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Medigram - June 6, 2008


TOP STORY

Society endorses resolution to improve patient safety, eliminate adverse events

The Wisconsin Medical Society has endorsed a resolution approved by the Wisconsin Hospital Association aimed at improving patient safety by working to eliminate nine of the most serious adverse events that can occur in hospitals. The resolution, which will be made available to the public tomorrow, covers nine rare serious adverse events and is based on nationally-accepted definitions provided by the National Quality Forum. The list includes:
  • surgery on wrong body part
  • air embolism-associated injury
  • surgery on wrong patient
  • infant discharged to wrong person
  • wrong surgical procedure
  • artificial insemination w/ wrong donor
  • retention of foreign object
  • incompatible blood-associated injury
  • any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances
This resolution states that hospitals should not bill patients for hospital costs related to any of the nine events. It also recognizes that while patient safety is the highest priority in health care, serious errors do occur, and Wisconsin is among a small, but growing, number of states to take this voluntary action.

“Patient safety and access to high quality care are top priorities for physicians across Wisconsin, which is why we support this resolution and look forward to working with hospitals in this effort,” said Society CEO Susan Turney, MD. “We are extremely proud of the care we deliver, and this is one more way we can improve health care in Wisconsin.”

CMS announced in April that beginning October 1, 2008, it will no longer reimburse hospitals the additional costs to cover care incurred for eight hospital-acquired conditions, some of which are also represented by the nine adverse events listed above. (Click here to access a CMS fact sheet with more detailed information.) Although this change directly impacts hospitals, physicians will also likely be affected. The Society has put together a workgroup to examine the impact these policy changes may have. Watch future issues of Medigram for more information, and contact Nancy Nankivil if you have questions.

NEWS BRIEFS

Register now to access 2007 PQRI feedback report

The Centers for Medicare & Medicaid Services (CMS) has announced that 2007 Physician Quality Reporting Initiative (PQRI) Final Feedback Reports will be available in mid-July on a secure Web site. Reports will include information on reporting rates, clinical performance, and incentives earned by individual professionals, with summary information on reporting success and incentives earned at the practice level. They will be available to each practice, identified by Taxpayer Identification Number (TIN), under which at least one eligible professional reported 2007 PQRI quality measures data.

Although the reports are not yet available, CMS recommends that practices set up their on-line account in order to access their report as soon as it becomes available. Registering for access through a new CMS security system known as the Individuals Authorized Access to CMS Computer Services—Provider Community (IACS-PC) is the first step.

Currently only practices with multiple professionals or individual professionals with staff members who will access the PQRI feedback reports should register with IACS. To establish a practice as an IACS-PC organization, a security official for the organization must be registered. Verifying the security official’s authorization to access the practice’s confidential information is not fully automated and can take some time, so such practices should begin registering their representatives for IACS accounts now.

Individual physicians who will access this service personally, and have no staff who will use the system should wait until further notice before registering in IACS.

For more information about the registration process, click here and here to access MLN Matters articles. CMS has indicated that more information about registering with IACS and accessing 2007 PQRI Participant Feedback Reports will soon be posted here.

Additionally, the CMS Provider Communications Group will host the fourth in a series of national provider conference calls on PQRI Wednesday, June 18 from 2:30 to 4 p.m. This call will provide information on accessing 2007 PQRI Feedback Report and an overview of the 2008 PQRI participation options along with a question and answer session. The call is free, but participants must register by 2:30 p.m. on June 17 to receive call-in information. Click here to register. For those who cannot participate, a replay will be accessible from 4:30 p.m. June 18 through June 25. To access the replay, call 800.642.1687 and enter passcode 47474458.


Reminder: Dane County’s ‘MedDrop’ offers safe disposal of unwanted meds

Residents of Dane County can easily and safely dispose unwanted prescription and over-the-counter medicine Saturday, June 7 from 9 a.m. to 1 p.m. The Madison Patient Safety Collaborative is once again sponsoring the “MedDrop,” event. Dane County residents can drop off old medications at the City of Madison Transfer Station—121 E. Olin Avenue (near the Goodman Pool). For more information, click here.


Society’s Medical Records & the Law seminar next week

Many questions arise when trying to determine how the law affects medical practice. During this day-long seminar sponsored by the Wisconsin Medical Society, a panel of presenters will provide participants with an overview of federal and Wisconsin state laws as they relate to medical records.

Participants will learn about a multitude of issues related to medical records including content and function of medical records, documentation principles, ownership of medical records, retention and destruction of medical records, the laws surrounding confidentiality and release of medical records, and electronic medical records. In addition, presenters will lead discussions using case studies and hypothetical situations, allowing seminar participants to discuss and apply the knowledge shared during the seminar to everyday situations. All attendees will receive a comprehensive resource manual prepared by the Wisconsin Medical Society.

The seminar is being held in Green Bay June 10, Madison June 11, and Pewaukee June 12, and there is still time to register. Click here for more information.

CAPITOL INSIDER

Society asks State for licensing delay answers

The Society has been hearing a growing number of complaints that the state’s licensing process for physicians new to Wisconsin is too lengthy and unresponsive. The wait for licenses can sometimes approach six months, with physicians or office staff unclear regarding what was causing delays. This confusion has been compounded due to difficulty reaching appropriate staff at the state’s Department of Regulation and Licensing (DRL), which administers the licensing process. While Society staff have helped many clinics gain licenses for their new physicians on an ad hoc basis, it became clear that DRL was experiencing some systemic problems in need of great improvement. The Society joined the Wisconsin Hospital Association in requesting a meeting with DRL to share these concerns.

At a meeting with DRL officials this week, the Society and WHA shared evidence of the concerns. This memo describes some specific instances of delays or DRL-caused confusion, while this PowerPoint summarizes results of a poll the Society conducted with the Wisconsin Medical Group Managers Association (WMGMA) of many clinics around the state regarding licensing time and experience. The DRL staff acknowledged problems with timeliness, accuracy and customer service in this area, and described present and future efforts to address the problems. DRL is already studying the Medical Examining Board's (MEB) requirements for different forms and information to gauge if there are redundancies that can be eliminated. The MEB is scheduled to discuss the issue at its next meeting on June 18, and the DRL plans to move one full-time staff member to assist the licensing effort.

The meeting results were positive; the Society expects DRL to achieve measurable short- and long-term improvements that allow license applications to be processed in a more reasonable timeframe. The Society will continue its positive relationship with DRL to ensure that this mutual desire for progress leads to actual results.

For more information, contact Mark Grapentine.

F.Y.I. FOR YOUR INSURANCE

Society member insurance options at age 65

Wisconsin Medical Society members have the opportunity to purchase a Society-endorsed health insurance plan either on an individual basis or as a group. This plan, available through WPS, includes the following additional benefits for members and their spouses:
  1. Lifetime coverage for retirees
  2. Extended coverage for life of widowed spouses
  3. Continuous coverage for spouses of Society members with a Medicare Supplement Plan
Click here to read a scenario that highlights benefit #3 by explaining what happens when a physician with a Society-endorsed plan becomes eligible for Medicare and his or her spouse is not.

WMSIFS has also introduced a new long term disability insurance plan exclusively for Society members, which features a special introductory offer for Guarantee Issue when you enroll before October 1, 2008. To read more about this coverage click here to review the plan flyer.

For additional information about any of the Society’s insurance products and financial services, contact a Wisconsin Medical Society Insurance and Financial Services agent at 866.442.3810 or complete this on-line contact form.

QUALITY CORNER

Physician level quality measures: CMS asks providers to help test new measures

The Centers for Medicare & Medicaid Services (CMS) will begin testing 11 new quality measures for possible adoption in the Physician Quality Reporting Initiative (PQRI) Program in future years. These new measures focus on kidney disease, skin disease, eye care, imaging, arthritis and cancer. CMS is encouraging providers to submit data for these test measures on Part B claims from July 1, 2008, through September 30, 2008. Providers will not receive financial incentive for reporting these test measures.

To learn more, click here and select the “Measures/Codes” link on the left side of the page.


2008 PQRI National Provider Call now available

CMS has released a PowerPoint presentation with an overview of the alternative reporting periods and alternative criteria for satisfactorily reporting quality measures for the 2008 PQRI. To access the presentation, click here and select the CMS Sponsored Calls tab on the left side of the page. Scroll to the Downloads section under the heading PowerPoint Presentations and select “National Provider Call 05/28/2008.”

FAQ

Question:
How long should our clinic retain a patient’s medical records?

Answer:
Different medical records are required to be kept for different lengths of time depending on the treatment setting, the programs involved, etc. For example, Wisconsin Administrative Code Chapter Med 21.03 requires physicians’ offices and clinics to retain patient health care records for a minimum of five years after the last date of entry, or longer if required by law. However, how long records are required by law to be kept and how long they should be kept are separate questions. Due to courts eroding the certainty provided by the statutes of limitations, the Wisconsin Medical Society and many malpractice insurance carriers recommend that physicians and clinics consider maintaining records for at least 10 years since the last date of treatment, or longer if possible.

The Wisconsin Supreme Court has ruled (in Kristy Haferman v. St. Clare Healthcare Foundation, Inc.) that the Wisconsin statutes do not contain a statute of limitations for developmentally disabled, mentally ill and imprisoned minors in medical liability cases. This ruling means that records for developmentally disabled, mentally ill and imprisoned minors should be maintained indefinitely, to ensure the records can be provided if a liability issue arises. Also, records should never be destroyed if related to a matter that is or may be a part of litigation.

For answers to other Frequently Asked Questions regarding legal issues click here (members only).