SDCMS "News You Can Use" (2010.01.26)

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SDCMS “News You Can Use”
— January 26, 2010

Healthcare Reform (HCR) in 10 Seconds

  • Healthcare reform as we know it is dead.
  • At best, we will see a significantly slimmed down version of the current bill.
  • I have absolutely no idea when the revised bill will happen or what will be in the bill.
  • Click here for the longer version.

The Wolf Closest to the Sled
With Congress' recent epiphany that it shouldn't be spending money, the challenge in the next month will be to get the SGR repealed when it expires on March 1, 2010.

CONTENTS

  • SDCMS Members: Meet One-on-One With Palmetto Medical Director on February 23
  • Notes on Haiti From Chris Van Gorder • January 24
  • Photos From a Mission by San Diego County Physicians and Others to Haiti
  • SDCMS Workshop — End-Game Planning: Charting a Course for Your Last Trimester of Practice • February 27
  • SDCMS Young and Resident Physicians Social • February 11
  • SDCMS New Member Social • April 2
  • GPCI: The Good, the Great, and the Ugly
  • CMA’s Medicare Consult Code Guide
  • Medicaid, CHIP Payments to Be Reviewed by New Federal Commission
  • CMS Unveils Plan for How Doctors, Hospitals Can Get EMR Incentives
  • Scope of Practice Incursions at the National Level
  • Health Spending — Two Great Factoids
  • Cardiologists’ Suit Against Medicare Pay Cuts Dismissed
  • Doctors to Rate Medicare Contractors
  • Medicare Participation Decision Deadline Extended to January 31, 2010
  • Appeals Court Rejects Effort to Sell Medicare Physician Claims Data
  • Sneaky Phishing Schemes Targeting Doctors
  • CMA Regulations Quick List
  • DMHC Finalizes Timely Access Regulations
  • CMA Webinars on DMHC's Timely Access Regulations: January 28 & February 3
  • CMA’s 2010 Model Medical Staff Bylaws Now Available
  • SDCMS SEMINARS / WEBINARS / EVENTS
  • SAN DIEGO COUNTY HEALTHCARE EVENTS

LOCAL

SDCMS Members: Meet One-on-One With Palmetto Medical Director on February 23, 2010
Arthur Lurvey, MD, J1 Medical Affairs Director for Palmetto GBA, will be in San Diego the evening of February 23, 2010, and has kindly offered to give a 30-minute presentation on Medicare updates and to meet one-on-one with SDCMS member physicians for 15 minutes each. If you would like to speak with Dr. Lurvey one-on-one for no more than 15 minutes, please contact Marisol Gonzolez (email MGonzalez@SDCMS.org), your SDCMS physician advocate, to set up an appointment. Following are the times available:

  • 5:00pm–5:15pm: 1st Appointment
  • 5:15pm–5:30pm: 2nd Appointment
  • 5:30pm–5:45pm: 3rd Appointment
  • 5:45pm–6:00pm: 4th Appointment
  • 6:00pm–6:15pm: 5th Appointment
  • 6:15pm–6:30pm: 6th Appointment
  • 6:30pm–7:00pm: Medicare Updates Presentation
  • 7:00pm–7:15pm: 7th Appointment
  • 7:15pm–7:30pm: 8th Appointment
  • 7:30pm–7:45pm: 9th Appointment
  • 7:45pm–8:00pm: 10th Appointment

Notes on Haiti From Chris Van Gorder, Scripps Health President and CEO • Sunday, January 24, 2010
"On Saturday, Dr. Brent Eastman and I spent the day in Atlanta with the CEO of MedAssets. During the day, we made contact with many physicians in Haiti or physicians who had already been there to plan our mission. We made several contacts in dozens of emails and calls during the day. We finally made arrangements with Dr. Edward Gamboa — a former trauma surgeon at Scripps La Jolla — to initially see and possibly work at Hospital Saint Francois de Sales in Port-au-Prince. Click here to read more.

Photos From a Mission by San Diego County Physicians and Others to Haiti
First Photo • Second Photo • Third Photo • Fourth Photo

SDCMS Endorsed Partner, The Doctors Company, Protects Members From Fastest Growing Practice Threat with New CyberGuardSM Liability Insurance
Beginning January 1, 2010, The Doctors Company has added the CyberGuard coverage enhancement for solo and small-group members as protection against claims arising from the theft, loss, or accidental transmission of patient information. In addition, specific coverage in CyberGuard includes costs associated with the defense of a Red Flag Violation, HIPAA or government investigation, fines, patient notification and credit monitoring costs for affected persons. It also includes coverage for both online and offline information, virus attacks, identity theft, and costs of data recovery. For more information about CyberGuard, click here or click here to access a PDF document.

SDCMS Workshop — End-Game Planning: Charting a Course for Your Last Trimester of Practice • Sat., Feb. 27, 9:00am-1:00pm
An intensive, half-day workshop conducted by SDCMS-endorsed Practice Performance Group (PPG) for physicians who want to plan for an orderly and rewarding exit from active practice. Saturday, February 27, 2010, 9:00am–1:00pm. Click here to download a registration form and for further information.

SDCMS Young and Resident Physicians Social • February 11, 2010
Join us for a fun and relaxing evening. Unwind with your colleagues and make new friends! Thursday, February 11, 2010, 6:30pm-8:30pm. Rock Bottom Restaurant and Brewery at 401 “G” Street, San Diego, CA 92101 (downtown across from Horton Plaza). RSVP is a must as space is limited! To RSVP, please contact Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org.

SDCMS New Member Social • April 2, 2010
Mark your calendars to attend SDCMS’ New Member Social on April 2, 2010. All new SDCMS member physicians and guest are invited to attend. RSVP required. For location and additional information, please contact Jen Ohmstede at (858) 300-2781 or at JOhmstede@SDCMS.org.

FEDERAL

GPCI: The Good, the Great, and the Ugly

  • The Good: The Union Tribune in a January 19, 2010, editorial focused on the Geographic Practice Cost Index (GPCI), an anomaly that classifies San Diego County as "rural" for the purposes of calculating Medicare rates, and asked Senators Boxer and Feinstein to take up this issue. Executive Director Comment: We've been lobbying/advocating for this fix for almost as long as I’ve been executive director (eight years); this public recognition of the problem is welcome!
  • The Great: All five of our congressional representatives signed one of two letters to the House Speaker in support of fixing the GPCI. Click here to read the Hunter/Issa letter, and click here to read the Filner/Davis/Bilbray letter.
  • The Ugly/Tragic: Had healthcare reform passed, a GPCI fix for San Diego County was part of the bill.

Executive Director Comment: Kind of reminds me of the Chargers game … so close, yet so far!

CMA’s Medicare Consult Code Guide
CMA has updated its Medicare Consult Code Guide to include the latest information and to provide some additional clarity on this understandably confusing and complex issue. Click here for details. CMA is also surveying major payors in California to find out which ones will be changing their own payment policies as a result of this change. The data that it has gathered thus far is available to SDCMS-CMA members here. If you have any additional questions about these new rules, please do not hesitate to call CMA’s member help center at (800) 786-4262 and ask to speak with a reimbursement specialist.

Medicaid, CHIP Payments to Be Reviewed by New Federal Commission
A newly appointed commission — the Medicaid and CHIP Payment and Access Commission, or MACPAC — will examine how Medicaid physician pay affects access to care by Medicaid patients and those in the Children’s Health Insurance Program, among other issues. MACPAC, which was created by a provision of the Children’s Health Insurance Program Reauthorization Act and signed by President Obama in February 2009, instructs the panel to examine the effect of Medicaid pay and other factors on the access and quality of care received by Medicaid and CHIP enrollees. Click here for further information.

CMS Unveils Plan for How Doctors, Hospitals Can Get EMR Incentives
The federal government has issued two sets of regulations that are designed to lay the groundwork for physicians and hospitals to receive payments for implementing and utilizing electronic medical records.

  1. A proposed rule issued by the Centers for Medicare and Medicaid Services outlines provisions governing EMR incentives and details what constitutes meaningful use of the technology — a prerequisite for receiving any bonus dollars.
  2. A separate, interim final regulation issued by the Office of the National Coordinator for Health Information Technology sets initial standards and certification criteria for the use of approved EMRs.

Both rules were posted in the Federal Register on January 13, 2010, and will be open for public comment for 60 days. Click here for more information.

Executive Director Comment: I saw this in an AMA newsletter: “Scope of Practice Incursions — They’re Everywhere.” This is a neverending battle in Sacramento, and I’m sure we’ll see more than our share this year.

Scope of Practice Incursions at the National Level
In 2009, physicians fought a blitz of scope-of-practice expansions by other health professionals on legislative, legal, and regulatory fronts. Organized medicine defeated attempts by naturopaths to seek licensure, prevented chiropractors from being able to perform invasive procedures, and achieved further regulation of lay midwives. Physicians don’t expect the battles to let up, and with patient safety on the line, they are countering such efforts with some fresh tactics. In anticipation of another onslaught in 2010, physicians plan to push lawmakers to establish state scope-of-practice review panels to evaluate plans by nonphysician health professionals who wish to expand their practice realm. Click here for details.

Health Spending — Two Great Factoids

  1. Growth at Lowest Recorded Rate: The economic recession restrained growth in healthcare spending in 2008 to the lowest it has been in at least 48 years. The downturn affected hospital revenues and out-of-pocket spending in particular and helped limit spending increases on physician services. Overall health spending grew by 4.4%, 1.6 percentage points slower than in 2007 — the smallest percentage increase since the Centers for Medicare and Medicaid Services began tracking spending in 1960. Click here for further information.
  2. Healthcare spending national reached $2.34 trillion in 2008.

Cardiologists’ Suit Against Medicare Pay Cuts Dismissed
The American College of Cardiology in December 2009 suit against the Department of Health and Human Services, alleging that the government violated federal Medicare laws when it based payment reductions for certain cardiology services — with some cuts ranging up to 40% — on flawed data used to calculate practice costs for the specialty was dismissed. An across-the-board cut of 21.2%, set to take effect March 1, 2010, would be on top of those reductions. Click here for further information.

Doctors to Rate Medicare Contractors
The Centers for Medicare and Medicaid Services (CMS) is sending the fifth annual Medicare Contractor Provider Satisfaction Survey to roughly 30,000 randomly selected program participants nationwide, including physicians, suppliers, and institutional facilities. If you get a survey, strongly suggest you respond.

Medicare Participation Decision Deadline Extended to January 31, 2010
In light of the uncertainty surrounding the SGR and health reform, CMS has extended the deadline for physicians to determine their Medicare participation status for 2010 until January 31, 2010. The effective date of the decision will be 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. Physicians, as always, have three choices regarding Medicare: 1) Be a participating provider; 2) Be a nonparticipating provider; 3) Opt out of Medicare entirely. Members may click here to access CMA ON-CALL document #0151, “Medicare Participation (and Nonparticipation) Options.” You may also click here for further information from AMA.

Appeals Court Rejects Effort to Sell Medicare Physician Claims Data
A federal appeals court cited an injunctive order from three decades ago when it said a private company does not have a right to sell physicians’ Medicare claims data to hospitals. The decision is the latest in a series of court actions protecting doctors’ privacy against the release of such information for various purposes. Click here for more information.

STATE

Sneaky Phishing Schemes Targeting Doctors
A faculty physician at the University of California, San Francisco, Medical Center received an email last fall — appearing to be from the hospital’s information technology staff — requesting the doctor’s login information in order to perform routine security upgrades to the system. Because it seemed like an ordinary request, the physician sent the information, but the email was from a scammer, and, by responding, the physician had unwittingly exposed the personal information of more than 600 of his patients. This type of scam has become so common it’s earned its own nickname: “spearphishing.” Click here for further information.

CMA Regulations Quick List
Click here to download CMA’s Regulations Quick List, which provides summaries on various regulations tracked by CMA’s Center for Medical and Regulatory Policy. For more information on a specific regulation, please contact the staff member listed in the list.

DMHC Finalizes Timely Access Regulations
The California Department of Managed Health Care (DMHC) has finalized regulations that require HMO patients to be seen in a timely manner. HMOs have until October 17, 2010, to file a compliance plan with DMHC, by which point CMA should have a more fully developed picture of what physicians need to know and do. HMOs must fully comply with the regulations by January 17, 2011. For more information on these regulations, click here; physicians can also consult the newly updated CMA ON-CALL document #1005, “Access to Physicians."

CMA Webinars on DMHC's Timely Access Regulations: January 28 & February 3
Registration is free to SDCMS-CMA members, but space is limited, so reserve your space today. If you are unable to participate in the live webinar, it will be available for on-demand viewing beginning the following day.

CMA’s 2010 Model Medical Staff Bylaws Now Available
CMA’s 2010 Annotated Model Medical Staff Bylaws are now available. These model medical staff bylaws are the definitive guide for medical staffs, providing details on professional and legal structures to support effective medical staff operations. This publication is available free to medical staff members of the Organized Medical Staff Section (OMSS); if you are a member, please call (916) 551-2053 to order your free copy. If you are not a member, click here to purchase a copy ($1,000).

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.

  • JAN 27 (WED 11:30am-1:00pm) • Human Resources Law Seminar/Webinar • "The Dance": The Overlap Between the Family and Medical Leave Act (FMLA), the Americans With Disabilities Act (ADA),?and Workers’ Compensation Leave Laws
  • FEB 4 (THU 11:00am-1:00pm) • Practice Management Seminar/Webinar (“Treating Patients Right”)
  • FEB 11 (THU 6:00pm-9:00pm) • Young and Resident Physicians Winter Social
  • FEB 17 (WED 10:00am-12:00pm) • Palmetto/Medicare Seminar/Webinar
  • FEB 27 (SAT 9:00am-1:00pm) • Retirement Workshop (“End-game Planning”)
  • MAR 5-26 (4 FRIDAYS 9:00am-4:00pm) • Certified Medical Office Manager Course
  • MAR 18 (THU 11:30am-1:00pm) • Contract Management Seminar/Webinar
  • MAR 24 (WED 9:00am-12:00pm) • Billing and Collections Procedures Seminar/Webinar (“Back to Basics”)
  • APR 2 (FRI 6:00pm-9:00pm) • SDCMS New Member Social
  • APR 17 (SAT 8:30am-3:30pm) • Resident Physician Workshop (“Preparing to Practice”)
  • APR 21 (WED 6:30pm-7:30pm) • Risk Management Seminar/Webinar (“eHealth: Telemedicine and Telehealth”)
  • APR 22 (THU 11:30am-12:30pm) • Risk Management Seminar/Webinar (“eHealth: Telemedicine and Telehealth”)
  • APR 28 (WED 11:30am-1:00pm) • Medi-Cal Seminar/Webinar
  • LATE APRIL / EARLY MAY • EMR/EHR Trunk Show
  • MAY 6 (THU 11:30am-1:00pm) • IT Seminar/Webinar
  • MAY 12 (WED 11:30am-12:30pm) • e-Town Hall
  • MAY 20 (THU 11:30am-1:00pm) • Workers’ Compensation Billing Seminar/Webinar
  • MAY 21 (FRI 6:00pm-9:00pm) • Young and Resident Physicians Spring Social
  • JUN 5 (SAT 6:00pm-11:00pm) • SDCMS Inaugural SDCMS
  • JUN 18-19 (FRI-SAT 8:00am-4:00pm) • Leader’s Toolbox Workshop
  • JUN 24 (THU 11:30am-1:00pm) • Sexual Harassment Seminar/Webinar

SAN DIEGO COUNTY HEALTHCARE EVENTS

"In the attempt to defeat death man has been inevitably obliged to defeat life, for the two are inextricably related. Life moves on to death, and to deny one is to deny the other."
— Henry Miller (1891–1980), American Novelist and Painter

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