Archive for November, 2016

MACRA Education from the AMA

MACRA Education from the AMA

The American Medical Association is offering several educational opportunities to help physicians understand the requirements of the new Quality Payment Program (QPP) that was created by the Medicare Access and CHIP Reauthorization Act (MACRA). The sessions have been scheduled to give physicians an understanding of what the final rule means for their practice and what they need to do as part of the QPP. All of the sessions, except Nov. 29, are open to physicians and medical society staff.  

Please take advantage and register for these additional learning opportunities and pass along the registration information to your physician members.

Tuesday, Nov. 29 @ 1 p.m. – 3 p.m. ET
Staff Train the Trainer Webinar
Registration: https://cc.readytalk.com/r/qptr0uqxdfip&eom
This session will be focused on helping medical society staff to gain a better understanding of the new regulations so you will be prepared to answer your questions.

Thursday, Dec. 1 @ 6:30 p.m. – 9 p.m. ET
Atlanta Regional Seminar (streaming and webinar)
Cobb Galleria Center in Atlanta, GA
Registration: https://www.eventbrite.com/e/macra-regional-seminar-atlanta-tickets-28840143646

Tuesday, Dec. 6 @ 8:00 p.m. – 9:30 p.m. ET
Physician/Staff Webinar
Registration: https://cc.readytalk.com/r/j8d0v8kh1qr3&eom

Saturday, Dec. 10 @ 9 a.m. – 11:30 a.m. PT
San Francisco Regional Seminar (streaming and webinar)
Marriot Marquis in San Francisco, CA
Registration: https://www.eventbrite.com/e/macra-regional-seminar-san-francisco-tickets-28863673023

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AMA Posthumously Honors Dr. Jeff Terry

AMA Posthumously Honors Dr. Jeff Terry

During its recent Interim Meeting the American Medical Association posthumously awarded Dr. Jeff Terry the AMA Special Award for Meritorious Service in recognition of his contributions to the medical profession. Dr. Terry’s wife, Elizabeth, and their son, Dr. William J. Terry, Jr., accepted the award on behalf of the family.

Dr. Terry was nominated for this award by the Medical Association and also received endorsements from physician leaders across the country. U.S. Sen. Bill Cassidy (R-LA) offered the following tribute: “Beyond serving his family and community, Dr. Jeff Terry genuinely cared about the future of the medical profession. His contributions to the policy-making process were absolutely invaluable. I am privileged to say that Dr. Terry was a fellow American and a colleague as a physician. He was a blessing to many.”

Rep. Tom Price (R-GA) recently described Dr. Terry as “a consummate physician advocate for patients” who always punctuated his advocacy efforts by reminding him that “if we don’t get this right we will not be able to care for patients the way we should.”

Drs. Greg Cooper and Bill Clark, former Southeastern Delegation colleagues of Dr. Terry’s, offered the following endorsement: “We in the Southeastern Delegation will feel Jeff’s presence whenever we rise to speak to important issues that impact the practice of medicine. When we do, because of him, we will be less self-conscious, more passionate, and more determined to carry forward the work of the AMA.”

AMA Delegation Chair Dr. Jorge Alsip also remembered his friend and colleague. “Jeff was a fierce defender of the patient-physician relationship and a force to be reckoned with in the AMA House of Delegates. The sacrifices he made traveling  across the country to advocate for patients and physicians set an example that few can ever hope to emulate.”

In his remarks to the AMA House of Delegates Dr. William Terry recalled his father’s love for the AMA and the privilege of being a physician, and he concluded with the following challenge to the AMA House of Delegates: “Dad would tell us that if we sometimes find the practice of medicine to be a cold place, then make it your business to build fires.”

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Medical Association Joins AMA for Release of Opioid Education and Resource Toolbox

Medical Association Joins AMA for Release of Opioid Education and Resource Toolbox

BIRMINGHAM – The Medical Association and the American Medical Association partnered in the development and release of a toolbox of data, education and other resources to aid physicians in their continued fight against Alabama’s epidemic of prescription drug misuse, overdose and death. The toolbox was released in a press conference during the Association’s November Opioid Prescribing Education conference in Birmingham.

This toolbox is part of the Medical Association’s continuing efforts – legislative and other – to reverse this epidemic, and Alabama is one of two states participating in this pilot program.

“Although Alabama is no longer the top prescriber of opioids in the country, we still have a very long way to go as far as educating our physicians and other prescribers how to properly handle the prescription of opioid pain medication and those patients that require that medication,” said Medical Association Executive Director Mark Jackson. “This toolbox will help physicians not only educate patients about pain, but also provide resources for overdose prevention and treatment.”

Jackson said he hopes Alabama’s physicians will find the toolbox useful and help strengthen their physician-patient relationships as they continue to discuss pain-related issues with their patients.

“This toolbox contains the types of data and resources that physicians can rely on to help improve their practices for their patients,” said Gerald Harmon, M.D., chair-elect of the American Medical Association Board of Trustees, who also spoke at the press conference. “We recognize that we have much more to accomplish, but physicians in Alabama and across the nation already have made important strides to reverse the nation’s opioid epidemic, and using these resources will help physicians continue that progress.”

Alabama, along with Rhode Island, are the only two states in this grant. These states were chosen due to many factors, including high rates of opioid-related harm as well as diverse demographic, socioeconomic, geographic and other characteristics. The characteristics offer excellent opportunities to study the implementation of the toolbox, refine it, and potentially use it as a model for other states that want to undertake similar efforts.

The toolbox can be viewed online at www.SmartAndSafeAL.org/physicians.

Funding for this initiative was made possible (in part) by Providers’ Clinical Support System for Opioid Therapies (grant no. 5H79TI025595) from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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Cruise Deals for Alaska in 2017 — Special Rates for Association Members!

Cruise Deals for Alaska in 2017 — Special Rates for Association Members!

Experience Alaska’s majesty next summer aboard a Princess Cruise! Book now though Nov. 16 with your travel partners at Two Sisters Travel, and take advantage of the 3-for-Free Sale Event offering complimentary cabin upgrades, onboard credits, and free gratuities. Package your cruise experience with 3-4 nights on land to explore Denali National Park.

Get a no-obligation cruise quote online or call Two Sisters Travel at (843) 284-3241 to discuss planning your next vacation whether it’s Alaska, Caribbean, Europe or Walt Disney World. Two Sisters Travel offers the Medical Association’s members free, easy and stress-free concierge travel planning services. Call or click today!

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Medicare Releases 2017 Physician Fee Schedule Final Rule

Medicare Releases 2017 Physician Fee Schedule Final Rule

The Centers for Medicare and Medicaid Services released its final rule for its 2017 physician fee schedule payment policies, which updates payment policies and payment rates for services provided under the Medicare Physician Fee Schedule (PFS) starting Jan 1, 2017.

The 1,400-page 2017 final rule discusses changes to a number of new policies that reflect a broader agencywide strategy to enhance quality, spend smarter and improve Americans’ health.

Here are eight changes to note:

CMS will begin gathering data on postoperative visits. The final rule requires reporting of postoperative visits for high-volume/high-cost procedures by a sample of practitioners in practices with 10 or more physicians. Reporting is required for services related to global procedures provided on or after July 1, 2017.

Changes were made to provider and supplier requirements for Medicare Part C. Providers and suppliers will be screened and enrolled in Medicare to contract with a Medicare Advantage organization to provide items and services to those enrolled in Medicare Advantage health plans.

CMS finalized its proposal to expand eligible telehealth services. The additional codes include those for end-stage renal disease-related dialysis, advanced care planning and critical care consultations. The critical care consultations provided via telehealth will use the new Medicare G-codes.

CMS will improve data transparency. Medicare Advantage organizations use a bidding process to apply to participate in the Medicare Advantage program, and the bidding process will reflect the organization’s estimated costs to provide benefits to enrollees. Under the final rule, Medicare Advantage organizations are required to release data associated with these bids on an annual basis. CMS will also require Medicare Advantage organizations and Part D sponsors to release medical loss ratio data on a yearly basis to help beneficiaries make enrollment decisions.

The agency revised the methodology used to calculate geographic practice cost indices. CMS adjusts payments under the physician fee schedule to reflect local differences in practice costs using geographic practice cost indices. The agency will revise the methodology used to calculate GPCIs to increase overall physician fee schedule payments in Puerto Rico. The updates will be phased in over 2017 and 2018.

CMS finalized expansion of the Medicare Diabetes Prevention Program. The 2017 rule finalizes some aspects of the expanded model, but future rulemaking will address payment policies, program safeguards and other issues. CMS expects to begin payment for MDPP services in 2018.

CMS revised the billing codes to more accurately pay for primary care, care management and other cognitive specialties. Among the changes are new codes to pay primary care practices that use interprofessional care management resources to treat patients with behavioral health conditions.

Physician payment rates will increase by 0.24 percent in 2017. CMS arrived at this increase after accounting for a 0.5 percent increase required by the Medicare Access and CHIP Reauthorization Act and mandated budget neutrality cuts, according to the American Hospital Association.

For more information, please see Final Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year (CY) 2017

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Splash Down in Haiti and Saving Lives with Richard McGlaughlin, M.D.

Splash Down in Haiti and Saving Lives with Richard McGlaughlin, M.D.

BIRMINGHAM — It was his love of flying and his intrinsic need to help others that originally led Richard McGlaughlin, M.D., to Haiti in 2010. In January 2010, the small Caribbean country of Haiti had been rocked by a devastating earthquake, and the task of getting supplies to the recovering nation was proving more than just difficult.

Transportation of what life-saving supplies to Haiti by cargo ship was nearly impossible because the ships were unable to get to Port-au-Prince. Dr. McGlaughlin, who owned a small, single-engine aircraft read about the situation on a member’s-forum for the Cirrus Owners & Pilots Association. Bahamas Habitat was asking for volunteers to fly missions to Haiti to transport supplies, so Dr. McGlaughlin loaded up his aircraft with medical supplies for a trip “that has changed my life.”

That was almost seven years ago, and Dr. McGlaughlin has continued making trips to Haiti every year since…including one trip that nearly took his life and that of his daughter.

Dr. McGlaughlin, a gastroenterologist in Birmingham, wasn’t sure what to expect when he first arrived at the makeshift medical camps in Haiti. The one thing he knew for certain was that he was there for a reason.

“It started out as an airplane adventure just bringing in the supplies that were needed. But, the needs of the Haitians were so great, I just couldn’t turn my back,” Dr. McGlaughlin said. “I felt I could make a difference here. I wanted to make a difference.”

For Dr. McGlaughlin, the key wasn’t just to volunteer once in a while. His theory is a little different. He believes that to make a difference, a constant presence is necessary.

“If you apply continual force on a single point more than once, not just over a weekend or two, it can open eyes. Even that wasn’t enough to help the Haitians. We would give them medicine and treat their wounds, but medicine runs out and sometimes wounds don’t heal, so visiting just once in a while wasn’t working the way we wanted it to. We knew the Haitians needed more,” Dr. McGlaughlin said.

When a cholera outbreak began to ravage the residents, Dr. McGlaughlin, whose background is in cholera research and treatment, found himself more useful than ever. He began working with St. Luke’s Hospital to not only treat the Haitians infected with cholera, but also help train other aid workers in the treatment protocols.

Soon Dr. McGlaughlin met a very charismatic Catholic priest named Father Rick Frechette, CP, D.O. Father Rick has worked in Haiti through St. Luke’s Hospital for more than 30 years, and when the two met, Dr. McGlaughlin was amazed by just what Father Rick had managed to do so much with so little.

“Father Rick is the type of person who makes you want to be a better person,” Dr. McGlaughlin said. “He finds these resources, these people that need work, and the people at the camp need certain things, and Father Rick just finds ways to put them together. He’s built a community through connections, given work and jobs to those who need it…it’s amazing to be part of that,” Dr. McGlaughlin said.

When Dr. McGlaughlin first started working with St. Luke’s, he likened the atmosphere to a smaller version of the United Nations with volunteers from many nations pooling their resources together. Everyone lived in tents, ate together, and unfortunately worked in less-than-the-best medical circumstances.

Eventually, the need for more permanent facilities became apparent, but without funding, because this is a charity operation, the permanent facilities would most likely take a while. So, Father Rick did what he did best and used the resources he had at hand – cargo containers.

After the earthquake in 2010, supplies had been shipped in to Haiti by cargo ships and housed in large, metal cargo containers. When the containers were emptied, they had served their purpose, for the moment. When Dr. McGlaughlin told Father Rick more permanent facilities were necessary for the more complicated and urgent cases needing some semblance of a sterile environment until a proper facility could be built, Father Rick produced a solution.

“We built a container hospital,” Dr. McGlaughlin laughed! “And, it worked for what we needed at the time. You use what you have, and that’s what we had.”

Dr. McGlaughlin continues to fly to Haiti, lending his medical skills and his flying expertise to the people of Haiti he has come to know and love. One flight stands out more than any other. In January 2012, he and his daughter, Elaine, were about to leave the Miami airport when he suggested she purchase a camera. This would be her first trip to Haiti with him, and he knew she would want to document the occasion. When she returned with a small, disposable camera, Dr. McGlaughlin laughed and suggested she try again with a better camera.

“It was a beautiful day for a flight,” he laughed. “You couldn’t have asked for more perfect conditions for flying…until I noticed the oil pressure was dropping. I didn’t want to alarm Elaine. She wasn’t paying much attention to me. She was studying the book for her new camera, but she finally looked at me when she noticed my voice changed.”

Dr. McGlaughlin said they didn’t have much time once the oil pressure sharply dropped, seizing the engine, and freezing the propeller. His plane was equipped with a parachute, which is now standard on all Cirrus models. With the parachute engaged, the pair had enough time to get out of the aircraft before it was too late. As they sat in the life raft, they watched the medicine and equipment floating to the surface, but they were safe. Then the disposable – waterproof – camera floated up. It wasn’t what they expected, but they made good use of it.

“It happened, and it could have been so much worse. So much worse,” Dr. McGlaughlin said shaking his head. “But, it wasn’t. Elaine and I flew back to Haiti together and finished the trip. I’ve even lectured on behalf of the use of the plane’s parachute. Some pilots won’t use it. It’s there…use it. I’m here today because I did.”

Father Rick, Dr. McGlaughlin and the battalion of volunteers attached to St. Luke’s Hospital in Haiti continue to work in Haiti by building schools and rendering medical aid to residents day in and day out. Dr. McGlaughlin’s next scheduled visit will be in January 2017, and he plans to take as many donated items as his plane will hold.

However, St. Luke’s Hospital is in great need of donations. The physicians and other volunteers donate of their time and skills, but monetary donations can move mountains. If you would like to donate and be a part of the St. Luke’s Hospital movement in Haiti, visit St. Luke’s Foundation for Haiti at www.stlukehaiti.org.

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Save more than $1,300 on Last-Minute Disney Cruises

Save more than $1,300 on Last-Minute Disney Cruises

Take advantage of incredible last minute Disney Cruise deals and share the splendor of the holidays aboard a Very MerryTime Cruise.

A winter wonderland awaits you aboard each Disney Cruise ship as well as on Disney’s private island, Castaway Cay! You’ll enjoy special holiday-themed entertainment, decorations, and activities, including:

Mickey’s Tree-Lighting Magic –Disney characters lead holiday carols and the lighting of the glittering, three-deck-tall tree.

Winter Wonderland Ball – Celebrate the arrival of Santa and Mrs. Claus, with your favorite Disney friends at a glamorous ball.

Holiday Carolers – Dickens-inspired characters and carolers carry the spirit of the holidays throughout the ship while singing holiday classics, sometimes with the help of favorite Disney friends.

All of these special events are in addition to the activities you already love, like meet and greets with Santa, building gingerbread houses, listening to holiday storytellers and dancing at the tropical-themed “Deck the Deck Holiday Party.”

With last minute rates as low as $130 per person, per night you don’t want to miss this opportunity to spend quality time with your family this holiday season! These rates are available on select 3, 4, or 7-night Caribbean & Bahamas itineraries sailing from Port Canaveral or Miami.

Hurry, these deals won’t last long. Call Tara McCoy at Two Sisters Travel at (843) 284-3241 for details, or get a no-obligation quote online! Become a Facebook fan at facebook.com/twosisterstravel. Two Sisters Travel is an official partner of the Medical Association.

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2017 Chronic Care Management Changes and Outsourcing Chronic Care

2017 Chronic Care Management Changes and Outsourcing Chronic Care

Medicare’s shift towards value-based care means the traditional model of health care reimbursement has just had a major shakeup. With value-based care, providers’ payments are now based on the value of care physicians deliver to patients and their health outcomes.

Patients with chronic conditions often require greater care outside of the office. Beginning Jan. 1, 2015, The Centers for Medicare & Medicaid Services (CMS) began paying for Chronic Care Management (CCM) services. Requiring at least 20 minutes of non-face-to-face care, providers receive an average reimbursement of $42 per patient per month with two or more chronic conditions. CCM has grown in popularity and many providers are seeing the increase in revenue. However, a number of physicians are still struggling to incorporate chronic care management into their practice. While the CMS requirements of CCM may be overwhelming, chances are many physicians are already managing Medicare patients with two or more chronic conditions and not getting the extra reimbursement to help with the added care.

The 2017 Medicare Physician Fee Schedule rule was finalized on Nov. 2, 2016. Providers will see payment changes for care management services in 2017. There are several changes that CMS has proposed regarding chronic care management. These changes are set to make billing rules within CCM simpler as well as expand the payment for complex CCM, including patients with behavioral health conditions. The new fee schedule rule will offer a new set of codes for providing care management to those patients.

Highlights from the 2017 Medicare Physician Fee Schedule regarding CCM

  • Simplification of CCM billing rules
  • Payment for complex CCM patients (CPT code 99487)
  • Supervision requirement change for CCM by Rural Health Clinics (RHC) and Federally Qualified Health Clinics (FQHC)
  • Pay for non-face-to-face extended E & M services

Part of the simplification of the CCM billing rules means the possibility of no longer requiring a consent form from the patient, but rather the provider would simply document in the patient’s medical record that CCM information was provided to the patient. Another benefit of this final rule is that initiating visits no longer have to be face-to-face office visits, unless the patient is considered a new patient or the patient has not been seen within the year prior to commencement of CCM. However, if providers do initiate CCM on a face-to-face visit, they can use the new GPPP7 to bill for that visit and receive a higher payment of $63.68.

Along with these changes to CCM for 2017, there is also a 3.5 percent increase in the CCM payment rate for 2017. The current rate in 2016 for CPT code 99490 is $40.82. This increase would make the 2017 rate $42.21. For complex CCM payments (CPT code 99487), the proposed rate for 2017 is $92.66. The complex CCM, CPT code 99487 requires 60 minutes of non-face-to-face care per month. CMS has also proposed an add-on code for complex CCM (CPT 99489) for each additional 30-minute increments of non-face-to-face time, at a proposed 2017 rate of $46.87. Please note: reimbursement rates vary by region.

MediSYS has outsourced full-service CCM to ease the burden on providers of meeting the CCM requirements while saving providers time and resources to enhance patient care.

“Providers have been very responsive to outsource chronic care management services because of the additional help they receive that saves them time and brings in additional revenue,” explained Jennifer Woodward, director of operations with MediSYS.

Outsourcing your CCM solution can help you increase revenue and expand patient satisfaction as well as provide you better patient access through a broader clinical depiction. CCM will also prepare providers for 2017 and the changes that MACRA has implemented in the healthcare industry to improve patient care and focus on value-based quality goals.

“With MIPS starting next year, providers are working hard to prepare for the changes that coming. By outsourcing this portion of the program, it provides them more time to work on the other aspects of the quality payment program to report effective care coordination,” Woodward said.

For information on MediSYS electronic health records and practice management solutions as well as outsourcing CCM services, please contact MediSYS at sales@medisysinc.com and visit the website at www.medisysinc.com. MediSYS is an official partner with the Medical Association.

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Help Your Patients Save on Their Medications

Help Your Patients Save on Their Medications

The CDC reports that Americans spend more on prescription drugs than people in any other country – some $45 billion in out-of-pocket dollars in the last year alone. With that in mind, the Alabama Rx Card is reminding physicians that the Alabama Rx Card is a free option to lower out-of-pocket prescription cost for their patients who aren’t insured or who take prescription drugs that aren’t covered by their health insurance plans.

The Alabama Rx Card can save your patients up to 75 percent off the retail price for FDA-approved medications. Alabama Rx Card has helped Alabama residents save more than $25 million since its inception in 2007.

Your patients can log on to www.alamedical.org to print a free Alabama Rx Card, search for participating pharmacies, and compare medication pricing.

Physicians may request a supply of custom cards mailed directly to their office at no cost by contacting the program’s development director, Heidi Barousse, at heidi@alabamarxcard.com or 844-818-9200. Alabama Rx Card is a partner with the Medical Association.

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