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SDCMS "News You Can Use" (2012.02.09)

by: San Diego County Medical Society
Published February 9, 2012

SDCMS “News You Can Use”
— February 9, 2012

Executive Director Comment: The next two items are huge! For all the nonmembers reading this, please recognize that you are benefitting (holding 10% Medi-Cal cuts at bay for more than three years, not having to take a $5 copayment that you’ll probably never see) from the legal and advocacy work made possible by members’ dues. Please join SDCMS-CMA to support the kind of advocacy that keeps the lions at bay.

Member Dues Dollars Block State’s Attempt to Cut Medi-Cal Reimbursement Rates
On February 1, because of the efforts of a coalition (which spent over $1million in legal fees) led by CMA, a federal judge’s ruling blocked a 10% Medi-Cal reimbursement rate reduction. Click here and click here to read more.

California’s Request to Impose Mandatory Copays Rejected
On February 6, CMS rejected California’s request to impose mandatory copayments for Medi-Cal patients. The copays — which would have included physician office and clinic visits ($5), emergency room visits ($50), and inpatient hospital stays ($100 per day up to a $200 maximum) — was another attempt by the state to balance the budget by slashing Medi-Cal. Click here to read more.

Executive Director Comment: Speaking of keeping the lions at bay (see my comment above), and with tongue firmly in cheek, we have three weeks before Congress will have to kick the 27.4% Medicare cuts down the road for another couple of months. Seriously though, CMA's federal lobbying team in DC is working hard on a solution. In our hyper-partisan political environment, the issue is not whether to delay the cuts but how to pay for them. I expect another cliffhanger ending in late February.

San Diego’s Obesity Epidemic: An SDCMS Call to Action
If you or your organization wishes to engage holistically in the communitywide fight to address obesity, please contact Robert Wailes, MD, SDCMS president, at President@SDCMS.org. On February 27, 2012, we will brainstorm how SDCMS can help.

Quick SDCMS Poll (One Question): Would You Be Interested in a Basic CPR Certification Course (1–3 hours) Held at SDCMS’ Offices in Kearny Mesa?

Are You Checking SDCMS’ Twitter Feed Daily From Your Browser / Smartphone?
Click here to check SDCMS’ latest Twitter feeds. SDCMS does an exceptional job of picking out the most interesting stuff for your daily review — and the worst that happens is you read the headline and ignore it.

CONTENTS

  • Cyberchondria
  • San Diego County Influenza Surveillance Update: February 8, 2012
  • How to Fund Medicare SGR Repeal?
  • CMA Urges Physicians to Call Members of Congress Now!
  • Comparative Effectiveness Research Plan Seeks Input From All Sides
  • CBO: Medicare Demos Didn’t Save Much Money
  • Medicare Participation Deadline Extended to February 14
  • AMA Advocacy Persuades CMS Not to Extend EMTALA to Inpatients
  • CMS Requires New ABN Form for 2012
  • State Announces Short-term Payment Delays for Medi-Cal Institutional Providers
  • CMA to Present Final Arguments in Nurse Anesthetists Ruling
  • Survey Request: Seniors and Persons with Disabilities Medi-Cal Managed Care Transition
  • New Law Punishes Tax Scofflaws by Suspending Medical Licenses
  • 5010 Quick Reference Guide From CMA
  • Call for Nominations: 2012 Frederick K.M. Plessner Memorial Award
  • Call for Nominations: 2012 Dev A. GnanaDev Membership Award
  • Physician Volunteerism Stories Needed
  • “Lights Camera Action” • Become an SDCMS Media Expert
  • Ask CMA’s Expert: Blue Cross Bilateral Billing
  • When to Use and Not Use Modifier -59
  • Receive Free EHR Implementation Assistance
  • Corrections Sheet for SDCMS’ San Diego County Physician Directory for 2012
  • SDCMS-CMA SEMINARS / WEBINARS / EVENTS
  • SAN DIEGO COUNTY HEALTHCARE EVENTS

MEDICAL …

Cyberchondria: Physicians Say Patient Anxiety Is Increasing Because of Medical Information Read Online, With Self-diagnoses of Diseases Like Fibromyalgia and Lupus • Click Here

San Diego County Influenza Surveillance Update: February 8, 2012 • Click Here

FEDERAL …

Executive Director Comment: And we’re working to include a GPCI fix (to eliminate the so-called “rural cuts” to Medicare for San Diego County) in the SGR fix. See portion in underlined below.

How to Fund Medicare SGR Repeal?
As the House-Senate Conference Committee continues to deliberate legislation to address the 27.4% Medicare fee-for-service payment cut and extension of unemployment benefits and payroll tax cuts beyond February 29, momentum is growing to repeal the sustainable growth rate (SGR) formula by using the unspent funds from the early withdrawal of troops from Iraq and Afghanistan. At CMA’s urging, the House Democratic leaders announced their full support for the proposal. The Democratic Senate leaders have expressed their support. Republicans in both houses are beginning to look on the proposal favorably. CMA is also working with Senator Feinstein and Congressmen Farr and Bilbray to include the California Medicare Geographic Payment Locality update in the conference agreement. Both California Congressmen Waxman and Becerra are on the conference committee and have been supportive of the California update. Both of these issues need to be addressed by the conference committee and passed by Congress before the deadline of February 29.

CMA Urges Physicians to Call Members of Congress Now!
It is imperative that we urge Congress to use military funds to repeal the Medicare SGR now! Please call the AMA Grassroots Hotline at (800) 833-6354 or click here to send a message to your U.S. representative and Senators Boxer and Feinstein. Leave your name, specialty, and county and tell your representative/senators:

  • Please use the unspent military (OCO) funds to REPEAL THE FLAWED MEDICARE SGR!
  • Please cosign the bipartisan Dear Colleague letter from Representatives Crowley and Benishek.
  • Repealing the SGR will reduce the deficit and improve access to doctors for California’s seniors and military families.
  • Physicians cannot sustain a nearly 30% payment cut and continue to see patients.

Click here for further information.

Comparative Effectiveness Research Plan Seeks Input From All Sides
The Patient-Centered Outcomes Research Institute expects the public to help shape its mission to determine the most effective medical care. Click here to read the complete article.

CBO: Medicare Demos Didn’t Save Much Money
A report details the lessons learned from Medicare demonstration projects that tried to reduce costs and improve quality of care. Click here to read the complete article.

Medicare Participation Deadline Extended to February 14
Physicians’ Medicare participation elections or withdrawals must be postmarked on or before February 14. Click here for details.

AMA Advocacy Persuades CMS Not to Extend EMTALA to Inpatients
On December 23, 2010, CMS published an Advanced Notice of Proposed Rulemaking on EMTALA, indicating that CMS was reconsidering its current policy, which provides that: 1) a hospital’s EMTALA obligation ends upon the admission of a patient as an inpatient; and 2) EMTALA does not apply to the transfer of an inpatient to a hospital with specialized capabilities. AMA submitted comments in response, strongly objecting to the extension of EMTALA to the inpatientsetting or to the transfer of an inpatient to a hospital with specialized capabilities. On February 2, 2012, CMS published a Request for Comment in which it states that it is maintaining its current policy that EMTALA does not extend to inpatients or to the transfer of inpatients to hospitals with specialized capabilities. CMS says that it will continue to monitor whether it may be appropriate in the future to reconsider the inapplicability of EMTALA to the transfer of inpatients to hospitals with specialized capabilities, and invites comment on that issue. AMA plans to comment in support of CMS’ decision not to extend EMTALA.

CMS Requires New ABN Form for 2012
Effective January 1, 2012, CMS has implemented a revised Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. This form is used by physicians when they expect Medicare will deny payment and to notify patients of their financial responsibility for those noncovered services. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012, will be considered invalid. The latest version of the ABN (with the release date of 3/2011 printed in the lower left-hand corner) and further information on the change is available on the CMS website. Click here to read more.

STATE …

State Announces Short-term Payment Delays for Medi-Cal Institutional Providers
The state of California announced February 2 that it will institute short-term payment delays to Medi-Cal institutional providers due to a severe cash-flow shortage. Implementation of the delays is effective March 1, 2012 (the first check release date of March). Click here to read more.

CMA to Present Final Arguments in Nurse Anesthetists Ruling
CMA and the California Society of Anesthesiologists will deliver their final arguments against a 2009 ruling by former Gov. Schwarzenegger that effectively allowed nurse anesthetists to administer anesthesia unsupervised by a physician. The arguments will be heard on February 14, 2012. The court will have 90 days after the oral argument to issue an opinion. Click here to read further.

California HealthCare Foundation-funded Survey Request: Seniors and Persons with Disabilities Medi-Cal Managed Care Transition • Click Here

New Law Punishes Tax Scofflaws by Suspending Medical Licenses
Assembly Bill 1424, passed last fall, will allow the Medical Board of California to deny an application for licensure or suspend the license/certification/registration of any applicant or licensee that owes more than $100,000 to the Franchise Tax Board or the State Board of Equalization, according to a press release issued by the board on January 26. Click here to read more.

5010 Quick Reference Guide From CMA
CMA surveyed the major payors in California to find out which of them will allow for an extension on the 5010 enforcement deadline. This guide will be updated regularly as new information becomes available. SDCMS-CMA members can click here to access this and other 5010 resources. Contact Kyle Lewis for website assistance at (858) 300-2784 or at KLewis@SDCMS.org.

Call for Nominations: 2012 Frederick K.M. Plessner Memorial Award
The Plessner Award honors a CMA member physician residing and practicing in California who best exemplifies the practice and ethics of a rural practitioner. Nominations must be submitted by May 25, 2012. Click here for details.

Call for Nominations: 2012 Dev A. GnanaDev Membership Award
The GnanaDev Membership Award honors a CMA member physician residing and practicing in California who during the past year demonstrated a special or unique effort towards membership recruitment resulting in membership growth in their area. Nominations must be submitted by May 25, 2012. Click here for details.

LOCAL …

Physician Volunteerism Stories Needed for SDCMS’ April San Diego Physician Magazine Issue
SDCMS physicians who would like to share their volunteer stories (either volunteering in the healthcare arena or in other areas) should contact Kyle Lewis at KLewis@SDCMS.org or at (858) 300-2784.

“Lights Camera Action” • Become an SDCMS Media Expert
SDCMS Physicians: If you would like SDCMS to consider using you as an expert in your particular field when we receive requests from local media, please contact Kyle Lewis at KLewis@SDCMS.org or at (858) 300-2784.

MEMBER BENEFITS …

Ask CMA’s Expert: Blue Cross Bilateral Billing
Over the past year, CMA has received several calls from practices that have received refund requests from Blue Cross in regards to bilateral surgical procedures that were overpaid. What we’ve learned is that oftentimes the overpayment stems from the way the bilateral procedure was billed. Click here to read more.

When to Use and Not Use Modifier -59
“The Coding Corner” from CMA’s Practice Resources (CPR) focuses on coding, compliance, and documentation issues relating specifically to physician billing. Click here to read further. For additional information on the usage of modifier -59, please see further articles from AAPC available free to members in CMA’s online resource library.

Receive Free EHR Implementation Assistance
Primary care practices of 10 or fewer practitioners can receive assistance in EHR implementation (internal medicine, family, adolescent, pediatrics, OB/GYN, or general practice all qualify through ARRA funding). contact Rob Yeates at Rob.Yeates@SDCMS.org or at (858) 300-2791.

Click Here for a Corrections Sheet for SDCMS’ Recently Mailed San Diego County Physician Directory for 2012 [top]

SDCMS-CMA SEMINARS / WEBINARS / EVENTS
For further information or to register for any of the following SDCMS seminars, webinars, or events, visit http://SDCMS.org/event or contact Serena Sauerheber at (858) 300-2779 or at Serena.Sauerheber@SDCMS.org.

SAN DIEGO COUNTY HEALTHCARE EVENTS
To submit a community healthcare event for possible publication, email KLewis@SDCMS.org. Events should be physician-focused and should take place in or near San Diego County.

  • FEB 16: Introducing New Technologies to Patient Care: The Promise and the Perils • UC San Diego Telemedicine and Medical Education Building, La Jolla • http://www.regonline.com/Register/Checkin.aspx?EventID=1012115
  • FEB: 17–18: Cell Society: 2nd Annual Clinical Meeting (Register Now for a $100 Discount — Code: sdcms100) • Coronado Island Marriott Resort • https://xmedicacme.com/cell_society
  • FEB 25: UC San Diego, Division of Plastic Surgery, Aesthetic Surgery Grand Rounds • 9:00am–12:30pm • UCSD Moores Cancer Center, Goldberg Auditorium, 3855 Health Sciences Drive, La Jolla, CA 92093 • RSVP to Amy Patterson atapatterson@ucsd.edu or at (619) 543-6084
  • FEB 25: Sharp HealthCare’s 2012 Cardiology Conference for Primary Care Clinicians • Marriott Marquis and Marina, 333 West Harbor Drive, San Diego • Contact Stacey Hunt at (858) 499-4530 or at stacey.hunt@sharp.com
  • FEB 25–26: Safe Opioid Prescribing • Palm Springs, Calif. • http://www.painmed.org/safeprescribing/
  • MAR 8–10 • Stepping up to Leadership: IMQ/PACE Platinum Level Training for Physician Leaders • Coronado Island Marriot and Spa • http://www.imq.org/programs/educational-programs/#a6
  • MAR 10–17: Timmy Global Health Mission Trip to Ecuador • Clinics seeing approximately 40 patients per provider per day. • http://www.timmyglobalhealth.org
  • MAR 12–16: Topics and Advances in Internal Medicine • Catamaran Resort Hotel, San Diego • http://cme.ucsd.edu/internalmed
  • MAR 15: Prescription Opioid Misuse Academy: The Dark Side of Prescription Opioids • An Educational Program of the American College of Medical Toxicology • Catamaran Resort Hotel, Mission Bay • http://www.acmt.net
  • MAR 17–18: Topics and Advances in Pulmonary and Critical Care Medicine • Catamaran Resort Hotel, San Diego • http://cme.ucsd.edu/internalmed
  • MAR 23: Emerging Markets and Global Health • San Diego Hilton Harbor Island Hotel • This is an invitation-only conference. If you are interested in attending, please contact Pam Tait, program administrator at The Institute of Health Law Studies, California Western School of Law, at (619)515-1568 or at prt@cwsl.edu to reserve a seat.
  • APR 1–4: Hospital Medicine 2012 • The Society of Hospital Medicine’s 15th Annual Meeting • San Diego Convention Center • http://hospitalmedicine2012.org
  • APR 15: Sharon’s Ride Run Walk for Epilepsy 2012! • Deanza Cove Mission Bay Park • $25 for Adults / $10 for Ages 7–17 / Free for Ages Six and Under • 7:30am-1:00pm • http://sharonsride2012.kintera.org/
  • APR 17 • CMA’s 38th Annual Legislative Leadership Conference • 9:30am–5:00pm • Sacramento Convention Center • http://www.cmanet.org/events/detail/?event=legislative-leadership-confer...
  • APR 19–22: California Orthopaedic Association Annual Meeting • Park Hyatt Resort in Carlsbad • http://www.coa.org/coa-annual-meeting.html
  • APR 27–29: 15th Annual California Health Care Leadership Academy • Disneyland Hotel, Anaheim, Calif. • Models of healthcare financing and delivery will change as implementation of federal health reform kicks into high gear. What are the best options for successful medical practice in the new environment? Hear from the experts and leaders of change, and attend a comprehensive slate of practice management seminars and workshops to position your practice for success. Details coming in January — stay tuned!
  • NOV 2: 13th Annual Science and Clinical Application of Integrative Holistic Medicine • Hilton San Diego Resort
  • Scripps Whittier Professional Education and Training Programs 2012 • http://www.scripps.org/assets/documents/final_draft_professional_educati...

“You may have a fresh start any moment you choose, for this thing that we call failure is not the falling down, but the staying down.”
— Mary Pickford (1892–1979) Canadian-born Motion Picture Actress

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