Colorado Medical Society 
News for Colorado Physicians                                                                                  January 25, 2013
Save the date for the CMS Spring Conference: May 3-5 in Vail
Learn to leverage practice transformation to improve your bottom line

The Colorado Medical Society invites you to attend its Spring Conference, May 3-5, 2013, at the Sonnenalp in Vail, Colo. Titled "Assembly Required: A User-Friendly Blueprint for Practice Transformation," attendees of the conference will learn what they need to do to improve the care experience and provide greater value for the premium dollar through an inter-connected compilation of hands-on practice transformation sessions.

Physicians commonly understand the fundamentals of practice transformation - and their importance - but they often lack the technical and practical support and mentoring to initiate and implement them. With narrow margins and unprecedented external pressures, most physicians cannot afford the luxury of trial and error experimentation. National and regional experts who have "been there, done that" and who have "caught the arrows" of practice transformation will share what works and in what settings and circumstances, giving you the knowledge to take your practice to the next level.

Click here to download a form and register today. Watch for updates in future ASAPs and the next issue of Colorado Medicine.


Chiropractic board votes unanimously to repeal rule that would have allowed chiropractors to inject non-FDA approved drugs

The Colorado Board of Chiropractic Examiners voted unanimously at a hearing on Jan. 24 to repeal Rule 7c "to comply with state law" and to protect "public health, safety, and welfare." Feeling the pressure from lawmakers and the medical community, the board voted to repeal the rule on an emergency basis, so it must be approved for permanent repeal during their March board meeting. This is expected to occur and will prevent the implementation date of April 30.

The chiropractic board passed changes to Rule 7(c) on Nov. 15, 2012, which would have authorized chiropractors to administer non-FDA approved compounds -- including glandular extracts, enzymes, homeopathic and botanical medicines -- topically, orally, and by inhalation and injection, after completing just 24 hours of study and a certification exam. CMS feared that improper injections could cause patients to suffer serious adverse outcomes and side effects.

In late December, CMS and 15 other medical associations filed a lawsuit to stop the rule, as it was originally scheduled to take effect Jan. 14. The chiropractic board took emergency action to delay its implementation until April to allow the legislature to weigh in. And in early January, the Colorado Legislature's Committee on Legal Services voted 8-0 to ask lawmakers to repeal the rule later in the session.


AMA Practice Management Alert: Deadline to request exemption from e-Prescribing penalty is Jan. 31

Physicians who were unable to file for a Medicare e-prescribing hardship exemption by the original June 30, 2012 deadline have until Jan. 31, 2013 to avoid the 1.5 percent payment penalty in 2013.

Acting upon AMA requests, the Centers for Medicare and Medicaid Services has re-opened the Communications Support webpage to allow physicians who missed the original deadline to file for an exemption.

Physicians may request a waiver of the 2013 penalty under any of the following categories.

  • The physician is unable to e-prescribe as a result of local, state or federal law or regulation.
  • The physician wrote fewer than 100 prescriptions during the period of Jan. 1 - June 30, 2012.
  • The physician practices in a rural area that doesn't have sufficient high-speed Internet access.
  • The physician practices in an area that doesn't have enough pharmacies that can do e-prescribing.

The federal CMS also added two hardship categories for those participating in Medicare's electronic health record meaningful use program. Physicians do not need to apply for an exemption related to these meaningful use hardship categories; they will automatically determine whether physicians meet those requirements.

Visit the federal CMS e-prescribing webpage to learn more. Physicians can contact their QualityNet Help Desk at (866) 288-8912 or via e-mail with questions or for assistance submitting their hardship exemption requests. Support is available from 8 a.m. to 8 p.m. Eastern time Monday through Friday.

Hardship exemption requests for the 2014 payment penalty will be accepted during a separate period this year. For more information on the Medicare e-Prescribing Program, visit the AMA's website.


CMS opposes bill to license naturopaths

A bill filed in the Colorado General Assembly would create a state board under the Department of Regulatory Agencies for the licensure of naturopaths, effectively allowing them to practice several health care professions including medicine. The CMS Council on Legislation voted at their Jan. 17 meeting to oppose this bill, HB 13-1111, citing concerns with patient safety.

Under the bill, a person who attends a school of naturopathy would be allowed to diagnose, treat, operate and prescribe for disease, pain, injury or other physical or mental conditions. Naturopaths are defined in the bill as "a system of primary health care practices for the prevention, diagnosis, evaluation and treatment of injuries, diseases, and conditions of the human body."

Click here to view more information on the bill.


Survey: Report your ICD-10 readiness and voice concerns

The Workgroup for Electronic Data Interchange (WEDI) is conducting its latest ICD-10 Industry Progress survey. This short survey contains questions on the status of an entity's ICD-10 implementation and the impact of the one-year delay in the compliance date.

Information from this survey will be used to inform WEDI, CMS, and other organizations of the progress of ICD-10 implementation and to plan necessary programs and actions to assist the industry in meeting the Oct. 1, 2014 compliance date. They ask one representative from each physician practice or organization to complete the survey to assure a wide variety of responses and an accurate picture of industry progress.

They are collecting responses online. However, before going online, they ask the representative to review this PDF of the survey and gather your answers. Once you have your answers, go to to fill out the survey.

The survey will close on Wednesday, Feb. 20. If you have any questions, contact Samantha Holvey at WEDI at (202) 618-8803 or [email protected].

Report from Jan. 18 CMS board meeting
Board takes action on Medicaid expansion and other issues

The CMS Board of Directors met on Friday, Jan. 18, and discussed public policy and House of Delegates referrals on topics including Medicaid expansion, prescription drug abuse, firearm safety, hydraulic fracturing, and covenants not to compete.

In early January, Gov. John Hickenlooper announced that the state will expand Medicaid coverage for adults as called for under the Affordable Care Act. Based on HOD direction, the Council on Legislation and the Committee on Physician Practice Evolution developed an advocacy position in support of expansion and advocating increased physician reimbursement, liability protections, administrative simplification, and patient responsibility.

CMS polled the membership on this position, asking if CMS is on the right or wrong track. Results from the survey were presented to the board and the board voted to approve the advocacy position. Click here to view a summary analysis of the survey results and the advocacy position.

Also, as prescription drug abuse has become more prevalent in Colorado and around the country, the board voted to make this issue a "high priority" and directed the society to work proactively with the governor, his staff, and appropriate state agencies and stakeholders on effective strategies to reduce prescription drug abuse in Colorado.

CMS President Jan Kief, MD, directed the CMS Workers Compensation and Personal Injury Committee, or WCPIC, to lead CMS' effort, and she named 12 special advisers to the committee with demonstrated expertise on the subject who will work with the governor's office to provide insight and feedback on policies.

Being on the forefront of this issue demonstrates a commitment by physicians to curbing abuse and allows CMS to influence future policies and regulations.

Click here to read a full report on the news page of the CMS website.


Medicaid rule clarification expands eligibility for bonus

All Medicaid providers should check to see if they are eligible to complete attestation to receive Medicaid bonus

Changes to Medicaid reimbursement were enacted as part of the Affordable Care Act (ACA). Eligible physicians will receive supplemental payments for services rendered between Jan. 1, 2013, and Dec. 31, 2014, that raise Medicaid reimbursement to Medicare rates. A recent study shows that for many Colorado physicians this change would represent an estimated 32% fee increase on average.

The statute specifies that higher payment applies to primary care services delivered by a physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine. It also specifies that specialists and subspecialists within those designations as recognized by the American Board of Medical Specialties (ABMS), the American Osteopathic Association (AOA) or the American Board of Physician Specialties (ABPS) also qualify for the enhanced payment. Under the regulation, "general internal medicine" encompasses internal medicine and all subspecialties recognized by the ABMS, ABPS and AOA. Click here for more information on covered specialties.

To be eligible for the supplemental payment, physicians must self-attest as having a specialty in family medicine, general internal medicine, and/or pediatric medicine, or as having a subspecialty within those specialties recognized by ABMS, ABPS and AOA. Only physicians can complete this form (staff or other representatives are not allowed).

Make sure that you are eligible for these increased payments by visiting the Colorado Department of Health Care Policy and Financing attestation page here. Learn more about ACA enhanced payments for Medicaid primary care physicians here.

To comment on something you read in ASAP or to update your contact information, send an e-mail to [email protected].