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Medigram - May 15, 2008


TOP STORY

NPI deadline next Friday; AMA seeking input by Monday

The National Provider Identifier (NPI) deadline is less than two weeks away, and the Centers for Medicare and Medicaid Services (CMS) has no plans to extend the NPI contingency timeframe past May 23. However, AMA is concerned about a number of physicians who may be unable to submit claims because of NPI enrollment/matching problems.

Medicare conducted an exercise May 7 in which clearinghouses “stripped off” legacy numbers contained on any claims they received and forwarded them on to Medicare with NPI numbers only. The purpose of this test was to determine what the situation may look like after May 23 when the NPI number will be the only identifier permitted on claims. Although Medicare reported that this exercise resulted in a low claims rejection rate, the AMA has expressed concern that the test did not include numerous physicians who are presently unable to bill Medicare because of NPI matching problems.

Therefore, Medicare has asked AMA to provide the following information:
  • Names of physicians who are unable to submit claims now due to enrollment/NPI matching problems
  • Where they are located (city/state)
  • The dollar amount of claims they are sitting on
  • A phone number (Medicare has said it will not be able to reach out to everyone)
  • Their Medicare legacy number(s)/NPI number(s) if available.
If you are unable to submit claims now due to the problems stated above, please supply this information to AMA by noon, Monday, May 19. Contact Mari Savickis at 202.789.7414 for more information.

NEWS BRIEFS

It’s in the mail!

The 9th Annual Midwest Practice Management and Coding Symposium brochure is now available. This year’s symposium September 21-23 at the Kalahari Resort in the Wisconsin Dells is packed full of sessions applicable to all specialties and will also feature many physician speakers. For a detailed description of the more than 30 breakout sessions, keep an eye on your mailbox or click here.


Free talk to focus on domestic violence SBIRT

Too many patients and their families suffer from unreported domestic abuse. To help health care professionals better identify this problem and offer assistance, the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL) is offering a free teleconference Thursday, May 22 from noon to 1 p.m. Speaker Bruce Ambuel, MD, of the Waukesha Family Practice Center, will address how SBIRT—screening, brief intervention, and referral-to-treatment services (as provided by WIPHL) can provide much-needed support to these patients. He will also discuss the co-occurrence of domestic/intimate partner violence with alcohol/drug use, depression, and other behavioral/mental health problems.

Although there is no fee, you must register to receive call-in instructions and teleconference materials. Click here to register. (If you do not have an account, you will be guided through steps to create one.) Contact Wisline (wislineaudio@ics.uwex.edu) at 608.262.0753 if you have registration problems. For other questions, please e-mail info@wiphl.org.


HHS adds new HIPAA enforcement data to Web site

In response to continuing interest in the Department of Health and Human Services’ (HHS) enforcement of the HIPAA Privacy Rule, the Office for Civil Rights (OCR) last week made available to the public additional information about these activities.

OCR has added a new data section on its Compliance and Enforcement Web site. The public can now access enhanced information about several aspects of OCR’s health information enforcement program:
  • Charts showing state-specific case investigation results;
  • Calendar-year enforcement-results graphs and charts;
  • Calendar-year graph showing complaint receipts;
  • Yearly variation in the issues in cases resolved through corrective action.
To access the new OCR data section, click here. To visit the enhanced Compliance and Enforcement Web site, click here.

NEWSMAKERS

Dunn to be honored with Distinguished Service Award

Michael J. Dunn, MD, Dean Emeritus of the Medical College of Wisconsin, will be honored May 16 with a Distinguished Service Award—the school's highest faculty honor—at its 95th annual commencement exercises. He is being honored specifically for his transformative leadership and his unwavering commitment to excellence.

Doctor Dunn will continue to serve as distinguished professor of medicine and physiology, and director of the Translational Research Resources Office of the Clinical and Translational Science Institute at the Medical College.

During his 13-year tenure as dean, which ended earlier this month, the Medical College's research support from the National Institutes of Health (NIH) grew to $92.3 million. Under his leadership, the Medical College has also established five new departments: Biophysics, Plastic Surgery, Population Health, Otolaryngology and Communication Sciences, and Urology.

Doctor Dunn received his medical degree from the Medical College's predecessor institution, Marquette University School of Medicine, in 1962.



CAPITOL INSIDER

Budget repair bill now in Gov. Doyle’s hands

This week, the State Legislature worked to fill a $652 million state funding shortfall, sending a budget repair bill to the Governor. The bill’s major components include the following:
  • Taking an advance on tobacco settlement payments: $209 million
  • Delay in school aids payment to next biennium: $125 million
  • Administration lapses (cuts in spending): $69 million
  • Use of “rainy day” fund and decrease in required statutory balance: $97 million
  • MA benefits reduction (per DHFS estimated “efficiencies”): $10 million
The Doyle Administration says it has already implemented more than $100 million in spending cuts following announcement of the deficit in February. The bill passed the Senate Tuesday with a close 17-16 vote (view the roll call here), and the Assembly Wednesday on another close tally (view that roll call here).

Gov. Doyle is expected to make changes to the bill; Thursday morning he said the vetoes could be announced very soon. At a press conference earlier this week, Doyle strongly criticized the actions on tobacco settlement funds and the school aids delay, instead stating that better options included cuts to transportation spending and creation of a tax on hospital gross receipts designed to capture federal matching funds for Medical Assistance. While the Governor’s veto power has been reduced slightly (a referendum ending the “Frankenstein veto” power passed the state in April), conventional wisdom predicts the Governor will use vetoes to dramatically change the final product.

Read a story about the bill from the Appleton Post-Crescent here. Another article from the Wisconsin State Journal notes that future budget problems could emerge pending resolution of various lawsuits against the state, including the Society’s effort to reverse a $200 million raid on the Injured Patients and Families Compensation Fund.

See legislative reaction from those voting for the bill (Speaker Huebsch, Senate Majority Leader Decker, Rep. Stone) and those voting against (Senators Ellis/Cowles, Sen. Darling, Rep. Wasserman).

For more information, contact Mark Grapentine or Jeremy Levin.

F.Y.I. FOR YOUR INSURANCE

Long-term care insurance: A smart investment at any age

Only 10 percent of Americans over age 50 have long-term care insurance, according to a report in Independent Agent. Considering there are nearly 78 million baby boomers in the nation and nursing home care averages more than $75,000 a year, long-term care insurance should warrant consideration.

Many people may have the misconception that Medicare will cover their long-term care costs, but in reality Medicare provides very little long-term-care coverage and Medicaid will only pay if you have depleted most of your assets. Additionally, studies show that nearly two-thirds of claims for long-term care benefits are paid to those aged 55-65, and the leading causes for claims of those under 65 are cancer, trauma, stroke or neurological disease.

The younger and healthier you are when you buy a policy, the lower your premium will be. You are also more likely to qualify for coverage at a younger age. To learn more about the benefits of a long-term care insurance policy, contact Wisconsin Medical Society Insurance & Financial Services, Inc. by contacting one of our agents at 866.442.3810 or clicking here to use our on-line contact form.

Source: Kiplinger’s Personal Finance, Retirement Planning 2007, Fall 2007.

QUALITY CORNER

Performance measures using electronic health records: 5 case studies

A new Commonwealth Fund report examines the experiences of five provider organizations in developing, testing and implementing quality-of-care indicators, based on data collected from their electronic health record (EHR) systems. Common themes emerged from these case studies. They included challenges—of ensuring the validity and reliability of data, efficient workflow and staff support—but the providers’ successes in implementing their respective EHR-based quality measures demonstrated that such measures are adaptable to different EHR systems, amenable to improvement and worth pursuing. To read the report, click here.

FAQ

Question:
Regarding the notice of privacy policies that must be given to patients under the HIPAA Privacy Rule, must a health care provider obtain a new signed acknowledgement of receipt of the notice from a patient every x number of years, or every time they change their privacy policy?

Answer:
No, covered health care providers must make a good faith effort to obtain a patient’s acknowledgement of receipt of the health care provider’s notice of privacy policies only at the time the health care provider first gives notice to the individual (at first service delivery). 45 CFR 164.520(c)(2).

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