June 9, 2016
Registration is now open for the 2016 CMS Annual Meeting

You're invited to the re-engineered CMS Annual Meeting in Keystone Sept. 16-18. Join your peers from across Colorado as we engage some of the top health care policy and political experts in the nation. In an era of burnout and relenting change and stress, this meeting will serve as a motivational sanctuary for physicians to share, argue and learn from the best of the best.

Attendees can experience:

  • A comprehensive and up-close discussion on Colorado Care/Amendment 69 and the Oregon/Washington State adaptation of physician-assisted death.
  • A deep dive into the complexities of the impending radical realignment of Medicare payments from fee for service to performance/quality-based reimbursement.
  • A motivational keynote led by one of Colorado's highly regarded wellness experts, followed by a series of workshops on how to get and stay healthy.
  • Recurring workshops, some with CME credit, by experts on the hot subjects of broad medical interest: best practices on how to wean a patient off pain medications, how to manage a dangerous patient with a firearm, and a doctor-friendly discussion with top antitrust experts on the trajectory of the proposed health plan mega-mergers.
  • A lively COMPAC lunch panel that will assess the consequences of the presidential contest and speculate on the various win/lose scenarios on state and federal health policy.

Your family and friends will have plenty to do in this mountain paradise: yoga, miles of biking and hiking, a 5K walk/run or a gondola ride to the top of the mountain for excellent views and photos. And you'll have time to sneak away, too.

Boulder County Medical Society urges U.S. DOJ to block the Aetna-Humana merger and to disregard and reject Colorado Division of Insurance approval
In a 14-page letter dated June 3, 2016, Boulder County Medical Society (BCMS), with the full support and backing of CMS and AMA, urged the U.S. Department of Justice to block the Aetna-Humana merger and to disregard and reject Colorado Division of Insurance's (DOI) approval of the merger.

BCMS President Leto Quarles, MD, emphasized that the Colorado DOI failed to consider relevant data and therefore erroneously concluded that there are no anticompetitive effects of the merger. By relying solely on a statewide review, Quarles argues in her letter that the DOI improperly ignored the likely substantial anticompetitive impact that an Aetna acquisition of Humana could have in a number of local health insurance and physician markets, including Boulder County. Based on AMA data, CMS had alerted the Colorado DOI as early as September 2015 that an Aetna-Humana merger would be likely to enhance market power or potentially raise significant competitive concerns in Boulder, Mesa, Larimer, Pueblo and Weld counties.

Quarles also highlighted that the market concentration of these companies already create a prima facie violation of Colorado's competitive standard. Data from the Centers for Medicare and Medicaid Services reveal the anticompetitive consequences of an Aetna-Humana merger in Medicare Advantage (MA) markets. In 2015 the four firm concentration ratio (CR 4) -- the Colorado statutory measure of market concentration obtained by adding up the percentage market shares of the four largest firms -- was 95.6 percent in an MA market consisting of the state of Colorado. This far surpasses the 75 percent CR 4 threshold that Colorado law utilizes in characterizing a market as "highly concentrated." The MA CR 4 for Boulder is 95.8 percent.
Poll: Coloradans overwhelmingly concerned with mega health care mergers
87 percent of Coloradans are worried about the pending merger of two of the nation's largest commercial health insurance companies, Anthem and Cigna

In a new poll by the Colorado Campaign for Consumer Choice, Coloradans expressed concern for health insurance mergers and are requesting a transparent and public process before the Division of Insurance approves.

"This poll confirms that Colorado consumers want opportunities to hear more about the impact of health insurance company mergers before the Division of Insurance makes its decision," said Diane Carman, spokeswoman for the Colorado Campaign for Consumer Choice, in a May 25 release. "While the law only requires one hearing over a 30-day period, we recommend more community forums and more chances for Colorado health care providers and patients to express their concerns."

The need for awareness and public discourse on this issue was apparent. While only 22 percent of Coloradans were aware of the mergers, 78 percent were unaware, and 79 percent of Coloradans shared the view of the Colorado Campaign for Consumer Choice that there should be expanded opportunities for public interaction, more than what is required by law.

In July 2015, Anthem announced its bid to take over Cigna in a $54 billion deal. The Colorado Division of Insurance must approve the mergers before they can move forward.

Division of Insurance releases preliminary 2017 health insurance information
Nine insurers ask for rate increases

The Colorado Division of Insurance (DOI) released the preliminary information for proposed health plans and premiums for 2017. Four insurance companies either will not offer or will significantly cut back individual plans next year. A new entrant into the Colorado market will sell plans in the individual market. And a number of companies currently offering individual plans are seeking significant premium increases for their 2017 individual plans.

"As we prepare for the fourth open enrollment of the Affordable Care Act, it's worth noting that we're still in the stabilization phase," said Colorado Insurance Commissioner Marguerite Salazar in a June 6 DOI release. "Companies are still figuring it out -- where to sell, how to sell, how to price -- which is why we're seeing some companies pull back on individual plans or requesting significant increases, while still other companies are coming into the market. Some companies have done a better job of figuring out how to operate in this new environment and compete for people's business, while others must step back and reevaluate their approach."

Read more on CMS.org.

New phase of HIPAA audits have begun - are you prepared?

As a part of their continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. The 2016 Phase 2 HIPAA Audit Program will review the policies and procedures adopted and employed by covered entities and their business associates to meet selected standards and implementation specifications of the rules. In an article for CORHIO, David Ginsberg, president of PrivaPlan Associates, discusses phase two. Click here to read the article on the CORHIO website and register for their June 28 webinar.

Confronting a crisis: An open letter to America's physicians on the opioid epidemic
American Medical Association President Steven Stack, MD, issued an open letter to physicians of the United States about the opioid epidemic. In it he calls on all physicians to take seven steps to reverse the nation's opioid overdose and death epidemic. Read the letter here.

The AMA also has resources through the AMA Task Force to Reduce Opioid Abuse webpages.
Collector applications now being accepted for the Colorado Household Medication Take-Back Program

The Colorado Department of Public Health and Environment is now accepting applications from entities that would like to participate as collectors in the Colorado Household Medication Take-Back Program. Eligible applicants include law enforcement agencies and DEA-registrants that are retail pharmacies or hospitals/clinics with on-site pharmacies.

Collectors will have access to the services of Assured Waste Solutions, LLC, recently contracted by the department to provide collection, transportation and disposal services for the program. AWS, a DEA-registered reverse distributor, allows the program to collect prescribed controlled substances along with other prescribed and over-the-counter medications at all collection sites. Learn more here.

Federal CMS clarifies MACRA's projected impact on solo physicians and small group practices

In response to concerns raised by the American Medical Association and others, the Centers for Medicare and Medicaid Services issued a small practice fact sheet that outlines aspects of the proposed MACRA (Medicare Access and CHIP Reauthorization Act of 2015) regulation that were intended to address the needs of smaller physician practices. MACRA replaced the flawed Sustainable Growth Rate formula for clinician payment in Medicare. The proposed rule would implement these changes through the unified framework called the "Quality Payment Program," which includes two paths: the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).

The fact sheet explains that the rather alarming impact table projecting a disproportionately severe impact on solo physicians and small groups is based on 2014 data when many small and solo practice physicians did not report their performance, therefore making it misleading. They agency says that the Quality Payment Program as proposed would provide accommodations for various practice sizes and configurations and, in particular, flexibility to small practices through exceptions like low-volume exclusions, alternate scoring, group reporting and others.

The AMA is working to identify further refinements that could be made to the proposed rule to provide relief and assistance to smaller practices and will include their recommendations in formal comments that will be submitted to the federal CMS in late June. The AMA has also updated their MACRA proposed rule summary. Access the most recent version here.

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 www.callcopic.com.

Carr Healthcare Realty exclusively represents healthcare tenants and buyers. We assist medical practices in all types of lease and purchase negotiations: New Offices, Expansions, Relocations, Practice Acquisitions, and Lease Renewals. Visit: www.carrhr.com

GreenLight is the national leader in web-enabled behavioral health testing with over half a million assessments in 35 states. GreenLight is designed to help physicians enhance patient care, improve population health and add incremental revenue to the practice. Visit www.Greenlight.md or call 866-602-1778.

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June 23-26, 2016: Attend Aspen Ideas Festival Spotlight Health, the premier creative health forum in the world. Qualifying physicians earn CME credits. Visit www.aspenideas.org/
festival/register. Call 970-544-7916 or email Karen.petersen

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The average physician can save $38,000 by refinancing their student loans with LendKey! CMS members get a $400 cash bonus when refinancing through this partnership.

Rates as low as 2.14% variable and 3.25% fixed. Visit www.LKrefi.com/co-med. Phone: 888-549-9050 Email: customer.care@lendkey.com

Expert help for Colorado healthcare providers in the battle against pain and prescription opioid abuse. FREE education and training sessions begin in April - enroll today!
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Transcription Outsourcing, LLC is the leading U.S. provider of medical transcription services. We provide physicians with the ability to be more productive and more profitable. To learn more, call 720-287-3710, visit www.transcriptionoutsourcing.net or email bwalker@transcription

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