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Government Affairs
PHYSICIAN ID BILL GETS LOOK IN STATE HOUSE
The PA House of Representatives returned to legislative session for one day this week to clean up and vote on several bills before adjourning. One of those bills requires that photo identification tags be worn by physicians and healthcare providers when taking part in direct patient care. The legislation specifies that “medical doctors” and “doctors of osteopathy” refer to themselves as “physicians.” The policy rationale is supported by the PAFP which is to create an understanding by patients of who is treating them and what credentials they have obtained through training and education. With so many different health care providers in all healthcare settings across the state involving themselves in direct patient care, physicians will clearly be considered and MD or DO. Interim regulations will be promulgated by the Department of Health within 90 days of enactment. The Governor has until November 27 to sign the bill.
 U.S. SENATE VOTES TO POSTPONE MEDICARE CUT; HOUSE STILL ON RECESS
According to the Medical Group Management Association (MGMA), the U.S. Senate approved legislation November 18 that will provide a 31-day payment patch to Medicare Sustainable Growth Rate (SGR) formula. The bill will freeze current rates for services provided through Dec. 31, and temporarily avert a 23 percent cut to physician payments that was slated to take effect on Dec. 1. This is a temporary fix and physicians will still face a 25 percent cut on January 1, 2011. The House of Representatives is expected to vote on the bill upon their return to session.
Practice Advocacy
DPW TO REQUIRE NPI NUMBER ON PHARMACY CLAIMS
According to the Pennsylvania Department of Public Welfare (DPW), effective January 1, 2011, prescribers will be required to provide a valid NPI number on all pharmacy claims. If a prescription does not include the NPI number of the provider, the claim will be denied. A bulletin issued by DPW will be sent to all providers enrolled in the Medical Assistance program. For more information, visit the DPW website.
CMS LAUNCHES INNOVATION CENTER TO AID IN HEALTHCARE REFORM
The Centers for Medicare and Medicaid Services (CMS) launched its new Center for Medicare and Medicaid Innovation on November 16. The Innovation Center, created by the Patient Protection and Affordable Care Act, will examine new ways of delivering health care and paying health care providers that can save money for Medicare and Medicaid while improving the quality of care. CMS also selected eight states, including Pennsylvania, to participate in the Multi-Payer Advanced Primary Care Practice Demonstration Project, an initiative to evaluate the effectiveness of doctors and other health professionals across the care system working in a more integrated fashion and receiving more coordinated payment from Medicare, Medicaid, and private health plans. The other states selected include Maine, Vermont, Rhode Island, New York, North Carolina, Michigan, and Minnesota. The demonstration will ultimately include over 1,200 medical homes serving almost one million Medicare beneficiaries. For more information, read the CMS press release.
CMS WANTS YOU TO E-PRESCRIBE IN 2011 OR FACE 1 PERCENT MEDICARE CUT IN 2012
According to a report from the MGMA, The Centers for Medicare & Medicaid Services (CMS) is requiring that claims-based reporting be used to report at least 10 eligible electronic prescribing (e-prescribing) encounters during the first six months of 2011 or Medicare payments will be reduced by 1 percent in 2012. This provision was included in the final Medicare physician fee schedule that outlines requirements for obtaining the 2011 e-prescribing bonus and avoiding future penalties. In addition to outlining the 2011 bonus details, which are consistent with the 2010 requirements, CMS finalizes a method for determining 2012 and 2013 penalties for eligible professionals (EPs) who are not successful e-prescribers. The penalties in 2012 and 2013, 1.0 percent and 1.5 percent, respectively, are mandated by the Patient Protection and Affordable Care Act (ACA). The 2013 penalty will be applied to any EP who does not successfully e-prescribe in 2011. An EP may earn an incentive payment of 1.0 percent of his or her estimated total allowed Medicare Part B fee schedule charges for covered professional services furnished in 2011. To earn the bonus, a provider must report the G-code G8553 25 times using claims-based, registry, or electronic health record reporting methods in 2011 to indicate that he or she has successfully e-prescribed using a qualified e-prescribing system.
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VACCINE UPDATES FOR FALL 2010
-- MCV4: ACIP voted for MCV4 at 11-12 years with a booster at 16 years; for those vaccinated age 13-15 years, a one-time booster after 5 years. 6 to 5 vote.
-- Single dose of Tdap may be given in place of Td in persons >/= 65 years; if close contact with an infant <12 months of age is anticipated (grandparent, child-care provider, HCW), then Tdap should be administered.
-- Children 7 thru 10 not fully immunized against pertussis should receive a single dose of Tdap; if additional doses of Td needed, then Td should be used. (for children 7-10 who receive Tdap; no further dose recommended at 11-12).
More detailed notes from PAFP member Richard Zimmerman, MD, (Pittsburgh) at www.pafp.com/vaccines.
UPDATED PEDIATRIC IMMUNIZATION ADMINISTRATION CODES
Reflecting the increased amount of time spent by physicians counseling patients on vaccines, immunization administration codes 90465-90468 will be replaced by codes 90460-90461 beginning Jan. 1, 2011. The new codes provide additional payment for administration of multi-“component” vaccines. Read more.
HELP KIDS WITH CONCUSSIONS GET BACK TO SCHOOL
More than 20,000 children sustain concussions (mild traumatic brain injuries) every year in Pennsylvania. Many students return to school with lingering effects that impact classroom performance. BrainSTEPS, a program of the PA Dept. of Health and PA Dept. of Education, helps students with a new injury to re-enter school and helps students with a previously identified injury if/when effects emerge. It’s a team-based approach and involves rehab professionals, parents, teachers and the injured student. You can help patients with any type of acquired brain injury access this program by making a referral. Locate your local BrainSTEPS team (organized by county) and contact the Team Leader. Go to www.brainsteps.net/_orbs/about/BrainSTEPSReferral10-11.pdf
WARNING: SMOKING CAN KILL YOU
That’s one of the proposed new warning labels for cigarette packaging. You can see all the proposed messages and ads at www.fda.gov/TobaccoProducts/Labeling/CigaretteProductWarningLabels/default.htm. You can also comment on the new proposed rule to require larger messages with images: go to www.regulations.gov and insert docket number FDA-2010-N-0568 into the “search” box and follow the prompts.
Current rates of smoking are above Healthy People goals: the rate for adults is 20% (far above the goal of 12%) and the rate for high school students is 19% (above the goal of 16%). Check out AAFP’s Ask and Act program for lots of resources to help patients stop cigarette smoking.
PUBLIC HEALTH INFORMATION AND CME IN KEYSTONE PHYSICIAN (PAFP MAGAZINE)
Adult immunization tip sheet: Summer 2010
Child abuse (FAQs for mandated reporters): Fall 2010
(CME) Clinical Scenario Series on Immunization: Summer/Fall 2010
Colorectal cancer screening tip sheets: Summer 2010
Health care worker immunization: Summer 2010
Safe medication disposal: Spring 2010
Snus and dissolvable tobacco: Summer/Fall 2010
Using PDSA cycles to implement better care (CME!): Summer 2010
Coming in Winter 2011 (due out in February): tip sheets on adolescent immunization and child sexual abuse
PUBLIC HEALTH CME WEBCASTS
Lots of free CME at www.pafp.com/onlineCME, most of which qualifies as patient safety. Topics such as rheumatoid arthritis, asthma and colorectal cancer. Hurry: webcast on adolescent depression expires Dec. 1.
NEW CME WEBCAST
IMPLEMENTING CHANGE: Best Practices For Continuous Quality Improvement
1.25 Prescribed Credits, qualifies as risk management CME for PA licensure. Watch this program to answer these questions: How do you make small changes that lead to big improvements? What changes should you focus on? What kind of changes can your practice team make? How do you engage patients in making changes?
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PA REACH TURNING "MEANINGFUL USE" INTO "MEANINGFUL" FINANCIAL GAINS
Physicians who adopt or upgrade their existing EHRs to a CCHIT-certified product/version can earn up to $44,000 per provider from Medicare over a 5-year span or up to $63,000 from Medicaid over a 6-year span. To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012. Do NOT miss out on this opportunity! Sign up now for the PA REACH Project! Contact PAFP REACH coordindator Tracy Koval at tkoval@pafp.com or call 717-635-7589.
MAINTENANCE OF CERTIFICATION (MOC) PART IV CREDIT AVAILABLE
Looking for a MOC Part IV activity? The PAFP Colorectal Cancer Screening (CRCS) Collaborative is an activity that qualifies as part of the performance improvement module for MOC Part IV. It’s a way to learn how to do performance measurement in a fully supported program that will not only improve your CRCS rates but also teach you skills to make improvements in other clinical areas (diabetes, for example). To get started or to receive more information, please visit www.pafp.com/IPIP and click the CRC Screening Collaborative icon, or email Michelle Seitz at mseitz@pafp.com.
ONLINE WEBCAST AND FREE CME
Click here to watch CME webcasts on Colorectal Cancer Screening (CRCS). Learn about the Guidelines for Care, Using Systems Change to Improve your Rates and Using the ACS toolkit on Increasing CRC screenings. These CME webcasts qualify for patient-safety credits.
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