Ohio KePRO Motion September 2004

new Medicare drug demonstration
project that will save seniors with
cancer substantial money on life-
enhancing medicines is now accepting
enrollment applications. This drug
demonstration project will be open to
50,000 people, and total spending on
the covered drugs will be up to
$500 million.

To enroll in the demonstration project,
beneficiaries should complete an appli-
cation, get their physician to complete
the required form cer tifying their need
for the covered drug, and submit both
forms to CMS' demonstration contractor,
TrailBlazer Health Enterprises.

Healthy Aging® Month is an annual month-
long obser vance designed to focus national
attention on the positive aspects of growing
older. The following are behaviors to keep in
mind throughout the month to promote
positive physical and mental health and
quality of life in aging populations:

Physical Fitness: Choose an exercise
that you like and stick with it. Engage
in 30 minutes of aerobic exercise and
weight-bearing exercise ever y day.
Social Well-Being: Contribute time to
your community through local volunteer
groups, religious organizations, or civic
groups. Stay in close contact with
family and friends. Write, e-mail or call
someone daily.
Mental Wellness: Keep your mind
exercised, too, by reading, learning a
new skill, and researching something
that interests you. Develop a hobby.
Financial Fitness: Save at least 10
percent of your income and invest in
savings plans that compound interest.
Establish financial goals, stick to a
planned budget, and sign up for a
retirement plan. I

Under this initiative, Medicare will pay
for cer tain drugs and biologicals that
can be taken by the patient at home
and that replace drugs cur rently
covered under Medicare Par t B when
given in a doctor's of fice. In addition,
newer, more ef fective medications that
replace some cur rently covered oral
anti-cancer dr ugs will be covered.

Ohio KePRO, the Medicare Quality
Improvement Organization for Ohio, is
working with the Centers for Medicare
& Medicaid Ser vices (CMS) and other
organizations throughout the state to
increase awareness of this drug
demonstration project among Medicare
beneficiaries with cancer and healthcare
providers. Ohio KePRO recommends
that beneficiaries take advantage of the
substantial healthcare benefits and
costs savings associated with this drug
demonstration project.

To be eligible for the demonstration
project, a Medicare beneficiar y must be
enrolled in Medicare Par t A and Par t B,
Medicare must be their primar y payer,
and the beneficiar y may not have com-
prehensive drug coverage through other
sources (such as TriCare, Medicaid, or
an employer or union sponsored plan).
A beneficiar y must also have a signed
cer tificate from a doctor that he or she
requires one of the drugs covered

Par ticipants in the demonstration will
be able to get their drugs at a local
retail pharmacy or by home deliver y
through Caremark, Trailblazer's subcon-
tractor for administering the drug benefit.

The demonstration project will run
through Dec. 31, 2005, at which time
all beneficiaries will be able to enroll in
the new Medicare Par t D drug benefit.

An updated list of covered dr ugs, a
fact sheet on eligibility requirements,
frequently asked questions, a dr ug
demonstration project brochure, and
enrollment applications may be
downloaded from the CMS Web site at
http://www.cms.hhs.gov/researchers/d
emos/drugcoveragedemo.asp.
Customer ser vice representatives are
also available at 1-866-563-5386, TTY
Number: 1-866-536-5387 to answer
questions about the demonstration project
and assist beneficiaries in obtaining
and completing the application forms.

Applications will be accepted through
Sept. 30, at which time another selection
process will be held. As long as the
application is received by Sept. 30, all
applicants will have an equal chance to
get into the demonstration project. If
enrollment slots are still available,
applications will continue to be accepted
after that date. I

A Letter to the Editor

It's Time to Vaccinate

By Alice Stollenwerk Petrulis, MD, FACP
Medical Director

The Depar tment of Health and Human
Ser vices has declared a national Take A
Loved One to the Doctor Day for Tuesday,
September 21. As the medical director at
Ohio KePRO, Medicare's Quality Improvement
Organization in Ohio, I cannot stress enough
how impor tant it is for all people to see a
healthcare professional.

Take A Loved One to the Doctor Day is par t
of HHS' Closing the Health Gap campaign,
an initiative that addresses the health
disparities among minority groups. When
compared to Caucasian populations in
general, minority groups in the United
States endure lower life expectancies and
higher rates of diabetes and cer tain cancers.

Ohio KePRO has a vested interest in this
campaign. A workgroup of physicians in
Ohio is currently par tnered with Ohio KePRO
in a quality improvement project to reduce
diabetes in the underser ved African American
population through patient education
regarding proper lipid management.

Readers are strongly urged to make an
appointment for a parent, a sibling, a good
friend or even a neighbor, and then go with
them to the doctor. Those without a regular
physician or healthcare provider can locate
one through the "Closing The Health Gap"
link in the beneficiar y section of the Ohio
KePRO Web site at www.ohiokepro.com.

The health of our community is our respon-
sibility. Show someone you care and take a
loved one to the doctor on September 21. I

What is the flu?
Influenza, also known as the flu, is an infection
caused by viruses that can lead to serious
complications. Viruses are passed from person
to person in the air by coughing or sneezing.

Is influenza a serious problem for senior
citizens?
Influenza and pneumonia are the fifth leading
cause of death among older Americans. Adults
aged 65 and older account for the most
hospitalizations and deaths related to the flu.

How does the flu shot wor k?
A flu shot activates your immune system to
develop antibodies against flu viruses. With
these antibodies, your immune system has
a better chance of fighting the flu ger ms
that circulate in the population ever y winter.

I received the flu shot last fall do I really
need another one?
Flu shots must be given ever y year because
the flu virus changes from year to year.

Award-Winning
Medicare Moment

                                         Ohio KePRO, the
                                         Medicare Quality
                                         Improvement
                                         Organization in Ohio,
                                         announces that its
                                         Medicare Moment radio
program has received, in conjunction with
WMKV-FM 89.3 in Cincinnati, the 2004
Bronze National Mature Media Award in the
category of Total Consumer Education Program.

Medicare Moment airs each Thursday at
2 p.m. Eastern and engages a variety of guests
for information about healthcare issues and

Each year vaccine manufacturers develop
new vaccines to match strains of viruses
that the Center s for Disease Control and
Prevention has predicted will be circulating
during the next flu season.

My friends tell me that I can get the flu
from getting the flu shot. Is this tr ue?
It is impossible to get the flu from the flu
shot. You may experience a mild reaction,
but this is rare. It is also impossible to get
pneumonia from the pneumococcal vaccination,
an equally impor tant vaccination for senior
citizens to ward off serious lung infections.

What is the Medicare coverage for the flu
and pneumonia vaccinations?
There is no charge for flu or pneumococcal
vaccinations and the Part B deductible is waived.

Information provided cour tesy of Ohio
KePRO, the Medicare Quality Improvement
Organization for Ohio. I

Medicare rights for beneficiaries. The Mature
Media award recognizes the outstanding
educational value of the Medicare Moment
program overall and similar programs aired
on WMKV.

WMKV is the nation's first FM educational
public radio station to be licensed to a retire-
ment community. Operating on the campus
of Maple Knoll Village, one of the nation's
top-rated retirement communities, WMKV
features big band music and information
regarding activities and ser vices available
to older adults and can be heard worldwide
on the Internet via streaming audio at
www.wmkvfm.org. I

Executive Editor : Suzana C. Iveljic, MBA

Editor : Daniel B. Moss, BSBA

e-mail: dmoss@ohqio.sdps.org

T H E S E P T E M B E R E D I T I O N O F O H I O Ke P RO M O T I O N H A S A R R I V E D !
Your News Source for Health & Rights Information for Ohio's Medicare Beneficiaries

Rock Run Center, Suite 100
5700 Lombardo Center Drive
Seven Hills, OH 44131-2545
Tel: 216.447.9604
Fax: 216.447.7925

Presor ted
First-Class Mail
U.S. Postage Paid
Cleveland, OH
Permit No. 882

Return Ser vice Requested

Publication No. 4123-OH-009-9/2004. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the
Centers for Medicare & Medicaid Ser vices (CMS), an agency of the U.S. Depar tment of Health and Human Ser vices. The contents presented do not necessarily
reflect CMS policy. For more information, please call 1-800-MEDICARE (1-800-633-4227), or visit the CMS Web site at www.medicare.gov.