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CSMS Recent Headlines

Flu Update: CDC Health Alert Network

CDC HEALTH UPDATE / Distributed via the CDC Health Alert NetworkJanuary 9, 2015, 11:00 ETCDCHAN-00375CDC Health Update Regarding Treatment of Patients with Influenza with Antiviral MedicationsAs a follow-up to HAN 00374 (http://emergency.cdc.gov/han/han00374.asp, Dec. 3, 2014), CDC is providing 1) a summary of influenza antiviral drug treatment recommendations, 2) an update about approved treatment drugs and supply this season, and 3) background information for patients regarding anti-influenza treatment.SummaryWidespread influenza activity is being reported in most U.S. states, with influenza A (H3N2) viruses most common. H3N2-predominant flu seasons have been associated with more hospitalizations and deaths in older people and young children …

Medicare Quality Reporting Programs: National Provider Call

The January MLN Connects™ National Provider Call will be held on Tuesday, January 13, 2015 from 1:30 – 3 pm.The presentation will provide an overview of the 2014 quality data submission process for Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier, and the Medicare Electronic Health Record (EHR) Incentive Program. The information being presented will apply to eligible professionals (EPs) and group practices submitting 2014 quality measure data. This session will provide guidance on how EPs and PQRS group practices can earn the 2014 PQRS incentive and avoid the 2016 negative PQRS payment adjustment …

Congratulations to Connecticut Valley Hospital

The CSMS CME Committee is pleased to announce that Connecticut Valley Hospital (CVH) of Middletown has been Accredited with Commendation as a CME provider. CVH was the only Connecticut hospital to receive re-accreditation with this designation in 2014.In addition, the CVH Medical Library received Special Recognition for its CME efforts.L-R: Karen Hutchinson, MD, CSMS CME Committee Chair; Kandace Yuen, MLS, AHIP, CVH Medical Librarian; Thomas Pisano, MD, CVH Director of Medical Staff; Helene Vartelas, MSN, RN, CVH CEO; John D’Eramo, RN, BSN, CVH COO. 

2014 PQRS Reporting Timeframes

The Centers for Medicare & Medicaid Services (CMS) has announced the 2014 PQRS data submission timeframes. A number of these are starting soon, so please take a moment to review if you are reporting PQRS data for 2014.Please note: 2014 PQRS data is used to determine 2016 payment adjustments. Be sure to submit your data by the deadline and avoid the 2016 payment adjustment.The 2014 data submission timeframes vary, based on reporting method. All submission deadlines are at 8 pm Eastern Time on the last day of the submission period.Reporting MethodSubmission PeriodEHR Direct or Data Submission Vendor that is certified …

Joint Statement on Tenet Healthcare Decision

The Presidents of the Connecticut State Medical Society, the Hartford County Medical Association, the New Haven County Medical Association, the Tolland County Medical Association, and the Waterbury Medical Association have released a joint statement expressing their concern about the recent decision by Tenet Healthcare to withdraw its application to purchase Waterbury Hospital and four other Connecticut hospitals: Saint Mary’s Hospital, Bristol Hospital, and Eastern Connecticut Health Network’s Rockville General Hospital and Manchester Memorial.The physician leaders noted that the decision could seriously affect patient access to care. They urged state regulators and legislators to immediately review OHCA’s actions, and determine how …

CSMS 2015 Legislative Agenda

The CSMS Legislative Committee has released the final Legislative Agenda for the 2015 General Assembly Session, which will begin on January 7.The Agenda focuses on four primary topics: Professional Liability Insurance and Reform Contracting, Transparency and Fairness Physician Workforce Issues Proactive Public Health InitiativesClick here for details of these agenda items, as well as ways to become involved in physician advocacy.Questions or comments? Please email advocacy@csms.org.

DSS Pharmacy Changes for 2015

The Connecticut Department of Social Services (CT DSS) has issued a new provider bulletin (PB 2014-86) detailing pharmacy changes for 2015.These changes include: January 1, 2015 Changes to the Connecticut Medicaid Preferred Drug List (PDL) - modifications to the list of preferred prescription products Reminder About the 5-Day Emergency Supply - DSS allows a 5-day emergency supply of a medication requiring PA for non-PDL/Brand Medically Necessary (BMN), in addition to the one-time 14 day temporary supply Billing Clarification for Brand Name Medications on the Preferred Drug List (PDL) - clarifies pharmacy billing requirements when dispensing a preferred product on the …

CEHRT Hardship Exception Deadline Reminder: 11/30

Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Due November 30, 2014CMS reopened the submission period for hardship exception applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT).The deadline is 11:59 PM EST November 30, 2014.Eligible professionals and eligible hospitals that have never met meaningful use before may apply during this reopened hardship exception application submission period if they meet both of the following: The provider was unable to attest by July 1, 2014 (for eligible hospitals) or October 1, 2014 …

10 Medicare PFS Revisions You Need to Know

The AMA has identified the "top 10" policy changes in the 2015 Medicare Physician Fee Schedule final rule. Below is a quick summary; the full document is available here.1. The sustainable growth rate (SGR) formula calls for a 21.2% cut to physician payments, effective April 1.2. Continuing medical education (CME) will not be reported under the Physician Payments Sunshine Act.3. Proposed penalties under the value-based payment modifier (VBM) will be scaled back.4. The Physician Quality Reporting System (PQRS) becomes a penalty-only program next year.5. The Physician Compare website will continue to expand - but not as much as planned.6. Chronic …

HIPAA Privacy in Emergency Situations: HHS/OCR Bulletin

In response to the recent cases of Ebola in the US, the HHS Office for Civil Rights (OCR) has released an updated bulletin with guidance on HIPAA privacy in emergency situations.The bulletin addresses sharing and safeguarding patient information, waivers, and other resources.Although the protections of the HIPAA Privacy Rule are not set aside during emergencies, the bulletin is meant to ensure that HIPAA covered entities are aware of the ways in which patient information may be shared under the Privacy Rule in an emergency situation.Additional OCR HIPAA privacy resources include an interactive decision tool and other materials for advance planning …

CMS Issues Final Rule on Physician Payment

The Centers for Medicare and Medicaid Services (CMS) late Friday issued a final rule for physician reimbursement under Medicare in 2015. The final rule is similar to the proposed rule that CMS issued in July, with a few modifications. For example, CMS had proposed a payment rate of $41.92 for its chronic care management code, but the rate was changed to $40.39 in the final rule.In terms of the sustainable growth rate (SGR) formula for physician reimbursement, the agency notes that the Protecting Access to Medicare Act of 2014 "provides for a 0% PFS [physician fee schedule] update for services …

H.R. 5539: Common-Sense Changes for the Sunshine Act

After nearly three decades in private practice, Texas physician Michael Burgess, MD now represents Texas' 26th District in the US House. Dr. Burgess has sponsored H.R. 5539, which would clarify that certain applicable manufacturer transfers of value to support independent certified/accredited medical educational programs and materials (including medical textbooks, peer-reviewed medical reprints, and journals) are exempt from reporting under the Physician Payments Sunshine Act (Sunshine Act).Dr. Burgess' bill will ensure that efforts to promote transparency do not undermine efforts to provide the most up-to-date independent medical knowledge, and CSMS was proud to join other state medical societies and national specialty …

Delay of Additional Documentation Request Letters Affecting Part B Connecticut and New York Providers

National Government Services has identified an issue with additional documentation request (ADR) letters for Medicare Part B claims were not sent in a timely manner. This impacted Part B providers from Connecticut and New York only.For the period of 9/17-10/20/2014, letters for claims requiring additional documentation to make a payment determination were not mailed.The cause of the issue has been corrected. Providers whose claims were affected by this issue were sent letters on 10/21/2014; however, the letter has the original issue date. The letters include the following statement:10/21/2014Supplemental NoticeDue to a technical systems issue, the date of the enclosed letter …

CSMS Participated in Ebola Roundtable

(October 22, 2014) -- CSMS President Robert Russo, MD and CSMS Legislative Chair David Emmel, MD were among those invited to participate in a roundtable on Ebola hosted by US Representative John Larson (CT-1) at Hartford Healthcare. Rep. Larson was joined by Sen. Richard Blumenthal, Sen. Chris Murphy, and US Rep. Joe Courtney (CT-2) for the discussion, which was closed to the media. Also in attendance were CSMS Members Rocco Orlando, MD (Chief Medical Officer, Hartford Healthcare) and Jack Ross, MD (Chief of Infectious Diseases, Hartford Hospital), who spoke about preparations at their institution.The purpose of the roundtable was to …

CSMS Health Insurance Survey: The Physician Perspective

Dear Colleague,As a Connecticut physician, you are well aware of the extent to which health insurance companies rate, rank, and categorize you and your practice.CSMS would like to offer you an opportunity to rate Connecticut’s health insurance companies. This brief survey will ask for your perspective on topics such as patient impact, timeliness of payments, claims denials, accuracy of information, and other important issues.Click here to take the surveyWe hope you’ll take a few minutes to complete the survey. Please feel free to forward the link to your colleagues – the more physician responses, the stronger our case will be.Thank …

New CDC Guidance for Managing Patients with Ebola

The CDC has released new guidance on personal protective equipment (PPE) for healthcare workers managing patients with Ebola virus.This guidance contains the following key principles:1. Prior to working with Ebola patients, all healthcare workers involved in the care of Ebola patients must have received repeated training and have demonstrated competency in performing all Ebola-related infection control practices and procedures, and specifically in donning/doffing proper PPE.2. While working in PPE, healthcare workers caring for Ebola patients should have no skin exposed.3. The overall safe care of Ebola patients in a facility must be overseen by an onsite manager at all times, …

Flu Vaccine Added to Fee Schedule - CT DSS Provider Bulletin

Effective for dates of service October 1, 2014 and forward, the Department of Social Services (DSS) will allow reimbursement for procedure code 90688 (Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use) under the physician office and outpatient fee schedule.Since procedure code 90688 is currently not supplied through the Department of Public Health’s (DPH) Connecticut Vaccine Program (CVP), providers should use the appropriate vaccine and procedure code that is available through the CVP for HUSKY Health members 18 years of age and younger. Please refer to the Immunization Home Page …

CDC issues new Ebola recommendations for health professionals

The CDC has released a new Health Alert Network (HAN) Advisory with Ebola recommendations for health professionals.The HAN Advisory provides background information, as well as information about the clinical presentation and clinical course of Ebola, infection control, patient management, and diagnostic testing. To view the full advisory, which includes downloadable clinical guidelines, please click here.