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Medigram - December 13, 2007


TOP STORIES

IPFCF Board votes to not increase fees for FY 2008

The Injured Patients and Families Compensation Fund Board (IPFCF) of Governors voted Wednesday to not raise Fund fees for the state’s 2008 fiscal year (July 2008-June 2009). The Fund's Actuarial and Underwriting Committee had recommended a 25 percent fee increase, but Society-led efforts at the Board prevented approval of this recommendation.

Increasing Fund fees to essentially backfill the Governor’s $200 million raid was questionable, especially considering that the legality of raiding the Fund is now in the courts; a fee increase could also be used to finance future raids. With those factors discussed in open session at Wednesday’s board meeting, a motion was made that there be no Fund fee increase at this time (Society member Robert Jaeger, MD, made the motion, with Society CEO Susan Turney, MD, seconding). That motion prevailed on a 7-5 vote, with all three physician Board members (Dr. Jaeger, Dr. Turney and Reid Olson, MD, public member) voting for no increase. You can see the full membership of the IPFCF Board of Governors here. For more information, contact Mark Grapentine.


Assembly takes first step toward Constitutional amendment to protect IPFCF, other funds

During its late-night session Tuesday, the Wisconsin State Assembly approved a resolution that would protect the state’s segregated funds from raids such as the one the IPFCF suffered in the 2007-2009 biennial state budget. Assembly Joint Resolution 34, authored by Sen. Roger Breske (D-Eland) and Rep. J.A. “Doc” Hines (R-Oxford), would amend the state constitution to bar raids on segregated funds and prohibit laws changing the purpose of funds (a tactic that was attempted on the IPFCF in a previous budget). Society President Clarence P. Chou, MD, sent this letter to the entire Assembly membership asking for a “yes” vote.

The Assembly voted overwhelmingly, 91-6, to approve the resolution. The Senate will need to approve the exact same language this legislative session, and then both houses will have to reaffirm their support in the 2009-2010 legislative session before the measure can be placed on a statewide ballot. The constitutional amendment would not retroactively protect the Fund; the Society’s lawsuit against the state remains necessary (Click here for media coverage of this action.)

What you can do: Contact your state senators, and ask them to co-sponsor AJR 34 and its Senate companion, SJR 24. Ask your senator to cosponsor both resolutions and push for a full Senate vote so that the IPFCF and other such funds can be protected from future raids. If your Assembly representative voted in favor of the resolution, please send him or her a thank-you note or e-mail. To verify your representatives in the State Legislature, click here.

For more information, contact Mark Grapentine or Jeremy Levin.

NEWS BRIEFS

UnitedHealthcare clarifies notification requirements

Recently announced changes in UnitedHealthcare’s notification protocol apparently caused some confusion among physicians, so it has clarified that physicians will not be penalized for failure to notify for the following:
  • Referrals to non-participating physicians
  • Pregnancy
  • Initiation of cancer treatment
  • Congenital heart disease without ICD-9 code
In addition, the changes that went into effect on December 3, 2007, eliminate requirements for advanced notification for most inpatient admissions. However, physicians will face reimbursement cuts for failing to provide notification for such services as spinal surgeries, bariatric surgeries, transplants, certain radiology procedures, among other services.

For more information, click here or visit unitedhealthcareonline.com or contact your local Network Account Manager.


Do you have your number?

Effective March 1, 2008, Medicare fee-for-service claims and CMS-1500 claims must include an NPI in the primary fields on the claim (i.e., the billing, pay-to, and rendering fields), according to the Centers for Medicare and Medicaid Services. Providers can continue to submit NPI/legacy pairs or NPI only in these fields.

Beginning March 1, 2008, claims submitted without an NPI in the primary provider fields will be rejected. The secondary provider fields (i.e., referring, ordering and supervising) may continue to include only a provider’s legacy number.

Additionally, CMS has indicated that if you already bill using the NPI/legacy pair in the primary provider fields and your claims are processing correctly, now is a good time to submit to your contractor a small number of claims containing only the NPI in the primary provider fields. This test will serve to assure your claims will successfully process when only the NPI is mandated on all claims.

If you have any questions, contact Joy Glass at 410.786.6125 or Marlene Biggs at 410.786.7880.

If you do not have an NPI, click here for more information.


Medical College of Wisconsin names new Dean

Jonathan I. Ravdin, MD, the Nesbitt Professor and Chairman of the Department of Medicine at the University of Minnesota Medical School and an international leader in infectious diseases, has been named Dean and Executive Vice President of the Medical College of Wisconsin. He will begin his new role May 5, 2008 and succeeds Michael J. Dunn, MD, who announced plans to step down as Dean in January 2007 but will continue to serve as a Distinguished Professor of Medicine.

Doctor Ravdin is widely recognized for contributing seminal research on the molecular mechanisms by which Entamoeba histolytica, an enteric protozoan parasite that is highly endemic worldwide, causes invasive amebiasis (colitis and liver abscess) and how humans develop an effective mucosal immune response. He is a Fellow of the American Association for the Advancement of Science and a member of the American Society for Clinical Investigation and the Association of American Physicians.

Doctor Ravdin has served as Chairman of Medicine at the University of Minnesota Medical School since 1996 and has authored or co-authored over 270 articles, abstracts and book chapters. Before joining the faculty of the University of Minnesota, he was Professor and Vice Chairman of Medicine and Professor of International Health at Case Western University School of Medicine, and Chief of Medicine at the Cleveland Veterans Affairs Medical Center. Doctor Ravdin also served on the faculty of the University of Virginia School of Medicine where he received four school-wide awards for excellence in teaching and research. He received his medical degree from Tufts University School of Medicine, and completed a residency Internal Medicine at The New York Hospital—Cornell Medical Center followed by a Fellowship in Infectious Diseases at the University of Virginia School of Medicine.


UW Hospital and Clinics names new CEO

Donna Katen-Bahensky will serve as CEO of UW Hospital and Clinics beginning Feb. 4, 2008. She is currently CEO at University of Iowa Hospitals and Clinics and senior associate vice president for medical affairs at University of Iowa Health Care since 2002.

“Katen-Bahensky brings a genuine zeal for compassionate, patient-centered care, solid leadership, and a commitment to community service,” said Patrick G. Boyle, chair of the UW Hospitals and Clinics Authority Board.

Prior to her time with the University of Iowa Hospitals and Clinics, Katen-Bahensky served as executive vice president and chief operating officer at the Virginia Commonwealth University Health System and Medical College of Virginia Hospitals and Clinics. Her experience also includes the University of Nebraska Medical Center and the University of Michigan Hospitals.


Dec. 19 seminar will teach strategies to help patients quit smoking

You’re invited to join Society member Michael Fiore, MD, Wednesday, Dec. 19 for an informative and interactive 45-minute Web-based training designed to help physicians help their patients quit smoking.

Wisconsin’s first tobacco tax increase in more than six years takes effect in January. That, coupled with the annual New Year’s swell of quitters, offers a virtually unprecedented opportunity to intervene with patients whose tobacco use and dependence endangers their health and that of those around them. It’s a great time to quit and you can help smokers do it.

During this free training, which is scheduled from 12:15 to 1 p.m., you will learn more about new medications, leading-edge methods and new Wisconsin resources to help your patients quit, and stay quit.

Doctor Fiore is a practicing internist, founder and 15-year director of the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI).

The seminar is sponsored by the Society, Smokefree Wisconsin and UW-CTRI. To sign up and receive login information, contact Jeremy Levin at 866.442.3800, ext. 3791.

YOUR PRACTICE. YOUR FUTURE.

Employer tips for holiday parties

Many employers wish to host a holiday party for their employees to boost morale and to thank them for their contributions during the year. Employers should be mindful, however, that the combination of alcohol and holiday cheer may lead to unanticipated problems. Typically, these problems involve alcohol consumption and sexual harassment, and in some cases, one leads to the other.

Drinker, Biddle and Reath LLP offers tips for employers in their December Labor & Employment Update. Click here to read more.

Editor’s Note: This article is reprinted with permission.

EDUCATIONAL PROGRAMS

Surgical and non-surgical modifiers—telling the whole story

There are many modifier changes for 2008, and the Wisconsin Medical Society Education Department can help you gain a better understanding of these changes and more. During this two-part teleconference series February 5 & 12, our speaker will discuss documentation requirements for both surgical and non-surgical modifiers, highlight the changes and provide examples to ensure that you are appending modifiers correctly for the best reimbursement. Click here to learn more.

FYI: FOR YOUR INSURANCE

Waiting to purchase long term care insurance can be costly

When you are still young, the need to plan for the future is important. You need to think about how to protect your family members from the burden of coordinating care, physical caregiving and financial worries. Preserving retirement portfolios and children’s inheritances are also important. Because long-term care costs are high, just a few years of providing care can wipe out a lifetime of savings.

Delaying the purchase of long-term care insurance means more costs down the road due to:
  • Age-based premiums: Premiums increase as a person ages. Example: For a comparable five-year policy with a $200-per-day benefit, and based on 4.4% inflation, a 50-year-old would pay $1,624 per year for life. But at age 65, he or she would pay $5,867 per year for life.
  • Changes in health: When you are younger you can leverage the time value of money to build retirement savings. You also can leverage your good health as a financial asset. If you are younger and in good health you may qualify for long-term care insurance, but that may not be true as you age.
  • Inflation: Paying long-term care premiums earlier ensures that benefits keep pace with the rising cost of care.
  • Discounts: Buying long-term care coverage early sometimes allows people to leverage available discounts—such as spousal, partner, family and corporate—as employee benefits.
For more information on long-term care coverage please call Wisconsin Medical Society Insurance and Financial Services at 866.442.3810 or complete our on-line contact form.

Source: Best Review, November 2007, A Fresh Approach

FOUNDATION FOCUS

During this season of giving…

Please consider the Wisconsin Medical Society Foundation as you review your year-end charitable goals or when renewing your membership with the Wisconsin Medical Society. Your tax-deductible contribution is instrumental as we work to expand support for existing programs and to develop new initiatives. Thanks to our donors, we anticipate awarding the following in 2008, a significant increase over our 2005 awards:

 
2005
2008 Budget
Scholarships
$46,500
$76,600
Grants
$69,500
$73,000
Fellowships
$3,500
$35,000 (10-fold increase)

We are excited about the impact Wisconsin physicians are having through these increased efforts and hope you will add your support.

To make a donation click here, mail a check payable to the Wisconsin Medical Society Foundation, 330 E. Lakeside St., Madison, WI 53715 or call 866.442.3800.

PLEASE NOTE: Donations for the tax year 2007 must be postmarked by December 31.

FAQ

Question:
How does Medicare address refunds sent in error by a clinic to Medicare?

Answer:
Medicare will apply excess money returned to Medicare voluntarily to any outstanding accounts receivable. Money returned to Medicare in excess of any outstanding or requested amounts will be returned to the provider. In the situation where money is returned to Traditional Fee for Service Medicare, but should have been returned to Railroad Medicare, the money will be returned to the provider.

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

QUALITY CORNER

Execution of Strategic Improvement Initiatives to Produce System-Level Results

A common organizational response to the emphasis on quality and safety is a long list of worthwhile projects and measures that are not well coordinated. "Execution of Strategic Improvement Initiatives to Produce System-Level Results" is a white paper available from the Institute for Healthcare Improvement (IHI) that proposes a framework for execution of strategic initiatives aimed at producing system-level results. Click here for more information and to download a copy of the paper.