SDCMS “News You Can Use”
— December 14, 2011
Executive Director Comment: We are closely watching what is happening with the Medicare 27.4% SGR cut in Washington. See details below. We will keep you posted of any developments via special NYCUs. It's a fluid situation!
Click Here [1] to Read the SDCMS President’s Op-Ed in the Union-Tribune About Medi-Cal's Hollow Promise
Click Here [2] to Take the SDCMS Workforce and Compensation Survey — Last Chance!
Please take it if you have NOT already done so — 5 minutes of your time, max.
Executive Director Comment: Please send us your stories of the impact this (see directly below) will have on your ability to care for Medi-Cal patients: Gehring@SDCMS.org [3]
DHCS Announces Plan to Recoup Provider Payments for Medi-Cal
The California Department of Health Care Services (DHCS) announced it intends recoup a 10% reduction in Medi-Cal provider payments retroactive to June 1, 2011, as part of the California Budget Act of 2011. CMA met with DHCS immediately after its announcement in an effort to understand how this news will impact physicians. DHCS is currently evaluating provider claims and payments to determine which providers must repay the state and by how much. DHCS said it intends to alert all impacted providers by January 2012. CMA will continue to meet with DHCS in an effort to provide updated information to physicians and to ensure that the state stands by its statement that recoupment will occur over an extended period of time. Click here [4] for further information.
CMA Needs Your Help to Ensure That Medi-Cal Patients Have Access to Healthcare:
- Contact Kyle Lewis at SDCMS — (858) 300-2784 or at KLewis@SDCMS.org [5] — if you, your clinic, or your medical group can no longer afford to treat Medi-Cal patients, cannot find specialists who take Medi-Cal patients, or would otherwise be negatively impacted by the recent cuts that California made to the Medi-Cal program.
- Click here [6] to download a form to give to your patients to determine how they're being affected.
- If you know of a Medi-Cal beneficiary who has a typical story (and would like to share it) of how Medi-Cal is not meeting its “access-to-care” requirements either because the beneficiary has had problems seeing a specialist or perhaps has had to wait longer than usual to see a primary-care physician, please contact Kyle Lewis at SDCMS.
CONTENTS
- Take a Short Survey on Clinical Research Trials
- San Diego County Influenza Surveillance Update
- Urge Congress to Stop the 27.4% Medicare Cut!
- Stage 2 of Meaningful Use Pushed Back to 2014
- CMA’s 5010 Quick Reference Guide (Updated Dec. 7)
- CMA Letter to CMS Questions Whether Palmetto Audit Volume Justified
- Availability of Medicare Data for Performance Measurement Final Rule
- CMA Petition for Verbal Order Authentication Amendments Rejected
- CMA Lawsuit Against DHCS and the U.S. DHHS
- Blue Cross Announces Changes to Prudent Buyer Contract
- Give the Gift of Health
- CMA’s Physicians’ Confidential Line
- Receive a Free Subscription to DocBookMD!
- Receive Free EHR Implementation Assistance
- SDCMS-CMA Seminars / Webinars / Events
- San Diego County Healthcare Events
MEDICAL …
Take a Short Survey on Clinical Research Trials • Click Here [7]
San Diego County Influenza Surveillance Update: December 7, 2011 • Click Here [8]
FEDERAL …
Urge Congress to Stop the 27.4% Medicare Cut Immediately and for Two Years!
Contact Your U.S. Representative and Senators Boxer and Feinstein:
- Telephone: AMA’s grassroots hotline at (800) 833-6354. You will be asked to enter your ZIP code and select your representative. Please select your representative first, then call back to connect with Senator Boxer and Senator Feinstein.
- Email: Click Here to Take Action Now [9]
Ask Your Patients to Call:
- Download, Print, and Post This Poster in Your Office [10]
- Download, Print, and Distribute to Your Patients This Flyer [11]
Click here [12] for further details from SDCMS. Click here [13] for further details from CMA.
Stage 2 of Meaningful Use for Medicare EHR Incentive Program Pushed Back to 2014
HHS intends to delay implementation of Stage 2 of Meaningful Use of EHRs until 2014. Under previous rules, physicians who achieved meaningful use in 2011 would have had to move to the higher Stage 2 standard in 2013. For more information from HHS, click here [14]. For further details from CMA, click here [15]. Click here [16] for a table that illustrates the stage that is relevant to each year of participation in the Medicare EHR incentive program. Of note: This extension resulted from comments crafted by CMA in response to a proposed Stage 2 of Meaningful Use.
CMA’s 5010 Quick Reference Guide (Updated Dec. 7, 2011) • Click Here [17]
For assistance with logging in to SDCMS' website, contact Kyle Lewis at (858) 300-2784 or at KLewis@SDCMS.org [5].
CMA Letter to CMS Questions Whether Current Volume of Audits Requested by Palmetto Is Justified
Click here [18] for a copy of CMA President Dr. James T. Hay's letter on December 5 to CMS regarding the multitude of medical review records currently being requested of physicians by Palmetto. In the letter, Dr. Hay expressed members’ concerns about the volume of requests and the tone of the audit letters. CMA has requested that CMS demand that Palmetto reduce the size of the special study and allow Palmetto to cease mailing any more requests for records. Click here [19] to read more.
Availability of Medicare Data for Performance Measurement Final Rule
On December 5, CMS published its final rule regarding the “Availability of Medicare Data for Performance Measurement.” The Affordable Care Act (ACA) authorizes the release of standardized extracts of Medicare claims data under parts A, B, and D to “qualified entities” for the performance evaluation of providers and suppliers. These entities will then make performance reports publicly available. This data will be provided to qualified entities beginning January 1, 2012. The final rule is very detailed and complex, and AMA is continuing to analyze it to better determine the impact on physicians. AMA is preparing an in-depth comparison of the provisions in the final rule and its AMA position. Click here [20] to read more.
CMA Petition for Amendments Extending Verbal Order Authentication Time Period Rejected by CDPH
The California Department of Public Health (CDPH) rejected amendments proposed by CMA that would have extended the time a physician has to countersign or authenticate a verbal order for treatment of a patient when a read-back and verify process is used. Click here [21] to read more.
STATE …
CMA Lawsuit Against DHCS and the U.S. DHHS
In November, CMA joined with the California Dental Association, the California Pharmacists Association, and the National Association of Chain Drug Stores to file a lawsuit [22] against DHCS and the U.S. Department of Health and Human Services in response to CMS’s approval of the reimbursement rate cut. CMA believes that DHCS has violated a federal law that requires that Medicaid (Medi-Cal in California) patients have the same access to physicians and other healthcare providers as the general insured public. A recent study showed that this is not the case for approximately 50% of Medi-Cal patients, even before the cuts go into place. Click here [23] for details.
Blue Cross Announces Changes to Prudent Buyer Contract
Anthem Blue Cross will soon be notifying its contracting physicians of impending changes to its Prudent Buyer Participating Physician Agreement, which will become effective April 1, 2012. The amendment, scheduled to be mailed December 14, includes an expanded confidentiality provision and several modifications to Exhibit F, which pertains to the Blue Cross Medicare Advantage PPO product. The amendment also modifies the reimbursement rates at which physicians will be paid for providing workers’ compensation services. Click here [24] for further details.
LOCAL …
Give the Gift of Health
Gift of Health sponsors health insurance premiums for medically and financially needy children in San Diego County. Gift of Health donations make great holiday gifts! This holiday season, in lieu of buying a gift, please consider making a donation on behalf of a friend or relative. You can help some of the most disadvantaged local children to have a healthy future. Click here [25] for details.
MEMBER BENEFITS …
CMA’s Physicians’ Confidential Line
A phone line service for physicians and their family members who request help with problems of alcoholism, drug dependence, or mental illness within their families: (213) 383-2691.
SDCMS Members With an iPad, iPod Touch, iPhone, and Now Any Android-based Phones and Tablets Receive a Free Subscription to DocBookMD!
DocBookMD gives you the entire San Diego County physician (members and nonmembers) database on your mobile devices. Bonus: You can HIPAA-compliantly, bi-directionally communicate with photos with other members who have signed up for the system. For details, contact Marisol at MGonzalez@SDCMS.org [26] or at (858) 300-2783.
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 [27] or at (858) 300-2791.
SDCMS-CMA SEMINARS / WEBINARS / EVENTS — MARK YOUR CALENDARS
For further information or to register for any of the following SDCMS seminars, webinars, or events, visit http://SDCMS.org/event [28] or contact Serena Sauerheber at (858) 300-2779 or at Serena.Sauerheber@SDCMS.org [29].
- DEC 14: Individualized Treatment Plans for Patients With Diabetes (CMA Foundation webinar) • 12:00pm–1:00pm • http://www.cmanet.org/events/?p=events [30]
- JAN 18: Workplace Harmony (SDCMS seminar/webinar) • 11:30am–1:00pm • Serena.Sauerheber@SDCMS.org [29]
- JAN 21: Legislative Advocacy Training (SDCMS workshop) • 8:00am–12:00pm • Gehring@SDCMS.org [3]
- JAN 25: Electronic Health Records: Best Practices (SDCMS webinar) • 6:30pm–7:30pm • Serena.Sauerheber@SDCMS.org [29]
- JAN 26: Electronic Health Records: Best Practices (SDCMS webinar) • 11:30am–12:30pm • Serena.Sauerheber@SDCMS.org [29]
- JAN 27, FEB 3, 10, 17, 24: Certified Medical Coder Course • 8:00am–4:00pm • Serena.Sauerheber@SDCMS.org [29]
- FEB 9: HIPAA 5010 (SDCMS webinar) • 11:30am–1:00pm • Serena.Sauerheber@SDCMS.org [29]
- FEB 16: Tax Time (SDCMS seminar/webinar) • 11:30am–1:00pm • Serena.Sauerheber@SDCMS.org [29]
SAN DIEGO COUNTY HEALTHCARE EVENTS
To submit a community healthcare event for possible publication, email KLewis@SDCMS.org [5]. Events should be physician-focused and should take place in or near San Diego County.
- JAN 19–22: 9th Annual Natural Supplements: An Evidence-based Update • Hilton San Diego Bayfront • http://www.scripps.org/events/natural-supplements-an-evidence-based-update [31]
- JAN 21: Brain Tumors: 2nd Annual Collaborative Care Conference • Catamaran Resort Hotel, San Diego • Sponsored by UC San Diego School of Medicine • http://cme.ucsd.edu/braintumors [32]
- FEB 4–5: Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education, and Research • Catamaran Hotel, San Diego • http://cme.ucsd.edu/bridging/ [33]
- FEB 9–11, 2012: 18th Annual Network of Oncology Clinicians and Researchers (NOCR) Meeting • Caesars Palace, Las Vegas • http://www.nocrannualmeeting.com/2012/index.asp [34]
- FEB: 17–18: Cell Society: 2nd Annual Clinical Meeting • Coronado Island Marriott Resort • https://xmedicacme.com/cell_society [35]
- MAR 10–17: Timmy Global Health Mission Trip to Ecuador • Clinics seeing approximately 40 patients per provider per day. • http://www.timmyglobalhealth.org [36]
- MAR 12–16: Topics and Advances in Internal Medicine • Catamaran Resort Hotel, San Diego • http://cme.ucsd.edu/internalmed [37]
- 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 [38]
- MAR 17–18: Topics and Advances in Pulmonary and Critical Care Medicine • Catamaran Resort Hotel, San Diego • http://cme.ucsd.edu/internalmed [37]
- APR 19–22: California Orthopaedic Association Annual Meeting • Park Hyatt Resort in Carlsbad • http://www.coa.org/coa-annual-meeting.html [39]
- APR 25: Sharon’s Ride Run Walk for Epilepsy 2012! • Deanza Cove Mission Bay Park • $25 Individuals/$50 Family/Phil’s BBQ Lunch Included • 7:30am-1:00pm • http://sharonsride2012.kintera.org/ [40]
- 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
"So of cheerfulness, or a good temper, the more it is spent, the more it remains."
— Ralph Waldo Emerson