Sept. 23, 2015
House of Delegates votes overwhelmingly to re-engineer CMS governance into a grassroots-centric model designed to engage all physicians

This past weekend at our 145th Annual Meeting, the House of Delegates, in response to a comprehensive set of governance retooling proposals developed over the past year by a special CMS task force, voted overwhelmingly to dissolve themselves into a realigned model that connects a streamlined board to the widest possible spectrum of its physician constituencies.

"The reforms adopted over the weekend were about member voice and empowerment and the ability of CMS to recruit and harness the intellectual and political muscle of physicians," said CMS President Michael Volz, MD. "We will then infuse that expertise into the boardrooms and halls of the legislature and Congress."

The revisions adopted Sunday contemplate extensive interactions between board members and the array of medical communities on policy direction and deployment, as well the thoughtful recruitment and involvement of emergent leadership drawn from a methodical process of issue-centric policy development.

"We will be building a farm system of our best and brightest and engage them where their ideas and insights will have real-world consequences," he said.

Read highlights of the new governance structure, as well as other highlights from the meeting, on

CMS task force responds to state questions on health care cost drivers

The CMS Task Force on Health Care Costs and Quality, co-chaired by Laird Cagan, MD, and Alan Kimura, MD, has met many times this summer to provide the physicians' perspective on health care cost drivers to the state's Commission on Affordable Health Care. The commission was formed following the 2015 Colorado General Assembly to identify systemic and other underlying causes of excessive and unnecessary health care costs and propose specific legislative, regulatory and market-based strategies to reduce costs and improve care value. Jeffrey Cain, MD, is the sole physician on the 12-member commission.

The cost commission submitted a request for information containing seven questions and the CMS task force provided its responses on Sept. 14. The questions were:

  • What are the fundamental cost drivers and why?
  • What are the barriers to reducing costs?
  • Can you list up to three things that you are doing to address cost that are unique?
  • Is there any supporting data that demonstrates a reduction in cost?
  • Where do you see waste in the system?
  • What are the principal barriers to transparency?
  • What would you change to make things better?

Read the task force's responses here.

AMA releases analyses on potential Anthem-Cigna and Aetna-Humana mergers

In light of the proposed mergers of Anthem-Cigna and Aetna-Humana, the American Medical Association analyzed commercial insurance markets and found the combined impact of proposed mergers among these health insurance companies - four of the nation's largest - would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within 17 states.

In a statement released on Sept. 8, the AMA expressed concern that the mergers would enhance market power, raise significant competitive concerns and diminish competition in up to 154 metropolitan areas in 23 states including Colorado.

"A lack of competition in health insurer markets is not in the best interests of patients or physicians," said AMA President Steven J. Stack, MD, in the release. "If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care. Given these factors, AMA is urging federal and state regulators to carefully review the proposed mergers and use enforcement tools to preserve competition."


Primary care practices: Submit your SIM application by Oct. 26

The State Innovation Model (SIM) Practice request for applications (RFA) was released on Sept. 15, 2015. The RFA will remain open until Oct. 26, 2015. The RFA and the actual online application can both be found on the new UC Denver Practice Transformation website:

The SIM initiative, a $65 million operating agreement with the federal government, aims to improve the health of Coloradans by providing access to integrated physical and behavioral health care services in coordinated systems, with value-based payment structures, for 80 percent of Colorado residents by 2019.


Federal CMS releases 2014 PQRS and QRUR reports; informal review period opens

On Sept. 9, the Centers for Medicare and Medicaid Services released the 2014 Quality and Resource Use Reports (QRURs) and 2014 Physician Quality Reporting System (PQRS) Feedback Reports. The 2016 PQRS and Value Modifier (VM) payment adjustments are based on 2014 reporting. For groups with 10 or more PQRS-eligible professionals (EPs) that are subject to the 2016 Value Modifier, the QRUR shows how the VM will affect Medicare's 2016 payments to physicians. VM cost and quality scores will also be provided in the QRURs for other practices even though they are not yet subject to the VM. If physicians or group practices feel an incentive payment or penalty was performed in error they must file an Informal Review by Nov. 9, 2015.


Apply to represent physicians on state council

The Colorado Department of Health Care Policy and Financing seeks a physician representative on the State Medical Assistance and Services Advisory Council (informally known as NightMAC).

The committee exists to improve and maintain the quality of the Medicaid Program by contributing specialized knowledge and experience and providing a two-way channel of communication with the individuals, organizations, and institutions in the community that provide medical care and services. The committee meets the fourth Wednesday of the month from 6-7:45 p.m. except for August and December. Travel expenses are reimbursed.

To find out more about NightMAC, visit their website. To apply online, go to this website. This is a governor-appointed position and is handled through the governor's office.

Get covered with COPIC

COPIC Insurance Company is Colorado's leading medical liability insurance provider. Three out of four physicians choose COPIC for this critically important coverage. CMS members receive a 10 percent premium discount from COPIC.

For more information, call (720) 858-6000 or visit

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A Legal "PotPourri"
Day 1: The New World of "Legal Marijuana"
Day 2: Challenges in Toxicologic Consulting

Dec. 9-10, 2015, Marriott City Center, Denver, CO
Click here for more. 

Medjet provides reduced rates to CMS members for its hospital of choice Air Medical Transport membership program. Visit or call Medjet at 1.800.527.7478, referring to Colorado Medical Society.

CO Drug Card
Compliments of CMS: Reduce patient callbacks, HIPAA compliant, RX Savings up to 75%, click for free customization COLORADO DRUG CARD.
Online CME
The Opioid Crisis: Guidelines and Tools for Improving Chronic Pain Management,
presented by the Colorado School of Public Health and accredited for two credits of CME and approved for COPIC points. This activity examines the best practices and universal precautions for treating chronic pain. Click here for more.
Upcoming events
Cultivating the Network of Care: A Learning Series from Healthy Transitions Colorado
Second program: Oct. 16, 2015
8 a.m. - 3:30 p.m.
Denver, Colo.
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