Upcoming Events
| National Capital Region Asthma Partnership Conference
May 6
9:00am-3:30pm
Kellogg Conference Center at Galaudett University
800 Florida Avenue, NE
Washington, DC
ProAssurance Loss Prevention Seminars**
Click to Register
April 20
American College of Cardiology
2400 N. St. NW
Washington, DC
May 20
American College of Cardiology
2400 N. St. NW
Washington, DC
June 16
American College of Cardiology
2400 N. St. NW
Washington, DC
July 14
Hilton Arlington
950 N. Stafford St.
Arlington, VA
**All programs begin registration at 5:30pm, and have the program from 6pm - 8pm.
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2009-2010 Board of Directors
| Stuart F. Seides, MD
At-Large; Chair of the Board
Peter E. Lavine, MD
President; AMA Alternate Delegate
Frederick C. Finelli, MD
President-Elect
Joseph Gutierrez, MD
Treasurer; AMA Delegation Chair
Robert W. Keisling, MD
At-Large; Secretary
Carlos A. Silva, MD
AMA Delegate
Laura L. Tosi, MD
At-Large; AMA Alternate Delegate
James C. Cobey, MD
At-Large
Julian R. Craig, MD
At-Large
John W. Larsen, MD
At-Large
Joan B. Loveland, MD
At-Large
Richard McCarthy, MD
At-Large
Reginald Robinson,MD
At-Large
K. Edward Shanbacker
Executive Vice President
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Contact the MSDC Office
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1115 30th Street, NW
Suite 100
Washington, DC 20007
(202) 466-1800 (phone)
(202) 452-1542 (fax)
info@msdc.org
www.msdc.org
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Forward Me!
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Medicare Payment Reform
is Pushed Back Once Again, MSDC Calls for Action Now with "Stop the Medicare
Meltdown"
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 Washington, DC- The U.S. Congress has once again stalled on permanently fixing
the Medicare program. The largest insurer of seniors and veterans continually
jeopardizes its patients' access to care with this irresponsible patching from
month to month of payment cuts to physicians, this time citing June 1, 2010 as the date for the
21.2% payment cut. This pattern has a ripple effect, with many private
insurers and state Medicaid programs aligning their payment rates with Medicare
rates. This is even true in the District of
Columbia, with a Medicaid payment cut of 20% proposed in the Mayoral budget
plan.
As a response, the Medical Society of DC has joined with 50
other state medical societies and 14 national specialty societies in the "Stop the Medicare Meltdown" campaign to enact a permanent replacement to Medicare's flawed
Sustainable Growth Rate (SGR) formula. Every year for a decade, physicians have
faced steep cuts that jeopardize our ability to care for our patients - all
thanks to that formula.
Please join in our campaign to gather 1 million signatures to "Stop the Medicare Meltdown." Add your name to the petition and share it with your friends,
family, colleagues, staff, and patients.
The petition asks Congress to
develop a rational Medicare physician payment system that automatically keeps up
with the cost of running a practice and is backed by a fair, stable funding
formula.
Remember, even if you don't take Medicare, the SGR affects TriCare and most commercial insurance
payment schedules are based on a percentage of Medicare rates.
To
sign the petition, please visit . Please
download and print a copy of our "Stop the Medicare Meltdown" toolkit.
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MSDC Past President, Joseph E. Gutierrez, MD, has been
Nominated for the AMA Board of Trustees
|  Over the weekend, volunteers and staff have been hard at work in an effort to
increase MSDC's leadership and participation with the AMA and national health
policy. Upon the suggestion of several state medical societies and national
specialty societies, Joseph E. Gutierrez, MD, an MSDC Board member, launched his
campaign to be an elected AMA Trustee.
Dr. Gutierrez champions many
important issues for District physicians, such as:
- Proven, effective Medical Malpractice Reform
- Managed Care Reform and Proper Determination of Quality Care
- Permanent Medicare Payment Reform
- Penalty-free Private Negotiating
- Accurate HITECH Act Meaningful Use Definitions for Physicians' Practices' EMRs
Dr. Gutierrez has been a vigorous advocate for medical malpractice reform here in the District over his career, and will continue to serve that cause aggressively and tirelessly as his #1 priority.
His campaign website, http://www.joeg4amatrustee.com, is the complete resource for Dr. Gutierrez's priority issues and solutions. Please visit his website for more information.
Dr. Gutierrez has twice served as President of the Medical Society of the District of Columbia (MSDC), and has been a long-time member of its Board of Directors. he has also served on and chaired numerous committees of MSDC, and has been a recipient of its Distinguished Service Award. he has served the District of Columbia on various mayoral Task Forces and Advisory Committees. he has also been selected by his peers to the Washingtonian Magazine's Top Doctors, and the Consumer's Research Committee, and serves on its Executive Committee.
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CMS Announces Series
of Nationwide RAC 101 Teleconferences
| The Centers for Medicare
and Medicaid Services have launched a program designed to reduce fraud within
the health care system as it pertains to health care providers. This program,
the Recovery Audit Contractor program (RAC), uses outside auditing and
collections agencies to review claims filed by specific medical care providers
who bill for Medicare or Medicaid. These audits can be very strenuous on a
medical practice and very onerous. Particularly
vulnerable if left unprepared is the physician community.
As a
response, CMS has scheduled a series of informational teleconferences to educate
their participants on what a RAC is, can be expected to do, and how to respond
in case you are audited. The information is as follows:
- April 28, 2010 1:00pm - 2:30pm : Nationwide RAC 101 Call, 1-877-251-0301
- May 4, 2010 1:00pm - 2:30pm: Nationwide RAC 101 Call for Home Health and
Hospice Providers, 1-877-251-0301
- May 5, 2010 1:00pm - 2:30pm: Nationwide RAC 101 Call for DMEPOS,
1-877-251-0301
- May 12, 2010 1:00pm - 2:30pm: Nationwide RAC 101 Call for Physicians,
1-877-251-0301
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Update from Highmark Medicare Services: Medicare Physician Fee Schedule Update
| Medicare Physician Fee Schedule Update, released
from Highmark
CMS has released the following Notice: On April
15, 2010, President Obama signed into law the "Continuing Extension Act of
2010." This law extends through May 31, 2010, the zero percent update to the
MPFS that was in effect for claims with dates of service January 1, 2010 through
March 31, 2010. The law is retroactive to April 1, 2010.
Consequently,
effective immediately, claims with dates of service April 1 and later, which
were being held by Medicare contractors, are being released for processing and
payment. Please keep in mind that the statutory payment floors still apply and,
therefore, clean electronic claims cannot be paid before 14 calendar days after
the date they are received by Medicare contractors (29 calendar days for clean
paper claims).
HMS Follow Up Notice: As instructed previously by CMS,
Highmark Medicare Services has been holding all Part A and Part B claims with
dates of service April 1, 2010 and after, that were to be paid based on the
Medicare Physician Fee Schedule. HMS has not paid any claims at the proposed
-21% reduced fee schedule. Therefore, no retroactive adjustments will be needed
for claims processed by HMS. HMS will be releasing currently held claims on a
first in - first out basis.
Upcoming Highmark Medicare Teleconferences:
- May 7, 2010 12:00 - 12:30pm: Medicare Eligibility
- May 10, 2010 12:00 - 12:30pm: Proper Place Of Service Reporting
- May 14, 2010 12:00-12:30pm: Overview of the LCD Process
- May 21, 2010 12:00 - 12:30pm: Timely Filing Requirements
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AMA Offers Physicians Help
Claiming Damages From $350 Million UnitedHealth Settlement
|  CHICAGO - The American Medical Association (AMA) today launched a new online resource that
will help thousands of physicians file claims in the record-breaking settlement
reached in the AMA legal victory against UnitedHealth Group - the nation's
largest health insurer. More than $350 million is available to help compensate
physicians and their patients for 15 years of artificially low payments for
out-of-network services. During the last decade, the AMA worked
diligently with the Medical Society of the State of New York, the Missouri State
Medical Association, the courts and regulators to expose and prohibit a
price-fixing scheme used by UnitedHealth and other health insurers to underpay
physicians and patients for out-of-network care. Evidence of
UnitedHealth's improper business practices gathered in the course of the AMA-led
litigation was brought to the attention of New York Attorney General Andrew
Cuomo, who confirmed the abuses with his own investigation. Under legal pressure
from Attorney General Cuomo, UnitedHealth and several major insurers agreed to
meaningful reforms that promise to help keep the system for determining
out-of-network reimbursements free from further corporate
manipulation. The UnitedHealth settlement is governed by a series of
court-imposed deadlines that physicians must follow. The current settlement
deadlines include the following key dates: - July 27 - Deadline for filing objections to the settlement or for opting out of the settlement
- September 13 - Date for the final settlement hearing to consider any filed objection
- October 5 - Deadline for filing a claim to share in the settlement fund
In addition to the information available in the new settlement guide, the AMA offers members personal assistance from the AMA's Practice Management Center if they have questions about the settlement or filing a claim form. AMA members interested in retaining a claims submission service can obtain a discounted rate offered by the Managed Care Advisory Group. For more information on the efectiveness of organized medicine's advocacy in the courts, including continued efforts to reform the improper practice of insurers, please visit the Litigation Center of the AMA and State Medical Societies. |
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From MedcomSoft: HITECH
Act: Meaningful Use vs. Practical Use
|  There has been a lot of hype within our industry over
the past year about electronic medical record (EMR) vendors being certified and
meeting the federal criteria for meaningful use. Let's step back for a moment
and take a practical look at the state of the industry and how the term
'meaningful use' really impacts you as a care provider.
Most EMR
companies today have complied and will continue to comply with meaningful use
requirements. As you move forward with your selection of an EMR, don't get
caught-up with all the federal meaningful use hype. Ask the EMR vendor if they
meet the federal mandates for meaningful use through certification and then move
on to the more important question: Can the EMR product meet my practice's needs?
Here are some key questions to ask about an EMR product:
- Can the EMR meet my daily office workflow needs?
- How many hoops do I have to go through to document a patient's chart?
- How easy is it to go back through the patient's clinical history?
- Does the tool identify and warn me about drug interactions?
- Can the EMR give me patient lab results when I need them?
- What daily steps can the tool eliminate from my busy work schedule?
- Can the EMR handle the practice management side of my office?
- Will the tool allow my office staff the capability to continue to bill claims or can I outsource that work to others?
The answer to all of these questions comes down to this: how practical is the tool for daily use? If you can answer these questions positively, you have just taken the first step in selecting a candidate for purchasing and implementing an EMR application. Of course, there are many other questions that will need answered covering everything from implementation, training, support, and the general terms and conditions of the EMR's use.
However, if you follow the practical course of assessing an EMR application, you will be further ahead of the game and you will gain a higher level of confidence knowing that the EMR selection will really meet your daily practice needs in the end.
Rich Lobb, MBA
Director of Operations
MedcomSoft
rlobb@medcomsoft.com
www.medcomsoft.com
800-699-5533
Content was developed by MedcomSoft, copyrightŠ2010 giving express permission to the Medical Society of DC for re-print and use within its marketing materials.
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