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Medigram - December 27, 2007


TOP STORY

State files answer to IPFCF complaint

The State defendants filed an answer to the complaint on December 14, 2007, in the Society’s lawsuit to protect the Injured Patients and Families Compensation Fund. The answer responds to each paragraph of the complaint with short statements that admit, deny or indicate a lack of information upon which to admit or deny the claims in the complaint. In addition to responding to the claims in the complaint, the State’s answer also raises five defenses to the Society’s complaint: sovereign immunity, failure to state a claim upon which relief can be granted, lack of standing, lack of ripeness and separation of powers. (Click here to read the answer.)

The information in the State’s answer was anticipated by attorney Tom Pyper and his litigation team, who engaged in extensive research prior to filing the complaint. They believe that there are adequate legal bases upon which to defeat the State’s affirmative defenses. Pyper, of Whyte Hirschboeck Dudeck, S.C., is representing the Society in the lawsuit.

In the next several weeks, the parties may engage in discovery and may file motions with the court on various issues in the case. We will keep you informed of new developments in the case through Insider and Medigram.

NEWS BRIEFS

Physician musicians in Brown County raise money for childhood safety

When they’re not saving lives, they’re enriching them with a little music. Brown County physicians are performing on Saturday, February 9 at St. Norbert College in DePere, in a fundraiser for the Center for Childhood Safety. The Brown County Medical Society Alliance is coordinating the event, courtesy of sponsors Heid Music and Steinway & Sons.

Tickets are $85 each or $75 each for groups of eight or more. Thirty dollars of each ticket is tax-deductible. To order, call 920.403.3950 or 800.762.2699. Click here for more information.

NEWS MAKERS

Dr. Luetzow appointed to AMA committee

Society Board of Directors Chair Thomas J. Luetzow, MD, has been appointed by the AMA as an alternate representative on The Joint Commission’s Ambulatory Health Care Professional and Technical Advisory Committee. The appointment will begin January 1, 2008 and span two years. As part of the committee, Dr. Luetzow will help represent the Wisconsin Medical Society and provide expert advice to help The Joint Commission develop and refine standards, survey processes and elements of performance.

YOUR PRACTICE. YOUR FUTURE.

California orders Blue Cross to stop using controversial confidentiality agreement

The California Department of Managed Health Care (DHMC) recently ordered Blue Cross of California (Blue Cross) to stop using a confidentiality agreement it required physicians to sign prior to negotiating contracts with Blue Cross, which forced physicians into negotiating and signing contracts without consulting a legal or financial advisor, unless that advisor was approved by Blue Cross. Under the confidentiality agreement, which Blue Cross presented on a non-negotiable “take it or leave it” basis, Blue Cross had the right to determine “at its sole and absolute discretion” whether or not a physician could use a particular attorney or negotiator.

The California DHMC called the agreement an “unlawful and unfair business practice,” and found that due to Blue Cross’s large market share, the threat of not being able to negotiate a contract with Blue Cross presented an unreasonable prospect of financial hardship for physicians if they refused to sign the confidentiality agreement. They also found that it presented an unjustifiable risk of insufficient provider networks and lack of access to health care for Blue Cross enrollees.

Wisconsin physicians who have signed, or been offered, a similar confidentiality agreement from Blue Cross Blue Shield restricting with whom they may consult when negotiating contracts, as well as those physicians who have had BCBS refuse to allow them to use a particular attorney or advisor to negotiate a contract, should contact Merry Earll at the Society.

EDUCATIONAL PROGRAMS

Vaccine administration under the Part D Program starting January 1, 2008

The Tax Relief and Health Care Act (TRHCA) of 2006 modified the definition of a Part D drug to include “for [Part D] vaccines administered on or after January 1, 2008, its administration.” Consequently, beginning January 1, the Part D program will cover vaccine administration costs associated with Part D vaccines. Thus, the reimbursement currently available in 2007 under Part B will cease, and reimbursement will be available solely under Part D.

The Centers for Medicare & Medicaid Services has outlined a number of options for Part D plans to consider regarding access to Part D vaccines and their administration. Beneficiaries should call their Part D plan in advance and inquire about what method works best for them.

Providers with questions about Part D vaccines and their administration can learn more in this special edition MLN Matters article: "Reimbursement for Vaccines and Vaccine Administration Under Medicare Part D."

In 2008, the Society's Education Department remains committed to providing high-quality educational programming and information for Society members and their staff. In addition to face-to-face seminars, teleconferences and our annual Midwest Coding and Practice Management Symposium, we will continue to provide you with practice management news and updates through Medigram and periodic e-mail. We also encourage you to visit our "frequently asked questions" Web page often.

FYI: FOR YOUR INSURANCE

Frozen pipes can wreak havoc

Thousands of families have one or more rooms in their homes ruined and their lives disrupted each winter by water pipes freezing and breaking. According to the Institute for Business and Home Safety, claim payments by all insurers over the past decade for these kinds of losses have exceeded $4 billion.

When the outside temperature drops below 20 degrees Fahrenheit, water pipes in homes will little or no insulation are likely to freeze and break. In fact, a one-eighth inch crack in a pipe can spew out more than 250 gallons of water a day, destroying floors, furniture, appliances and personal items.

Homeowners can avoid frozen pipes by doing some simple measures. They can make sure they have adequate insulation where pipes run along outside walls, floors and ceilings. They can disconnect outside garden hoses, wrap exposed pipes with insulating sleeves or tape, and seal foundation cracks that let arctic air freeze pipes in crawlspaces.

Additionally, insurance loss control experts advise that there are two simple tasks homeowners can do in about two minutes that can help protect pipes and homes when a severe freeze is predicted: (1) open cabinet doors to allow heat to get to piping under sinks and vanities near exterior walls, and (2) run a small trickle of water at vulnerable cold and hot faucets.

Wisconsin Medical Society Insurance and Financial Services, Inc. carries a full line of insurance products to meet your needs, including homeowners insurance. For more information, visit our Web site or contact us using the on-line contact form.

Source: Independent Insurance Agent, 2007, No. 1

FOUNDATION FOCUS

During this season of giving…

As 2007 comes to the end, the Wisconsin Medical Society Foundation Board of Trustees and staff extends our heartfelt thank you to all of our donors for their generosity. Behind each dollar that we have awarded for a scholarship, community grant, fellowship or medical student loan, are individuals who are directly impacted by your contributions. To add your support, click here or 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.

Personal expressions of appreciation like the following are thanks to you, our donors:
  • “Thank you for the generous scholarship… I will continue my involvement with the Wisconsin Medical Society and hope to one day give my financial resources back to other aspiring physicians.” —Robert Beyer, Medical College of Wisconsin
  • “I really appreciate everything the Foundation has done for me… between the white coat, award monies and interest-free loans, you’ve been a great help, and for that I am thankful.” —Chris Luty, UW School of Medicine & Public Health
  • “I sincerely wish to thank you… It has been especially financially challenging with my son and I both working toward college degrees at the same time. Your support will not be forgotten.” —Amy Lavin, UW Eau Claire School of Nursing
  • “More than 275 attendees had the opportunity to learn, network, build skills and take home resources on reducing the burden of tobacco. The conference also served as a motivating force to get re-energized and get more involved in tobacco control issues.” —Final Report, Grant to SmokeFree Wisconsin to support the 2007 Wisconsin Tobacco Prevention and Control Board Conference
  • “The Health Fair offered an excellent opportunity to improve team-building and leadership skills and provided unique, hands-on education about community health, preventative health and cultural issues in health care. Patients and student volunteers benefited from their mutual interaction.” —Final Report, Grant to the UW School of Medicine & Public Health to support the Medical Students for Minority Concerns 2007 Minority Health Fair
  • “The best part about having a summer fellow is that Holly was willing to work on a project that I needed completed (based upon our community needs assessment and community health plan) and not only did she share the same interests but was very motivated.” —Terri Kramolis, RN, MS, Ashland County Health and Human Services, reporting on the work completed by Medical College of Wisconsin student, Holly Grunst, through her 2007 Summer Fellowship in Government and Community Service
Operation: Education program at UW School of Medicine & Public Health
Cops ‘N Kids Nutrition Education Program in Racine
2007 Presidential Scholar recipient Jaime Hook (second from left) with other medical students
White Coat Investiture Ceremony at the Medical College of Wisconsin


As we look ahead to 2008, we are excited about the projected increase in funds available for our mission to support medical and health education.
 
2005
2008 Budget
Scholarships
$46,500
$76,600
Grants
$69,500
$73,000
Fellowships
$3,500
$35,000 (a 10-fold increase!)

This growth is a tribute to each of you as a donor. We look forward to reporting back on progress toward these goals throughout 2008 in Medigram articles, our newsletters and our annual report to the Society’s House of Delegates.

We wish all of you a wonderful holiday and great health in 2008.

FAQ

Question:
How do I Log in to the “Members-only” section of the Society Web site?

Answer:
If you are a Society member and you’ve forgotten your username and password, you’ll need to reset your password. To do so, follow these simple steps:
  1. From the left menu bar, click “Log in”
  2. Click the “Request New Password” tab
  3. Enter your e-mail address
  4. Click “E-mail new password”
  5. You will receive an e-mail message from it@wismed.org
  6. Click the link in that e-mail message. (Your username is on the first line and in the subject)
  7. Click “Log in”
  8. Enter new Password (twice)
  9. Click “Submit”

To confirm the new password is working:
  1. Click “Sign Out”
  2. Click “Log in”
  3. Enter your username (NOT your e-mail address) and password
  4. Click “Log in”

If you have questions about this, e-mail communications@wismed.org.

QUALITY CORNER

The Centers for Medicare & Medicaid Services (CMS) has announced details of the 2008 Physician Quality Reporting Initiative (PQRI) program. As in 2007, participating eligible professionals may earn a 1.5 percent bonus by successfully reporting at least three quality measures for at least 80 percent of the cases in which a measure was reportable.

The complete specifications for the 119 measures that make up the 2008 Physician Quality Reporting Initiative (PQRI) are available here.

Details of the changes made from the 2007 PQRI Specifications are described in the document entitled "2008 PQRI Measure Specifications Release Notes, Version 1.0" available here.

For additional information please refer to the PQRI Web site or contact Cindy Helstad at the Society at 608.442.3751.