Upcoming meetings in Montana

  

May 12

 

May 15 

 

 

 

MMA Webinars 

 

May 22

The Children, Families, Health, & Human Services Interim Committee will be meeting on Monday, May 14 to make decisions on a legislative bill that could restore lost funding for physicians who are Medicaid providers. 

The MMA was successful in urging the Committee to include physician providers along with the other health care providers named in the initial bill draft.  The Committee was responsive and requested a revised bill draft that took into consideration the 6% provider rate increase that physician Medicaid providers did not get in fiscal year 2011 due to anticipated budget shortfalls.  

   

Help ensure Medicaid patients will maintain access to physician care by expressing your support of including physician providers in the final bill.  Contact any Committee member by May 14 to express appreciation of their support for physician providers and ask them to keep physicians in the final version of the bill.  The bill draft will be discussed during their meeting on Monday, May 14.  Please include the Executive Office in your written communications.

The Department of Public Health and Human Services (DPHHS) is accepting comments until May 24, 2012, on the department's administrative rule proposal that will implement Montana Medicaid's resource based relative value scale (RBRVS) reimbursement method for specified provider types.  Montana Medicaid uses the RBRVS rate system to calculate the fees Montana Medicaid will pay to health care professionals, including physicians.  DPHHS annually proposes the amending of the rules to adopt current relative value units (RVUs).  It is noted in the rule proposal that no rate increases were included in the department's budget.  Thus, fees for services performed by physicians using the RBRVS reimbursement system will in aggregate remain at a minimum at the State Fiscal Year 2010 levels.  With the changes to the RVUs, it is expected that fees for some services will increase and some will decrease. Please click here to read the rule.

 

The MMA Legislative Committee will discuss this rule proposal on Tuesday, May 15 and welcomes your comments.  Please submit any comments to the Executive Office. 

Douglas Carr, M.D., Medical Director of Education & System Initiatives at Billings Clinic and the Chair of the Patient-Centered Medical Home (PCMH) Advisory Council, will describe the Framework for Payment the council developed and recommended to MT Insurance Commissioner Monica J. Lindeen. The Commissioner accepted the recommendation and has pledged to work with insurers toward implementation.  Representatives from Allegiance, Blue Cross Blue Shield of Montana, Medicaid, Employee Benefit Management Services (EBMS), and the Health Care Co-op will speak to their support and involvement in the PCMH initiative.  

To join the webinar on Tuesday, May 15 at 12:00 p.m. to 1:00 p.m.

Montana Medical Association and Oakstone Publishing, LLC, have formed a relationship to offer non-biased continuing education and board review materials at a discount to Association members.  

 

This added member benefit has the ability to save you valuable time and money by obtaining quality CME at a discount from your home or office.   In addition to the CME and board review products Oakstone Publishing, LLC., also offers award-winning wellness resources to those interested in encouraging healthy lifestyle choices among their staff.   

 

Oakstone received Accreditation with Commendation from the Accreditation Council for Continuing Medical Education (ACCME), which places them in the top 8% of medical education content providers in the country. 

 

To obtain your member discount of up to 20%, please access the Members Only area of the MMA website or contact the Executive Office for the member code.

The Montana Medical Association hosted the recent Carrier Advisory Committee (CAC) meeting on Thursday, May 10.  The purpose of the regional CAC meetings are to provide: 

•  A formal mechanism for physicians in the State to be informed of and participate in the development of a Local Coverage Determination (LCD) in an advisory capacity;
• A mechanism to discuss and improve administrative policies that are within carrier discretion; and
• A forum for information exchange between carriers and physicians.

The CAC meeting brought forward five draft LCD policies for discussion:

• Application of Bioengineered Skin Substitutes: Ulcers (of Lower Extremities)
• Circulating Tumor Cell Marker Assays
• Non-Covered Services
• Paravertebral Facet Joint Nerve Blockade
• Stereotactic Radiation Therapy (SRS) and Stereotactic Body Radiation Therapy (SBRT)

Details for each can be found on the Noridian Medicare website by clicking Medicare Part B, Jurisdiction F. You must read and accept their user agreement, then click the LCD tab in the Medicare Part B menu, then select to view draft LCDs for Montana. Written comments must be submitted in writing and received by July 16 for consideration.

The next CAC meeting will be held at the MMA Executive office on Thursday, September 13.   If you would like information on attending or participating, please contact the MMA Executive Office.

A report released last week by the Medicare Board of Trustees highlights the need for congressional intervention to stop a devastating cut to physician payments.

The 2012 Medicare Trustees Report, which outlines the Medicare program's financial state, explains that current legislation leaves physicians facing a nearly 30 percent cut in Medicare payments beginning Jan. 1. The cut would come after a decade of nearly frozen payment rates, during which time the cost to care for patients has increased by more than 20 percent. Unable to afford the expenses of caring for Medicare patients, many physicians already have been forced to leave the program, as confirmed by a 2010 survey.

"The AMA is dedicated to ending this damaging cycle and stabilizing Medicare for patients and physicians," AMA Board Chair-elect Steven J. Stack, MD, said in a statement. "We will continue to work with policymakers on both sides of the aisle to eliminate the broken Medicare physician payment formula once and for all."

Visit the AMA Wire to read more.

Physicians enrolled in Medicare through its legacy system can continue to order and refer without immediately re-enrolling through the cumbersome Provider Enrollment, Chain and Ownership System (PECOS), according to a final rule issued by the Centers for Medicare & Medicaid Services (CMS).

The final rule, issued April 27, eliminates many of the challenges posed by the interim final rule, which would have disrupted access to care for Medicare patients, interrupted legitimate payments and care coordination, and caused other administrative hassles.

The changes reflect a number of the comments submitted by the AMA and 42 medical specialty societies after the interim final rule was proposed, including the following: 

• Physicians will satisfy the enrollment requirement whether they have enrolled through PECOS or Medicare's legacy system.
• Referrals to specialist physicians no longer require enrollment in PECOS.
• Medical residents who are permitted by state law to order and certify services will be allowed to enroll in Medicare at the discretion of their institutions. 
• CMS will give a 60-day notice before denying claims to physicians who lack an enrollment record.

Visit the AMA Wire to read more.