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Medigram - January 29, 2009


NEWS BRIEFS

Difficulty getting your patients into nursing homes? Share your experience

The state’s well intended efforts to ensure that nursing home patients are safe has impacted physician care by sometimes delaying hospital discharge and sometimes denying placement close to home. This may happen more often with patients at risk of fall or confusion. In an effort to gauge the scope of this issue, Tim Bartholow, MD, Society senior vice president of Member Services, Policy Planning and Physician Professional Development invites your feedback. Click here to share a brief anecdote or opinion on this topic. We will share your feedback with Tom Moore of the Wisconsin Health Care Association.


Get to know candidates for Society offices

Society members may now view letters of intent and candidate questionnaires from physicians seeking nominations for the positions of President-Elect, Speaker and Vice Speaker of the House of Delegates, and AMA Delegate and Alternate Delegate. The new on-line candidate page increases the transparency of the nomination process and gives the entire membership the opportunity to “meet” the physicians who endeavor to serve the Society in the various offices.

Click here to access the list of candidates and the information they provided. This information is posted in the Members Only section of the Society’s Web site. (Note: If you are not currently logged in to the site, you will be asked for your username and password. If you do not remember this information, click here for login instructions.)

The Nominating Committee will meet on February 6, 2009, at 4 p.m. at the Wisconsin Medical Society to interview candidates and prepare a slate of nominees for the House of Delegates.


UHC extends appeal deadline

UnitedHealthcare (UHC) has agreed to extend the deadline from January 27 to February 11 for physicians to appeal their rating in its Premium® Designation Program (PDP). UHC will review all properly filed appeals received by this date prior to its use or public release of these new ratings. Physicians who are unable to meet this new deadline may still appeal their rating at any time, and UHC will update any changes in physician ratings on a weekly basis.

UHC sent letters to physicians participating in PDP in December regarding their “quality” and “cost efficiency” ratings under the program. Those letters included information about the appeal process. If you do not have that letter, click here for instructions for requesting your ID and password, which are required to access your PDP data. For more information, including instructions on the steps necessary to appeal a rating, click here.


Call for speakers—10th Annual Midwest Coding & Practice Management Symposium

The Wisconsin Medical Society is seeking speakers for the 2009 Midwest Coding & Practice Management Symposium to be held October 18-20 at the Kalahari Resort in Wisconsin Dells. Physicians, coders, group managers and other health care professionals comfortable presenting to a large group are encouraged to participate. Topics this year will include E/M, pediatrics, surgery, compliance and more. If you are interested in sharing your specialized knowledge or there is a topic you would like to see added to the agenda please e-mail Penny Osmon.


Fee assessment for Wisconsin-licensed physicians mailing soon

The Wisconsin Department of Health Services (DHS) notified the Society that it will soon be mailing fee assessment notices to all Wisconsin-licensed physicians as required by state law. Some physicians will not be sent letters because their assessments have already been paid by the health care organizations with whom they are affiliated.

This annual assessment is not related to state licensing fees but is a separate fee required under Chapter 153, Wis. Stats., to support the costs of utilizing health care information for health care quality and safety improvements. The assessment amount for State Fiscal Year 2009 is $70. The DHS Web site contains information about this requirement and who may be exempt. Click here to learn more.


AMA award nomination deadline approaching

The deadline for nominations for the American Medical Association Awards Program is February 23. Awards include AMA Medal of Valor, Distinguished Service Award, Citation for Distinguished Service, Scientific Achievement Award, Benjamin Rush Award for Citizenship and Community Service, President's Citation for Service to the Public, Joseph B. Goldberger Award in Clinical Nutrition, Dr. William Beaumont Award in Medicine, AMA Foundation Award for Health Education, Medical Executive Lifetime Achievement Award, Medical Executive Meritorious Achievement Award, and the Isaac Hays, MD, and John Bell, MD, Award for Leadership in Medical Ethics and Professionalism. (Click here for more information about each award.)

Nomination forms and instructions can be found at this link on the AMA Web site. If you would like to suggest someone for the Society to nominate, please e-mail your suggestion and supporting information to Dana Jansen by February 13.

YOUR PRACTICE. YOUR FUTURE.

Physicians should review closely hold harmless clauses in managed care contracts

Managed Care Organization (MCO) contracts can be daunting, as they are often long and contain small print and extensive legal terminology. Physicians should review closely such contracts and, when possible, negotiate changes to the contract language to better protect their interests. While the entire managed care contract warrants careful review, the “hold harmless” clause is a contract area that warrants close review, and deletion from the MCO contracts whenever possible. Otherwise known as indemnification clauses, hold harmless clauses are included in many MCO contracts, and they expose physicians to greater liability. It is especially important for physicians to understand this, because many professional liability insurance providers specifically exempt such clauses from professional liability coverage, which may result in the physician being exposed to the MCO’s liability.

Click here to read more…

CAPITOL INSIDER

Governor’s State of the State address touches health care issues

There were no surprises in last night’s State of the State address, with Governor James E. Doyle painting a grim picture of the state’s economy. In the address, Gov. Doyle referred to estimates of a $5.4 billion budget deficit for the upcoming biennium. Today, the Legislative Fiscal Bureau revised that number to $5.7 billion due to lower-than-expected tax collections. As other states have reduced their Medical Assistance programs because of growing deficits, Gov. Doyle perhaps foreshadowed proposing a similar path when he gives his budget address in February: “I am not going to say we won’t make reductions in Medicaid,” Doyle said, “but I will not allow cuts to undermine our ability to get a sick kid to a doctor.”

State of the State speeches are usually the vehicle for announcing major new proposals or programs, none of which were mentioned last night. Gov. Doyle did highlight some legislative priorities where Society policy is in agreement:
  • Requiring private insurance to cover autism treatment
  • Authorizing sobriety checkpoints to combat the state's drinking problem
  • Making a third OWI offense a felony; state law currently makes 5th offense OWI a felony
  • Instituting a statewide workplace smoking ban
Interestingly, the Governor did not mention his BadgerChoice proposal from the 2008 State of the State address, aimed at government getting involved in small businesses health care pooling. Budget observers believe the proposal is now too expensive to be included in the budget.

Stay tuned to future editions of Medigram for more information about the state budget. For more information, contact Mark Grapentine, JD.


Bipartisan effort to constitutionally protect IPFCF-like state funds underway

Legislators will soon introduce a resolution that would amend the state constitution to protect monies in segregated funds—like the Injured Patients and Families Compensation Fund—from being used for purposes other than original intent. Rep. Gary Tauchen (R-Bonduel) and Sen. Jeff Plale (D-South Milwaukee) announced Wednesday their intention to “prevent Wisconsin governors and legislators from using segregated funds as a piggy bank to solve the state’s fiscal problems.” The Legislative Fiscal Bureau provided Rep. Tauchen with a list showing more than a billion dollars in such recent transfers and raids.

To amend the Wisconsin Constitution, two consecutive sessions of the Wisconsin Legislature must pass the exact same resolution language. Then, the question must pass a statewide referendum. This year’s effort is similar to last session’s AJR 34, which also enjoyed broad bipartisan support. That measure passed the Assembly 91-6 late in December 2007, but failed to get a vote in the State Senate.

While this resolution will not undo the 2007 raid on the IPFCF (the Society’s lawsuit continues), the Society strongly supports this effort; call your State Senator and State Assembly Representative and ask them not only to support the measure, but to push their leadership to schedule a vote on the resolution. Visit the State Legislature’s Web site to get your legislator’s contact information.

For more information, contact Mark Grapentine, JD.


Medical license process improving

The Society met with senior staff from the Department of Regulation and Licensing (Department) January 23 to receive a progress report on efforts to improve customer service for physicians applying for their initial Wisconsin medical license. The Department, responding to concerns raised in 2008 by both the Society and the Wisconsin Hospital Association, shifted internal staff to concentrate on physician licensing while collaborating with the Medical Examining Board (MEB) on ways to streamline the application process.

The Department reported positive progress: the time lag between receipt of a license application and the beginning of application processing has dropped dramatically. The Department began tracking this process time at the request of MEB chair Gene Musser, MD, who also attended the meeting.

The Society has noticed a drop in the number of complaints from physicians and clinics regarding the Department’s processing time and responsiveness, and will continue to closely monitor member satisfaction and communicate regularly with the Department on this issue.

For more information, contact Mark Grapentine, JD.

EDUCATIONAL PROGRAMS

Accurate charge capture—It affects your bottom line!

Are you cashing in on all of your office visit revenue opportunities? Many organizations spend a great deal of time concentrating on the front and back end of the revenue cycle. But they may overlook the middle section—charge capture, which can be a costly mistake. Charge capture is simply documenting the services performed and billing for them. Missed opportunities include administration fees, in-office lab services, choosing accurate HCPCS codes and nurse visits. To help you identify potential revenue opportunities you could be cashing in on in 2009, the Wisconsin Medical Society is offering a teleconference February 17. Click here for more information and to register.

QUALITY CORNER

AHRQ reports highlight findings from Health IT Portfolio

The AHRQ National Resource Center for Health IT has released a series of new reports that highlight lessons and best practices from AHRQ's Health IT Portfolio. Each report provides details on common challenges and lessons that AHRQ's grantees have faced when implementing and using health IT systems, such as electronic health record (EHR), computerized provider order entry (CPOE), telehealth and barcode medication administration (BCMA) systems. Click here for more information.

FAQ

Question:
If there are errors or omissions in the 2009 CPT book, where would someone find this updated information?

Answer:
This information, known as the CPT errata, can be found on the American Medical Association (AMA) Web site at this link, which is updated as errors and omissions are identified throughout the year. The AMA also publishes clarifications and corrections through the CPT Assistant articles published monthly.