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CSMS Recent Headlines

How to Request an Informal PQRS Review (Deadline Extended to 12/16)

Do you have questions about your 2014 PQRS reporting status, or concerns about potentially receiving the -2.0% PQRS negative payment adjustment in 2016?It's not too late to submit an informal review request.CMS will be in contact with every individual eligible professional (EP) or PQRS group practice that submits a request for an informal review of their 2014 PQRS data. Additionally, revised 2014 Annual Quality and Resource Use Reports (QRURs) are now available via the CMS Enterprise Portal.Not sure how to navigate your AQRUR? Check out the free, on-demand CSMS AQRUR webinar.All informal review requests must be submitted electronically via the …

CSMS Members Honored as HBJ Health Care Heroes

CSMS was well-represented at today's Hartford Business Journal Health Care Heroes Awards ceremony: award finalists Pauline Olsen, MD, William Petit, Jr., MD, Jack Ross, MD, Hank Schwartz, MD, and Prasad Srinivasan, MD are all accomplished professionals who have demonstrated tireless commitment to the communities they serve.Dr. Olsen, winner of the 2016 Health Care Heroes Volunteer Award, is one of the founders of Malta House of Care, which utilizes a mobile medical van and volunteer health providers to deliver free primary health care to vulnerable communities in the Greater Hartford region. Dr. Olsen helped found the organization in 2006 after retiring …

CMS Extends Informal Review Deadline

CMS has announced an extension of the deadline to request an informal review of 2014 Annual Quality and Resource Use Reports (AQRUR) - it is now December 16, 2015 at 11:59 pm (previously 12/11/15).Your 2014 AQRUR (Annual Quality and Resource Use Report) shows whether you successfully participated in PQRS in 2014.If you didn't report PQRS in 2014, you will receive an automatic -2.0% adjustment in your 2016 Medicare payments.For groups of 10+, 2014 non-participation in PQRS results in an additional automatic -2.0% Value-Based Payment Modifier (VM) adjustment in 2016 Medicare payments.***Review your 2014 AQRUR to make sure your PQRS status …

Veterans Health Resources: "A Nationwide Community of Care"

CSMS was honored to host Lucile Burgo-Black, MD for a program on healthcare for veterans and their families. Dr. Burgo-Black is the National Co-director, Post Deployment Integrated Care Initiative, Associate Primary Care at the Veterans' Administration (VA) Connecticut Healthcare System in West Haven, CT.The program opened with remarks by State Rep. David Yaccarino (R-North Haven), who is a Ranking Member of the Committee on Veterans' Affairs. Rep. Yaccarino is a strong advocate for veterans, and has worked closely with CSMS on veterans' mental health issues.Dr. Burgo-Black’s talk, titled From the War Zone to the Home Front: Supporting the Mental Health …

CSMS Joins National Call for MACRA Information, Design Input

The Connecticut State Medical Society (CSMS) joined more than 100 state and national medical specialty societies in letters submitted to the CMS Administrator and to the CMS regulatory comments site.The first letter lays out principles CMS should follow in designing regulations to implement the Medicare Access and Chip Reauthorization Act (MACRA). Full text of the letter is available at http://www.ama-assn.org/resources/doc/washington/x-pub/macra-sign-on-letter-16nov2015.pdf. CSMS and some other medical societies have asked the AMA to provide further detail on particular items and issues.Additionally, the group submitted a request for information (RFI) on MACRA implementation. Full text of this letter is available at:http://www.ama-assn.org/resources/doc/washington/x-pub/macra-letter-17nov2015.pdf. The detailed …

Original CSMS Research Presented in ACOG Journal: Racial and Ethnic Disparities in Hospital Readmissions After Delivery

For immediate releaseNovember 10, 2015(North Haven, CT) – The Connecticut State Medical Society (CSMS) believes that the identification of health disparities among and within Connecticut’s increasingly diverse population is central to providing quality patient medical care. Original research data from a multi-year CSMS readmission disparities study was used in an article published in the November issue of Obstetrics and Gynecology, the journal of the American College of Obstetricians and Gynecologists (the “Green Journal”).The study, Racial and Ethnic Disparities in Hospital Readmissions After Delivery, was authored by CSMS members Mark DeFrancesco, MD and Steven Fleischman, MD; CSMS EVP/CEO Matthew Katz; and …

Adult Pneumococcal Vaccines

The Connecticut Immunization Coalition recognizes that there is some confusion surrounding pneumococcal vaccination in adults with the two vaccines in circulation (13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine).In response, they have provided these pneumococcal vaccine resources: September 4, 2015 MMWR highlighting the intervals between the two vaccines: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a4.htm?s_cid=mm6434a4_w The CA Dept. of Public Health's Pneumococcal Vaccine Timing for Adults tool (a nice one-page algorithm): http://eziz.org/assets/docs/IMM-1152.pdf September 19, 2014 MMWR highlighting the use of the two pneumococcal vaccines among adults: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6337a4.htm?s_cid=mm6337a4_w Ask the Experts (Pneumococcal Vaccines): http://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp

CSMS Signs on to Congressional MU Letter

The Connecticut State Medical Society joined with 49 other state medical societies and 63 national medical associations in signing a letter to House and Senate leadership. The letter expressed strong concerns with the Administration's decision to move ahead with implementation of Stage 3 of the Meaningful Use program, despite the widespread failure of Stage 2.While the overall goal of the HITECH Act, namely to promote widespread adoption of electronic health records by physicians and hospitals, has largely been achieved, the Stage 3 requirements are inconsistent with the goal of promoting better coordinated and high quality patient care. Congressional action to …

CMS Informal Review Deadline Extended to 11/23

CMS has extended the deadline for informal review of 2016 Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) to 11:59 pm on November 23, 2015.If you have reviewed your 2014 AQRUR and think that: you have been incorrectly assessed the 2016 PQRS negative payment adjustment (-2.0% of 2016 Medicare FFS payments) OR there is a perceived error in your 2016 VM calculation (applicable to groups of 10+ Eligible Professionals as identified by Tax ID Number/TIN)you can submit an informal review request for CMS to investigate your incentive eligibility and/or payment adjustment determination.Submit your request through the Quality Reporting …

Webinars, We've Got Webinars

CSMS is hosting a series of convenient webinars on Medicare quality programs: PQRS: An Overview Decoding MYQRUR Understanding the AQRUR Understanding the Value-Based Payment Modifier (VM)Each webinar is less than an hour long, and includes links to CMS resources and information. Each webinar topic is offered live at two different times, and presentations are also archived for on-demand learning.Click here to learn more. 

Henry Jacobs, MD, JD Sworn in as 177th CSMS President

At the 223rd Annual Meeting of the Connecticut State Medical Society, Henry E. Jacobs, MD, JD was sworn in as the Society's 177th President.Dr. Jacobs is a West Hartford Obstetrician-Gynecologist and Senior Attending at Hartford Hospital.Long active in organized medicine, Dr. Jacobs has served in a number of leadership roles at the Connecticut State Medical Society, including Councilor, Chair of the CSMS Judiciary and Ethics Committee, Co-Chair of the CSMS Managed Care Committee, and a member of the CSMS Quality of Care Committee. He is also a Past President of the Hartford County Medical Association, and chaired the HCMA Board …

CSMS Opposes Announced Medicaid Cuts

(NORTH HAVEN) – The Connecticut State Medical Society (CSMS) is deeply concerned by Governor Malloy’s recent announcement of significant rescissions to Medicaid and mental health services, on top of cuts made in April and June of this year.CSMS President Robert Russo, MD has released this statement in response:These unexpected and unprecedented rescissions to the 2016-2017 Medicaid budget will dramatically reduce access to care for the neediest patients across the state, the nearly one in five Connecticut residents who today rely on Medicaid for their health care coverage. It will be more difficult for patients to get preventive care services, which …

CSMS Supports CDC Recommendations for Childhood Immunization

September 18, 2015For Immediate Release (North Haven, CT) – At its founding in 1792, the Connecticut State Medical Society stated its dedication to the “diffusion of science and knowledge of the healing arts.” More than two centuries later, as the wealth of medical knowledge has expanded far beyond anything the CSMS founding physicians could have imagined, CSMS remains a trusted source of information for patients and their families.In the current environment of skepticism about the efficacy and safety of childhood immunizations, CSMS reaffirms its support for the childhood immunization schedule recommended by the US Centers for Disease Control and Prevention.CSMS …

Million Hearts Model Deadline Extension

CMS has extended the deadline for the Million Hearts Cardiovascular Disease Risk Reduction Model letter of intent and application to October 8, 2015. The extension will ensure that all interested practices have an opportunity to become part of this important initiative.The Million Hearts Cardiovascular Disease Risk Reduction Model (MH Model) supports both the Million Hearts’ goal to prevent one million heart attacks and strokes, and CMS’ objective to identify and spread better models of care delivery and payment. The MH Model employs a randomized-controlled design; CMS is seeking a diverse range of at least of 720 practices, approximately 360 intervention …

PQRS 2016 Informal Review Process

Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, and group practices participating in GPRO (including ACOs) that did not satisfactorily report PQRS in 2014 will receive a negative payment adjustment in 2016. In addition, those individuals and groups will not receive a 2014 PQRS incentive payment.If you believe that you have been incorrectly assessed the 2016 PQRS negative payment adjustment, you may request an informal CMS review of your incentive eligibility and/or payment adjustment determination.Informal review requests must be submitted between September 9, 2015 and November 9, 2015.Submit your request via the Quality Reporting Communication Support Page (CSP) …

AMA Releases Analyses of Potential Anthem-Cigna and Aetna-Humana Mergers

This morning, the AMA released the following press statement that summarizes the key findings of new special analyses of the impact of the proposed Anthem-Cigna and Aetna-Humana health insurance mergers. These analyses coincide with the release of the 2015 Update to the AMA’s Competition in Health Insurance: A Comprehensive Study of U.S. Markets. Notably, the combined impact of these proposed mergers would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within 17 states, in the commercial combined health insurance markets.The AMA press statement contains links to the special analyses of these two mergers, …

Congratulations to Smilow/YNHH Team on $11M Oncology Research Grant

CSMS member Roy Herbst, MD recently received some excellent news.Dr. Herbst, chief of medical oncology at YNHH/Smilow, and his team were awarded an $11M grant for their Specialized Program of Research Excellence (SPORE) focusing on non-small cell lung cancers.“What this grant is designed to do is to take new therapies and discoveries from the lab to the patients who need them in the clinic and to raise the bar … to develop even better therapies for those who come after,” said Dr. Roy S. Herbst, chief of the medical oncology program at Smilow.He emphasized that “my proudest thing about the …

PECOS Reminder

Please ensure all information is correctly reflected within your Provider Enrollment, Chain, and Ownership System (PECOS) account.Information such as National Provider Identifier (NPI), Taxpayer Identification Number (TIN), organization name and address may be used by CMS for upcoming communication.You can review and make changes to your Medicare enrollment information by accessing https://pecos.cms.hhs.gov/pecos/login.do#headingLv1.Need contact information or live support for PECOS account issues and system errors? Please visit https://pecos.cms.hhs.gov/pecos/help-main/contact.jsp.For other system questions, please see your Medicare Administrative Contractor (MAC) or CMS.

With Apologies to Mark Twain, Reports of the Death of Organized Medicine Have Been Greatly Exaggerated

CSMS President Robert Russo, MD and CSMS EVP/CEO Matthew Katz recently wrote this op-ed for the Hartford Business Journal on the importance of organized medicine:With apologies to Mark Twain, reports of the death of organized medicine have been greatly exaggerated.In a recent HBJ article ("Healthcare consolidation means waning influence for medical societies") two Hartford-area physicians shared their opinions and perspectives about organized medicine and the role of the medical society in today's practice environment.Connecticut is not the only state facing membership challenges in a rapidly-evolving healthcare environment. Medical societies across the country — states, counties, locals, specialties — are all …

ICD-10: Coming Soon to a Claim Near You

With the October 1 implementation date for ICD-10 just weeks away, physicians recently got some good news: the American Medical Association (AMA) and the Centers for Medicare and Medicaid (CMS) released additional guidance that allows some flexibility in the claims auditing and quality reporting process during the ICD-10 transition. The Connecticut State Medical Society had signed onto the AMA's national letter supporting these changes.The AMA and CMS will help physicians and other health care providers learn about the updated codes and prepare for the transition through webinars, on-site training, educational articles and national provider calls. AMA President Steven Stack, MD …