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 Dear Members: I'm pleased to introduce myself as the new Director of Membership and Communications and to be part of the Medical Society of the District of Columbia. In addition to preparing eNewsline - with this being my first edition - I will be your point of contact for membership benefits, communications and meetings. The annual meeting and reception takes place on Wednesday, October 24, 2012, and I hope to see you there. It's your chance to reconnect with local physicians and discuss the issues that impact you directly. This year, there will be a discussion on the upcoming election as it relates to physicians. If you haven't already done so, please register now. Since coming on board a month ago, I've already had a chance to speak with some of you about the issues that you are facing - from new licensing renewal requirements to payment for services, including those provided by telemedicine, and the health benefits exchange board. Remember, MSDC exists to advocate on your behalf on these and other issues that affect the integrity of the physician-patient relationship and how you practice medicine. So please let us know what matters to you. Pia R. Duryea
Director of Membership and Communications
Medical Society of the District of Columbia
Tel: 202-355-9414
Email: Duryea@msdc.org |
 THE ANNUAL MEETING IS LESS THAN 3 WEEKS AWAY- SIGN UP NOW! The Annual Meeting is coming up soon, on Wednesday, October 24, 2012, from 6:00 to 9:00 pm at The Metropolitan Club in Washington, DC, so register now by clicking here. Highlights of the meeting include:
- What the 2012 Election Will Mean to Physicians. Robert A. Berenson, M.D., F.A.C.P., is a Senior Fellow at the
 Urban Institute with a focus on policy research on Medicare-related issues, including physician payment reform, chronic care management, contracting with private plans, coverage and payment policy for new technology, health delivery system reform options; and malpractice issues. He has worked in the Carter and Clinton White Houses and will answer the question, "What will the 2012 election mean to physicians?"
- Socializing with your colleagues from across the city
- Installation of the President-Elect, Daniel Perlin, M.D.
- Drinks and heavy hors d'oeuvres.
The Metropolitan Club is made available through the courtesy of Dr. James C. Cobey. Please observe the dress code: coat and tie for gentlemen, commensurate attire for ladies. You may not use cell phones or personal communications devices in the meeting room, but you may take and make calls in a separate "Communications Room".
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October 8, 2012
| Vol. 19, No. 21
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| Upcoming Events | |
2012 Annual Meeting & Reception
October 24, 2012
6:00 - 9:00 p.m.
Metropolitan Club
Washington, DC
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2011-2012 Board of Directors
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Catherine S. May, MD
At-Large; Chair of the Board
James C. Cobey, MD
President
Daniel I. Perlin, MD
President-Elect
Joseph Gutierrez, MD
Treasurer; AMA Delegation Chair
Reginald Robinson,MD
Secretary; At-Large
Peter E. Lavine, MD
AMA Delegate
J. Desiree Pineda, MD
AMA Alternate-Delegate
Laura L. Tosi, MD
AMA Alternate Delegate
Julian R. Craig, MD
Frederick C. Finelli, MD
John W. Larsen, MD
Barry Lewis, MD, MBA
At-Large
Joan B. Loveland, MD
Carla Sandy, MD
At-Large
Stuart F. Seides, MD
At-Large
K. Edward Shanbacker
Executive Vice President
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MSDC eNewsline
| Editor
Pia R. Duryea
202-355-9414 (direct)
duryea@msdc.org
MSDC Offices
1250 23rd Street, NW
Suite 270
Washington, DC 20037
202-466-1800 (phone)
202-452-1542 (fax)
info@msdc.org
www.msdc.org |
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| Important Changes to Physician License Renewal Process |
 The physician license renewal cycle began on October 1, 2012, and there are some very important changes that will affect the licensure renewal process to be noted.
This year all licensees will be required to undergo a criminal background check (CBC). You must first complete the renewal application online to be eligible for your CBC. To learn more about the CBC process, visit http://doh.dc.gov/service/criminal-background-check or call 202- 442-9004.
Editor's Note: The Board of Medicine has provided an overview of the renewal process and has indicated to MSDC that CBCs currently will be valid for four years - or two renewal cycles (2012 and 2014).
Also, this year, we will be conducting phase 2 of the physician and physician assistant workforce census survey. For physicians, the questions will be incorporated into your renewal application and physician profile. The survey questions are part of our ongoing effort to capture and analyze critical demographic and practice information data we began collecting in the 2010 renewal cycle in order to measure current, and determine future, physician and health care professional workforce needs in our nation's capital. We appreciate how busy you are but ask for your continued cooperation as we collect this very important data.
Complete the renewal process as soon as as possible and by no later than December 1, 2012, to avoid any potential delays in your license renewal. All licenses will expire on December 31, 2012.
If you currently have any District of Columbia tax liens/fines or holds on your license because you failed to respond to correspondence sent to you by the Board of Medicine requiring an action on your part, you will be barred from renewing online until the matter is resolved.
Please remember that only CMEs (50 AMA PRA Category 1 credits) obtained in the two years immediately preceding the application date will be accepted. If you have an active DC license you are required to fulfill the CME requirement for renewal. CME audits will be conducted immediately following the renewal period.
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Tax Alert: DC Employers Subject to New Use Tax Filing Requirement
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The Washington, DC Department of Tax and Revenue has posted a notice about the Employer Use Tax Return Act of 2012, the details of which we are sharing for your information.
District of Columbia employers required to file a DC withholding return, including businesses and nonprofits, may face an additional filing requirement regarding use tax, which impacts purchases made outside the District of Columbia for use by the employer but for which no DC sales tax has been paid.
All DC-based employers including those that have made no purchases will now be required to file an annual use tax return (FR-800A) on or before October 20 and remit use tax payment for the year October 1, 2011 through September 30, 2012.
Our presumption is that charitable organizations exempt from sales tax will not be required to pay use tax for purchases that fall within the entity's exempt mission though we will continue to advise clients should new information become available. This exemption may not apply to business income generated from a nonprofit's unrelated activity.
The Employer Use Tax Return Act of 2012 modifies previous filing obligations for DC-based businesses. In the past, only those required to collect and remit sales tax also had a use tax filing obligation. The Act now requires use tax payment for those employers that do not collect and remit sales taxes.
The Act is intended to close a loophole through which purchases made outside the District of Columbia for use within the District were subjected to neither a sales tax nor a use tax obligation.
The District of Columbia will distribute forms and instructions to businesses required to pay use tax prior to the October 20 filing deadline.
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District News: Telemedicine Services Reimbursement; HBX Executive Board
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 MSDC Urges Fair Reimbursement for Telemedicine Services
The "Telemedicine Reimbursement Act of 2012" was introduced in September by Councilmember Mary Cheh (Ward 3) and a hearing is expected in November. MSDC is continuing to work with Mrs. Cheh's staff to expand the reach of the bill. To read a current copy of the bill, please click here. HBX Board Votes on Health Insurance Market Structure
Last Wednesday, the DC Health Benefit Exchange (HBX) Authority Executive Board voted unanimously to approve a recommendation that the HBX insurance marketplace be the sole marketplace in the District for the purchase of individual and small group insurance plans, a position opposed by the city's business community which argues the decision will increase costs for employers. The board also approved the recommendation that the small group size in the District should continue to be defined as organizations with two to 50 employees, instead of two to 100 employees.
While it is unclear what steps come next, the Washington Post reports that the authority's chairman, Mohammad N. Akhter, intends to move forward swiftly. Akhter plans to send the board's recommendations to the DC Department of Insurance, Securities and Banking Commissioner William White, who is charged with implementing the mandate, and may seek legislative action by the DC Council.
Interim HBX Executive Director Named
Sandra Robinson has been selected to serve as the Interim Executive Director for the DC HBX while a national search is conducted for the permanent position. Ms. Robinson is currently the Chief Operating Officer for the District of Columbia Department of Health (DOH), where she oversees the day-to-day operations of a vast array of agency functions for one of the District's largest agencies.
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| Medicare News: Physical Therapy Plan of Care Requirements |
Physical Therapy Plan of Care Requirements
Novitas Solutions, in concert with the Centers for Medicare & Medicaid Services (CMS), is continuing to focus on lowering the Comprehensive Error Rate Testing (CERT) claims paid error rate. Currently, one area of concern identified in the CERT data is denial of outpatient rehabilitation therapy services due to missing physician/non-physician practitioner signature and dates on the certification of the plan of care. This has lead to Novitas Solutions recouping overpayments totaling over $164.70. More importantly, when CMS and CERT extrapolate these errors to the universe they will account for approximately $19.3 million, in claims payment errors for the November 2011 report.
Medicare defines rehabilitative services as those services that lead to "recovery or improvement in function and, when possible, restoration to a previous level of health and well-being."
Outpatient rehabilitation therapy services must relate directly to a written treatment plan (also known as the plan of care or plan of treatment). Medicare states "the plan of care shall contain, at minimum, the following information: diagnoses, long term treatment goals, and type, amount, duration, and frequency of therapy services."
The plan of care is established by a physician, non-physician practitioner, physical therapist, an occupational therapist, or a speech-language pathologist. The signature and professional identity of the person who established the plan of care and the date it was established must be documented within the plan of care. The plan of care must be established before the therapy treatment can begin.
Establishing the plan of care is different than certifying the plan of care. Medicare states that certification of the plan of care requires a dated signature on the plan of care, or some other document, by the physician or non-physician practitioner who is the primary care provider for the patient. In the absence of a formal certification document, a physician progress note indicating the physician's agreement with the plan of care is acceptable. The certification of the plan of care should occur as soon as possible after it is established or within 30 calendar days of the initial therapy treatment. Payment may be denied if the physician does not certify the plan of care; therefore, the therapist should forward the plan to the physician as soon as it is established. Recertification of the plan of care, which also requires a physician or non-physician signature and date, should occur whenever there is a significant change in the plan or every 90 days from the initial plan of care certification. A therapy provider, per Medicare, may obtain a verbal order for certification or recertification of the plan of care; however, the verbal order must be signed and dated by the physician/non-physician practitioner within 14 calendar days.
In order to avoid an error and the denial of services, when submitting documentation for review, be sure to:
- Have established a complete initial plan of care, making certain to include your signature, your professional identification (i.e. PT, OT, etc.), and have the date the plan was established.
- Ensure that the plan of care is certified (recertified when appropriate) with a physician/non-physician practitioner signature and date.
- Clearly document when the plan of care has been modified, including how it was modified and why the previous goals could not be met.
If additional questions arise, providers can contact Novitas Solutions' Provider Outreach and Education Department. The contact information is available on our website at www.novitas-solutions.com.
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From the AMA: Operating Rules for EFT & ERA Adopted
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AMA supports operating rules for EFT and ERA adopted by CMS
The Centers for Medicare and Medicaid Services (CMS) published an Interim Final Rule with comment period (IFC) which adopts operating rules for the health care electronic funds transfers (EFT) and remittance advice (ERA) transaction under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Among other requirements, the EFT & ERA Operating Rule Set requires health plans to send the EFT within a certain number of days of the ERA, making it easier for physician practices and hospitals to reconcile their accounts. The EFT & ERA Operating Rule Set also includes requirements for the initial set-up for the electronic communication between providers and health plans, and it standardizes payer reporting of claim adjustment reason and remark codes to explain denials, something the AMA has long supported. CMS named the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) as the authoring entity for operating rules for all health care EFT and ERA transactions.
The AMA has long championed uniform standards for EFT and ERA and is very pleased that CMS listened to many of our recommendations, as they have the potential to significantly reduce administrative burdens and allow physicians to redirect their resources toward patient care. The AMA's comment letter can be found here. The compliance date for operating rules for the health care EFT and ERA transactions is January 1, 2014, although many payers who have voluntarily agreed to be certified by CAQH CORE have already implemented these beneficial changes. Visit www.caqh.org/CORE_organizations.php to access CAQH CORE certified organizations. HHS' fact sheet on the rule is located at: www.cms.gov/apps/media/fact_sheets.asp.
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Care Coordination Webinar for MSDC Members
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 A Care Coordination Model that Benefits All
October 18, 2012, 12:15 p.m. EST
From new reimbursement models to Stage 2 Meaningful Use Requirements, health care demands better, and more frequent, sharing of patient information. But conventional approaches to care coordination-acquisitions, HIEs-have proven unsustainable and financially risky.
Athenahealth has developed a sustainable model for care coordination that benefits everyone in the order cycle. It saves time, encourages participation and effectively "closes the loop" on patient care.
MSDC members are welcome to join this webinar, where we'll discuss:
- The risks, problems and expense of traditional care coordination
- A model that can boost efficiency and lower costs
- Why an open, sustainable model is necessary for improvement
- athenahealth's unique, cloud-based approach to effective care coordination
Register here today and see how care coordination can really work.
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| Gittleson-Zuppas partners for new medical office building |
 Lerner Enterprises, Washington, DC's largest private real estate developer announced it has awarded the firm Gittleson Zuppas Medical Realty, Inc. the exclusive agency assignment to market Lerner's newest project, Fallsgrove Plaza. Lerner has also announced that it has selected HITT Contracting of Falls Church, Va. as the general contractor with construction proposed for fall 2012.
Nicholas M. Zuppas and David A. Gittleson of Gittleson Zuppas Medical Realty will head the leasing effort for the new building. The firm specializes in leasing to firms in the medical field throughout the Washington, DC metropolitan area in addition to representing numerous medical practices.
The proposed five-story state of the art Class A 110,000 square foot medical | office building will be located at the intersection of Shady Grove and Blackwell Roads in Rockville, Md. within the award-winning Fallsgrove master planned community, strategically located near Shady Grove Adventist Hospital and the Life Science Corridor. The Donnally Vujcic Associates (DVA Architects) of Gaithersburg, Maryland designed building is proposed to achieve LEEDŽ Gold Certification.
The new building will be within walking distance to Lerner's other projects including the award-winning Fallsgrove Village Center (FallsgroveVillageCtr.com), a community shopping center featuring Safeway plus 30 shops and restaurants; the award-winning fully leased Class A
Fallsgrove Village Office Center (FallsgroveOffice.com); and the Fallsgrove HiltonŽ Garden Inn (RockvilleGaithersburg.HGI.com)and Fallsgrove Homewood Suites (RockvilleGaithersburg.homewoodsuites.com) hotels. These projects are located across from the region's leading hospital and life science centers, Shady Grove Adventist Hospital and the Life Sciences Center.
For more information, please click here.
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| Strengthen Your Practice Immunization Performance |
 Primary Care Physicians are in the best position to improve adolescent and adult vaccination rates. Immunization for Flu, Pneumococcal, Shingles, and Tdap vaccines continue to fall short of the U.S Department of Health and Human Services objectives.
Fortunately, the Medical Society of DC has a strong partner in providing our members the resources and support to cost-effectively improve immunization rates, and in turn, strengthen your practice. Atlantic Health Partners, the nation's leading vaccine buying group, offers you the lowest vaccine prices and finest customer service to improve the performance of your immunization initiatives. Atlantic even has a program that enables you to provide vaccines like Zostavax (Shingles) and Adacel (Tdap) to Medicare Part D patients.
MSDC members that currently participate with Atlantic are very satisfied with the savings and support. We encourage you to contact Atlantic at 800-741-2044 or info@atlantichealthpartners.com to better determine how they can benefit your practice.
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| Save up to 75% using MSDC's Drug Discount Program Card |
 As a physician in Washington, DC, you and your patients have access to a FREE Prescription Drug Card program. The Medical Society is please to offer the DCRx CARD. Your patients can save up to 75% on precriptions, selected eye-wear, vitamins and other products. The card is accepted in pharmacies in the District, Maryland and Virginia.
The Medical Society of DC has received a shipment of these cards and have 250 cards available to each Society member who requests them. Please email Pia Duryea at duryea@msdc.org and ask for the cards for your patients.
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| Classified Ads |
Psychotherapist Opens Office, Available for Speaking Engagements
Lise Van Susteren, MD, specializing in psychotherapy for adults and couples and psychopharmacology, has opened an office at Dupont Circle. She is also available as a speaker on the health impacts, including psychological, of climate change. For details, call 301-787-1780 or email lvs350@verizon.net.
Retiring Physician Seeking Family Physician to Take Over Practice
Retiring family practice physician looking for interested physician to take over practice of 25 years, DuPont Circle area. Please contact 202-365-2344.
Washington DC/Bethesda Border - Spring Valley Location
Medical Office sublet available. Prime location in beautiful Spring Valley section of Northwest DC. Spacious office with 5 exam rooms. EMR with computers in all rooms. Available for full-time or part-time lease. Large convenient parking lot located behind building and plenty of additional street parking. Walking distance to Metro and Metrobus. Short distance from both Sibley Hospital and Suburban Hospital. Please call Maria at 202-237-0808 for additional details.
For Sale: Tropical/Travel Medicine Practice
Long established and nationally recognized private practice serving Washington, D.C. and surrounding areas. Includes consulting practice in tropical medicine; travel clinic seeing over 7,000-8,000 clients per year; and diagnostic parasitology laboratory. It is in an excellent central city location. This is a unique opportunity for a physician with a passion for tropical/travel medicine and infectious diseases. Send expressions of interest to: tmsdc@verizon.net.
Office Furniture for Sale
Retired Physician has office furnishings for sale. Beautiful executive desk and credenza. Reed chairs and small table. Numerous other items suitable for office or apartment. Offering reasonable price for complete lot but willing to negotiate separate items. To review, please call 301-656-6309 or 301-656-3977.
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