Medigram - August 21, 2008 | Wisconsin Medical Society

TOP STORY

Hearing in the Society’s lawsuit against the State scheduled for Monday

On Monday, August 25, 2008 at 1:15 p.m., the Honorable Michael Nowakowski will hold a hearing in Dane County Circuit Court Branch 13 to allow the parties to present oral arguments in the Society’s lawsuit challenging the State’s raid of the Injured Patients and Families Compensation Fund (Fund). The Society is asking the court to restore the $200 million that the State took from the Fund along with any lost investment earnings. The Society’s written arguments are in its Brief in Support of Motion for Summary Judgment as well as in other documents filed with the court. Copies of the Society’s briefs and other documents are accessible via the Society’s Web site.

The key issues in the case are legal in nature. Therefore, it is likely that Judge Nowakowski will resolve the case by deciding the legal issues, without a trial. It is unclear whether Judge Nowakowski will issue his decision on the hearing date or at some point after the hearing. Once Judge Nowakowski issues his decision, the party that does not prevail at the trial court level may file an appeal to the Court of Appeals. The Society anticipates that the case might ultimately be appealed to the Wisconsin Supreme Court. Therefore, a final resolution of the case may not occur for at least another year or two. Meanwhile, the Society will issue a Medigram Alert and will post information to www.wisconsinmedicalsociety.org to notify members when the judge issues his decision in this hearing.

NEWS BRIEFS

E/M coding and the EMR—How to adhere to the CMS documentation guidelines

Most medical practices assume the coding and compliance aspects of the documentation guidelines are inherent in the electronic medical record (EMR) product. However, that is not always the case. EMRs can be a wonderful tool, but may have limitations when it comes to meeting the E/M documentation requirements.

If you have ever wondered how to be certain you are following the E/M documentation guidelines EMR, join Jeannie Cagle of the Coker Group Monday, September 22 at the 9th Annual Midwest Coding and Practice Management Symposium, as she shares information on EMR standard templates, auditing criteria and much more. She will also share tips on how to adapt the charting system for your physician’s practice style ensuring that you are still adhering to the documentation guidelines.

This year’s Symposium has been approved for up to 15 CEUs by the AAPC and ACMCS. It is also approved for a maximum of 13.0 AMA PRA Category 1 Credits. Click here to view the agenda in detail.

Council on Health Care Ethics meeting Sept 5

The Council on Health Care Ethics will meet Friday, September 5 from 10 a.m. to 2 p.m. at the Wisconsin Medical Society. The Council will discuss Society policy ETH-004 Physicians Accepting Gifts from the Pharmaceutical Industry. In addition, the Council’s subcommittee on physician health and the Medical Examining Board will provide an update of the subcommittee’s activities. (Click here to view Resolution 6 – Support an Evaluation of the State Medical Examining Board Funding and Functioning.) Society members are welcome to join all or a portion of the meeting in-person or by conference call. To participate, please contact Merry Earll.

CMS seeks feedback on use of Social Security Numbers for Medicare beneficiary identifier

The Centers for Medicare & Medicaid Services (CMS) is evaluating the use of Social Security Numbers (SSN) for its business practices. Currently, the Medicare beneficiary identifier generally contains an individual’s SSN or the SSN of the primary wage earner (spouse, parent, etc.). CMS is considering removing the display of the SSN when used as the Medicare beneficiary identifier (sometimes referred to as the Health Insurance Claim Number [HICN]) in Medicare fee-for-service (FFS). For each option listed below, CMS is looking for costs Medicare providers may incur and the impact these options would have on provider practices.

The first approach would assign a unique non-SSN based identifier for all new beneficiaries and replace the SSN based identifiers currently assigned to existing beneficiaries with a non-SSN based identifier over time. Medicare health insurance cards would be issued or reissued (in the case of existing beneficiaries) to beneficiaries and contain the non-SSN based identifier. Anyone interacting with Medicare would need to begin using the non-SSN based identifier associated with the beneficiary and replace the use of existing SSN based identifiers as Medicare reissues existing beneficiary identifiers.
With the second approach, CMS would continue to use the SSN based Medicare beneficiary identifier. However, the SSN would no longer be displayed on Medicare health insurance cards. Instead, there would be a PIN/number displayed on the cards and other Medicare correspondence. Anyone interacting with Medicare would obtain this number from the beneficiary. Providers will then use a CMS lookup tool for obtaining the SSN based Medicare beneficiary identifier using the PIN/number. Once providers obtain the SSN based Medicare beneficiary identifier, they can use it on appropriate Medicare transactions such as submitting Medicare claims.

Please submit your feedback to CMS by Monday, August 25 by e-mailing MFG@cms.hhs.gov.

QUALITY & EFFICIENCY

Society, WCHQ to host symposium Sept. 16

The Wisconsin Medical Society (Society) is partnering with the Wisconsin Collaborative for Healthcare Quality (WCHQ) to hold a symposium on efficiency and effectiveness of care Tuesday, September 16: “Methods, Measures and Policy Impact.” The symposium will be held at Monona Terrace Convention Center in Madison in conjunction with the Society’s regularly scheduled Quality Forum. The agenda is as follows:

7:30 a.m.	Symposium – Efficiency and effectiveness of care: Methods, Measures and Policy Impact
Noon	Lunch
12:30–2 p.m.	Quality Forum

WHIO’s impending health care Data Mart presents numerous challenges and questions for physicians and other health care professionals including the credibility, validity and actionability of the WHIO data in regard to efficiency and effectiveness measurement. Featured speakers are industry experts, Elizabeth McGlynn, PhD, and Mark Rattray, MD, whose research and experiences promise to offer symposium participants the opportunity to gain new understanding and have a dialogue on critical issues that may influence the direction of Wisconsin’s effort through WHIO.

The Quality Forum will feature Rich Brown, MD, a family medicine physician with the UW Health Medical Foundation, who will discuss SBIRT services. SBIRT (Screening, Brief Intervention, Referral, and Treatment) services is a proactive approach to identify and treat patients at risk for drug and alcohol problems. The Forum will also include a presentation on the updated continuing medical education criteria, which will further promote physician efforts in quality improvement. Read more about the symposium in this previous Medigram article.

If you are interested in the attending the symposium, click here. To learn more about the Society’s involvement in WHIO, click here to access a series of articles featured in recent Medigrams.

CAPITOL INSIDER

Medical Examining Board August meeting: A wrap-up

At its August 20 meeting, the Wisconsin Medical Examining Board:

Approved a policy statement endorsing the practice of Expedited Partner Therapy, a Centers for Disease Control-endorsed action where a physician provides two prescriptions to a single patient: one for personal use and the other to be filled by a sexual partner who likely suffers from chlamydia or gonorrhea but is not examined by the physician. The policy statement, which will be published on the MEB’s Web site, is the result of effort by Rep. Sheldon Wasserman, MD (D-Milwaukee), who recently appeared before the Board to ask for action on EPT, citing physicians’ fears of discipline should prescriptions be written in such a way.

While the policy statement does not hold the force of state statute or an administrative rule, it does give an indication of how the Board would handle any complaints in this area.

Continued efforts to streamline the application process for new physicians. Responding to complaints from the Society, the Wisconsin Hospital Association and the Wisconsin Medical Group Management Association (WMGMA), the Department of Regulation and Licensing (which administrates the MEB) has begun examining methods for improving what has historically been less-than-stellar customer service for physicians in this area.

The MEB approved a new single form related to hospital, facility and employer verification that replaces the current multiple-form requirement to get the same information. The MEB is also considering alterations to current forms aimed at capturing medical malpractice histories.

The Society will continue efforts to work with the Department while expecting progress toward improving the licensing process.

Agreed to stay in communication with the Society’s Council on Ethics to examine how legislation could improve how the MEB functions, including exploring if the MEB could operate independently of the state. A subcommittee of the Ethics Council is also examining the need for a statewide impaired physician program.

For more information on these specific issues or the MEB in general, contact Mark Grapentine.

FOUNDATION FOCUS

A closer look at 2 of the 10 fellowships awarded this summer

The Foundation’s Board of Trustees took bold action earlier this year, deciding to offer 10 Summer Fellowships in Government and Community Service to medical students in 2008—a tenfold increase over previous years!

“The fellowship program meets both vital parts of the Foundation’s mission of supporting medical education and health education. It offers students valuable service oriented, community-focused learning experiences throughout Wisconsin,” said Renee Reback, Foundation Executive Director. “Generous contributions from our donors will ensure we can continue to offer 10 or more fellowships each year.”

As the end of summer nears and the fellowships begin to wrap up, below is a sampling of two of the 10 fellowships.

Infant Safety—Brittany Bettendorf, Medical College of Wisconsin

As part of the Downtown Health Center Cribs for Kids program in Milwaukee, new babies without a crib in their home are provided with Graco Pack ‘N Plays and Bettendorf educated families on how to provide a safe sleep environment for their infant and create awareness of Sudden Infant Death Syndrome.

Bettendorf (right) discusses safe sleep for infants with a mom and big brother

Assisting Elderly Residents in Rural Wisconsin—Diane Anderson, UW School of Medicine and Public Health

As part of her fellowship this summer, Anderson helped establish a medical equipment loan program at the LaPointe Community Clinic on Madeline Island. It started with a patient who required a lift chair to remain independent, but insurance would not cover it. This first piece of medical equipment was kindly donated by Earl Thayer after the recent loss of his wife, Alice. As the program expands, it will help many elderly residents and their caregivers in this remote area.

Anderson (left) poses with Joseph Hackett and his caregiver and niece Sue Hackett after receiving an electric lift chair

QUALITY CORNER

MIPPA Legislation means changes for 2009

The Medicare Improvements for Patients and Providers Act (MIPPA), passed in July 2008, contains new provisions in the following areas for 2009 Medicare incentive payments.

PQRI
The 2009 Physician Quality Reporting Initiaitive (PQRI) incentive payment will be raised to 2 percent. Eligible professionals will receive 2 percent of their 2009 estimated allowable Medicare charges for successfully reporting PQRI measures.

Electronic prescriber
MIPPA provides for a 2 percent incentive payment to eligible professionals who successfully prescribe their patients’ medications electronically. Successful performance is defined as reporting PQRI Measure #125 on at least 50 percent of eligible patients. The electronic prescribing program must meet ALL of the requirements listed in PQRI measure #125. If a physician has not adopted an electronic prescribing system that meets the PQRI measure #125 requirements, he or she may not report the electronic prescriber measure. A qualified electronic prescribing system must be able to perform the following tasks:

Generate a medication list
Select medications, transmit prescriptions electronically and conduct safety checks. Safety checks include automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration of the drug, drug-drug interactions, allergy concerns, and warnings/cautions.
Provide information on lower cost alternatives
Provide information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan

For an overview of the PQRI provisions in the new Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, e-prescribing, and the 2007 PQRI feedback reports, click here, then click on the "08/13/08 National Provider Call" pdf link under the "User Guides" directory. (You do not need to sign in to access the user guide.)

FAQ

Question:
What is “Return of Premium” life insurance?

Answer:
“Return of Premium” life insurance is a term life insurance policy that provides both death benefit protection and a return of premium insurance feature. If you keep your policy for the term period, at the end of that time, whether 15, 20 or 30 years, the company that issued the insurance with the return of premium policy returns the entire premium that you paid for the insurance. Unlike regular term policies, Return of Premium term life insurance rewards you for keeping the policy by giving a guaranteed return of your total cumulative premium paid on the policy during the policy term period.

For more information, contact your Wisconsin Medical Society Insurance & Financial Services agent to learn more about your particular plan, or use this on-line contact form.