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Medigram - June 28, 2007


TOP STORY

Governance Task Force chair offers insights

Better representation, greater efficiency. That’s how Terry Hankey, MD, chair of the Wisconsin Medical Society’s Governance Task Force, sums up the group’s recommendations. They are among the top agenda items at next week's Annual Meeting. Click here to listen to Dr. Hankey’s audio interview, in which he summarizes the key aspects of the report. For more information about the Annual Meeting, click here.

NEWS BRIEFS

NPI Contingency Plan released – but you still need to be prepared!

The Centers for Medicare and Medicaid Services issued a contingency plan on April 2 for HIPAA covered entities that will not meet the May 23, 2007 deadline for compliance with the National Provider Identifier (NPI). The focus of the contingency plan seems to be avoiding penalties for those payers that are showing “good faith effort,” but will not be ready to comply with the scheduled deadline.

Physicians and other providers covered under HIPAA should still make every effort to obtain the NPI as soon as possible and document their compliance efforts because if CMS receives a complaint about a physician for non-compliance, the agency will consider whether the physician obtained his or her NPI by the May deadline. Additionally, payers that are ready may opt to stick to the original deadline, and the NPI will be necessary to participate in Medicare’s Physician Quality Reporting Initiative.

Fee for Service Medicare has yet to release their own contingency plan, and Medicare plans to hold a NPI Contingency Guidance Roundtable following the release of this plan.

Additional information, including a comprehensive list of FAQs can be found at: www.cms.hhs.gov/NationalProvIdentStand. If you have not already done so, click here to apply on-line for your NPI.


Medical students collecting vacuums for worthy cause

In an attempt to address serious medical concerns, such as high rates of asthma and other respiratory problems among residents of Allied Drive in Madison, the University of Wisconsin chapter of the American Medical Association-Medical Student Section is sponsoring a vacuum drive this spring.

The AMA-MSS chapter is looking for gently used vacuums or monetary donations that will go toward the purchase of new vacuums at a reduced price. The chapter is pursuing grants from the AMA and donations from local department stores. They hope to encourage the community at the medical school and UW Hospital to become involved as well.

With a population of approximately 5,000 people, the Allied Drive area has one of the highest rates of poverty and crime in Dane County. The diverse community experiences a high transient rate for those with low incomes, ex-offenders, or those with a history of drug or alcohol abuse. Members of the Allied Community often struggle to meet their basic needs, and face challenges such as employment, health care, childcare and transportation. The AMA-MSS drive is hoping to tackle health related issues that are in correlation to the poor state of cleanliness in residents’ homes due to the inability to afford cleaning supplies, such as larger appliances like vacuums.

The drive will continue through the end of June with the possibility of running longer. Any interested donors can contact community service committee chair Kristine Rustad at kcrustad@wisc.edu or at 414.430.0749 for more information. Checks should be made payable to Rachel Uttech and will be directly deposited into the AMA-MSS account until the end of the drive when a large purchase of vacuums will be made. Donations of cash or check can be sent to: c/o Kristine Rustad, Med 1, Student Services, 2130 Health Sciences Learning Center, 750 Highland Ave., Madison, WI 53705.


AAP Web site offers resources to help people cope

Following the tragic shootings Monday at Virginia Tech, the American Academy of Pediatrics assembled a collection of resources on its Web site designed to help parents, teachers, students, schools and pediatricians cope with the aftermath of this terrible event. Additional resources are provided on violence prevention, school safety and promoting mental health. Visit www.aap.org/featured/resourcepage.htm to learn more.


Digital Healthcare Conference coming in May

Leaders of major health care institutions and national experts will convene May 9-10, 2007 in Madison to discuss key strategies that will allow them to continue to deliver quality care while navigating the complex technologies that are available for use today.

At the Digital Healthcare Conference, attendees will learn how industry leaders are providing better information and knowledge to deliver benefits that include improved and faster communications, electronic health records and improved patient care. Panelists will discuss the new technologies available, challenges they have encountered, and how to determine when you will start to see the benefits of implementing new health care strategies.

Full agenda, speaker bios and more information are available at http://dhc2007.com.

YOUR PRACTICE. YOUR FUTURE.

Do physician non-compete agreements violate public policy?

By Robert Dreps

The Illinois Supreme Court recently answered that question “no,” and ruled that any change in that policy would have to come from the legislature. The same rule applies in Wisconsin, although this state is more likely to find activity, temporal, and geographic restrictions in non-competition agreements unreasonable and, therefore, unenforceable.

Physician Non-competition Agreements in Illinois
The Illinois case involved two cardiologists who had been employed by St. John Heart Clinic in Chicago. Mohanty v. St. John Heart Clinic, S.C., No. 101251, N.E.2d, 2006 WL 341970 (Illinois, December 21, 2006). Their employment agreements prohibited them from engaging in the practice of medicine upon termination of their employment at any of the four hospitals where the clinic’s sole owner had privileges. One physician was restricted for a period of three years at the four hospitals and within a two-mile radius of the clinic’s two offices; the other physician was restricted for a period of five years at the four hospitals and within a five-mile radius of those offices. The court found both agreements reasonable.

The Illinois court rejected the argument that physician non-competition agreements should be held void as against public policy because they restrict patient choice. Although attorneys may not enter into non-competition agreements in Illinois and most states, including Wisconsin, for that reason, the court noted that the AMA’s Council on Ethical and Judicial Affairs merely discourages such agreements and has not found them unethical as they are under the Rules of Professional Conduct for attorneys. (See, AMA Opinion 9.02.) The court further noted that those states that do prohibit non-competition covenants in medical employment contracts (Colorado, Delaware and Massachusetts) did so by legislation and not court rule.

The court went on to find the agreements’ activity, temporal, and geographic restrictions reasonable under Illinois law, in stark contrast to the rule in Wisconsin. Looking at the more restrictive of the agreements, the court ruled that plaintiffs faced no undue hardship because “they are free to practice medicine outside the five-mile limit, which, given the heavily populated Chicago metropolitan area, would not deprive them of employment.” Yet, the same agreements would be held unreasonable and, therefore, void under existing Wisconsin law.

Physician Non-competition Agreements in Wisconsin
Non-competition agreements are only enforceable in Wisconsin if they meet the following five requirements:
  1. Are necessary for the protection of the employer;
  2. Provide a reasonable time restriction;
  3. Provide a reasonable territorial limit;
  4. Are not harsh or oppressive to the employee; and
  5. Are not contrary to public policy.
To read the full article, click here.

Note: Mr. Dreps is an attorney with Godfrey & Kahn, S.C.’s Health Care Team. This article first appeared in the Spring 2007 Health Law Vantage Point and is reprinted with permission.

EDUCATIONAL PROGRAMS

Coding resources just a click away

The Department of Education and Management Services is committed to providing high-quality educational programming and information for Society members and their staff. And thanks to current health care initiatives like PQRI and the approaching NPI deadline, we have experienced a significant increase in the number of calls and e-mails we are receiving.

To be able to more efficiently address your questions, we are asking that all questions are submitted via e-mail ( efaq@wismed.org ). Our educators will post answers to your questions on-line on the "frequently asked questions" page, where they will be available for all. Please bookmark this page.

We will also continue to provide you with practice management news and updates through Medigram and periodic e-mails. Additionally, other sources for your coding and billing questions are the following.

FYI: FOR YOUR INSURANCE

Selecting medical professional liability coverage? Compare carriers carefully

With so many coverage choices, it is terribly important to understand the differences between medical malpractice carriers. Make sure to compare their operating philosophies, defense records, stability and experience.

PIC WISCONSIN joined the ProAssurance Group family of medical professional liability insurers last year. What does this mean to you? PIC Wisconsin will be there in the event of a claim with the added strength and experience of ProAssurance, a physician-founded group. They will also work diligently to keep your reputation flawless. These attributes are testaments to their long-term commitment of helping physicians keep practicing good medicine.

ProAssurance Group companies vigorously defend non-meritorious claims, including 725 cases tried before juries in 2006. The professional liability industry as a whole reports favorable outcomes in 76.4 percent of cases, while ProAssurance Group outperforms by obtaining favorable outcomes in 86.3 percent of cases. (For these and other numbers, refer to ProAssurance Corporation’s Form 8-K, filed with the SEC on March 5, 2007.)

PIC WISCONSIN, a ProAssurance Group company, defends the practice of medicine. In addition to fighting non-meritorious claims, PIC WISCONSIN provides effective risk management information and consultation to help prevent claims and improve patient safety. The company offers targeted publications, networking sessions, audio conferences, phone consultations, and risk assessments—all designed to help protect physicians and their patients.

Please click here to review PIC WISCONSIN’s Risk Management Services. And to find out how to obtain medical professional liability coverage with PIC WISCONSIN, please use our on-line contact form.

FOUNDATION FOCUS

Last chance

Time is running out to register for the Wisconsin Medical Society Foundation's 2007 Fundraising Event and Silent Auction Thursday, April 26. The event features Stephen Dubner, co-author of the international bestseller, Freakonomics. The silent auction book is now available on our Web site. For more information regarding this event or raffle tickets or to register, click here.


Raffle sales support medical students

Even if you can’t attend the fundraiser, you can still participate by purchasing a raffle ticket from a member of the UW School of Medicine and Public Health student sales force. First prize is two round-trip airline tickets to anywhere in the Continental United States, plus $1,000 spending money. Second prize is a 32-inch flat panel Sharp HDTV.

A portion of the proceeds from the tickets will help support health education activities in a Madison low-income neighborhood, as well as other student initiatives. Additionally, proceeds will help fund the Foundation’s 2008 programs including scholarships and summer fellowships for medical students and community grants.

Help make this a successful project for medical students! For raffle tickets, contact Charlie Czeczok, AMA Student Section, UW School of Medicine & Public Health at caczeczok@wisc.edu, or any Foundation staff member. Tickets are $20 each or 6 for $100. A maximum of 1,500 tickets will be sold. Airline tickets are courtesy of Fox World Travel; minimal exclusions apply.

FAQ

Question:
If a patient has a lab draw through a Venous Access Device and irrigation/flush, can the irrigation be billed separately?

Answer:
No. The irrigation/flush cannot be billed if there is any other service performed and billed during the same encounter.

If you have questions about this or other coding matters, click here to review the Society’s FAQ archives, or e-mail efaq@wismed.org.

QUALITY CORNER

Wisconsin Health Information Exchange announces Emergency Department Linking Project

The Wisconsin Health Information Exchange (WHIE) held a kickoff event for the Emergency Department (ED) Linking Project June 20. The project will provide emergency physicians rapid access to the medical histories of patients who register for care at their facilities. The goal is to improve health care quality by reducing errors and enhancing cost effectiveness. Common protocols and workflows have been established so that regional queries for medical history data occur automatically when patients present for care. Data feeds will include both clinical systems and claims systems. Plans call for the ED Linking Project to be implemented in at least 10 hospitals in the Milwaukee metropolitan area. To read more, including the press release and executive summary, visit the WHIE Web site.

New on-line tools available to help physicians participate in PQRI

The AMA has posted new tools on its Web site that physicians can use to participate in the Centers for Medicare & Medicaid Services’ (CMS) Physician Quality Reporting Initiative (PQRI). PQRI, which kicks off July 1, is a voluntary program to encourage quality of care improvement through the use of 74 performance measures on a variety of clinical conditions. Under the PQRI, physicians who successfully report a designated set of quality measures on claims for dates of service from July 1 to Dec. 31, 2007, may earn a bonus payment of up to 1.5 percent of their total allowed charges for Medicare physician fee schedule services. For more information about PQRI, click here.