around 18 months of age. However, there are earlier subtle signs that if detected could lead to earlier diagnosis. View the details of the reports.
U.S. Schools Making Progress in Decreasing Availability of Junk Food and Promoting Physical Activity The nation's schools have made considerable improvements in their policies and programs to promote the health and safety of students, particularly in the areas of nutrition, physical activity and tobacco use, says a study by the Centers for Disease Control and Prevention (CDC). Read more about this study.
Ask Janet - TNAAP Coding EducatorQuestions about the TNAAP website? cathyjolley@bellsouth.net