IRIS IRIS Proxy Children’s Hospitals Graduate Medical Education Payment Program Agenda I IRIS II IRIS Proxy Updates III IRIS Common Errors IV IRIS EDV3 Edit Prog

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IRIS IRIS Proxy Children’s Hospitals Graduate Medical Education Payment Program Agenda I IRIS II IRIS Proxy Updates III IRIS Common Errors IV IRIS EDV3 Edit Prog Powered By Docstoc
					IRIS & IRIS Proxy
    Children’s Hospitals
 Graduate Medical Education
     Payment Program
II. IRIS Proxy Updates
III. IRIS Common Errors
IV. IRIS EDV3 Edit Program
V. Q & A Session
        I. IRIS
Intern and Resident Information System
               IRIS Recap
 Who can use the IRIS?
  Full Filing Providers
 DOS based program (CMS)
 Does NOT compute the FTE count of
                   IRIS Files
 Master File (M3XXXXXX.dbf)
  Contains pertinent information about the
 Assignment File (A3XXXXXX.dbf)
   Contains the rotational assignment data for
   those interns/residents

Some text fields report Numbers. Microsoft Excel XP will
             try to identify this as an error.
            IRIS V3 Updates
 Residency Code Table in Alphabetic Sequence
 Operating Instructions
    New
      Part II, Section 7.4
      Part V
    Revised
      Part II, Section 7.2
      Part II, Section 7.3
      Part II, Section 7.5
    Refer to Table of Residency Codes (page 7-17).
        IRIS V3 Clarifications
Employer’s Name
   Add additional name to the Employer Name Table
   Add, Modify, or Delete
     <5> Reference Files/Data Management
     <2> IRIS Reference Data Management Menu
    IRIS V3 Clarifications
 Residency Years Completed
  Range for Total Number of Program
 Medical School Code
  “99998” – Foreign Dental School
  “99999” – Foreign Medical School
  Dental School Codes
    10000 & 20000 – Obsolete
    Use New Codes 80002-80109
       IRIS V3 Clarifications
• Assignment Time Periods
   Added Non-Hospital Reference
    42 CFR 413.78(e)
   Periods that Span July 1
    Enter as 2 periods on IRIS
       Fiscal Year : 10/01/04 – 09/30/05
       Rotation: 05/01/05 – 11/30/05
       Report Assignments:
          • 05/01/05 - 06/30/05
          • 07/01/05 - 09/30/05
IRIS V3 Updates – Effective Dates

 New Dental School Codes
  For cost reporting periods BEGINNING on or
   after July 1, 2006 AND
  Interns & Residents (I&Rs) in dental
   specialties with dental school Graduation
   Dates after April 30, 2006
 New Residency Type Codes
  Highlighted in YELLOW
         IRIS V3 Reminders
 Assignment File
   Percentages (GME/IME %, Part/Full time
    Use Whole Numbers
   Social Security Numbers
    Links the Assignment file to the Master file
   CMS Assistance
 Certification of IRIS Diskette

 Since the IRIS report is submitted with
  the MCR, the signature on the MCR is
  all that is needed (W/S S, Part I).
 All rotation schedules or additional
  certification is not necessary for IRIS
          IRIS Proxy Recap
 Who can use the IRIS Proxy?
  No/Low Utilization Providers who are not
   required by CMS to submit an IRIS with their
   Medicare Cost Report
 Excel program
 Computes the FTE resident count
 Available at no charge to hospitals
                     IRIS Proxy
 Calculates Total GME Unweighted and Weighted
  Resident FTE counts by:
   Each Intern/Resident Rotation
   Current Specialty
   Summary Totals
     Total Allopathic and Osteopathic Residents
     Total Allopathic and Osteopathic in Initial Residency Period
     Total Dental and Podiatric Residents
     Total Dental and Podiatric Residents in Initial Residency
 Option to create IRIS Master and Assignment
  data files
        IRIS Proxy – Summary Totals
Summary Totals
 Located in upper right corner of the worksheet

                                            Total FTEs   Total FTEs
SUMMARY TOTALS:                            Unweighted    Weighted
Total Allopathic & Osteopathic Residents        0.2179       0.1718
Total Dental & Podiatric Residents              0.4180       0.4180

       Summary Totals do NOT account for any duplicate
              assignment periods (overlaps).
IRIS Proxy – Summary Totals Report
Update: Summary Totals Report
   Totals Report identifies Unweighted and
    Weighted resident FTE summary by specialty.
   After viewing Totals Report, click “CHGME”
    tab at the bottom of the screen to return to
    original listing.
                               Update Totals Report

                Totals Report FTE Count =
    Allopathic/Osteopathic FTEs + Dental/Podiatric FTEs
           IRIS Proxy – Edits
 IRIS Proxy Edits
  The following input errors will result in the
   FTE being reduced to zero:
      Listed as a international/foreign medical school
       graduate but NO IMG/FMG Complete Date is
      A Graduation Date is NOT entered or date is
       NOT PRIOR to first rotational begin date
      Rotational Assignment Dates begin or end
       OUTSIDE of the fiscal year
     IRIS Proxy – Edit Check
 Edit Check
  Highly recommended that the IRIS data be
   validated by a separate IRIS/GME edit
    CMS IRIS FI Edit Program (IRISEDV3)
        Same software used by Full Filing hospitals and all FIs
    Third-Party Vendor GME Software

   Data that does not pass CHGME FI edits may be
         returned to the hospital for rework.
     IRIS/IRIS Proxy Updates
 New/Revised Program Codes
  Combined Programs
         IRIS Proxy Updates
 Medical School Codes
   Revised 6 of 8 Podiatry Schools
     Codes 30100 – 30600
   New Dental School Codes
     United States, Canada, Puerto Rico
     Codes 80002 – 80109
   Replaced Codes
     Codes 30010 – 30090 for Podiatry Schools
     Codes 10000 and 20000 for all Dental Schools
    Refer to Table of Medical Schools (page 7-10).
               IRIS Proxy Updates
Medical School Codes (continued)
      30010 – Barry University School of Podiatric Medicine (Miami
         Shores, FL)
            New Code - 30500
        30020 – William M. Scholl College (Chicago, IL)
            New Code – 30100
        30040 – College of Podiatric Medicine (Des Moines, IA)
            New Code - 30600
         30050 – New York College of Podiatric Medicine (New York, NY)
            New Code - 30200
         30080 – Ohio College of Podiatric Medicine (Cleveland, OH)
            New Code - 30300
         30090 – Temple University School of Podiatric Medicine
         (Philadelphia, PA)
            New Code - 30400
        IRIS Proxy Updates
 Current Version updated 2009
 Addition of New Programs and Medical
  School Codes
 Updated Formatting Errors
III. IRIS Common
             IRIS – Key Inputs
 Intern/Resident Name
  Do not use nicknames or abbreviations!
 Employer Name
  Institution currently paying the resident’s salary
 Residency Type Code
  Initial Specialty Program
     • Specialty initially chosen by resident during the first
       year of post graduate training program
 Medical School Graduation Date
  If the specific graduation date cannot be
   determined, but the graduation month is known,
   use the first day of the known month
    Assignment Time Periods
 Assignment Beginning and Ending Date
  Resident’s start and end dates for EACH
   rotational assignment during which the
   intern/resident was assigned to and worked at
   the hospital complex or any of its hospital
   based providers.
  Follow original source documentation
    Rotation schedules, calendars, etc.
     GME Time Percentages
 GME Percentage
  Percentage of time intern/resident worked in
   the hospital in comparison to the total time
   worked at all facilities (Resident’s Total GME must
    equal 100%) .
  If in a non-hospital setting must have a
   written agreement.
  Hospitals must coordinate GME data
   reported in IRIS
      IME % does NOT apply to Children’s hospitals.
    Enter the same % as the GME % or enter zero(0).
              Initial Specialty
 Initial Residency Period
  Prior to 10/01/04
      Determined as of the time the resident enters the
      “initial” or first residency training program
      Based on the period of board eligibility associated
      with the program in which a resident participates in
      the first year of training, without regard to specialty
      in which the resident ultimately seeks board
Initial Specialty - Simultaneous Match

  69 FR 49170 (August 11, 2004)
   FY 2005 DRG Rates for Hospital Inpatient PPS
  CMS’ definition..
   For purposes of direct GME, a national
    process by which applicants to approved
    medical residency programs are paired with
    programs on the basis of preferences
    expressed by both the applicants and the
    program directors
Initial Specialty – First Policy Change
 Effective for portions of cost reporting periods
  beginning on or after 10/01/04
 If hospital documents….
    Resident matched in an advanced specialty
     program that requires clinical base year prior to
     resident’s first training year
 Then….
    IRP is determined based upon period of board
     eligibility associated with second year specialty
Initial Specialty – Second Policy Change

 70 FR 47449 (August 12, 2005)
   Inpatient Hospital PPS for 2006
 To claim specialty program as IRP..
   Hospital must document that a resident
    matched PRIOR to beginning any
    residency training in an advanced
    residency training program beginning in the
    second residency year
            Initial Specialty –
        Supporting Documentation
 National Residency Matching Program (NRMP)
 San Francisco Matching Program
 Urology Matching Program
 American Osteopathic Association Residency
  Match Program
   Residency Years Completed
 Residency Year
  The total number of years the intern/resident
   has completed in ALL types of approved
   residency programs
  Based on the number of years completed as of
   FIRST DAY of reported rotational assignment
  This includes CLINICAL BASE year or
   transitional year for “Matched Residents”
                   Do NOT Use:
                Resident’s PGY Level or
        Only Years Complete in Current Specialty
The key is ……
Document, Document,
What is the IRISEDV3?
 A program used to run edit checks on the
  Intern and Resident Information System
  (IRIS) diskette
 Available at no charge to hospitals
 Provides all major edit checks that will be
  done by your CHGME FI

           IRISEDV3 - Setup
Setup of the IRISEDV3
   Obtain all necessary files:
   Program should be on computer’s hard drive
                    This is a MUST:
     Read the installation instructions (Readme.doc)
             BEFORE beginning installation!
         IRISEDV3 - Setup
 First Time Use
  The FIRST time the program is opened,
   complete “Data Management” from Main Menu
          IRISEDV3 - Setup
 First Time Use (cont.)
  Data Management
     Setup Administrative Data
     Rebuild Data Indexes
   Be sure to save (“S”) set-up and exit (“X”)

     During Step <2> Rebuilding Data Indexes –
          Screen may flicker. This is okay!
IRISEDV3 – Process Data
 <1> Capture IRIS Data Submitted
  Ensure diskette with IRIS files
   (M3XXXXXX.dbf and A3XXXXXX.dbf) is in
   the disk drive (usually “A”).
  Verify provider number is correct.
 <2> Import Captured Provider Data into
  Test Shells
  Automatically completed by program
IRISEDV3 – Process Data
 <3> Evaluate and Edit Imported Provider Data
  Provides on-screen EDITS during processing

                          Assignment End Date
                           is after FY End Date
IRISEDV3 – Process Data
 <4> Print Report of Evaluation and Edit
  It is optional to print reports

       Default = <2> Print All Records
       IRISEDV3 – Reports
 Report Sections
  Part I – New Records that Passed all IRIS
  Part II – Records that Failed One or More
   IRIS Edits
    e.g. Assignment date outside fiscal year
  Part III – Invalid Records
    e.g. Assignment record with invalid or blank
     fiscal year begin date
    Part III may also include any duplicate records
     in the Master File
    IRISEDV3 – Reminders

 IRISEDV3 cannot be used to change
  data. It is only capable of edit checks.
 IRISEDV3 does not check for zero
  values or blanks in the Full Time/ Part
  Time Percentage (%) and GME
  Percentages (%) fields of the IRIS
     IRISEDV3-                 Conclusion
 IRISEDV3 will greatly improve your chances of
  submitting a good IRIS/IRIS Proxy, but it will
  not guarantee complete success.
 The CHGME FI may determine that an
  IRIS/IRIS Proxy diskette is still incorrect even
  though it cleared IRISEDV3 edits.
   Example
     Full Time/Part Time Percentage (%) was entered
      as the portion of the year the intern/resident was
      at a hospital instead of the type of residency slot
      he/she filled.

Description: Proxy Agreement document sample