Medigram - August 9, 2007 | Wisconsin Medical Society

NEWS BRIEFS

Wisconsin Medicaid now collecting NPIs

Wisconsin Medicaid is now collecting National Provider Identifiers (NPIs) from Medicaid-certified health care professionals. All providers are encouraged to submit their NPI(s) to Wisconsin Medicaid by November 1, 2007, via e-mail, mail or a Web-based application. Detailed information about submitting NPIs is available in the July 2007 Wisconsin Medicaid and Badgercare Update.

In the future, all health care providers will be required to indicate their NPI when conducting business with Wisconsin Medicaid. Currently, however, providers are required to continue indicating their eight-digit Medicaid provider number on all electronic and paper claims and other transactions (e.g., prior authorization requirements) submitted to Wisconsin Medicaid until further notice.

NPI registry and database dissemination delayed

The Centers for Medicare and Medicaid Services is delaying until September 4 the deployment of the NPI Registry and the dissemination of FOIA-disclosable health care provider data from the National Plan and Provider Enumeration System (NPPES). This delay means that all providers now have until to August 20 to update and delete “optional” NPPES data elements that will be published. These may include, dependent upon the data field where reported, Social Security Number, Taxpayer Identification Number, other personal identification number and home address. For assistance in making these changes to FOIA-disclosable NPPES provider data, please review “National Plan and Provider Enumeration System (NPPES) Data Elements - Data Dissemination - Information for Providers” available here. To update and delete "optional" data elements from your application, access your application by using your established UserID and password here or contact the NPI Enumerator at 800.465.3203. As provider and payer transaction partners will need adequate information to ensure proper NPI usage on claims, health care providers are strongly encouraged to consider allowing continued access to as many data elements as feasible especially including UPIN and business address ZIP code + 4.

Click here for more information.

An Extraordinary Art Exhibit

An extraordinary, unique art exhibit—Windows of Genius: Artwork of the Prodigious Savant—will provide an exceptional educational event at the Windhover Center for the Arts in Fond du Lac, Wisconsin from September 7 to October 12, 2007. This exhibit provides a very rare opportunity to see paintings, drawings, sculptures and other art forms of various prodigious savants displayed in a single show. Text summaries of the background of these extraordinary artists will provide an educational glimpse into the mind, as well as the world, of the prodigious savant. Additionally, video clips will be used to further illustrate these prodigious abilities and skills of these extraordinary people.

This brochure describes the event in detail. More information about the exhibit can be obtained by e-mailing savants@charter.net or by contacting the Windhover Center for the Arts in Fond du Lac at 920.921.5410.

Wisconsin Women’s Health Foundation to host second annual dialogue

Each year, Wisconsin businesses lose $1.4 billion in worker productivity due to illness and premature death caused by tobacco use. Wisconsin businesses spend $1.5 billion annually in health care costs related to employee smoking.

The Wisconsin Women’s Health Foundation is working to drive down those numbers by hosting “The Economic Impact of Smoking” Tuesday, September 18 in Madison. The event will feature a dialogue among panelists, including Society member Michael Fiore, MD, Department of Health and Family Services Secretary Kevin Hayden, and former Governor and Secretary of Health and Human Services Tommy Thompson.

Following the panel dialogue, participants are invited to attend the workshop “Strategies for a Tobacco-Free Workplace in Wisconsin,” and to receive a first-of-its-kind employer toolkit specifically for Wisconsin businesses. For more information about the program, click here.

YOUR PRACTICE. YOUR FUTURE.

New federal law requires Medicaid patients’ prescriptions be written on tamper-resistant pads

As a result of a little-publicized provision that was included in the recently passed US Troop Readiness, Veterans’ Health Care, Katrina Recovery and Iraq Accountability Appropriations Act of 2007 (P.L. 110-28), Medicaid patients’ handwritten prescriptions will have to be written on tamper-resistant pads starting October 1, 2007. The rule is intended to make it harder to forge or alter prescriptions to gain unauthorized access to drugs, but many physicians and pharmacists are concerned about the short timetable for implementation because it may lead to prescription drug access problems for Medicaid patients.

Since Congress’s only instruction was that Medicaid prescriptions must be written on a tamper-resistant pad, the Centers for Medicare and Medicaid Services (CMS) must now issue guidance to state Medicaid directors on the details of the new law. The AMA and the National Association of State Medicaid Directors have voiced their concerns to Congress and CMS that physicians cannot be educated and sufficient prescription pads cannot be printed and distributed by October 1. Since CMS has not yet issued guidance on the definition or minimum standards of tamper-resistant pads, it is difficult for suppliers to produce or states to order these pads. The pads may cost twice as much as standard prescription pads. The AMA has strongly urged CMS to adopt a transition period of 6-12 months for states and physicians to get up to speed, as well as to provide for emergency dispensing in cases where tamper-resistant pads are not used. CMS has indicated it is making a major effort to provide for emergency dispensing, but that it does not believe it has the authority to delay implementation or provide a transition period. CMS is trying to issue guidance as quickly as possible on the law; this guidance should resolve many currently unanswered questions about implementation.

Currently, 10 states, not including Wisconsin, have some sort of tamper-resistant prescription pad requirement. In seven of those states, the requirement applies only to Schedule II controlled substances.

On July 19, several members of Congress introduced H.R. 3090, the “Patient and Pharmacy Protection Act of 2007,” which would limit the Medicaid tamper-resistant prescribing pad requirement to Schedule II controlled substances instead of having it apply to all prescriptions. While this act would limit the tamper-resistant pad requirement, it would not delay its implementation. Unless this bill is passed and signed into law, the requirement will apply to all prescriptions for Medicaid patients.

EDUCATIONAL PROGRAMS

Time running out for ‘early bird’ savings

The “Early Bird” registration deadline for the Wisconsin Medical Society’s 2007 Midwest Coding and Practice Management Symposium, October 14-16 at the Kalahari Resort in Wisconsin Dells is quickly approaching. Register by September 7 to save $80!

This year’s Symposium includes something for everyone. Topics include Compliance, Contracting, The Pitfalls of EMR, Chart Auditing and much, much more. You won’t want to miss it. To view the agenda and to register, please click here.

FYI: FOR YOUR INSURANCE

Retirement Savings Shortfall

A majority of American workers continue to believe they’ll have enough money for a comfortable retirement, but few have saved enough to ensure that will happen, a new study shows. The annual Retirement Confidence Survey, released by the non-profit Employee Benefit Research Institute in Washington, DC, found that 65 percent of workers are “very confident” or “somewhat confident” of funding their retirements. That’s down slightly from 68 percent last year, despite the improving economy.

Although the overall confidence reading remains high, workers acknowledge they haven’t saved as much as they should. In fact, most haven’t saved much at all. The study found that 52 percent of those surveyed have less than $25,000 set aside for retirement; 13 percent have $25,000 to $49,000, and 11 percent have $50,000 to $99,000. Just 21 percent have $100,000 or more, and most of those are workers 45 and older.

Wisconsin Medical Society Insurance and Financial Services has a great aid to help you with your retirement plans. The Wealth Management Solutions System, developed by Principal Financial Group, is a tool that can be easily followed to help ensure that your retirement savings doesn’t fall short.

Contact us today through our on-line contact to get started.

Editor’s note: This article is adapted with permission from Independent Insurance Agents, Commercial Coverage Newsletter, 2007, No 1.

FOUNDATION FOCUS

White Coat Campaign achieves goal

Donations for the 2007 White Coat Campaign broke last year’s response record, according to Eileen Wilson, the Foundation’s White Coat Campaign coordinator.

“Because of the generosity of returning participants plus several new donors this year, we achieved our goal much earlier than in any previous year and have officially closed the 2007 campaign,” she said. “Thank you to all who participated.”

The White Coat Campaign generates a wealth of goodwill between medical students and Wisconsin physicians. For a relatively small donation of $50 per coat, physicians can purchase the white coat for one or more first year medical students and provide them with a message of encouragement as they begin their journey through medical school.

Foundation staff coordinates ordering appropriate coat sizes and adds a note from a physician for each first-year student at both medical schools. The coats are presented to students at their school’s white coat investiture ceremony, which this year is scheduled for Friday, August 17 at the Medical College of Wisconsin, and Sunday, September 16 at the UW School of Medicine and Public Health. The Foundation provides students with a preaddressed and stamped envelope with the name of their sponsoring physician and encourages them to send a thank you note. Participating physicians should watch for their thank you soon!

For more information about the campaign and other activities of the Foundation, click here.

FAQ

Question:
In May, CMS released Transmittal R1248CP regarding the implementation of the JW modifier for discarded drugs and biologicals effective July 1, 2007. A question that continues to be asked is: Do drugs that are paid under ASP need to have the JW modifier appended?

Answer:
When reporting drugs/biological from a single use vial under the ASP reimbursement methodology, WPS Medicare Part B does not require the use of the JW modifier. Simply report the total amount of the single use vial in the unit’s field of the CMS-1500. For example, if the vial holds 10 mg but only 8 mg is administered, 10 mg is reported. The JW modifier may continue to be reported for physicians participating in the CAP. For multi-use vials the wastage will continue to be reported in item 19 of the CMS-1500.

For reporting of Botulinum Toxin Type A see: http://www.wpsmedicare.com/policies/wisconsin/inj018.pdf.

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

Quality Corner

If you would you like to learn more about the Physician Quality Reporting Initiative (PQRI), WPS Medicare is hosting a two-hour Ask the Contactor Teleconference (ACT) on Wednesday September 5, 2007, from 9 - 11 a.m. CDT. WPS Medicare will open with a brief overview on PQRI. Participants will then have the opportunity to ask questions about PQRI. Covered topics include

The definition of the PQRI program
The effective dates of PQRI
How to report PQRI
The PQRI measures
Bonus payments

No registration is necessary. Participants should simply dial 877.290.9695 at the appropriate time. The conference ID/password is 4147508.