|
AMA/FEDERATION NEWS: National headlines, grassroots news and important AMA announcements for medical society executives and communicators.
April 15, 2008
TOP STORIES 1. Important NPI date approaching for claims and cash flow 2. AMA supports call for transparency and accurate reporting among health insurers
3. Chart measures
FEDERATION NEWS
4. Health insurer transparency bill becomes law in
5. Report finds fewer physicians in
6. Physician work force survey finds increasing shortage in 7. Task force on Standard MS.1.20 to continue its work
PUBLIC HEALTH 8. AMA provides guidance on creation of patient safety organizations
9. Virtual
ANNOUNCEMENTS 10. Save the date: AMA Foundation to hold annual Celebration of Giving 11. AMA GME e-Letter: Pediatrics faces “triple whammy” of funding cuts, elimination 12. Joint Commission addresses preventing pediatric medication errors 13. Nation’s preventive medicine specialists offer board review course
************************** TOP STORIES **************************
1. Important NPI date approaching for claims and cash flow Pursuant to the Health Insurance Portability and Accountability Act (HIPAA), old legacy numbers will not be accepted on any electronic claims after May 23. Claims will only be accepted with a National Provider Identification (NPI) number. That deadline applies to all payers—public and commercial.
Physicians are strongly urged to test sending their claims with just their NPI as soon as possible to avert claims processing and cash flow interruptions that could occur after May 23. Physicians also should ensure that all of their information in the NPI database is up to date. Incorrect information in the NPI database can affect a payer’s ability to identify a physician and pay his or her claims.
Physicians can change or update their information by visiting https://nppes.cms.hhs.gov/NPPES or calling (800) 465-3203. In section 3C of the paper form, physicians are encouraged to write their legacy numbers in the optional field labeled “other identifiers.”
Medicare has taken several steps to prepare for the May 23 deadline. As of March 1, claims sent to Medicare must not contain a legacy number alone; they must contain an NPI or both an NPI and a legacy number. The Centers for Medicare and Medicaid Services (CMS) has said that 98 percent of claims have been submitted successfully since mid-March.
However, some physicians are experiencing disrupted cash flow and claims processing, particularly if Medicare has been unable to appropriately “match” a physician’s old legacy number to their new NPI number in their systems. In some cases, physicians have been required to re-enroll in order for Medicare to establish a good match. The AMA has strongly advocated through numerous phone calls and letters to CMS against policies that adversely impact physicians in this way.
2. AMA supports call for transparency and accurate reporting among
health insurers
“These crucial principles offer hope that patients will be able to trust the information to make informed health care choices,” AMA President-elect Nancy H. Nielsen, MD, PhD, said.
The guidelines, announced April 1, should raise the bar on the reliability and validity of information that insurers provide to patients, although additional work must be done to accurately and fairly evaluate the individual work of physicians.
“The AMA sees the Patient Charter as an important step in the right direction, and we offer our assistance in ensuring that its criteria are appropriate and measurable,” Dr. Nielsen said.
Visit http://healthcaredisclosure.org/docs/files/PatientCharter040108.pdf to learn more about these new guidelines.
Visit http://www.ama-assn.org/ama/pub/category/18458.html to view Dr. Nielsen’s full statement.
3. Chart measures To
help physicians effectively analyze and identify problems and positive
practices of
The
chart will help physicians analyze and identify problems and positive
practices of the Aexcel program, and includes AMA analyses of, and
comments on, each Aexcel program component.
Visit http://www.ama-assn.org/go/pfp to view the Aexcel chart, along with charts of UnitedHealthcare’s Premium Designation program and Wellmark’s Incent and Reward Best Practices program.
************************** FEDERATION NEWS **************************
4. Health insurer transparency bill becomes law in
Legislation recently enacted in
Gov. Ted Strickland’s signing of the Healthcare Simplification Act, which occurred March 31, is the culmination of a 1½-year lobbying effort by the Ohio State Medical Association (OSMA) to help legislators understand the need for insurance industry contract reform. The law is composed of several provisions that would bring transparency to the contracting process, more fairness in contracting and a standardized and time-efficient physician credentialing process.
“This new law is a terrific step toward eliminating some of the most
bureaucratic, unfair and anti-competitive practices that have been
imposed on physicians by
Visit http://www.osma.org/i4a/pages/headlinedetails.cfm?id=709&archive=1 to learn more about this new law.
Visit http://www.osma.org/files/public/HSA.Fact.Sheet.pdf to download a two-page explanation of the law.
5.
Report finds fewer physicians in A
study released earlier this month by the Center for California Health
Workforce Studies at the
The
study also found that these physicians are more likely to practice in
underserved communities and to enter primary care practice, two critical
needs facing
“Every Californian deserves access to a doctor, and this study shows that particularly in some communities we have a ways to go,” CMA President Richard Frankenstein, MD, said.
Visit
http://www.cmanet.org/publicdoc.cfm/2/1/presssection2/422 to access
the report and to learn about solutions the CMA is supporting to help
provide access to care for patients who live in
6.
Physician work force survey finds increasing
shortage in A
recent statewide survey of
Visit
http://www.msms.org/AM/Template.cfm?Section=Your_Practice_Home&CONTENTID=6548&TEMPLATE=/CM/ContentDisplay.cfm
to download results of the survey and to learn more about
7. Task force on Standard MS.1.20 to continue its work The Joint Commission Board of Commissioners recently authorized the Standard MS.1.20 task force to continue preparing recommendations for the board’s May 31 meeting. The implementation of Standard MS.1.20 will not be affected by this decision.
The board also appointed a neutral member of the public as the task force chair, amended the charge to the task force so that mitigating remedies can include revisions to the language of the MS.1.20, and included equal representation of both the medical staff and hospital leadership points of view on the task force membership. The chair of the task force will be well-versed in issues of health care quality and safety, will have no bias toward a particular point of view regarding Standard MS.1.20 and will be a skilled facilitator.
The Joint Commission established the task force in December to examine and address implementation issues related to revised hospital medical staff standard MS.1.20. The revised standard MS.1.20 was approved last June and will become effective in July 2009.
************************** PUBLIC HEALTH **************************
8. AMA provides guidance on creation of patient safety organizations The AMA last week submitted final comments to the Agency for Healthcare Research and Quality (AHRQ) about the U.S. Department of Health and Human Services’ proposed rule on the Patient Safety and Quality Improvement Act of 2005.
The comments provide physicians’ viewpoint on how to best proceed with the creation of patient safety organizations (PSOs), and they highlight the AMA’s strong support for the establishment of a federal framework that will allow health care professionals to voluntarily report patient safety information without fear of legal prosecution.
“The proposed rule strikes the appropriate balance between federal oversight and the creation of a voluntary reporting system, as the government will ensure the integrity of PSOs and allow for innovative initiatives to improve patient safety driven by health care professionals,” AMA Trustee J. James Rohack, MD, said. “To ensure success, the AMA will educate physicians on the reporting system, encourage their active participation and provide input on the system’s creation.”
Visit http://www.ama-assn.org/ama1/pub/upload/mm/31/ahrq041108.pdf to view the AMA’s comments to the AHRQ.
9. Virtual
The April issue of Virtual Mentor, the AMA’s online ethics journal, explores these questions and others, as well as a number of cases and scenarios in which ethical dilemmas arise.
In his op-ed piece, Ron J. Anderson, MD, writes “our health system should in no way allow the care of someone who is seriously ill or injured to be compromised because of citizenship status. We have a clear mandate to provide medical care to all who enter our health system.”
Visit http://virtualmentor.ama-assn.org to learn more and view this month’s issue.
************************** ANNOUNCEMENTS **************************
10. Save the date: AMA Foundation to hold annual Celebration of Giving Preceding the Annual Meeting of the AMA House of Delegates, the AMA Foundation will hold its Celebration of Giving event from 6 to 7:30 p.m. on June 13 in the Grand Ballroom of the Hyatt Regency Chicago. Each year, the AMA Foundation hosts this event to celebrate the generosity of its donors, as well as to generate awareness in the health care profession of its worthy contributions and programs. All are invited to celebrate the spirit of giving with a raffle, complimentary cocktails, hors d’oeuvres and live music. Raffle rules are available on-site.
The
AMA Foundation also is offering the opportunity to thank
To
spons
Visit http://www.amafoundation.org to learn more about the AMA Foundation’s programs.
11. AMA GME e-Letter: Pediatrics faces “triple whammy” of funding cuts, elimination Threatened cuts to both Medicare and Medicaid funding of graduate medical education (GME) are an ill-timed “double whammy” for medical education. Pediatrics, however, is facing a triple whammy, with the added threat to the Children’s Hospital Graduate Medical Education program. The proposed 2009 federal budget eliminates this program, through which hospitals train 35 percent of all pediatricians, half of all pediatric subspecialists and the large majority of the nation's pediatric research scientists.
This is just one topic tackled in the April issue of the AMA’s GME e-Letter. Other highlights from this issue:
Visit http://www.ama-assn.org/ama/pub/category/18452.html to access the April newsletter.
12. Joint Commission addresses preventing pediatric medication errors Medication safety is a big problem for small children. Because most medications are formulated and packaged for adults and most health care settings are built around the needs of adults, young patients are at greater risk for drug errors.
A study in the April issue of Pediatrics reveals that medication mix-ups, accidental overdoses and bad drug reactions harm roughly one out of 15 hospitalized children. With that, the Joint Commission has issued an alert on the steps that are critical to reducing pediatric medication errors.
Visit http://www.jointcommission.org/SentinelEvents/AdvisoryGroup to access this alert.
In addition, the Joint Commission will sponsor a free one-hour audio conference at 11 a.m. CST May 7 that explores this and other issues that impact pediatric patient safety.
Visit http://www.surveymonkey.com/s.aspx?sm=2jZA_2bP0uAh_2fFWF8vdt03QA_3d_3d_ to register for the audio conference.
13. Nation’s preventive medicine specialists offer board review course The
Visit http://www.acpm.org/review.htm to learn more about the ACPM course.
**************************
External links to Web sites and e-mail addresses are offered to provide
readers with additional sources of news and information. The AMA is not
responsible for the content contained in these external sources.
|