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Medigram - July 2, 2009


TOP STORY

Physician groups show support for Society’s lawsuit to return $200 million to Fund

Physicians and medical organizations across the state support the Society’s efforts to restore the $200 million that the state transferred from the Injured Patients and Families Compensation Fund (Fund). Several medical organizations recently filed amicus briefs with the Court of Appeals in the Society’s lawsuit, Wisconsin Medical Society and David Hoffmann, MD v. Michael Morgan. They are:
  • Wisconsin Hospital Association
  • Medical College of Wisconsin
  • Dean Health Systems, Inc., Marshfield Clinic and Gundersen Lutheran Health System, Inc.
  • Wisconsin Academy of Family Physicians, the American Academy of Family Physicians, the Wisconsin Chapter of the American College of Physicians, the Milwaukee District Association of Osteopathic Physicians and Surgeons and the American Medical Association
The Society is filing its final reply brief with the Court of Appeals this afternoon. The newly filed briefs and other court documents are posted on the Society’s Web site. Stay tuned to the Web site and Medigram for updates regarding the lawsuit.

NEWS BRIEFS

Wisconsin leads nation in 2008 National Healthcare Quality Report

Wisconsin was the top performing state across all measures of overall health care quality according to data collected for the 2008 National Healthcare Quality Report, just released by the Agency for Healthcare Research and Quality.

Minnesota earned the top honor in 2007, but Wisconsin moved to the front of the pack by improving in 8 out of 11 areas and ranking “strong” in 11 out of 12 categories in comparison to other states. To view state rankings, click here.


DHS adds on-line option for regional HIE summits

In response to a great deal of interest in the regional health information exchange (HIE) summits announced in the June 18 issue of Medigram, the Department of Health Services (DHS) has decided to Web cast the already scheduled five summits.

Please note that you may sign up for any one of the regional sites if you choose the Web-based option. Whether you participate in a summit on-line or in person, it is important to listen, interact, ask questions and communicate your ideas and concerns about HIE and other health information technology (HIT) to state health officials.

Details about the Web-based summits, including registration information, are available here. If you are unable to participate, the Web casts will be recorded and can be viewed at a later date.


CMS proposes payment rate changes for services provided by MPFS physicians

The Centers for Medicare & Medicaid Services (CMS) announced yesterday a set of proposed changes to policies and payment rates for services to be furnished during the 2010 calendar year by more than 1 million health care professionals who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals and other settings.

CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.

CMS is also proposing to stop making payment for consultation codes, which are typically billed by specialists and are paid at a higher rate than equivalent evaluation and management (E/M) services. Instead, health care professionals will use existing E/M service codes when providing these services. Resulting savings would be redistributed to increase payments for the existing E/M services.

Click here to read the full CMS press release on the proposed payment rate changes.


New resources for developing free community clinics available from DPH

The Wisconsin Department of Public Health (DPH) has expanded its list of tips and resources for developing free clinics, rural health clinics and federally qualified health centers. The new information is housed on DPH’s Primary Care Web pages, available here.

This resource list was developed in response to an increasing number of questions about what communities can do to improve access to care for their underserved populations, many of which arose during a May 14 teleconference on community development, sponsored by the Wisconsin Primary Health Care Association. View the complete PowerPoint on Health Care Access Models from the teleconference here or contact Anne Dopp at DPH if you have questions on this topic.


New CMS Web page outlines federal incentives for EHR adoption

A new Web page concerning health information technology (HIT), as provided for in the American Recovery and Reinvestment Act of 2009, is now available from the Centers for Medicare & Medicaid Services (CMS).

This page contains information pertaining to the Medicare and Medicaid incentives for electronic health records (EHR) adoption and important links to related Web sites at the Department of Health and Human Services. Other information on this page includes:
  • A CMS fact sheet and questions and answers pertaining to the incentive programs
  • Links to press releases about the process of defining “meaningful use”
  • Resources to help you meet HIPAA requirements regarding HIT, privacy and security
Click here to visit this new resource.


Kaiser Family Foundation issues new report on federal health care reform


President Obama has outlined eight principles for health care reform, seeking to address not only the 45 million people who lack health insurance but rising health care costs and quality issues. In Congress, a number of comprehensive reform proposals have been announced as the debate about how to overhaul the health care system begins. To help health care professionals and policymakers put these proposals in perspective, the Kaiser Family Foundation has issued an interactive side-by-side comparison of the leading comprehensive reform proposals across a number of key characteristics and plan components.

Included in this document are proposals for moving toward universal coverage that have been put forward by the president and members of Congress. This side-by-side comparison will be updated regularly to reflect changes in the proposals and to incorporate major new proposals as they are announced.

View the most current version of the report here.

CAPITOL INSIDER

Biennial budget signed: Progress made, but challenges ahead

Gov. Jim Doyle, after making 81 vetoes Monday, signed the $61 billion state biennial budget into law as 2009 Act 28. Here are some highlights from the bill:
  • The state’s Medical Examining Board (MEB) will become a dedicated work unit within the Department of Regulation and Licensing (DRL). This means that for the first time, the license fees physicians pay will go solely to MEB operations, not to the other boards within DRL.
  • The Department of Health Services (DHS) is required to find about $600 million in savings from the Medicaid program. The Society will continue to press Medicaid staff for greater collaboration as this savings target looms this biennium.
  • The budget includes an expansion of the state’s Medicaid program to include childless adults who fall below a certain income threshold and meet other requirements. The BadgerCare Plus Core Plan takes effect July 15 and is funded primarily through the new tax on hospital revenues. Click here to read an article describing the program.
  • A number of changes were made to the state laws related to health care records, including a change in the maximum fees that can be charged for copies of health care records. Watch for additional information on these changes in future editions of Medigram.
  • Other provisions include a 75-cent increase in the per-pack cigarette tax and a provision for law enforcement officers to pull over drivers solely for not wearing a seatbelt.
The budget process was notable for two items that were not part of the final Act:
  • Gov. Doyle’s proposal to lower the attachment threshold for joint and several liability from 51 percent liability to 1 percent liability was rejected. The Joint Committee on Finance initially floated the compromise of a 20 percent attachment point, but both the Assembly and Senate removed that provision in their separate versions of the budget.
  • A statewide smoking ban had been a part of the initial budget proposal but was pulled from the bill and instead enacted as standalone legislation. Read the Legislative Council summary of 2009 Act 12 here. That ban takes effect July 5, 2010.
For more information on these issues, contact Mark Grapentine, JD.

YOUR PRACTICE. YOUR FUTURE.

Inspector General’s testimony on health care fraud now available on-line

Daniel R. Levinson, the nation's Inspector General, recently presented testimony about health care fraud before the Subcommittee on Health of the House Energy and Commerce Committee on Health Care Reform. His full statement is now available on the Web site of the U.S. Department of Health and Human Services’ Office of Inspector General. Click here to read it.

FOUNDATION FOCUS

White Coat Campaign: Small gifts have powerful impact

Some wonderful connections have been made through the Wisconsin Medical Society Foundation’s White Coat Campaign. For instance, one medical student randomly ended up being sponsored by her childhood pediatrician and another reconnected with a distant relative who is now a physician in Wisconsin. Others have made new friends that span generations.

With a gift of just $60, you too can provide a white coat and personal message of welcome and encouragement for a first-year medical student through the White Coat Campaign. The Foundation still needs sponsors for about 65 students, so if you have not participated before, this is the year to get involved. We especially need physicians from rural areas and small towns to provide coats and encouraging words for students in the Wisconsin Academy for Rural Medicine program.

To participate, e-mail Mary Oleson or call 608.442.3756 and indicate that you would like to take part in the 2009 White Coat Campaign.


First Slota-Varma Scholarship awarded

The Foundation is pleased to award the first $2,500 Catherine M. Slota-Varma, MD, Scholarship to Nicholas Kuehnel, a third-year student at the Medical College of Wisconsin.

Over the course of his medical training, Kuehnel has developed a strong desire to pursue a career in pediatrics. He is very involved in school and volunteer activities with an emphasis on interacting with youth. He is also a member of MCW's Pediatric Interest Group, participates in the Adolescent Obesity Education Program and volunteers at a camp for children with cancer.

In her letter of recommendation, Sue Haldemann, PhD, of MCW Student Support Services, stated: “Nick’s community activities point to his strong desire and commitment to working with children. When you read his description of his interactions with children, it becomes clear that he has a great compassion for them and will do whatever he can to improve the quality of their lives. This is the type of future pediatrician that every family needs.”

This is the type of pediatrician the Wisconsin Medical Society knew and admired in Dr. Slota-Varma as well. A longtime Society member and member of the Board of Directors, former chief of staff of Children’s Hospital of Wisconsin and past chair of the Department of Pediatrics at St. Mary’s Hospital in Milwaukee, Dr. Slota-Varma will be remembered for her compassion, dedication and optimism as well as her exceptional talents as a physician. For more information on Dr. Slota-Varma and her scholarship fund, click here.


Scholarship recipient Nicholas Kuehnel sharing some fun with his niece, Ella.

EDUCATIONAL PROGRAMS

July 16 teleconference to address key risk management topics

Practicing medicine can sometimes be as stressful as it is rewarding—and as the face of medicine changes, the potential for risk increases. A teleconference titled And You Think You’ve Had a Bad Day!—taking place Thursday, July 16 from noon to 1:15 p.m.—will explore some of the toughest risk management situations physicians face in their practices, including drug-seeking patients, patient noncompliance and patients who can’t pay.

Presented by Laurette Salzman, CPHRM, of ProAssurance Companies, this teleconference will better enable participants to:
  • Describe difficult risk management situations and their solutions.
  • Identify physician practices that make medical malpractice lawsuits difficult to defend.
The Wisconsin Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Wisconsin Medical Society designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The program is one in a series of risk-management sessions being offered this year by the Wisconsin Medical Society and ProAssurance Wisconsin Insurance Company (formerly PIC WISCONSIN). Society members who have chosen ProAssurance as their insurance carrier through Wisconsin Medical Society Insurance and Financial Services may qualify for a 2.5 percent reduction of their premium at renewal time for participating in one of these programs. To see if you qualify for this premium discount or if you have questions about applying for medical professional liability insurance through Wisconsin Medical Society Insurance and Financial Services, please click here.

Click here for more information about this educational program, including registration details.

QUALITY CORNER

AHRQ Effective Health Care Program seeks your input

Through a partnership with the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program, the U.S. Preventive Services Task Force is inviting the public to comment on the key questions of the evidence on screening for thyroid disease. To provide comments, please click here and select “Effectiveness of Screening and Treatment of Subclinical Hypo- or Hyperthyroidism.”

In addition, nominations are being sought for the first revision of Registries for Evaluating Patient Outcomes: A User’s Guide, published in 2007 by AHRQ as a reference handbook for patient registries focused on collecting information to assess patient outcomes. Abstracts are due July 10. For more information, click here.