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Medigram - February 5, 2009


NEWS BRIEFS

WPS appeals CMS decision to award contract to Noridian; your feedback encouraged

The Centers for Medicare and Medicaid Services (CMS) last month awarded Noridian Administrative Services the Jurisdiction 6 Medicare Administrative Contractor (MAC) contract. (See the Jan 8 Medigram.) On January 26, WPS appealed that decision by filing a bid protest with the Government Accountability Office (GAO).

WPS, headquartered in Madison, has been a CMS-contracted payer of Medicare Part B claims in Wisconsin since 1966. Jurisdiction 6 is comprised of Wisconsin, Illinois and Minnesota. Noridian is located in Fargo, ND.

GAO will issue a decision within 100 days, or no later than May 6. The MAC reform provides for combined administration of Medicare Part A and B. Implementation is scheduled for completion by March 2010; however, that process is on hold until the final decision is issued. For more information, click here.

WPS and the Wisconsin Medical Society share a long history. WPS was created as a division of the Society in 1946, and in 1977 the Society transferred the business, assets and liabilities of WPS to WPS. The company’s longevity in the business and their local presence has resulted in overall excellent contractor/physician relationships. WPS has been responsive, proactive and a leader in the industry relating to education and outreach. If you would like to share a comment or anecdote about your experience with WPS, please click here. Your comments will be forwarded to Penny Osmon, CHC, CPC, CPC-I, PCS, Coding & Reimbursement Educator, and Tim Bartholow, MD, Society Executive Vice President of Member Services, Policy Planning and Physician Professional Development. You will have the option to keep any contact information confidential.


When to make the switch from pediatric to adult care?
Physicians asked to complete on-line survey

The transition from pediatric to adult health care is an important issue affecting Wisconsin’s pediatric patients and families, especially children with special health care needs. Although there is consensus among specialty societies representing family medicine physicians, internists and pediatricians that a transition plan be in place by age 14, the 2005 National Survey of Children with Special Health Care Needs reveals that less than 50 percent of children with special health care needs (12-17 years) receive services needed for transition to adult health care, work and independence.

To explore how transition practices affect this population, the UW Pediatric Pulmonary Center and the Children’s Hospital of Wisconsin in Milwaukee, in collaboration with Wisconsin’s Department of Health Services, is asking health care professionals who treat adults to complete an on-line survey. All responses are confidential and only aggregated results will be shared. Click here to complete the survey.


AMA launches redesigned Web site

The American Medical Association (AMA) launched a new Web site this week that was redesigned to provide physicians, residents and medical students easy access to resources.

Dedicated sections for physicians, residents, and medical students are filled with information and resources specific to each group. Physicians can find billing and reimbursement resources, along with numerous tools ranging from patient education to clinical practice standards. Medical residents can benefit from tips on how to survive the rigors of residency, including advice on handling medical school education debt. Medical students can access information on financial aid, choosing a medical specialty and understanding medical ethics. In addition to exploring the site by professional status, visitors can also search content by subject matter. Topics include physician resources, education and the profession, legislation and advocacy, and AMA news and events.

Click here to view the new look and structure.


2009 John M. Eisenberg Patient Safety and Quality Awards

Information about the 2009 John M. Eisenberg Patient Safety and Quality Award, including nomination and application forms is now available on both The Joint Commission’s and the National Quality Forum’s Web sites. This award provides a unique opportunity to showcase the important patient safety and quality-related work that you are doing within your organization. Nominations and applications are due to The Joint Commission by April 20, 2009.


New free on-line course helps clinicians make better prescribing decisions

A new course for physicians, physician assistants, nurse practitioners and medical students has been created with the overall goal of improving patient experiences with prescription drugs.

SmartPrescribe is a free, on-line course to help clinicians make better prescribing decisions by sharpening their skills for assessing drug-related information. The course, which was developed by Wake Forest University School of Medicine and the Northwest Area Health Education Center of the North Carolina Area Health Education Centers Program, helps prescribers sort through the confusing pharmaceutical messages.

For more information, visit www.SmartPrescribe.org.

QUALITY & EFFICIENCY

Tuesday Quality Forum to focus on transparency—WHIO, the Capitol, the patient and the health care professional

The Wisconsin Medical Society (Society) is kicking off its 2009 slate of Quality Forum meetings Tuesday, Feb. 10 at 9 a.m. This is a very important Forum due to the number of national and state initiatives focused on transparency and the impact they may have on the patient-physician relationship. This Forum is open to all interested Society members. Registration will be limited to 40 participants in person with a call-in number available for those off-site. Click here for key agenda items.

Click here to read more...

CAPITOL INSIDER

Psychologist prescribing bill looming—Grassroots contacts needed

Every legislative biennium non-medical health care groups introduce legislation aimed at broadening their scope of practice. One such bill is already imminent: allowing psychologists prescription privileges. The Society has been working since last September with physician leaders from the Wisconsin Psychiatric Association to help prepare strategy and advocacy materials aimed at educating lawmakers about the issue. The Society is also working closely with the American Medical Association’s Advocacy Research Center to learn the experiences in other states.

The psychologists’ arguments are typical for these scope issues: expanding scope would allow for better access while touting extra education that “equals or exceeds that of most currently licensed prescribers.” (To see an example of the types of information that lobbyists are distributing to legislators, click here. The e-mail in this link is a matter of open record because it was sent to a state office.)

While this issue is a top priority for psychiatrists, all physicians should contact their state legislators to register their concerns over a dramatic broadening of prescriptive powers for a non-medically-trained group attempting to equate their training to that of a physician. Click here for your legislators’ contact information. You can review talking points that psychiatrists are using here.

For more information, contact Mark Grapentine, JD.


State budget to wait for federal stimulus approval

Wisconsin’s 2009-2011 biennial budget is expected to be the most difficult in decades, as the national economic downturn coupled with the state’s provision of extensive benefit programs have coalesced into a $5.7 billion budget deficit. With more than 40 states suffering from differing deficit levels, the federal legislation includes nine figures-worth of assistance as part of the $900 billion proposal, with further amendments on the way. With no concrete knowledge of how much money will come to the states—primarily for transportation improvements and Medicaid funding—the moving target makes crafting a state budget difficult.

Governor James E. Doyle announced Wednesday that he would delay his budget address to the legislature by one week; he will now deliver his budget proposal on February 17 with the hope that the details of the federal package will be known by then. Various estimates put Wisconsin’s share somewhere in the $3 billion—$3.5 billion range. Even with that boost, filling the rest of that deficit will not prove easy or pleasant.

Some major issues the Society will be watching for in the budget address:
  • How the budget will treat the Medicaid program, which alone makes up $1.4 billion of the overall deficit.
  • Whether the budget will propose another raid on the Injured Patients and Families Compensation Fund, despite a proposed 9.9 percent increase in Fund fees for the 2009 Fiscal Year to address an actuarial deficit in the Fund due, of course, to the $200 million raided in the 2007-2009 biennial budget. (The Society’s lawsuit against the State to defend the Fund is still pending.)
Following Governor Doyle’s budget introduction on February 17, the Legislature’s Joint Committee on Finance will deliberate and undoubtedly make changes to the proposal before sending the bill to both legislative houses for further debate. Budget passage is due by the time the next fiscal year begins on July 1; the current biennial budget passed more than three months late, albeit due in part to the two houses controlled by different political parties.

For more information, contact Mark Grapentine, JD.


DRL proposes license fee increase

The State’s Department of Regulation and Licensing (DRL), responsible for administering the Medical Examining Board (MEB) and dozens of other professional boards, has proposed increasing fees physicians pay for an initial or renewal medical license. According to a report filed with the Joint Committee on Finance, DRL proposes increasing the initial license fee from $53 to $75 and renewals from $106 to $170.

While Wisconsin’s license fees are generally lower than those in the rest of the country, Wisconsin’s physicians have also suffered from sub-par service, at least anecdotally. While DRL has made progress in this area, a fee increase should be accompanied by assurances that service will be enhanced.

As reported in previous Medigrams, the Society has encouraged DRL to provide better customer service for processing license applications and renewals; DRL has shown some short-term success, but sustained improvement is necessary. The Society has also discussed different methods DRL could adopt to better match money physicians pay to the Department with the needs of the MEB. The Society will closely examine Governor Doyle’s budget proposal for any innovations in this area.

For more information, contact Mark Grapentine, JD.

FOUNDATION FOCUS

2009 Foundation Fundraising Event April 16

Join us for a unique opportunity to meet Gary Telgenhoff, MD, Forensic Pathologist, Deputy Medical Examiner at the Clark County Coroner’s Office, Las Vegas, and Consultant to CSI: Crime Scene Investigation. Dr. Telgenhoff will dispel some of the myths perpetuated by TV shows like CSI and provide a more accurate and fascinating “behind the scenes” peek into how medicine solves crime. Watch for your invitation in March. Visit www.wisconsinmedicalsociety.org/foundation for more information.




Win a Wisconsin vacation package

The Foundation’s 2009 Raffle prize features four Wisconsin vacation packages, with destinations including Madison, Lake Geneva, Minocqua and Tomahawk. The complete package includes gift certificates for lodging, restaurants and/or activities for each destination plus luggage and four unique bottles of premium wine. It even includes limousine service in the Madison area! The total value of this prize is $2,000. The memories you will create... priceless.

Tickets are $20 each or six tickets for $100. No more than 1,000 tickets will be sold.

The raffle drawing will be held April 16, 2009, at the Wisconsin Medical Society Foundation’s Fundraising Event at the Monona Terrace Convention Center. You need not be present to win. Tickets are available at the Wisconsin Medical Society Foundation office at 330 E. Lakeside St., Madison or from Foundation Trustees or staff members. For more details, contact Mary Oleson at 608.442.3756 or visit www.wisconsinmedicalsociety.org/foundation/events.

Proceeds will help support our scholarship and grant programs.

QUALITY CORNER

AHRQ Evidence Report—Health information technology use

Interactive consumer health information technology (health IT) promises to engage consumers and promote their active participation in improving their health. Interactive technologies provide health information and tools that are patient-centered, offering care and support that integrates individual needs and preferences into clinical information systems. The AHRQ report describes factors influencing the use, usefulness, and usability of interactive consumer health IT for elderly, chronically ill, and underserved populations. It also summarizes the scientific evidence on the effectiveness of interactive health IT applications and identifies gaps in research. By examining factors that influence the use and outcomes of interactive consumer health IT, the report provides a context for future inquiry in the study of applications designed for patients to participate more fully in their health care and health care decisions. To read the report, click here.

FAQ

Question:
What is the best way to speed up the insurance claims settlement process?

Answer:
The Insurance Information Institute offers the following advice:
  • Be prepared to give your agent or insurance company a description of the damage to your property.
  • If the area is safe to access, take photographs of the damaged property.
  • Prepare a detailed inventory of all damaged or destroyed personal property. Make two copies—one for you and one for the insurance adjuster. The list should include a description of the item(s), date(s) of purchase or approximate age, cost at time of purchase and estimated replacement cost.
  • Collect canceled checks, invoices, receipts or other papers to help the adjuster obtain the value of the destroyed property.
  • Make whatever temporary repairs you can to broken windows or damaged roofs and walls to prevent further damage. Save the receipts for any supplies you purchase to make the repairs as your insurance company may reimburse you for some of the expenses you incurred to make the temporary repairs.
  • Secure a detailed estimate for permanent repairs to your property from a licensed contractor to give to the insurance adjuster. The estimate should contain the proposed repairs, repair costs and replacement prices.
  • If your home is severely damaged and you need to find other accommodations while repairs are being made, keep a record of all expenses, such as hotel and restaurant receipts.
For more information, contact Wisconsin Medical Society Insurance & Financial Services at insurance@wiswmed.org or use our on-line contact form.