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Medigram - December 18, 2008


Editors Note:

The staff of the Wisconsin Medical Society wishes you a happy and safe holiday season. Due to the holidays, Medigram will not be published again until Thursday January 8, 2009. In the event of any critical developments during this time, Society staff will send out a Medigram Alert.

TOP STORIES

IPFCF Board approves 9.9% fee increase; Society Reps oppose

The Board of Governors for the Injured Patients and Families Compensation Fund voted 7-4 Wednesday to increase fees for Fiscal Year 2010, meaning the increase will take effect July 1, 2009. The fee increase will be 9.9 percent, pending the Legislature approving the administrative rule that will implement the new rates. Fund rates for the current fiscal year can be seen here.

The Wisconsin Medical Society has two representatives on the 12-member Board; both opposed the increase, questioning the wisdom of increasing fees when state government has shown its willingness to use Fund monies for non-Fund purposes—highlighted by $200 million raid from the Fund during the last biennium. The Society's lawsuit against the state over that raid is still pending in Dane County Circuit Court.

Those voting "NO" on the increase: Robert Jaeger, MD, Wisconsin Medical Society; Susan Turney, MD, Wisconsin Medical Society; Marilu Bintz, MD, Wisconsin Hospital Association; James Jansen, Wisconsin Association for Justice

Those voting "YES": Randy Blumer, Industry Representative; Dennis Conta, Public Member; Stan Davis, Public Member; Scott Froehlke, Public Member; Erik Huth, Industry Representative; Reid Olson, MD, Public Member; John Walsh, State Bar of Wisconsin

One Board member, Christopher Spencer, Industry Representative, was absent.

Contact Mark Grapentine, JD, for more information.


Society launches statewide radio campaign

The Wisconsin Medical Society today launched the first in a series of radio messages designed to help educate patients about key health care issues. (Click here to listen.)

“At a time when so much media attention is focused on the need for health system reform, we feel it is also important to provide constructive information on key medical issues and problems confronting Wisconsin families,” said Society President Steven C. Bergin, MD in this press release. “These messages will focus on health care issues as wide-ranging as stress management, preventive health care, communicating effectively with your doctor and physician recruitment and retention.”

The first two 30-second spots will run on 74 radio stations statewide over the holidays and features a message on stress management. In one, Tim Bartholow, MD, reminds listeners, “You can stay healthy by getting plenty of rest, staying warm, limiting your alcohol intake and pushing the plate away just before you feel full. One of the most effective ways of managing stress is exercise. Just 20 minutes walking in our brisk Wisconsin air can do wonders.” Doctor Bartholow practiced family medicine for 16 years in Sauk City before joining the Society staff in November as Senior Vice President of Member Services, Policy Planning and Physician Professional Development.

The campaign will continue throughout 2009 and will feature Society members with the key message, “We are doctors because we care for you and your family.” The next spot, scheduled to air in January, will feature Dr. Bergin.

NEWS BRIEFS

FowardHealth December Update outlines J-code carve-out requirements

Beginning January 1, 2009 physicians will be required to “carve out” all physician-administered drugs, including the administration fee, from Medicaid managed care organizations (MCOs) and submit them to Fee-For-Service Medicaid. For detailed requirements, click here.


New OCR guidance on the HIPAA Privacy Rule and electronic health information exchange available

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has published new HIPAA Privacy Rule guidance as part of the Department’s Privacy and Security Toolkit to implement The Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information (Privacy and Security Framework). The Privacy and Security Framework and Toolkit is designed to establish privacy and security principles for health care stakeholders engaged in the electronic exchange of health information and includes tangible tools to facilitate implementation of these principles. The new HIPAA Privacy Rule guidance in the Toolkit discusses how the Privacy Rule supports and can facilitate electronic health information exchange in a networked environment. In addition, the guidance includes documents that address electronic access by an individual to his or her protected health information and how the Privacy Rule may apply to and supports the use of Personal Health Records.

These new HIPAA guidance documents are available on the OCR Privacy Rule Web Site at www.hhs.gov/ocr/hipaa/hit/. For more information on the Privacy and Security Framework and to view other documents in the Privacy and Security Toolkit, click here.


Reference Committees seeking members

The Wisconsin Medical Society is seeking members for the reference committees at the Annual Meeting, April 17-18, 2009. A reference committees member must be a delegate or alternate delegate from his or her respective county medical society or specialty/special sections.

The delegates who serve on a reference committee have a most important assignment. Effective action by the House of Delegates depends on the deliberations of each reference committee. Without this type of prior consideration, the House could not accomplish such a large volume of work in such a short time.

There are three reference committees: 1) Health Insurance Coverage/Access, 2) Quality/Clinical Outcomes, 3) Organization and Finances. If you are interested in serving on one of these reference committees, please contact Merry Earll at 866.442.3800 ext. 3766/608.442.3766. Click here to learn more about reference committee members’ duties and responsibilities.


Society Councils seeking members

The Wisconsin Medical Society is seeking members for the following strategic councils:
  • Health Care Access – Issues include review of health system reform proposals, increasing access to health care, Medicare and Medicaid reimbursement, medical malpractice issues, administrative costs
  • Health Care Ethics – Issues include physician professionalism, pharmaceutical gifts, interprofessional code for physicians and attorneys, cloning/embryonic research, end-of-life care
  • Health Care Quality and Population Health – Issues include patient-centered medical care, public/patient safety, population health, occupational health
  • Legislation – Membership on this council is limited to the number deemed sufficient to execute its responsibilities by the Board of Directors. It also includes a representative from each of the Society’s specialty sections, subject to Board approval
  • Policy Panel – This panel reviews existing five-year policies for germaneness and continued alignment with the Society’s Strategic Plan. The council crafts new policies based on referrals by the Board of Directors, House of Delegates and recommendations from the Strategic Councils. In order to promote continuity and history, no ad hoc members serve on the panel.
Strategic Council members are appointed to three, three-year terms (or a total of nine years). At the end of each three-year term, members have the option of continuing. Society members will also have opportunities to participate in council discussions on a topic-by-topic basis. These opportunities will be published in Medigram. Non-member experts may be invited to participate depending on the topic, but will not be able to vote on Council matters.

If you are currently serving on a Council and wish to continue, no action is needed. If you are interested in being appointed to a Council, please contact Merry Earll at 866.442.3800 ext. 3766/608.442.3766.


Health plans and vendors evaluate WEDI standardized health ID cards

Health plans and vendors across the country are evaluating the use and implementation of the universally standardized machine-readable health identification card. Adopting the WEDI (Workgroup for Electronic Data Interchange) standard would facilitate real time eligibility verification and work toward real time claim adjudication as well. The WEDI has created an implementation guide to enable automated and interoperable identification using standardized health identification cards. Nationwide adoption of a standard health ID card would provide uniformity of information, appearance and technology to the numerous cards used today by health plans, providers, government programs, and others.

The WEDI standard provides for the card to be an access key, which can obtain information and initiate transactions. Patients use the card to convey information to health care professionals. That information may include multiple insurance identifiers for multiple benefits involving different administrators on a single card.

Moving to a standard, machine readable health ID card can lead to numerous benefits including reduced costs associated with photocopying current insurance cards, streamlined office procedures and increased patient satisfaction. Real time insurance benefit information will result in decreased claim errors and reduce lengthy admission processes.

Although the Society in unaware of any health plans in Wisconsin looking to implement the use of standardized health ID cards, Humana and Blue Cross/Blue Shield are offering them in Florida, and United Health Care is evaluating their use with its new portal/ID card program. For additional information, click here.

QUALITY & EFFICIENCY

Early Society findings from the WHIO Data Mart

Two Society staff members joined other WHIO organizations the week of December 8 for an in-depth training on the WHIO Data Mart and its tools and applications. During WHIO’s first quarter study period, the Society’s efforts will be centered on, first and foremost, evaluating the reliability and validity of the WHIO data and then in identifying the potential uses and value of the Data Mart for physician practices in Wisconsin. In this article, general and early findings from working with the Data Mart are presented.

F.Y.I. FOR YOUR INSURANCE

No 2009 increase in Dental Dental premiums for Society members

For the third year in a row, the Delta Dental Plan for Society members is holding steady. Individual and group premium rates have not increased. Click here to check out plans and rates for 2009.

When determining your coverage, Wisconsin Medical Society Insurance and Financial Services encourages you to consider the value of an individual or group dental plan for yourself or your business. According to the U.S. Surgeon General’s report on oral health, working Americans lose an estimated 164 million hours annually to dental disease or dental visits. Delta Dental’s emphasis on regular, ongoing preventive care and early detection can significantly reduce the possibility of dental emergencies for you, your employees and their families, keeping people on the job rather than in the dentist’s chair.

Because people with dental insurance visit their dentists more often, they are more likely to avoid serious oral health problems that are expensive and time-consuming to treat. Dentists have always recommended preventive care, and Delta Dental Insurance is set up to emphasize prevention and early detection. At a time when increases in medical premiums are squeezing other benefits, this cost-control-by-prevention model is more important than ever before.

Please contact our office at 866.442.3810, visit our Web site at www.wisconsinmedicalsociety.org/insurance to learn more about this product and others, or simply complete our on-line contact form for more information and to have one of our agents work with you on your individual/employee needs.

Source: Delta Dental Insurance, Dental Benefits Summary

FOUNDATION FOCUS

During this season of giving...

Please remember the Wisconsin Medical Society Foundation as you consider your year-end charitable giving or when renewing your membership with the Wisconsin Medical Society. Your contribution is critical during these difficult economic times.

Like so many foundations, our investment losses have negatively impacted the funds available for medical student loans, scholarships, fellowships and community grants. Yet, it is during unprecedented times like these that students and communities need our support. With other sources of financial aid drying up, medical students are increasingly looking to us for assistance. While the Foundation Board of Trustees voted to use reserve funds to maintain support for our most vital programs, these funds alone will not make up the difference.

It is only by combining your generosity with that of your colleagues that we will be able to maintain our funding for medical students and health initiatives. We hope you will help.

To make a donation, please click here or mail a check payable to the Wisconsin Medical Society Foundation to 330 E. Lakeside St., Madison, WI 53715 or call 866.442.3800. Please note: Donations for the tax year 2008 must be postmarked by December 31.

Warm wishes for the holidays!

QUALITY CORNER

A new quality improvement resource: whynotthebest.org

The Commonwealth Fund has launched a new Web site, WhyNotTheBest.org, that allows health care professionals and researchers to easily conduct side-by-side comparisons of 4,500 hospitals nationwide, track performance over time against numerous benchmarks and download tools to improve health care quality. To learn more, click here.

FAQ

Question:
How can I qualify for discounted premiums on my medical professional liability insurance?

Answer:
Society members can qualify for a 12.5 percent maximum discount off of their PIC WISCONSIN professional liability premium when they are insured through Wisconsin Medical Society Insurance and Financial Services. In addition to the 7.5 percent discount eligible program participants already receive, members can qualify for additional savings of up to 5 percent by meeting two of the following three requirements:

  1. Implement an accredited (CCHIT) electronic medical record system.
  2. Attend an approved risk management program.
  3. Qualify under the loss-free credit program.

Click here for more information.