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SDCMS "News You Can Use" (2010.03.08)

by: San Diego County Medical Society
Published March 5, 2010

SDCMS “News You Can Use”
— March 8, 2010

Executive Director Comment: An SDCMS delegation will be travelling to Washington, DC, next week to meet with our representatives. If you have a consequential story or stories about how what is going on in DC is affecting your patients, please send me an email at Gehring@SDCMS.org.

SDCMS Seminars / Webinars Available on the Web!
SDCMS presents seminars and webinars on a range of topics, which SDCMS member physicians and their staff can watch at anytime by clicking here. Here are our five most recent seminars available for viewing:

  • “Medicare Updates” (recorded February 17, 2010)
  • “Treating Patients Right” (recorded February 4, 2010)
  • “The Dance: The Overlap Between the Family and Medical Leave Act (FMLA), the Americans With Disabilities Act (ADA),?and Workers’ Compensation Leave Laws” (recorded January 27, 2010)
  • “Top 10 Collections Procedures (to Cover Your Assets)” (recorded January 7, 2010)
  • “10 Strategies for Economic Survival” (recorded October 15, 2009)

21% Medicare Cuts Stopped Until April 1, 2010
Click here to read SDCMS’ March 3, 2010, News You Can Use” on the one-month delay enacted by the Senate on March 2, 2010.

CONTENTS

  • CMA Regulations Quick List
  • CMA Publishes Timely Access Guide for Physicians
  • Hospital Clout Spurs Higher California Health Costs
  • California Attorney General Asks U.S. Supreme Court to Review Medi-Cal Injunction
  • Blue Cross Healthy Families Continuity of Care Plan Ends March 31, 2010
  • Legislative Advocacy Training: A Medical Student’s Guide to Successfully Advocating for Your Profession
  • SDCMS Physician List to Be Published in San Diego Magazine’s May 2010 Health Annex
  • UCSD Student-Run Free Clinic Project Annual Benefit & Award Celebration on April 24, 2010
  • You Are Invited to Participate in a Community-wide Needs Assessment
  • Medicare Participation Status Deadline Is March 17 … for Now
  • Medicare Pay-for-Reporting Still Gets Bad Grades From Physicians
  • CMS Delays PECOS Enrollment Policy Until January 1, 2011
  • Step-by-Step PECOS Enrollment Guide
  • Physicians: Are You Compliant with Recent HIPAA Changes?
  • CMA Hosting March 18 “HIPAA Overview and Compliance” Webinar
  • Confidential Line to Help Doctors With Substance Abuse, Depression, and Career Burnout
  • California Pneumonia Vaccination Rates Among Worst in Nation
  • Syphilis Education Posters for Medical and Dental Providers in San Diego County
  • Neisseria gonorrhoeae Infections With Azithromycin Resistance (2010.02.12)
  • SDCMS SEMINARS / WEBINARS / EVENTS
  • SAN DIEGO COUNTY HEALTHCARE EVENTS

STATE

CMA Regulations Quick List
Click here to access CMA’s Feb. 10, 2010, Regulations Quick List, which provides summaries on various regulations tracked by CMA’s Center for Medical and Regulatory Policy. Current regulations being tracked include the following:

  • Scope of Practice in Licensed Health Facilities (California Department of Public Health, CDPH)
  • Manipulation Under Anesthesia (Board of Chiropractic Examiners)
  • Physician Office Signage (Medical Board of California)
  • Rescission and Underwriting (Department of Insurance, DOI)
  • Changes to CME Requirements (Physician Assistant Committee)
  • Disciplinary Guidelines (Medical Board of California)
  • Timely Access Regulation (Department of Managed Health Care, DMHC)
  • Glaucoma Certification Requirements (Board of Optometry)
  • Healthy Families Program: Legal Immigrants (Managed Risk Medical Insurance Board)
  • Patient-centered Prescription Labels (Board of Pharmacy)
  • Discount Health Plans (Department of Managed Health Care)
  • Meaningful Use of Electronic Health Records (Federal Centers for Medicare and Medicaid Services)

CMA Publishes Timely Access Guide for Physicians
The California Department of Managed Health Care (DMHC) recently finalized regulations that require HMO patients to be seen within certain timeframes for various levels of care. The primary intent of these regulations and the underlying legislation is to require HMOs to ensure that their networks of providers have the capacity and availability to provide care to enrollees in a timely manner. A CMA Toolkit is available at to help member physicians understand these new regulations and what they could mean for their practices.

Hospital Clout Spurs Higher California Health Costs
According to a study by the Center for Studying Health System Change published in the journal Health Affairs, California's hospital fees surged 10.6% annually from 1999 to 2005, twice the national average, as the state's biggest hospital networks began to demand higher rates from insurers. Click here for further information.

California Attorney General Asks U.S. Supreme Court to Review Medi-Cal Injunction
On Feb. 17, 2010, the California attorney general asked the U.S. Supreme Court to review a court judgment forcing the state to reverse the 10% cut in Medi-Cal reimbursement that took effect on July 1, 2008. The 9th Circuit Court of Appeal upheld a federal trial court’s July 2009 injunction, which was based upon the finding that the cuts would irreparably harm access to healthcare for nearly seven million Californians and were enacted in violation of federal Medicaid laws. The Supreme Court previously declined to review a 9th Circuit decision confirming the right of California’s Medi-Cal providers to challenge state cuts to Medi-Cal provider reimbursement.

Blue Cross Healthy Families Continuity of Care Plan Ends March 31, 2010
In March 2009, Blue Cross announced that it would require physicians to sign a separate contract and accept reduced rates if they wanted to continue treating Blue Cross-insured Healthy Families and AIM patients. The new rates vary, but have been dropped generally to barely above Medi-Cal rates. Although the effective date on the new contracts was September 1, 2009, the plan extended its continuity of care plan through March 31, 2010, allowing physicians with Prudent Buyer contracts to continue treating Blue Cross Healthy Families patients. With the continuity of care plan coming to an end, physicians are encouraged to notify patients who would be affected by a decision not to sign the new contract. CMA has prepared a sample letter member physicians can use for this purpose. For more information, see CMA ON-CALL document #0805, “Termination of the Physician-Patient Relationship,” and CMA ON-CALL document #1055, “Contract Termination by Physicians and Continuity of Care Provisions." Click here for more information.

Legislative Advocacy Training: A Medical Student’s Guide to Successfully Advocating for Your Profession
It is critical to master the advocacy arena to seize control of the future of our profession. Medical students can learn how policy is made and how they can influence its direction for the sake of the patients they will serve. Thursday, March 11, 2010. 6:00pm – 7:00pm. After registering, you will receive a confirmation email containing information about joining the webinar. Space is limited. Click here to reserve your webinar seat now.

LOCAL

SDCMS Physician List to Be Published in San Diego Magazine’s May 2010 Health Annex
In its May 2010 “Health Annex” issue, San Diego Magazine will publish a listing of SDCMS member physicians. Due to space constraints, only name, one address, one telephone number, board certifications/self-designated special interest areas, additional languages spoken, and area of town will be listed. In addition to an alphabetical listing, indices sorted for board certifications/special interest areas and languages spoken will be included. In order to ensure the accuracy of the data that will be published, please carefully review your listing:

  • VERIFY YOUR LISTING: Click here to access a read-only PDF of SDCMS member physicians listed alphabetically. To find your listing without having to scroll through the entire document, click on “Search” and type in your last name. If there is more than one physician with your last name, click on “next” until you find your listing. Along with your office address, telephone number, and languages spoken, we will include your board-certified specialties and/or self-designated interest areas using the preferences you listed on the 2010 SDCMS pictorial membership directory update form.
  • PLEASE NOTE — SPECIALTY LISTINGS: You may list any combination of board-certified specialties and/or self-designated special interest areas; however, due to space constraints, you are limited to listing only TWO (2) board-certified specialties or self-designated special interest areas.
  • PLEASE NOTE — DEADLINE: The PDF of SDCMS member physicians is password-protected, i.e., it cannot be printed or edited. If you want to correct or change your listing, let us know via email at JOhmstede@SDCMS.org or via fax at (858) 569-1334 NO LATER THAN WEDNESDAY, MARCH 24, 2010. Contact Jen Ohmstede at JOhmstede@SDCMS.org or at (858) 300-2781 with questions.

UCSD Student-Run Free Clinic Project Annual Benefit & Award Celebration on April 24, 2010
Saturday, April 24, 2010. 6:00pm–10:00pm. Price Center Ballroom at UCSD. Silent auction, opportunity drawing, wine tasting, entertainment and award dinner. Proceeds will go to the UCSD Student-Run Free Clinic Project, dedicated to providing free, high-quality healthcare with underserved communities of San Diego. $175 per person ($150 of ticket price is tax deductible). Tables available at the $1,500 and $1,750 level. Student prices available upon request. To RSVP for dinner tickets or for information about event sponsorship and opportunities to support the Free Clinic Project, contact Anne Crane (acrane@ucsd.edu) or Carol Whitener (cbloomwhitener@ucsd.edu) by email or by phone at (858) 534-6160. Click here for more information about the UCSD Student-Run Free Clinic Project.

You Are Invited to Participate in a Community-wide Needs Assessment
For the past 15 years, Community Health Improvement Partners (CHIP) has conducted a triennial community needs assessment (“Charting the Course”) for San Diego County, outlining trends and gaps in the healthcare system and meeting the legal requirements for San Diego County’s nonprofit hospitals. This year, CHIP is excited to broaden the reach of and input into the process and would like to invite physicians to participate. On Friday, March 19, 2010, from 9:30 a.m. to 11:30 a.m., CHIP is holding a “2010 San Diego Needs Assessment Kickoff” event at Sharp Spectrum, 8695 Spectrum Center Court, San Diego 92123. For more information or to RSVP, contact Aron Fleck at (858) 614-1558 or at afleck@hasdic.org.

FEDERAL

Medicare Participation Status Deadline Is March 17 … for Now
Physicians have until March 17, 2010, to change their Medicare participation status for 2010, meaning that physicians who have not already changed their status can still do so, and those who have already made changes can still retract them. It is possible, however, that Medicare may need to extend the participation deadline again. The effective date of any decision will ultimately be retroactive to January 1, 2010. Participation decisions are binding for one year, unless physicians choose to opt out entirely. Once you opt out, you cannot opt back in for two years. Be aware that because changes in participation status are retroactive to January 1, physicians who switch from “nonparticipating” to “participating” will have to refund to patients any balance billing collected between January 1, 2010, and their new decision date. For more information on physicians’ Medicare participation options, see CMA ON-CALL document #0151, “Medicare Participation (and Nonparticipation) Options."

Medicare Pay-for-Reporting Still Gets Bad Grades From Physicians
Now in its fourth reporting year, Medicare’s Physician Quality Reporting Initiative (PQRI) continues to frustrate physician practices that are looking to access feedback reports from past years and use them to improve their patient care. Fewer than half of physicians were able to access their PQRI feedback reports from the 2008 reporting year, a decline from the 51% who successfully obtained their reports for 2007. Sixty percent of practices that were able to access their 2008 reports were either dissatisfied or very dissatisfied with the information. Click here to read the complete article.

CMS Delays PECOS Enrollment Policy Until January 1, 2011
Medicare physicians who have not updated their enrollment information in the past five years may need to fill out another application or face payment problems for ordered or referred services. The new rules, which will now take effect January 1, 2011, authorize Medicare to reject claims if an ordering or referring physician is not identified in Medicare’s PECOS (Provider Enrollment, Chain, and Ownership System) enrollment system. If you are not in PECOS, you can add or revalidate your enrollment with the CMS 855I enrollment form submitted to Palmetto GBA, or utilize the Internet-based PECOS enrollment system.

Step-by-Step PECOS Enrollment Guide
CMA has developed a step-by-step guide to walk physicians through the PECOS enrollment system process, from determining if you are in PECOS, to accessing the Internet–based PECOS enrollment system. Click here to access CMA’s PECOS enrollment guide at SDCMS.org. SDCMS member physicians who are having difficulty

Physicians: Are You Compliant with Recent HIPAA Changes?
The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was enacted last year and took full effect last month, has added additional privacy and security safeguards to existing HIPAA regulations. The safeguards include new rules regarding, among other things, notifying patients of data breaches, marketing restrictions, the sale and disclosure of protected health information, and the use of electronic health records. The HITECH Act has also dramatically increased the obligations of business associates, making them directly accountable under HIPAA. As a result, physicians must ensure that they have updated agreements with all of their business associates, including entities such as Regional Health Information Organizations (RHIOs) that were not considered business associates under the prior regulations. Under the new rules, business associates are also subject to the same civil and criminal penalties that physicians, hospitals, and other HIPAA-covered entities face for violations. Previously, business associates that failed to protect patient information were liable to the covered entities via their service contracts, but they did not face governmental penalties. To help physicians understand their responsibilities under HIPAA and the HITECH Act, CMA has updated several of its ON-CALL documents, including:

  • #1600, “HIPAA Overview & Enforcement”
  • #1602, “Business Associate Agreements”
  • #1603, “HIPAA ACT SMART: Introduction to the HIPAA Privacy Rules”
  • #1607, “HIPAA Security Rule”
  • #1132, “Electronic Medical Records”
  • #1144 “Security Breach of Health Information”

All of the above documents are available to SDCMS-CMA members at SDCMS’ website or at CMA’s website under the heading “Medical Records: HIPAA.”

CMA Hosting Webinar: “HIPAA Overview and Compliance — How to Be Compliant with Recent Changes” — Thursday, March 18, 12:15 p.m.
Click here to register for CMA’s “HIPAA Overview and Compliance” webinar, to be held Thursday, March 18, at 12:15 p.m. This webinar will give a brief overview of the HIPAA privacy and security rules, highlight the recent changes, and provide resources to help physicians understand and comply with the new HIPAA regulations. Registration is free, but space is limited, so reserve your spot today.

MEDICAL

Confidential Line to Help Doctors With Substance Abuse, Depression, and Career Burnout
CMA’s confidential hotline’s sole mission is to help impaired doctors and dentists help themselves before their lives and livelihood are put into jeopardy. Callers are quickly put in touch with hotline staff, all of whom are physicians or dentists with expertise in the field of addiction. All calls are treated with the utmost confidentiality. If you are a physician looking for help with substance abuse or a psychological or emotional problem, or if you are a colleague or family member of an impaired physician, call (213) 383-2691.

California Pneumonia Vaccination Rates Among Worst in Nation
Bacterial pneumococcal infections are by far the leading cause of death for seniors who contract H1N1 or seasonal influenza, but far too many are not immunized against pneumonia, according to a recent report that shows that California has one of the lowest vaccination rates, with 39% of adults over the age of 65 going unvaccinated in 2008. Nationally, 33.1% of elderly adults were not vaccinated. CDC recommends pneumococcal vaccines for all people 65 years of age and older and for people 2 to 64 years of age with certain high-risk conditions. Although H1N1 infections are on the decline, CDC is also encouraging continued vaccination efforts to minimize the risk of a potential “third wave” of infections this spring.

Syphilis Education Posters for Medical and Dental Providers in San Diego County
Syphilis has dramatically increased in San Diego County from 71 reported cases in 2002 to 382 reported cases in 2009. The County of San Diego, Family Health Centers of San Diego (FHCSD), and other government and community partners are rolling out two new posters (one for physicians and one for dentists) that can further raise syphilis awareness among healthcare providers and thereby enabling early diagnosis and treatment, a key prevention and control strategy. Click here to download the physician poster or contact Tom Gray at (619) 692-8835.

Neisseria gonorrhoeae Infections With Azithromycin Resistance (2010.02.12)
Five (5) cases of Neisseria gonorrhoeae infection with azithromycin resistance have been identified at the County of San Diego STD Clinic since September 2009. This is the first such cluster to be identified in San Diego County and has important implications for testing and treatment of Neisseria gonorrhoeae infections in San Diego County. Click here for further information.

SDCMS SEMINARS / WEBINARS / EVENTS
For Further Information on or to Register for Any of the Below Seminars, Webinars, or Events, Contact Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org.

  • MAR 18 • Managed Care Contract Negotiations Seminar/Webinar — “Work Smarter, NOT Harder!” • Thursday, March 18, 11:30am–1:00pm • You will learn 10 things you should know about managed care, including how to build a financially productive practice, how to limit your portfolio to contracts that have quantifiable benefits, how to review EOBs to determine underpayments or bad rates, and much more! Click here to access a registration form.
  • APR 14 • Best Practices Seminar — What Every Physician Needs to Know About Their Practice • Wednesday, April 14, 11:30am–1:00pm — Geared Toward Office Managers, but Physicians Are Welcome to Attend!
  • APR 14 • Best Practices Seminar — What Every Physician Needs to Know About Their Practice • Wednesday, April 14, 6:00pm–8:30pm — Geared Toward Physicians
  • APR 16 • SDCMS Membership Social • Friday, April 16, 6:30pm–9:30pm • Mark your calendars to attend SDCMS’ upcoming Membership Social at the Rock Bottom Brewery. Only SDCMS member physicians can attend. Space is VERY limited, so please RSVP as soon as possible to Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org.
  • APR 21 • Risk Management Seminar/Webinar — “eHealth: Telemedicine and Telehealth” • Wednesday, April 21, 6:30pm–7:30pm
  • APR 22 • Risk Management Seminar/Webinar — “eHealth: Telemedicine and Telehealth” • Thursday, April 22, 11:30am–12:30pm
  • APR 28 • Medi-Cal Seminar/Webinar • Wednesday, April 28, 11:30am–1:00pm
  • APR/MAY • EMR/EHR Trunk Show • Late April, Early May — Watch for Updates
  • MAY 6 • IT Seminar/Webinar • Thursday, May 6, 11:30am–1:00pm
  • MAY 12 • E-town Hall • Wednesday, May 12, 11:30am–12:30pm
  • MAY 20 • Workers’ Compensation Billing Seminar/Webinar • Thursday, May 20, 11:30am–1:00pm
  • MAY 21 • Young and Resident Physicians Spring Social • Friday, May 21, 6:00pm–9:00pm
  • JUN 5 • 140th Annual SDCMS Installation Dinner and Dance • Saturday, June 5, 6:00pm–11:00pm • Hyatt Regency Mission Bay, 1441 Quivira Road, San Diego, CA 92109. For ticket information and sponsorship opportunities, please contact Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org.
  • JUN 18–19 • Physician Leader’s Toolbox Workshop • Friday and Saturday, June 18–19, 8:00am–4:00pm
  • JUN 24 • Sexual Harassment Seminar/Webinar • Thursday, June 24, 11:30am–1:00pm
  • JUL 21 • Risk Management Webinar — “The Employee’s Role in Decreasing Liability Risks in the Physician Office” • Wednesday, July 21, 6:30pm–7:30pm
  • JUL 22 • Risk Management Webinar — “The Employee’s Role in Decreasing Liability Risks in the Physician Office” • Thursday, July 22, 11:30am–12:30pm

SAN DIEGO COUNTY HEALTHCARE EVENTS

“Yes, there is a Nirvana; it is leading your sheep to a green pasture, and in putting your child to sleep, and in writing the last line of your poem.”
— Kahlil Gibran (1883 – 1931) Lebanese-American Artist, Poet, and Writer

Read more about: Healthcare News and Updates, Managing Your Practice, NYCU, SDCMS News and Updates, News You Can Use

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