Medigram - August 28, 2008 | Wisconsin Medical Society

TOP STORY

Fund lawsuit receives media coverage following Court arguments

Monday’s oral arguments in the Society’s lawsuit to overturn the State’s raid on the Injured Patients and Families Compensation Fund resulted in considerable media coverage statewide even though no decision was handed down. (See this Medigram Alert.)

Click on the links below to access a sampling of these articles and editorials.

A written decision in the suit is expected from Dane County Circuit Court Judge Michael Nowakowski in the coming weeks. Meanwhile, Society members are urged to attend informational meetings being held to obtain an update about the lawsuit in Madison and La Crosse Sept. 2 and 10 respectively. Please contact kendip@wismed.org for more details, and watch future issues of Medigram for information about meetings being planned for Milwaukee and Green Bay in October.

NEWS BRIEFS

UnitedHealthcare announces changes to Premium Designation Program

The Wisconsin Medical Society received information from UnitedHealthcare regarding various changes to its Premium Designation Program as well as notification that the designation review cycle for 2008 is underway. We have been asked to share this information with our members. The Society does not endorse UnitedHealthcare’s Premium Designation Program and has previously communicated to UnitedHealthcare concerns by Wisconsin physicians about earlier versions of the program.

In October 2008, UnitedHealthcare will send an assessment report to participating physicians. Physicians who receive an assessment report should review it immediately and contact UnitedHealthcare to request clarification or reconsideration if there are any concerns about the designation. According to UnitedHealthcare, physicians have approximately 45 days to review their designation before it is disclosed to the public.

Time is running out!

Wisconsin Medical Society members are encouraged to enroll in the EPIC Long-term Disability plan by October 1 to take advantage of the special introductory offer of guarantee issue. This plan was exclusively designed for Society members and provides tailored physician-oriented benefits. Click here for more information, and if you have questions, please contact Wisconsin Medical Society Insurance and Financial Services at 866.442.3810 or use our on-line contact form.

Register now for 2008 WI Quality and Patient Safety Forum

Program and registration materials are now available for the 2008 Wisconsin Quality and Safety Forum, which is being co-sponsored by the Wisconsin Medical Society, the Wisconsin Hospital Association, MetaStar, the Wisconsin Collaborative for Healthcare Quality and the Wisconsin Health Information Organization. Scheduled October 20-21, 2008, at the Kalahari Resort in Wisconsin Dells, this forum is designed for physicians, quality improvement managers/specialists, risk managers, nurse executives, pharmacists, patient care services staff, chief executive officers, administrators, vice presidents, and patient safety improvement team members. Click here for a forum brochure or here for just the registration form.

HHS proposes adoption of ICD-10 code sets and updated electronic transaction standards

The Department of Health and Human Services (HHS) recently announced a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.

“We are taking a giant step forward toward developing a health care system that focuses on quality and affordability through the implementation of health information technology,” HHS Secretary Mike Leavitt said in this press release. “The greatly expanded ICD-10 code sets will enable HHS to fully support quality reporting, pay-for-performance, bio-surveillance and other critical activities. Conversion to ICD-10 is essential to the development of a nationwide electronic health information environment, and the updated X12 transaction standards are a critical step in the implementation of these new codes.”

Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. CMS says the additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.

Comments on both the ICD-10 code sets proposed rule the proposed updated transaction standards are due by 4 p.m. October 21, 2008. Both regulations may be viewed here and here.

New statewide group takes concussion ‘epidemic’ head on

Seven medical organizations in Wisconsin, along with several advocacy groups and sports organizations, have created a statewide voluntary group committed to improving concussion care for athletes in the state. The Wisconsin Sports Concussion Collaborative (WSCC) aims to promote the health, safety and academic performance of Wisconsin student-athletes and others by improving the education, identification, diagnosis and treatment of concussions.

The WSCC founding members include ThedaCare Orthopedics Plus in Appleton; UW Health-Sports Medicine in Madison; Children’s Hospital of Wisconsin in Milwaukee; Gundersen Lutheran in La Crosse; Bellin Health-Sports Medicine in Green Bay; Froedtert Health-Sports Medicine in Milwaukee; and Ministry Health Care-Sports Medicine in Stevens Point. Recently the Collaborative added new members from Menomonie, Eau Claire and Wausau, and would like to add more members.

Click here to read a press release announcing the collaboration. Click here for more information.

Council on Health Care Access meeting Sept 10

The Council on Health Care Access will meet Wednesday, September 10 from 11 a.m. to 2 p.m. at the Wisconsin Medical Society. The Council will discuss Society Resolution 1 - Reducing Excessive Costs of Medical Care among other topics. 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.

QUALITY & EFFICIENCY

WHIO and 1 health plan's program: How do they compare?

In an article in today’s Medigram, UnitedHealthcare notified Society members about changes to its Premium Designation Program (UHPD) and that its 2008 review cycle is underway. For the past several weeks, Medigram has published a series of articles about the Wisconsin Health Information Organization (WHIO). The timing of UnitedHealthcare’s announcements affords us the opportunity this week to examine some of the differences and similarities that exist between a health plan program like that of UnitedHealthcare’s and the work underway with WHIO. Click here to read more.

CAPITOL INSIDER

Review of draft policy on physician licensure urged

The Federation of State Medical Boards (FSMB) has taken on the task of determining how well physicians are maintaining their competence and how frequently their skills and knowledge should be assessed during re-licensure. But the American Medical Association says the report from a special committee of the FSMB contains areas of concern.

For example, the report recommends physicians demonstrate competence in areas such as medical knowledge, communications skills and practice-based-learning, among other areas. But the AMA’s Council on Medical Education says, “There is no current evidence that physicians’ skills in the areas identified for maintenance of licensure decay at a constant rate.” The report, however, suggests all areas should be reviewed every time a doctor renews his or her license.

Because of these concerns, the AMA recommends physicians review this report carefully and express concerns to your medical society and licensing board. Both ethics subgroups in the Wisconsin Medical Society will be reviewing the report.

“Any process as potentially far-reaching for the medical profession as this should be subject to careful analysis and broad scrutiny,” says AMA CEO Michael Maves, MD. For more information, contact Daniel Winship, MD, AMA Council on Medical Education Secretary, or Mark Grapentine, JD, Society Senior Vice President of Government Relations.

F.Y.I. FOR YOUR INSURANCE

ProAssurance ranks in Ward’s top 50

ProAssurance, the parent company of PIC WISCONSIN, was named one of the 2008 Ward’s 50. Click here to read the press release announcing the honor.

To identify the best performing property-casualty insurance companies in America, The Ward Group analyzed the financial performance of more than 3,000 insurance companies during the years 2003-2007. The elite group of companies that make up the 2008 Ward’s 50 are those that passed Ward’s rigorous safety and consistency screening process while achieving superior financial results. ProAssurance was chosen once again for 2008.

QUALITY CORNER

Info available now for 2007 PQRI participants

2007 PQRI Final Feedback Reports are available on a secure Web site, according to the Centers for Medicare and Medicaid (CMS). Additionally, two MLN Matters articles on accessing the reports are available to assist individual eligible professionals and group practices that reported valid 2007 PQRI quality measures data to Medicare. The reports are organized by Tax Identification Number (TIN). For eligible professionals reporting measures for 2007 PQRI under a group practice TIN, the group practice determines who can access the Feedback Report for the group practice or organization. Click on the titles below to access these articles.

Steps for Individual Eligible Professionals to Access Their 2007 PQRI Feedback Reports Personally, MM SE0830

Steps for Organizations to Access Their 2007 PQRI Feedback Reports

Once you are registered in the Individuals Authorized Access to CMS Computer Services (IACS) system and have access to the PQRI feedback report application, any questions about the Feedback Report should be directed to the Report Delivery System Help Desk referenced at the end of the MLN Matters articles. Click here for additional educational resources and information about the PQRI program.

FAQ: ABN Deadline Extended

Question:
When are you required to begin using the revised advance beneficiary notices (ABN) form for Medicare beneficiaries?

Answer:
The implementation date for the revised ABN form has been extended to March 1, 2009, according to a Joint Signature Memorandum issued by CMS to all carriers on Wednesday, August 27, 2008.

If you have questions about this or other coding matters, click here to review our FAQ archives, or e-mail efaq@wismed.org.