Welcome Guest, if you have an account you may login

Medigram - March 12, 2009


NEWS BRIEFS

Turney represents Society at White House Regional Forum on Health Reform

Society CEO Susan Turney, MD, today joined physicians, patients, insurers and policy experts in Michigan for the Obama administration’s Regional Forum on Health Care Reform. Doctor Turney was invited to participate by Governor Jim Doyle, who cohosted the event with Michigan Governor Jennifer Granholm, and Melody Barnes, director of the White House Domestic Policy Council.

The Michigan forum is one of a series being held around the country as part of President Obama’s efforts to rally national support for comprehensive changes to the health care system. It comes on the heels of a forum held last week in Washington, DC, that drew participants from across the country, including UW medical student Siavash Sarlati. (See related article below.)

For more information, visit www.healthreform.gov.


Stimulus package to provide Medicare/Medicaid incentives to promote EHR adoption

The $787 billion American Recovery and Reinvestment Act (ARRA) of 2009 passed last month injects more than $100 million into specific areas of health care. One specific provision that impacts practices is additional funding through financial incentives for physicians who adopt and use Electronic Health Record (EHR) systems. (For a summary of the major health care provisions in ARRA prepared by the American Medical Association, click here.)

The ARRA authorizes the Department of Health and Human Services (HHS) to use Medicare reimbursement through defined incentives to reward physicians that qualify as “meaningful users.” Meaningful users are defined as those that meet the following requirements:
  • Use an EHR that is certified as defined by HHS standards and allows for information exchange
  • Using certified EHR technology, reports clinical quality data and other measures as defined by HHS
  • Includes the use of e-prescribing as appropriate
Click here to read more…


Callers to Medicare will be required to verify ID

Effective April 6, 2009, the Centers for Medicare & Medicaid Services (CMS) will require health care professionals to provide the following three data elements for authentication when calling either the Interactive Voice Response (IVR) system or a Customer Service Representative (CSR):
  • The provider’s National Provider Identifier (NPI)
  • The Provider Transaction Access Number (PTAN)
  • The last 5-digits of the provider’s tax identification number (TIN)
The Medicare contractor’s system will verify that the NPI, PTAN and the last 5-digits of the TIN are correct and belong to the caller before providing the information requested. The caller will be allowed only three attempts to correctly provide the NPI, PTAN and the last five-digits of the provider’s TIN.

CMS revised Change Request 6139 on February 10, 2009, to reflect a change in the effective and implementation dates for this new requirement. More information is available in this Medicare Learning Network (MLN) Matters article.


HIPAA COW conducting survey to clarify compliance

Because the implementation specifications of the HIPAA Security Rule are written to be scalable and flexible, many covered entities are uncertain as to whether they are truly compliant with all the standards. To help clarify, the HIPAA Collaborative of Wisconsin (COW) Security Networking Group has created an on-line Benchmarking Survey.

The survey’s goal is to provide Wisconsin organizations with a point of reference on which to focus their compliance efforts. Data will be compiled into a summary of how organizations have interpreted and implemented the regulations, and results will be presented at an upcoming HIPAA COW conference and posted on the group's Web site.

The survey should be completed by the individual within an organization who is primarily responsible for HIPAA Security implementation. It should take only 10-15 minutes and participants will remain anonymous. The deadline is March 27. Click here to complete the survey.


Green Bay’s ‘Doctor’s in Recital’ raises $20K for parenting coalition



Mary Frantz, MD, & Genadi Maltinski, MD

For the third straight year, Green Bay physician musicians took part in the Doctors in Recital fundraiser at St. Norbert College, February 14. The event, hosted by the Brown County Medical Society and Alliance, Heid Music and Steinway & Sons, raised $20,000 for the Adolescent Parenting Coalition, Inc. of Brown County. Nearly 20 doctors donated their time and musical talents to this event.



Donald Jenny, MD

NEWSMAKER

UW med student represents Wisconsin at Obama’s health care reform forum

UW-Madison medical student and Society member Siavash Sarlati had no idea just how far his grassroots health care reform efforts would take him when he launched a discussion group on the topic last December. As it turns out, his first destination was the White House.

Sarlati, a Milwaukee resident who gained US citizenship just two years ago, was one of seven everyday people Obama administration selected to attend its March 5 health care reform forum in Washington D.C. Like 9,000 other Americans, Sarlati began a community discussion group in response to a challenge Obama issued following the election.

Sixteen people joined Sarlati at his dad’s Milwaukee home over the holiday season to work through a list of health care questions President Obama had posed. In the process, the group submitted an application to participate in the forum. (Click here to see the application.)

In Washington D.C., Sarlati attended a breakout session led by presidential adviser Valerie Jarrett and the National Institute of Health’s Zeke Emanuel, which also included Sen. Chris Dodd, Rep. Steny Hoyer, and representatives from Pfizer, the National Association of Manufacturers and the Alliance for Retired Americans. In addition, Sarlati got to meet the President, with whom he discussed another hot topic: medical school loans.

“I told him I’m interested in going into primary care medicine, but [that] I’ll have a six-digit debt by the time I graduate,” Sarlati said. “President Obama said [he’d] have to figure out a way to fix that.”

For additional details about the forum, click here.

CAPITOL INSIDER

Society appears before Assembly Public Health Committee

At the first meeting of the Assembly Public Health Committee this legislative session on Tuesday, the Society voiced support for two bills—Assembly Bill 44 and Assembly Bill 56. AB 44 grants wider protections for health care professionals under the state’s Volunteer Health Care Provider Program. Rep. Dean Kaufert (R-Neenah) authored the bill after hearing concerns from physicians in his district that medical liability insurance rates would rise if they participated in the state program.

UW School of Medicine and Public Health medical student Jonathan Knoche testified on AB 56, which would place restrictions on direct-to-consumer drug advertising in Wisconsin. Society policy supports federal efforts to control such advertising. While some provisions of AB 56 have raised constitutional concerns, the core issue falls within the realm of Society policy and this warrants the Society's support.

Knoche gave to the Committee an abbreviated version of a DTCA presentation he presented to the Society’s Council on Ethics on February 20. The Committee also received these handouts. The Assembly Public Health Committee is chaired by Society member and Rep. Chuck Benedict, MD (D-Beloit). You can watch Tuesday’s hearing on the Wisconsin Eye Web site by clicking on the listing for the Assembly Committee on Public Health for March 10, 2009.

For more information, contact Mark Grapentine, JD.

EDUCATIONAL PROGRAMS

Medicare changes in 2009—Are you prepared?
We are coming to a city near you and this is one you can’t afford to miss!

It is no secret that in today’s economy, we all are feeling a financial pinch in some way. In health care, we need to increase efficiency by assessing our processes and refining our workflow—all with fewer resources. In 2009, there are many Medicare changes and, now more than ever, you need to know how this will affect your practice's bottom line. Join us in March as the Wisconsin Medical Society partners with WPS Medicare Part B for face-to-face seminars throughout the state. We will discuss:
  • Highlights of the new stimulus package passed as part of the American Recovery and Reinvestment Act
  • When you can expect to see the Recovery Audit Contractors (RAC) and provide tips for getting prepared now
  • An update on the transition to the Medicare Administrative Contractors (MAC) for jurisdiction 6
Other important topics on the agenda that could impact your revenue cycle include e-prescribing, an ICD-10 update, changes to provider enrollment, value-based purchasing, coding and policy updates and much, much more! We will conclude these all-day sessions with an open Q&A, so come prepared with your most important Medicare questions and get the answers you need to ensure you are prepared for 2009.

For registration information, click here.

QUALITY CORNER

IOM seeks input into comparative effectiveness research priorities

In the American Recovery and Reinvestment Act of 2009, Congress requested that the Institute of Medicine (IOM) recommend priorities for spending on comparative effectiveness research (CER). To facilitate that request, the IOM’s Committee on Comparative Effectiveness Research Priorities is gathering input from stakeholders to help determine CER priorities that reflect the needs of patients, consumers and the American health care community. Click here for more information about the project.

You can submit your priorities by clicking here. To be considered for the final report, the deadline is March 27. Your name and submission will be available in a public document; your contact information will remain confidential, or you are free to omit contact information.

FAQ

Question:
Beginning January 1, 2009, ForwardHealth requires that physician-administered drugs and the administration be “carved-out” from Medicaid Managed Care Organizations (MCO) and be filed to fee-for-service Medicaid for reimbursement. What are the CPT codes for the administration that specifically apply to this requirement?

Answer:
Currently, all of the drugs administered have to be “carved-out” and sent to fee-for-service Medicaid. The following CPT codes are the administration codes that need to be “carved-out” from the MCO’s claim: 96372, 96373, 96374, 96375, 96376 and 96379.

If you administer a drug in the office for a Medicaid managed care patient and the CPT code for the administration is not one identified above, you would submit a claim to fee-for-service Medicaid for the drug reimbursement and the administration would continue to be billed to the MCO.

Vaccines and radiopharmaceuticals are exempt and will continue to be billed to the MCO. See the article in the December 18 issue of Medigram for additional information.

For answers to other Frequently Asked Questions about coding matters and more, click here to review our Education Department’s FAQ archive, or e-mail efaq@wismed.org.