Monday
Feb212011

Member News

ArMPAC ANNOUNCES PRIMARY ELECTIONS ENDORSEMENTS: While PCMS does not endorse or fund candidates, the Arizona Medical Association political action committee (ArMPAC) recently released their primary recommendations for the upcoming elections on Tuesday, August 26. Click here to view: http://origin.library.constantcontact.com/download/get/file/1102079664619-511/ArMPAC+2014+Primary+Endorsments.pdf. Further recommendations will be release after the primaries.

HOSPITAL CONCOLIDATION CONTINUES:  Carondelet Health Network of Tucson, Ariz. and its parent company, Ascension, have signed an exclusive, non-binding letter of Intent with a subsidiary of Tenet Healthcare Corporation {NYSE: THC) to create a joint venture with Dignity Health that would own and operate Carondelet. It is anticipated that Ascension would retain a minority interest in such a joint venture. The parties have launched a period of due diligence which they expect will result in a definitive agreement.

Under the proposed agreement, Tenet would be the majority partner in the joint venture with management responsibility for all operations of Carondelet’s assets, including St. Joseph's and St Mary's Hospitals in Tucson, Ariz.; Holy Cross Hospital in Nogales, Ariz.: Carondelet Medical Group; Carondelet Specialist Group; and Carondelet's ancillary businesses.

CMS ISSUES 2015 MEDICARE PHYSICIAN PAYMENT PROPOSED RULE: Major changes in the Medicare physician payment policy were proposed by the Centers for Medicare & Medicaid Services (CMS) with the release of its annual notice of proposed rulemaking July 3. Public comments on the proposed rule are due September 2. The final rule is expected to be issued by November 1, and implementation is scheduled for January 1. Some of the key issues addressed in the CMS proposal include:

  • Unbundling of the 10- and 90-day global surgical services
  • Changes to the process and timelines for revising relative values
  • New payment policies and rates for chronic care management services
  • Changes to the Sunshine Act regulationsModifications to the Medicare performance-based payment programs, such as the Physician Quality Reporting System and Value-Based Modifier

These proposals and others are outlined in several fact sheets available on the CMS website: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets.html.

PHYSICIANS SHIFTING TO EMPLYMENT RATHER THAN PRIVATE PRACTICE: Jackson Healthcare this week released the findings of a survey on physician practice environment, workload and patient access. A total of 1,527 physicians across the nation completed the survey this spring. When comparing previous survey results, this year's findings noted that the percentage of hospital-employed primary care physicians doubled from 10 percent in 2012 to 20 percent in 2014. The number of primary care physicians with an ownership stake in a single-specialty practice decreased from 12 percent in 2012 to 7 percent in 2014. When responding to why they chose employment, overall, the lifestyle that employment offers is the underlying factor driving physician preference. The number of physicians taking call in 2012 (77 percent) dropped to 57 percent in 2014. Eighty-five percent of physician practices reported accepting new Medicare patients. Sixty percent reported accepting new Medicaid patients. Survey details here: http://www.jacksonhealthcare.com/media-room/articles/physician-trends/physician-data-on-practice-environment-workload-and-patient-access.aspx

UNIVERSITY OF ARIZONA / BANNER HEALTH FORMALIZE AFFILIATION: Each year, Banner and the UA Colleges of Medicine collaborate in the training of nearly 260 physicians in five residency programs and in numerous fellowships. This week saw the execution of a formal agreement between the University of Arizona Health Network (UAHN) and the University of Arizona (UA) and Banner Health, to create a statewide health care organization and a new model for academic medicine. The Arizona Board of Regents (ABOR) voted Thursday to authorize the UA to move forward with UAHN and Banner. Final definitive agreements are expected this fall, and must also be approved by the ABOR and the boards of directors of UAHN and Banner. The anticipated transition of 6,300 employees working at UAHN's two hospitals, the health plan and the medical group into Banner will create Arizona's largest private employer with more than 37,000 employees. According to the press release, proposed transition key elements include the following:

  • Create an Arizona-based, statewide health system that improves care for all the state's citizens by reliably and compassionately delivering superior care to all who turn to this system;
  • Expand University of Arizona Medical Center capabilities for complex academic/clinical programs such as transplantations, neurosciences, genomics-driven precision health, geriatrics, and pediatrics while providing for investment opportunities in other areas;
  • Bolster fiscal sustainability, eliminating persistent shortfalls and low operating margins currently experienced by UAHN, i.e., eliminate the debt burdening UAHN (currently projected to be $146 million), provide resources for improved hospital infrastructure, and create a $300 million endowment with a $20 million per year revenue stream to advance the UA's clinical and translational research mission;
  • Secure and sustain a lasting relationship with, and commitment to, the University of Arizona, anchored by an Academic Division within Banner. The Academic Medical Centers: The University of Arizona Medical Center - University and South Campuses and Banner Good Samaritan Medical Center and the faculty practice plan, will support the growing needs of the Colleges of Medicine in Phoenix and Tucson;
  • Train more physician specialists and allied health professionals, including pharmacists and advanced practice nurses for Arizona;
  • Provide a comprehensive platform for the development of physician-scientists who will drive discovery across basic science studies, patient-oriented clinical research, health services research, and population health; and
  • Secure and sustain an operational foundation for the Colleges of Medicine in Tucson and Phoenix that will maximize the value of the ongoing state funding received annually through legislative appropriations.

The complete press release is here: http://opa.ahsc.arizona.edu/newsroom/news/2014/university-arizona-health-network-and-banner-health-launch-effort-create-state-wi.

REGISTER TO VIEW SUNSHINE ACT DISCLOSURES BEFORE RELEASE: The Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The data is to be made publicly available by September 2014. Physicians wishing to review and potentially dispute their Sunshine Act financial disclosures must complete a three-step process to access their data:

  • Register now in the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal. This gateway provides access to a number of CMS programs, so many physicians may have already completed this step.
  • On July 1, physicians will be able to request access to the Open Payments Program system. Physicians can do so by logging back into the CMS Enterprise Portal and following the appropriate steps.
  • Physicians should review their individual report and seek corrections through the Open Payments System. CMS reports that this step also will be available in July.

CMS EXTENDS DEADLINE FOR MEANINGFUL USE STAGE TWO:  Under a proposed rule and joint announcement by CMS and the Office of the National Coordinator for Health Information Technology issued this week, CMS extended the deadline for providers to meet Meaningful Use Stage 2. Healthcare providers will have an extra year to use 2011 Edition software in their electronic health record (EHR) systems, and providers scheduled to jump to the program's Stage 2 criteria will have another year to stay at Stage 1. The agencies cited the slow delivery and implementation of the upgraded 2014 Edition software as the reason for the delay. Although providers have been urging CMS to delay Stage 2 implementation, the timeline of the protracted rulemaking process still means many providers have to make implementation decisions before the rule can take effect. Learn more here.

Meaningful Use is a set of criteria for the use of Electronic Health Record (HER) systems to improve patient care by healthcare providers. The concept of meaningful use was developed by the National Quality Forum (NQF); their ideas included improved population health, coordination of care, improved safety, and patient engagement. The U.S. Healthcare Information Technology for Economic and Clinical Health Act (HITECH) established incentives for adopting Meaningful Use criteria beginning in 2012, with the possibility of penalties for failure to achieve the standards by 2015. In August 2012, CMS released the final rules for meaningful use Stage 2.

If you are struggling with Meaningful Use, contact Arizona's Regional Extension Center! REC logo Important & Time Sensitive: The Office of the National Coordinator for Health Information Technology (ONC) recently granted a no-cost extension award to the Arizona Regional Extension Center (REC) program. This extension allows the REC to continue offering eligible providers free assistance towards achievement of Stage 1 Meaningful Use. This award is particularly helpful for providers who are still struggling with Meaningful Use requirements, or are at risk of receiving payment adjustment penalties in 2015. The no-cost extension provides additional time, until April 5, 2015, for the REC to sign up eligible providers who are currently using an EHR or are considering EHR adoption. Learn more and find out if you qualify - call the REC at 602-688-7200 or fill out an interest form at www.arizonarec.org! 

PHYSICIANS CHALLENGED BY ACA PLANS:  A new study released by the Medical Group Management Association (MGMA) surveyed 728 practices representing 40,000 physicians in 46 states during April 2014. Almost 80% of the medical groups reported their practice is participating with new health insurance products sold on the ACA exchanges, and over 90% of these practices have already seen patients with this coverage. These practices report that verification processes were more difficult and lengthy than with commercial plans. Nearly 60% of respondents indicated that it is more difficult to verify patient eligibility, obtain cost-sharing or network information, or get information about the plan's provider network, in order to facilitate referrals. For practices not participating with ACA insurance exchange product, 48.1% cited concerns about assuming financial liability during a 90-day grace period for ACA exchange enrollees. For practices that chose to participate with ACA insurance exchange products, 57.6% cited remaining competitive in the local market as the reason for doing so. Almost half of respondents reported they have been unable to provide covered services to exchange patients because their practice is out of the patient's network. About 36.6% of respondents indicated that average payment rates for ACA exchange insurers were equal to payment rates from traditional commercial and traditional Medicare contracts; 32% indicated that average payment rates were somewhat lower. The American Medical Association (AMA) has created a physician practice resource page for grace period information. Resources include model language and sample letter forms for notifying patients.

PHYSICIAN TAX RETURN SCAM UPDATE: ArMA staff continues to receive updates on the physician, IRS tax scam. Nearly 100 physicians have notified ArMA they are victims of this scam. ArMA staff has been in constant communication with the Arizona offices of the IRS and FBI as well as the United States Secret Service Agent assigned to coordinate the investigation and response nationwide.

This week, they report that while it was initially thought that a data breach had occurred with a physician or healthcare related entity, there is now more reason to suspect a broader general data breach where physicians were identified. The state offices of the FBI and IRS have been responsive to ArMA inquiries and have pursued all angles and verifications provided by ArMA. The Secret Service agent assigned to the case feels they are making progress in their investigation.

All victims are urged to be vigilant in monitoring their credit reports and any potential for fraudulent charges, changes or anomalies in their finances. These agencies do not ask for confidential information via email. All three agencies agree that direct communication with physicians in Arizona will be validated through the Arizona Medical Association (ArMA). The agents notify ArMA staff of their intent to contact the affected physician, and then we notify that physician that the agent plans to contact them.

If you are a victim of this scam, please email Chic Older, EVP, with your full name, home address and phone number. The agencies involved have asked us to provide them with known victims so please let us know in your email that you authorize release of your contact information, including email address.

WEBSITE OFFERS ACCESS TO CLINICAL TRIALS:  Participating in vital health-related research to help improve or saves lives has gotten easier, thanks to a new website that features the clinical trials at the Arizona Health Sciences Center. The new Clinical Research Studies website facilitates access to research studies at the University of Arizona for the general public and for researchers recruiting people to their studies. The UA Clinical Research Studies website is searchable by health topic and makes access to information about the studies easy to find. The studies are listed by disease area and in laymen's terms for ease of navigation and understanding, and more in-depth medical information also is included for both UA and community health-care providers. Currently, there are over 100 UA studies focusing on a variety of diseases. The studies are led by nationally renowned researchers who are working to identify new cancer therapies, treatments for heart disease, asthma and lung disease, depression, Alzheimer's disease, Parkinson's disease, diabetes, and to find innovative uses for technology in health care.

LEGISLATIVE MINORITY WINS COURT BATTLE CHALLENGING MEDICAID HOSPITAL ASSESSMENT:

Legislators who voted against the expansion of Arizona’s Medicaid won an appeals court battle yesterday allowing them to challenge the law and the levy it imposes. The ruling puts in jeopardy the state’s ability to fund the health program’s expansion without the estimated $256 million the hospital assessment would generate.

The judges voted unanimously the state’s constitutional language is plain – the voter-approved mandate for a two-thirds vote to increase revenues applies to a host of changes including taxes, fees or assessments.  It also applies to authorizing any state agency to set fees.

The court rejected Gov. Brewer’s arguments that:

  • Only hospitals subject to the levy have the ability to argue that it’s a tax and not an assessment.
  • The Governor’s contention that a simple majority of lawmakers have the constitutional power to decide when a measure needs a two-thirds vote.

The ruling allows Medicaid expansion opponents to argue the levy imposed on hospitals was unconstitutional since only a slim majority of the legislature voted for its approval not the two-thirds needed. Gov. Brewer is expected to challenge the ruling in the Supreme Court.

AMA STUDY SHOWS AZ PHYSICIAN IMPACT ON ECONOMY:  According to the American Medical Association's (AMA) new Economic Impact Study, each physician in the United States supports 13.84 jobs on average and contributes $2.2 million in economic output, underscoring how physicians influence the health of both their patients and the economy. The study, prepared by IMS Health and released this week, focused on the roughly 720,000 physicians who primarily engage in patient care activities, as opposed to those who focus on research or teaching. Nationally, these physicians support $1.6 trillion in total economic output-that's $2.2 million per physician-and 10 million jobs. The study also found that:

  • Physicians support $775.5 billion in wages and benefits at the national level.
  • Physicians contribute $65.2 billion in total state and local taxes nationally, or $90,449 in local and state tax revenue per physician.

The study estimated the total economic impact of patient care physicians at the national level and for each of the 50 states and Washington, D.C., measuring output, jobs, wages and benefits, and state and local tax revenue. At the national level, physicians support greater economic output than the following industries: legal services, home health care, higher education and nursing home and residential care. Here in Arizona, physicians impacted the economy by:

  • Creating $21.5 billion in direct and indirect economic output
  • Supporting 149,844 jobs (including their own)
  • Contributing $11,907.8 million in direct and indirect wages and benefits for all supported jobs
  • Supporting $847.4 million in local and state tax revenues

Visit the AMA Economic Impact Study Web page to access an interactive map and see a specific break-down of economic contributions for other states.

SOCIETIES WORK TO HELP ADDRESS BACKLOG OF AMB APPLICANTS: 

In April the Executive Directors from Pima County Medical Society, Maricopa County Medical Society and the Arizona Medical Association met with new Arizona Medical Board Executive Director to develop solutions to the current physician licensing backlog.The situation is critical.

During the last several months, the average processing time for new license applications has gone from 11 days to more than 120 days. It is clear this backlog is a deterrent to physicians considering practicing in AZ. The AMB has been funneling its limited resources to revalidate licenses issued under a potentially compromised system and this has resulted in a backlog of more than 700 new applicants. We want the AMB to speed up the process by having access to increased staff and the ability to contract with appropriately qualified primary source credentialing.

If your practice is currently being impacted by the backlog situation, contact Bill Fearneyhough at billf5199@gmail. He will share your information with AMB.

PHYSICIANS NOT HAPPY WITH EHR FUNCTIONALITY: A recent survey conducted by research firm MPI Group and Medical Economics shows two-thirds of physicians would not purchase their current EHR system again. Find the full story here: http://medicaleconomics.modernmedicine.com/medical-economics/news/physician-outcry-ehr-functionality-cost-will-shake-health-information-technol

ICD-10 CODING:  The requirement to use the ICD-10 coding system has been extended to Oct. 1, 2015, however if your practice hasn’t developed an implementation plan these resource sites can assist.  

Online ICD-10 Guide: http://www.cms.gov/Medicare/Coding/ICD10/ICD-10ImplementationTimelines.html

Introduction to ICD-10: http://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html

Basics for Small and Rural Practices: http://www.cms.gov/Medicare/Coding/ICD10/Medicare-Fee-for-Service-Provider-Resources.html

AMA’s What You Need to Know for the Upcoming Transition to ICD-10:  http://www.azmed.org/ckfinder/userfiles/files/icd-10-transition.pdf

AMA’s Your 12-Step Transition Plan for ICD-10: http://www.azmed.org/ckfinder/userfiles/files/AMA_icd-10-action-plan-12-step-transition.pdf

FMCSA SETS NEW RULES TO CONDUCT MEDICAL CERTIFICATION EXAMS:  Family physicians who conduct physicals for interstate commercial motor vehicle drivers have new federal requirements for certification starting May 21. The Department of Transportation’s Federal Motor Carrier Safety Administration (FMCSA) now requires medical examiners to undergo training, testing and be registered before performing physicals. More information may be found at the FMCSA website.

PCMS / FAVORITE STAFFING SERVICE:  If you need staffing, contact Favorite our affiliate medical staffing service. Favorite provides a full range of services including direct hire, contract, temp- to-perm, permanent placement and “just –in-time” per diem.  Special rates are given to member physicians.  Call Amy Erbe at 319-5766. She is anxious to assist. 

WALK-WITH-A-DOC:  The Society is teaming with the Arizona Chapter of the American College of Physicians (ACP) to host and provide physician leaders for the monthly Walk-With-A-Doc outings.  Walkers sign in at the ramada east of Swan Bridge on the south bank.PCMS physicians are encouraged to urge patients to participate in the program. Each walk begins with a brief discussion on a health topic and includes a one- or two-mile walk on level ground. Please contact Dennis Carey at 795-7985 or dcarey5199@gmail.com with questions. There is one more walk scheduled for 2013. It's on December 14. In 2014 walks will be held on January 11, February 8, March 8, April 12, September 13, October 11, November 8 and December 13. They begin at 8 a.m.