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The Oral Health Program of the District of Columbia, Department of Health would like to thank the following for their assistance in planning the Oral Health Leadership Summit. The time, creativity and hard work contributed by these individuals resulted in the success of the Summit.
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Equal in men & women in all socioeconomic groups An estimated 4.5 million Americans are affected 1.5 million have moderate to severe disease Approximately 35% to 45% of patients are not currently being treated by a dermatologist Up to 42% with psoriasis with psoriatic arthritis Average age of onset 28 years old Main finding: Metformin delivered as a gum has a pharmokinetic profile similar to that of tablets and may be an alternative method for taking the drug. Design: Metformin concentration in 10 healthy volunteers was measured sequentially for 12 h after taking a 850-mg metformin tablet; for 24 h after taking 2 units of metformin gum developed in Canada in a 214 mg unit formulation; and for 24 h after taking 429 mg of metformin as a fraction of a larger tablet. From: Institute of Endocrinology, Metabolism and Reproduction, Quito, Ecuador. Insurers are not required to offer individuals coverage under all the health insurance policies they sell in the non-group market. At a minimum, plans must offer the two most popular non-group plans, such as the policies with the largest premium volume. While insurers have to offer coverage to certain individuals in the non-group market, there is no limit on the premiums that can be charged [N.C.G.S. 58-68-60 et seq.]. Pre-Existing Conditions. Some people may have more limited coverage when they first apply for health insurance coverage. These are people who received medical advice, diagnosis, or treatment for a physical or mental condition within six months of enrolling in the health insurance plan called a "pre-existing condition" ; . Some persons with pre-existing conditions may be subject to a pre-existing condition exclusion period. In these instances, the insurer will provide health insurance--but need not cover the health condition that existed prior to coverage. For example, if a person had a heart attack within the six months prior to coverage, then the insurance can exclude coverage for any heart-related health condition for a "pre-existing exclusionary period." However, an insurer cannot impose a pre-existing exclusionary period if you were previously insured, had health insurance coverage for at least twelve months, and did not experience a gap in coverage for more than 63 days [N.C.G.S. 58-68-30]. The length of the exclusionary period depends on two factors: 1 ; when you enroll in your health insurance plan; and 2 ; if you previously had health insurance coverage and met part of the pre-existing condition exclusionary time period. Enrolling During an Open-Enrollment Period. The maximum pre-existing exclusionary period is 12 months if you enroll during your employer's open-enrollment period i.e., generally within 30-31 days of when you become eligible for enrollment ; . Note: an employer need not impose any pre-existing exclusionary time period. Often very large employers do not impose pre-existing condition exclusionary periods regardless of whether you sought care within the six month prior to enrolling in health insurance. Late Enrollment. People who do not enroll during the "open-enrollment" period can generally be subject to an 18-month exclusionary time period. However, certain enrollees are not considered "late enrollees." For example, newborns are not considered late enrollees if they enroll within 30 days after birth. Similarly, children who are adopted are not late enrollees if enrolled within 30 days after being placed for adoption. Individuals who lose other coverage for example, because their spouse or parent who was providing health insurance coverage loses that coverage ; are also not considered late enrollees. Creditable Prior Coverage. People who were previously covered with health insurance will get credit for any coverage as long as there was not a gap in coverage for more than 63 days ; . Thus, if a person had a pre-existing condition and was previously covered by a health plan for four months, he or she will be credited with four months' coverage in meeting their new 12-month or 18-month pre-existing condition exclusionary period. 209 Chapter 24 Consumer Protections.

Care fiscal intermediaries FIs ; see : cms.hhs.gov providers hopps cciedits on the CMS Web site. What You Need to Do Affected providers should begin immediately to prepare their systems with any necessary software, educate their staff and management about the 2006 CCI application to their claims, and watch for forthcoming information from CMS and their local contractor carrier or fiscal intermediary ; , after October 1, 2005, although the CCI concept should not be unfamiliar, just its application. Background Special Edition, SE0545, is published by the Centers for Medicare & Medicaid Services CMS ; as a "heads-up" to institutional therapy providers to make certain that they are aware of the changes in Medicare's payment processes that are to begin January 1, 2006. It is important to note that the CCI edits are applied to services billed by the same provider for the same beneficiary on the same date of service. Medicare's National Correct Coding Initiative NCCI ; is an edit system that was developed to promote national correct coding methodologies and eliminate improper coding. These edits are developed based on coding conventions defined in the American Medical Association's Current Procedural Terminology CPT ; manual, current standards of medical and surgical coding practice, input from specialty societies, and analysis of current coding practices.

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