As we have been reporting over the past few months, the Centers for Medicare and Medicaid Services (CMS) have required physicians accepting Medicare to e-prescribe using a qualifying e-prescribing system and report the G8553 code on at least 10 Medicare Part B claims from January 1, 2011 through June 30, 2011 to avoid the 2012 e-prescribing penalty.  If your practice has not been able to meet these requirements, CMS has issued a proposed rule that makes significant changes to the e-prescribing penalty program to ensure that physicians are not unfairly penalized for failing to meet the requirements under the 2012 e-prescribing penalty program.  These changes include the addition of "hardship waivers" that can exempt a physician from being subject to a 1% cut in Medicare reimbursement for pay for service claims.  The following waivers are acceptable:

• Physician infrequently prescribes (e.g., prescribe fewer than 10 prescriptions between January 1, 2011 -June 30, 2011); 
• Physician is unable to electronically prescribe due to local, State, or Federal law or Regulation (e.g., prescribes controlled substances);
• Physician is registered to participate in the Medicare or Medicaid EHR Incentive Program and has adopted certified EHR technology; 
• There are insufficient opportunities to report the e-prescribing measure due to program limitations;
• Physician's practice is located in an area without sufficient available pharmacies for electronic prescribing;
• Physician's practice is located in a rural area without high speed internet access.

In order to avoid the 2012 e-prescribing penalty, physicians will have an opportunity to attest through an on-line web portal that they should be eligible for one of the exemptions.  Once the on-line portal has been launched, MSDC will notify the members with that information.

Click here to view the proposed rule under "Related Links Outside of CMS".

Click here to access a resource to help guide you with eRx service/product selection, that also lays out the requirements for the product.

Click here to access CMS's Medicare Learning Network article.

Click hereTo access the "Steps Physicians Can Take to Avoid the Medicare E-Prescribing Penalty" information sheet.
Click here to access "The Clinician's Guide to E-Prescribing" resource.

MSDC has created a short poll to help us fit our resources on the subject to your needs. Please follow this link to complete the one-question poll. 

If you need further assistance, please call the MSDC office at (202) 466-1800.

MSDC Fights to Maintain Indoor Tanning Dangers as a Public Health Concern

     CMS has proposed a rule on Methods for Assuring Access to Covered Medicaid Services, which was published on May 6, 2011, that addresses the equal access provision found in section 1902(a)(30)(A) of the Social Security Act.  This provision states in part that Medicaid rates must be "sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area." This provision has generated significant litigation and legal interpretation in recent years, particularly in determining whether state Medicaid programs failed to meet this requirement by cutting Medicaid provider payments without analyzing the impact on access to care. The proposed rule seeks to clarify that beneficiary access must be considered in setting and adjusting payment methodologies for Medicaid, and would require that states follow certain procedures in cutting rates and changing payment methodologies.
    MSDC, along with other medical societies, supports CMS' effort to create a standardized and transparent process for states to comply with the equal access provision, and encourage CMS to strengthen the enforcement, oversight and scope of the rule.

     To view the letter, please click here.

National Uniform Claims Committee Announces 45-day Public Comment Period on Proposed Revisions to the 1500 Health Insurance Claim Form
     The National Uniform Claim Committee (NUCC) has announced the opening of a 45-day public comment period, ending July 21, 2011, for proposed revisions to the 1500 Health Insurance Claim Form (1500 Form). The proposed revisions to the 1500 Form will accommodate data reporting changes in the Version 005010 837 professional electronic claim transaction and other business needs. The NUCC is conducting this survey to receive feedback on the proposed revisions and the costs and benefits of implementing the proposed revised 1500 Form. The NUCC will use this feedback in making its decision on moving forward with revising the 1500 Form. The timeframe for when a revised form would be required is not yet known.
     Use the following link to access the survey: http://www.surveymonkey.com/s/75WVJFJ
     Draft mock-ups of the proposed revised form are available on the home page of the NUCC's website, www.nucc.org. Three draft versions of the mock-up form are being made available for evaluation - a "clean", a "grid" and a "byte" version.
     The NUCC will review the results of the survey at its in-person meeting in Baltimore, MD on August 10, 2011. Additional information about the meeting is available on the NUCC's website. 

MSDC Begins Working with Stakeholders on the DC Health Insurance Exchange 

The DC Cancer Consortium and the DC Pediatric Palliative Care Collaboration host "The Carlos F. Gomez Quality Of Life for the Children Conference" 

• Christopher Feudtner, MD, PHD, MPH, Director of the Department of Medical Ethics and Attending Physician and Director of Research for the Pediatric Advanced Care Team (PACT) at The Children's Hospital of Philadelphia.
• Sarah Friebert, MD, Director, Pediatric Palliative Care at Akron Children's Hospital and director of the Halsinger Family Pediatric Palliative Care division.
• Stefan J. Friedrichsdorf, MD, Medical Director of the Pain and Palliative Care Program at the Children's Hospitals and Clinics of Minnesota Minneapolis/St. Paul MN.
• Timothy Culbert MD, Medical Director for the Integrative Medicine Program at Ridgeview Medical Center, Minnesota.

     The Fred Rogers Company Team, Pittsburgh. Health Services for Children with Special Needs, Inc. (HSCSN) designates this educational activity for a maximum of 12.5 AMA PR Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. For additional information on the conference and registration, please click here, or contact Alisha Baptiste at: abaptiste@dccancerconsortium.org.