|
ADVERTISEMENT
1. Quality Matters: CMS Begins Collecting Quality Data from Physicians
The Centers for Medicare & Medicaid Services (CMS) in April began collecting data for its voluntary quality reporting initiative, the Physicians Voluntary Reporting Program. Participating physicians and groups are asked to report on any of the applicable 16 core measures, including low-density lipoprotein control in diabetics, antibiotic prophylaxis in surgical patients, and beta-blocker therapy for patients with a history of heart attack. (Click here for a full list.)
Physicians are not being reimbursed for participating in the program. Participants report their data to CMS on standard claim forms using newly created HCPCS G-codes with a $0 charge. In exchange for the data, CMS will provide quarterly feedback to physicians on how to improve their performance and their reporting accuracy.
The federal agency urges physicians to participate in the program, saying it will give physicians valuable experience in preparation for future quality reporting programs. Physicians who do wish to take part may declare their “intent to participate” online. Though it is not required and doing so does not obligate participation, declaring your intent will help CMS gauge how many physicians plan to participate in the program in the future.
Although CMA supports quality initiatives, the association believes that CMS’s program has many shortcomings. CMA will continue to work with CMS to improve this and future quality programs so that they allow for strong physician input into how “quality” is defined and measured, as well as protect patient access to care. CMA will also work to ensure that participation in the program is administratively simple, the measures are relevant to physicians (as opposed to hospitals and other facilities), and physicians are appropriately reimbursed to cover the costs of clinical care and the additional IT-related costs of reporting.
Click here for more information, including previous issues of Quality Matters.
Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
Quality Matters is a monthly feature that focuses on practical ways physicians can improve the quality of the care they provide to their patients. Quality Matters is published in CMA Alert and at the California Physician website the second Thursday of every month.
BACK TO TOP
2. Division of Workers’ Comp Hires UCLA to
Study Injured Workers’ Access to Care
The California Division of Workers’ Compensation (DWC) is sponsoring a scientific study about access to medical care for injured workers. The study is being conducted by the highly regarded Center for Health Policy Research, an independent research center at UCLA.
Up to 1,200 physicians will be sampled and surveyed for their opinions about and experiences with providing workers’ compensation care in California. The study includes medical doctors, osteopaths, podiatrists, chiropractors, acupuncturists, and psychologists.
CMA urges selected physicians to participate in this important study. Your responses will help DWC understand the challenges of treating injured workers in California so the agency can make the system more effective for both patients and their health care providers.
The ten-minute survey can be completed on the phone, by mail, or on a secure website. You will be asked about the scope of your workers’ compensation practice, reasons for any changes in that practice, and experiences providing care in the workers’ compensation system. Participants will also be asked to suggest ways to encourage providers to continue to treat work-related injuries and illnesses.
Providers randomly selected for the survey will receive a letter requesting their participation. Participation in the survey is voluntary and confidential and responses will be reported in the aggregate only.
Click here for more information.
BACK TO TOP
3. Highlights from CMA Board of Trustees Available
CMA’s Board of Trustees met Thursday, May 4, in Indian Wells.
A summary of the board’s major actions is available online at http://www.calphys.org/html/board.asp.
Contact: Ginnie Yee, 415/882-5170 or gyee@cmanet.org.
BACK TO TOP
4. Senate Defeats Federal Medical Malpractice Reform Bill
The United States Senate on Monday voted down two flawed federal medical malpractice reform bills. The first (S. 22) would have capped noneconomic damages at $250,000 for all physicians, and separately capped noneconomic damages for hospitals and other health care institutions at $250,000 to $500,000 (depending on the total number of institutions named in the suit); the second (S. 23) would have capped damages only in cases involving obstetricians, who have been especially hard hit by malpractice rates.
The malpractice reform bills were modeled after Texas’s $750,000 “stacked” cap. While the Texas law has provided some relief to physicians who previously had no protection at all, CMA is concerned that it is too soon to know whether the Texas law (enacted in 2003) is adequate. CMA is particularly concerned that the $750,000 joint cap could create incentives to keep physicians in lawsuits to extract a settlement even when the liability clearly lies with the hospital.
While the bill was a significant improvement over last year’s failed attempt at federal malpractice reform (S. 354), CMA did not support this bill. CMA believes that California’s MICRA—with its single $250,000 cap—is a far better law and that any federal malpractice law must contain a “no federal preemption” clause to protect MICRA, a law that has stabilized insurance premiums for physicians and protected access to doctors in California since 1975.
Click here for more information.
Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
BACK TO TOP
5. Senate Rejects Bill that Would Have Wiped Out
California’s Managed Care Protections
The U.S. Senate this week voted down a CMA-opposed bill (S. 1955) that would have stripped away almost all state-enacted protections for health insurance consumers and physicians, including California’s prompt pay law and the Knox-Keene Act. Though the bill’s alleged purpose was to make insurance affordable for small businesses, CMA believes that eliminating hard-won state regulatory protections, including fair limitations on surcharges for those who are ill or have preexisting conditions, will actually have the opposite effect, making health insurance unaffordable for most older or sicker patients.
“California law provides some of the strongest managed care checks and balances in the country. These laws have helped to ensure patients have access to appropriate care in California and any weakening of these laws would be viewed with great concern from the physician community,” wrote CMA CEO Jack Lewin, M.D., and CMA president Michael Sexton, M.D., in a letter to the bill’s author, Senator Michael Enzi (R-Wyo.). “Many of these laws were enacted in response to widespread abuse by plans and insurers. Physicians will not want to participate in plans without these basic protections.”
Click here for more information.
Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org. BACK TO TOP
6. CMA Hosts Online Seminar to Introduce
Physicians
to its Newest Partner, athenahealth
CMA recently partnered with athenahealth—a leading revenue management company—to help physicians get paid quickly, correctly, and with minimal hassle. CMA and athenahealth are hosting an online seminar for physicians and their office staff May 16, from 12 to 1 p.m.
Participants will learn how athenahealth can help them increase collections and operate more efficiently, allowing them more time and energy to care for their patients. CMA member and athenahealth client Bo Greaves, M.D., will discuss his personal experience with athenahealth.
CMA members receive a 6 percent discount on athenahealth’s unique web-based practice management services, which include automated eligibility verification, coding validation, automated contract compliance monitoring, payor-specific reverse rules engine and insurance collection services.
CMA endorsed athenahealth’s award-winning solution after an extensive review of its software and services, lengthy discussions with California customers, and independent confirmation of the company’s unusually high user satisfaction rate. On average, practices that use Athenahealth’s revenue cycle management service get paid 30 percent faster and see a 5 to 10 percent increase in collections.
athenahealth has even developed a “Prompt Payment Robocop,” to help physicians take full advantage of California’s prompt-payment law. The system monitors every claim, calculates interest when a claim has not been paid on time, and flags the unpaid claim for follow-up.
Click here for more information.
Contact: Jewel Thompson, 916/551-2061 or jthompson@cmanet.org.
BACK TO TOP
7.
 150th Anniversary Trivia: Did You Know?
Did you know that in 1889, the state legislature passed a CMA-sponsored law requiring all children to have smallpox vaccinations before entering the public school system? In force until 1972, when smallpox was declared officially eradicated, that law was the precursor for current law, which requires schoolchildren to receive multiple immunizations before entering the school system.
CMA is celebrating its 150th birthday! Visit http://www.cmanet.org/150 for other interesting information about CMA history.
Contact: Karen Nikos, 916/444-5532 or knikos@cmanet.org.
BACK TO TOP
8. CMA Member Benefit of the Week: Online Practice Management
CMA has partnered with athenahealth—a leading revenue management company—to help physicians get paid quickly, correctly, and with minimal hassle. CMA members receive 6 percent off athenahealth’s unique web-based practice management services, which include eligibility verification, claims submission, and insurance collection.
athenahealth is the only revenue management service for physicians that integrates work flow, billing, and collections into a single web-based service. This HIPAA-compliant system was developed by former medical practice managers who have a thorough understanding of the business problems facing physicians in California. athenahealth has the largest real-time database of payor rules and regulations in the country—a database that helps prevent billing problems before they result in denied claims and lost cash flow. Because it’s a web-based service, every time a new rule or feature is added, your practice benefits immediately.
On average, practices that use athenahealth get paid 30 percent faster and see a 5 to 10 percent increase in collections.
To receive your CMA member discount, call CMA at (888) 401-5911 and you
will be connected with an athenahealth representative.
Click here for more information about the benefits and discounts available to CMA members.
BACK TO TOP |
No. 2051 
