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Click to edit Master title style ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/master05.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Making Medicare Pay
Austin    April 5, 2006
Making Medicare Pay
1
Making Medicare Pay
How to Bring Appeals Under Medicare Part B
Paula McCann, Esq.,
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Austin    April 5, 2006
Making Medicare Pay
2
Presenter
lPaula McCann, Esq= . Of Counsel, Kenlan, Schwiebert & Facey, Rutland, VT 05702 (802) 773-3300
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lEmail: pmccann@kenlanlaw.com
l
lFormer Director, Medicare Advocacy Project
l Vermont Legal Aid, Inc.
l
l
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Austin    April 5, 2006
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3
Vermont’s
Medicare Advocacy Project
<= span class=3DBB style=3D'position:absolute;left:-4.32%;top:.3em'>lVLA Jo= int Venture with Vermont Medicaid
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lStarte= d in 1987 with state legislation
lContrac= t to Recover Medicare Payments for dual eligibles lVT has= 40,000 duals, about 40% of Medicare beneficiaries in VT have Medicaid= 3;
<= span class=3DBB style=3D'position:absolute;left:-4.24%;top:.3em'>lMAP Re= covers $1 million or more per year
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Austin    April 5, 2006
Making Medicare Pay
4
Medicare Basics
lPart A:  Hospital, Home Health, Skilled Nursing Facility, Hospice, Blood while Inpatient lPart B: Dr. Visit= s; Outpatient Labs/Tests; Therapies (OT, PT, Speech), DME, Blo= od as Outpatient, some Home Health lPart D:  Drug coverage through private plans with financial limitations.
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Austin    April 5, 2006
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Preventive Medicare Services
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lCancer Screenings
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lBone M= ass Screenings
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lDiabet= es Screening
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lFlu and Pneumonia Vaccines
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lHepati= tis B Vaccine
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lMammog= rams and Pap Smears
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>l1 Time Physical
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Austin    April 5, 2006
Making Medicare Pay
6
Appeals Process
lThe Law
–Sections 1869 and 1879 Social Security Act
–Section = 521 of the Medicare, Medicaid, and SCHIP Benefits Act of 2000 (BIPA)
–Title IX of the Medicare Prescription Drug, Improv= ement, and Modernization Act of 2003 (MMA).
–42 C.F.= R. Part 401 and 405, published as Interim Final Rule = on March 8, 2005; FR 3/8/2005 Vol. 70, Number 44, = pages 11419-11499.
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Austin    April 5, 2006
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7
6 Levels of Appeals
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lInitial Determinations/Reopenings
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lRedete= rmination
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lRecons= ideration (QIC)
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lAdmini= strative Law Judge Hearing
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lAppeals Council Review
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lFedera= l Court Review – very limited
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Austin    April 5, 2006
Making Medicare Pay
8
Initial Claims Review & Appeal<= /div>
lMedicare Contractors
–Take in and adjudicate initial claims
–Provider or Beneficiary Can Request Reopening
lIf technical error on claims forms, supplemental = documents  42 C.F.R. 405.920 et seq. <= /div>
–Take in redeterminations or 2nd level Appeals
lMedical reviewers
lMainly policy argument
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Austin    April 5, 2006
Making Medicare Pay
9
Who Are Your Medicare
DME Contractors?<= /span>
lNational Heritage Insurance Company/EDS =
–Regio= n A DMERC
lAdminiStar Federal Inc.
– Region B DMERC
lPalmetto GBA LLC
–Regio= n C DMERC
lNoridian Administrative Services
–Regio= n D DMERC
–
–
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Austin    April 5, 2006
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Map of DMERCs
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SgAh1ahjmRYEIAABCEAAAukJIKTSM2YECEAAAhCAAAQaJYCQatSxTAsCEIAABCAAgfQEEFLpGTMC BCAAAQhAAAKNEkBINepYpgUBCEAAAhCAQHoCCKn0jBkBAhCAAAQgAIFGCSCkGnUs04IABCAAAQhA ID0BhFR6xowAAQhAAAIQgECjBBBSjTqWaUEAAhCAAAQgkJ4AQio9Y0aAAAQgAAEIQKBRAv8/wZZY EumWeL8AAAAASUVORK5CYIJ= ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/slide0028.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Making Medicare Pay
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Initial Determinations
lPatient Demand Bill
–If DME Supplier Says Medicare Won’t Pay
lMedicare policy does not specifically cover <= /div>
lWheelchair within 5 years
lUltralight K5 Chair
–Case Example
lMedicaid Paid Already
–Up to 4 years to file
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Initial Determinations
lSupporting Documentation
–Letter from PT on Necessity
–Letter from MD on Necessity
–Repair bills showing breakdown of chair
–Statement from Caregiver on skin breakdown
lMUST HAVE MSN
–Problems with Access – case example
l
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Redetermination
lRight to Redetermination  42 C.F.R. 405.940
–120 d= ays from initial determination
–5 day mail rule for clock running
–Good cause for late filing
–File = with contractor in writing
–Evide= nce submitted
–Contr= actor has 60 days to complete
–Can be dismissed if not proper party 42 C.F.R. 405.906(b)
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Redetermination cont.
lForms Not Necessary
–CMS Form not necessary
–Use Letter Brief Format
–
lMedical Chart information helpful
l
lStatement(s) from client, health care provider
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Reconsideration
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lNew St= ep for Part B – 1/1/2006
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lQIC Contractor:  ON MSN
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lLaw: 4= 2 C.F.R. 405.960 et seq.
l180 Da= y Filing Deadline from receipt of Redetermination
<= span class=3DBB style=3D'position:absolute;left:-4.46%;top:.3em'>lCMS Fo= rm or Written Letter w/same info
<= span class=3DBB style=3D'position:absolute;left:-4.77%;top:.3em'>lQIC ha= s 60 Days to Issue Decision
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Reconsideration cont.
lCan Submit Evidence
–Medical Charts
–Statements
–Providers Must Submit All Evidence, Barred from New Evidence at ALJ =
–Beneficiaries Not Barred on Evidence
–Recommend submitting all relevant evidence
l
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Reconsideration
lNo Opportunity for Hearing
–QIC is Paper Review by Medical Personnel
lLaw Not Interpreted – Pure Policy
–QIC Contractors Base Determinations on CMS Policy, not statutory/regulatory law
lHighly Subjective
–Medic= al personnel
–Have right to discovery at ALJ – find out who at QIC made determination
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MAP Experience with QIC
lCases filed since November 2005 – only 3 wins at this level (two blind, one di= ed from conditions) l“Review” appears to ignore factual evidence = such as affidavits from beneficiaries, law lReviewers move the target – cite brand new reason for denial than that used at = all levels below
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Administrative Law Judge
l = CMS Offices of Hearings and Appeals
l
lArlington, Virginia ( Mid-Atlantic Field Office and Headquarters)
lCleveland, Ohio (Mid-West Field Office)
lIrvine, California (Western Field Office)
lMiami, Florida (Southern Field Office)
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Administrative Law Judge
lRequest w/in 60 Days of QIC Decision
–5 day rule applies
lCMS Form Exists
–but Letter Brief Preferred
lHearings and Appeals Offices
–Can answer questions on rules/regulations
–Hearing or Decision on Brief
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Administrative Law Judge
lResearching ALJs
–Find out who the judge is – all new at this <= /div>
–Get support – MAP, CMA, Private Attorney
lThe Law
–42 C.F.R. 405.1004-1006 Right to Hearing
–Amount in Controversy $110
–Aggregating Claims to Meet $110
l
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Administrative Law Judge
lAppellate Argument
–Lower level review inconsistent with law
–Heavy on Facts/Medical Support
–Law vs. Policy
–Medicare to be broadly construed
lCase law minimal importance
lPersuasive not Binding Fed Ct. Decisions
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The MAC – Appeals Council
lThe Departmental Appeals Board Medicare Appeals Council (DAB MAC)
–See handout for reference
lMAC Appeals Rights
–42 C.F.R. 405.1100
–90 Days to Uphold, Reverse or Remand to ALJ <= /div>
–180 Days on Escalated Cases
–Can Request Oral Argument
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Federal District Court
lAmount in Controversy $1,100
lFile w/in 60 Days
lUS Attorney Office will fight
lDual Eligible Standing Issue
–NH Case Law – can be fought
l
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&& parent.IsFullScrMode() ) ) document.body.scroll=3D"no" _RSW() if( IsWin("PPTSld") && parent.IsFullScrMode() ) FullScrInit(); =09 MakeSldVis(); ChkAutoAdv() if( runAnimations ) { if( document.all("NSPlay") ) document.all("NSPlay").autoStart =3D false; if( sld.filters && sld.filters.revealtrans ) setTimeout( "document.body.start()", sld.filters.revealtrans.duration * = 1000 ); else document.body.start(); } } function MakeSldVis() { var fTrans=3Dg_showAnimation && SldHasTrans() if( fTrans ) { if( g_bgSound ) { idx=3Dg_bgSound.indexOf(","); pptSound.src=3Dg_bgSound.substr( 0, idx ); pptSound.loop=3D -(parseInt(g_bgSound.substr(idx+1))); } SlideObj.filters.revealtrans.Apply() } SlideObj.style.visibility=3D"visible" if( fTrans ) SlideObj.filters.revealtrans.Play() } function MakeNotesVis() { if( !IsNts() ) return false SlideObj.style.display=3D"none" nObj =3D document.all.item("NotesObj") parent.SetHasNts(0) if( nObj ) { nObj.style.display=3D"" parent.SetHasNts(1) } return 1 } function ChkAutoAdv() { if(SldHasTrans()) SlideObj.onfilterchange=3DAutoAdv else AutoAdv() } function AutoAdv() { if(!IsWin("PPTSld") || !gUseSldTimings )return var sld=3DGetCurSld() if( (sld.mAdvDelay>0) && !parent.IsFramesMode() ) setTimeout("parent.GoToNextSld()",sld.mAdvDelay) } function GetObj(id) { if(g_supportsPPTHTML) return document.all(id); else return document.getElementById(id); } function SldHasTrans() { return SlideObj.style.getAttribute("filter")!=3D""= } function GetSldId() { return sId=3Dlocation.href.substring(location.href.la= stIndexOf('/')+1) } function HideMenu() { if( frames["PPTSld"] && PPTSld.document.all.item("ctx= tmenu") && PPTSld.ctxtmenu.style.display!=3D"none" ) { PPTSld.ctxtmenu.styl= e.display=3D'none'; return true } return false } function IsWin( name ) { return window.name =3D=3D name } function IsNts() { return IsWin("PPTNts") } function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) } function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"= && navigator.appVersion.indexOf("Windows")>0 ) } function SupportsPPTHTML() { var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0 if( msie >=3D 0 ) ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) ) else ver=3DparseInt(appVer) return( ver >=3D 4 && msie >=3D 0 ) } function _RSW() { if( !g_supportsPPTHTML || IsNts() || ( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) ) return var padding=3D0; if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6 cltWidth=3Ddocument.body.clientWidth-padding cltHeight=3Ddocument.body.clientHeight-padding factor=3D(1.0*cltWidth)/g_origW if( cltHeight < g_origH*factor ) factor=3D(1.0*cltHeight)/g_origH newSize =3D g_origSz * factor if( newSize < 1 ) newSize=3D1 s=3DSlideObj.style s.fontSize=3DnewSize+"px" s.posWidth=3Dg_origW*factor s.posHeight=3Dg_origH*factor s.posLeft=3D(cltWidth-s.posWidth+padding)/2 s.posTop=3D(cltHeight-s.posHeight+padding)/2 if( g_scaleHyperlinks ) ScaleHyperlinks( factor ) } function _InitAnimations() { animRuntimeInstalled =3D ''+document.body.localTime !=3D 'undefined'; isFullScreen =3D (window.name =3D=3D "PPTSld") && !parent.IsFramesMode(); g_animUseRuntime =3D g_showAnimation && animRuntimeInstalled && !(isFullSc= reen && parent.IsSldVisited()); if( g_animUseRuntime ) { collSeq =3D document.all.tags("seq"); if( collSeq !=3D null ) { for(ii=3D0;ii numSlds ) gSldJumpIdx =3D numSlds; if ( gSldJumpIdx >=3D 0 ) { if ( gSldJumpIdx =3D=3D 0 ) gSldJumpIdx =3D 1; var jumpTo =3D parseInt(gSldJumpIdx); gSldJump =3D 0; gSldJumpIdx =3D ""; win.GoToSld( parent.GetSldList().mList[jumpTo-1].mSldHref ) } } } function _KDH() { if( event.keyCode =3D=3D 8 ) { event.returnValue =3D 0; parent.GoToPrevSld(); } } function DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && !parent.IsFramesMode() ) || (event && (event.keyCode=3D=3D32) ) ) parent.GoToNextSld(); } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"End of slide show, click to exit.", SCREEN_MODE=3D"Fram= es", gIsEndShow=3D0, NUM_VIS_SLDS=3D24, SCRIPT_HREF=3D"script.js", FULLSCR_= HREF=3D"fullscreen.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var gMainDoc=3Dnew Array(new hrefList("slide0001.htm",1,-1,1),new hrefList(= "slide0025.htm",1,-1,1),new hrefList("slide0026.htm",1,-1,1),new hrefList("= slide0002.htm",1,-1,1),new hrefList("slide0003.htm",1,-1,1),new hrefList("s= lide0004.htm",1,-1,1),new hrefList("slide0009.htm",1,-1,1),new hrefList("sl= ide0010.htm",1,-1,1),new hrefList("slide0011.htm",1,-1,1),new hrefList("sli= de0027.htm",1,-1,1),new hrefList("slide0028.htm",1,-1,1),new hrefList("slid= e0029.htm",1,-1,1),new hrefList("slide0012.htm",1,-1,1),new hrefList("slide= 0013.htm",1,-1,1),new hrefList("slide0014.htm",1,-1,1),new hrefList("slide0= 015.htm",1,-1,1),new hrefList("slide0016.htm",1,-1,1),new hrefList("slide00= 17.htm",1,-1,1),new hrefList("slide0018.htm",1,-1,1),new hrefList("slide001= 9.htm",1,-1,1),new hrefList("slide0020.htm",1,-1,1),new hrefList("slide0021= .htm",1,-1,1),new hrefList("slide0022.htm",1,-1,1),new hrefList("slide0023.= htm",1,-1,1)); function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) { var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix(); function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') { href=3Dnew String(document.location.href) Start=3Dhref.indexOf('!')+1 End=3Dhref.lastIndexOf('/')+1 if (End < Start) return href.substring(0, Start) else return href.substring(0, End) } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ToggleOtlPane() { frmset=3Ddocument.all("PPTHorizAdjust") frm=3Ddocument.all("PPTOtl") if( gOtlOpen ) frmset.cols=3D"*,100%" else frmset.cols=3D"25%,*" gOtlOpen=3D!gOtlOpen frm.noResize=3D!frm.noResize UpdOtNavPane() } function ToggleNtsPane() { frmset=3Ddocument.all("PPTVertAdjust") frm=3Ddocument.all("PPTNts") if( gNtsOpen ) frmset.rows=3D"100%,*" else frmset.rows=3D"*,20%" gNtsOpen=3D!gNtsOpen UpdNtsPane() } function ClearMedia() { if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() { if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else return gCurSld } function GetNumSlds() { if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; PPTSld.location.replace(MHTMLPrefix+obj.mSldHref) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 PPTSld.location.replace(MHTMLPrefix+href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document doc.open() doc.writeln('


' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); function ImgBtn( oId,bId,w,action ) { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } function TxtBtn( oId,oeId,action,chkState ) { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new TxtBtn( "nb_nts","nb_ntsElem",parent.ToggleNtsPan= e,GetNtsState ) gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","nb_prevBorder",30,parent.GoToP= revSld ) gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","nb_nextBorder",30,parent.GoToN= extSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D new ImgBtn( "nb_voice","nb_voiceBorder",18,parent.= ToggleVNarration ) gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlTxt","nb_otlTxtBorder",23,parent= .ToggleOtlText ) gBtnArr["nb_nts"].m_flagId=3D "notes_flag" gBtnArr["nb_nts"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { history.back(); PPTSld.event.ca= ncelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; s.fontFamily=3DsFont s.fontSize=3D"9pt" s.paddingLeft=3D2 } function CreateSeparator( node ) { var sObj=3DCreateItem( node ) SetCMBorder(sObj,"menu","menu") var s=3DsObj.style s.borderTopColor=3D"threedshadow" s.borderBottomColor=3D"threedhighlight" s.height=3D1 s.fontSize=3D"0px" } function CreateItem( node ) { var elem=3DPPTSld.document.createElement("DIV") node.insertBefore( elem ) return elem } function SetCMBorder( o,ltClr,rbClr ) { var s=3Do.style s.backgroundColor=3D"menu" s.borderStyle=3D"solid" s.borderWidth=3D1 s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr } ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/fullscreen.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; 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charset="windows-1252" Making Medicare Pay ------=_NextPart_01C66DFD.51ED7DB0 Content-Location: file:///C:/D8F395C5/MakingMedicarePay-AustinCLE_files/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252"
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