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SDCMS "News You Can Use" (2010.05.26)

by: San Diego County Medical Society
Published May 25, 2010

SDCMS "News You Can Use"
— May 26, 2010

Executive Director Comment on SGR [the (un)Sustainable (non)Growing Rate formula — i.e., the Medicare cost-of-living adjustment for Medicare Part B that has been flat for six years, before inflation]: Seems like we’ve been here before …. When we last tuned in, the 21% cut was postponed until 1 June 2010. Now Congress is once again considering a fix to the SGR. While we are not yet sure of the details, and, of course, we’ll let everyone know the instant it’s approved, it looks as if a three-year patch with small increases, plus a GPCI fix, BUT …

… if the House does not vote on that bill by tonight (Wednesday), then the Senate won’t get to it in time before the Memorial Day recess, and we’re back to the “Perils of Pauline,” where the 21% cut goes into effect and physicians are retroactively reimbursed.

Now for the good news: Due to some really strong work by CMA and the California delegation, a GPCI fix is in the House bill, and the Senate side looks receptive to a GPCI fix. While we’ll hold the champagne until the ink is dry, this represents another HUGE step in fixing this long-standing inequity. Click here to read CMA's letter to the California congressional delegation in support of the Medicaid, Medicare SGR, and GPCI provisions in HR 4213.

SDCMS' White Coat Gala (Installation Dinner & Dance) ...
... will be at the Hyatt Regency Mission Bay on Saturday, June 5, 2010, 6pm–11pm. For SDCMS members of 33 or more years, come as our guest! (Guest tickets may also be purchased at the standard ticket cost of $75.00 each.) Please contact Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org to RSVP or for additional details.

Only Five Seats Left for Our Physician Leader's Toolbox Seminar • June 18 & 19, 8:00am–4:00pm
This is an exceptional opportunity for SDCMS members to build your leadership skills and your network. As a bonus, the CEO of CMA will be one of the students. This unique, small-group seminar will be held at SDCMS for physicians who are either leaders or leaders to be. The topics will include Strategic Planning and Execution, Leading Your Team, Building Your Team: Focusing on Hiring and Firing, Managing Your Time, Managing Your Organization's Money, Managing the Message: Communicating One-on-one, Speaking to Many, Emailing, and Making Formal Presentations, and Managing Your Meetings, Including Parliamentary Procedures. For further information or to register, email me at Gehring@SDCMS.org.

Executive Director's Note: If you have not made an EMR decision, or are about to, then this is a must-attend event (see below). We will spread the educational portion out throughout the workday to accommodate everyone's busy clinical schedule.

How the Heck Do I Buy an EMR? Should I Buy an EMR? Which One? Come to SDCMS' "EMR Trunk Show" and Find Out!
Experience side-by-side demonstrations of the leading EMRs on Thursday, June 10, 2010, at SDCMS' "EMR Trunk Show" — an all-day event (11:00am–7:30pm) hosted by SDCMS for only SDCMS members to allow physicians and office staff to see the major EMR/EHRs in operation, to meet the sales staff, and to learn HOW to choose an EMR. Click here for more information.

CONTENTS

  • Supreme Court Delays Decision on Whether to Review Medi-Cal Rate Case
  • California Physicians Required to Notify Patients They Are MBC-licensed Effective June 27, 2010
  • "Microsoft Outlook for Busy Docs" SDCMS Seminar — August 7
  • Project Access San Diego Success Story
  • PECOS Enrollment Moved Up to July 6, 2010
  • Physicians Can Now Claim their Share of $350 Million UnitedHealth Settlement
  • FTC Red Flags Rule Take Effect June 1, 2010
  • Red Flags Rule Resources From SDCMS and CMA
  • Pertussis Cases Increasing in San Diego County
  • Measles Cluster Identified in San Diego County
  • Rx for Obesity at 211SanDiego.org
  • SDCMS SEMINARS / WEBINARS / EVENTS
  • SAN DIEGO COUNTY HEALTHCARE EVENTS

STATE

Executive Director Comment: This pushes back any cuts to Medi-Cal rates for physicians to no earlier than October 2010 … essentially taking it out of consideration for this budget cycle.

Supreme Court Delays Decision on Whether to Review Medi-Cal Rate Case
The U.S. Supreme Court did not grant or deny the state's petition to review a 9th Circuit Court of Appeals decision blocking a 10% cut to Medi-Cal provider rates. Instead, on May 24 the court asked the solicitor general of the United States to provide the views of the federal government as to whether the court should grant or deny cert. This means that the Supreme Court will not decide whether to grant or deny the petition until at least October 2010, when it returns from its summer recess. CMA led a coalition of providers who challenged the cut, which the state legislature passed and the governor signed into law early in 2008. The court ruled that providers were entitled to sue, thanks to the federal supremacy clause, and the state had failed to follow federal law in implementing the cuts

Executive Director "Gotcha" Alert: While the MBC will not likely raid your office to check for compliance, it is the law … and it's relatively easy to comply with.

California Physicians Required to Notify Patients They Are MBC-licensed Effective June 27, 2010
Effective June 27, 2010, physicians practicing in California must inform their patients that they are licensed by the Medical Board of California (MBC) and include the MBC's contact information. SDCMS member physicians can click here to access sample notices from CMA and other materials developed to help satisfy the new MBC notice requirements.

LOCAL

"Microsoft Outlook for Busy Docs" SDCMS Seminar - Saturday, August 7, 2010, 8:00am-11:30am
This three-and-a-half hour SDCMS members-only course on how to make Microsoft Outlook your servant and not your master. This will be a very, very practical and user-focused seminar. Please mark it down on your calendar and email me (Gehring@SDCMS.org) if you're interested.

Project Access San Diego Success Story
On May 18, 2010, SDCMSF and Project Access San Diego (PASD) received a proclamation from the San Diego County Board of Supervisors for recent surgical accomplishments and over $1 million in donated care. Recently, PASD was proud to be able to provide life-saving services for Felix. With a diagnosis of achalasia, Felix received an inpatient Heller laparoscopic myotomy surgery on April 20 at UCSD with Dr. Santiago Horgan. Felix is a new father and is excited to "be able to eat normally again, as it was painful and uncomfortable to eat" prior to the surgery. To learn more about Project Access, email Lauren Radano at LRadano@SDCMS.org.

FEDERAL

Executive Director "Gotcha" Alert: Be aware that federal law requires providers who are enrolling or revalidating their PECOS enrollment (see below) to also sign up for electronic funds transfer (EFT). Although the online PECOS revalidation process appears to allow you to opt out of EFT, opting out is not an option.

PECOS Enrollment Moved Up to July 6, 2010
PECOS (Provider Enrollment Chain and Ownership System) enrollment deadline will be moved up by six months from January 1, 2011, to July 6, 2010. Medicare is authorized to reject claims if an ordering or referring physician is not identified in Medicare's Internet-based PECOS enrollment system.

  • Providers must include their NPIs (if applicable) on Medicare and Medicaid enrollment applications and claims.
  • The ordering/referring supplier must be a physician or an eligible professional with an approved enrollment record in the Provider Enrollment Chain and Ownership System (PECOS).
  • Claims that do not meet these requirements will be rejected.

If you do not also complete the CMS-588 form to enroll in EFT, your claims will not be paid. As the actual PECOS enrollment process can be quite confusing for physicians, CMA has developed a step-by-step guide to walk physicians through the process, from determining if they are already in PECOS to accessing the Internet-based PECOS enrollment system. CMA also hosted a PECOS enrollment webinar with Palmetto, California's Medicare contractor, available for on-demand viewing to members only. Visit Palmetto online for answers to frequently asked questions.

Physicians Can Now Claim their Share of $350 Million UnitedHealth Settlement
Physicians will soon be able to get their share of a $350 million settlement with UnitedHealth Group. To help physicians understand the settlement and what they need to do to claim their share, CMA has created a settlement resource center where you will find CMA's United Healthcare/Ingenix Settlement Guide, claim forms, and a number of other helpful resources. A hearing to determine final approval of the settlement is set for September 13 in U.S. District Court in New York. Doctors have until July 27 to file any objections to the settlement or to opt out. The deadline to submit claims for payment from the settlement fund is October 5. Notices to class members were mailed on April 16, 2010. Upcoming dates to remember:

  • July 27, 2010: Deadline for class members to opt out or object to the settlement.
  • September 13, 2010: Court hearing to finally approve the settlement.
  • October 5, 2010: Deadline to submit claims for payment from the settlement fund.

This guide is intended to help physicians understand the key terms of the settlement agreement and the procedures established to distribute settlement funds. Physicians can use this information to decide whether they qualify to participate in the settlement, whether to opt out, and how to submit claims on the settlement fund. For further information:

FTC Red Flags Rule Take Effect June 1, 2010
The Federal Trade Commission (FTC) will soon begin enforcing its new Red Flag Rule, which requires "creditors" — including many physicians — to develop and implement identity theft detection and prevention programs. The new regulations take effect on June 1, 2010.

Red Flags Rule Resources From SDCMS and CMA

  • SDCMS Brief Webinar on the Red Flags Rule (recorded April 22, 2009) • Click Here
  • SDCMS Sample Policy in Word • Click Here
  • SDCMS' Sample Policy in PDF • Click Here
  • CMA's Toolkit in PDF • Click Here
  • AMA's Red Flags Rule Guidance Document in PDF • Click Here
  • AMA's Sample Policy in PDF • Click Here
  • The FTC's Do-it-yourself Prevention Program for Businesses and Organizations at Low Risk for Identity Theft • Click Here

MEDICAL

Pertussis Cases Increasing in San Diego County (May 24, 2010)
From January to April 2010, a total of 50 pertussis cases were identified among San Diego County residents, compared to 13 cases identified during the same time period last year. San Diego County clinicians are encouraged to consider pertussis in their patients and symptomatic close contacts. All suspected or confirmed cases should be promptly reported to the San Diego County Immunization Program at (866) 358-2966 on weekdays and (858) 565-5255 on weekends and holidays. All healthcare workers and persons having close contact with infants should be immunized against pertussis with Tdap vaccine. CDPH recommends that each patient encounter be treated as an opportunity to administer pertussis vaccine if it is indicated.

Measles Cluster Identified in San Diego County (May 14, 2010)
A cluster of three confirmed measles cases has been identified by the San Diego County Health and Human Services Agency. Healthcare providers should consider measles in persons with acute febrile and rash illness. In addition to serologic (IgM) specimens, throat swabs or urine should be collected for viral isolation. Patients suspected of having measles should be immediately reported to the San Diego County Immunization Program at (866) 358-2966 during weekdays and (858) 565-5255 after hours and weekends. Early identification and prompt reporting of suspect cases will facilitate timely case investigation and post-exposure prophylaxis of close contacts to prevent the spread of measles in the community. For more information, please contact the Immunization Program at (866) 358-2966 or visit their website. Additional information about measles can be found at the CDC website.

Rx for Obesity at 211SanDiego.org • Community Health Brief
Healthcare professionals have a new tool in their fight against obesity: a comprehensive, online, countywide database of programs and services that address the various aspects of obesity, managed by 211 San Diego. Click here for details.

SDCMS SEMINARS / WEBINARS / EVENTS
For further information on or to register for any of the following SDCMS seminars, webinars, and events, contact Sonia Gonzales at (858) 300-2782 or at SGonzales@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 San Diego County.

"To create a little flower is the labor of ages."
— William Blake, English Poet, Painter, and Printmaker (1757–1827)

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

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