Monday
Feb212011

Member News

FREE ICD-10 TRAINING:  The Pima County Medical Society, Tucson Osteopathic Medical Foundation and Centers for Medicare & Medicaid Services (CMS) are sponsoring FREE ICD-10 training.

Presentation Objective:

  • Study the basics, differences, and benefits of ICD-10
  • Explore common codes, primers for clinical documentation, clinical scenarios, and
  • Create a customized Action Plan, personalized by specialty and practice details.

Date/Time/Location:

Date: June 23, 2015

Time: 1-3 PM

Location: Tucson Osteopathic Medical Foundation | 3182 N. Swan Rd | Tucson, Arizona 85712|

Topics:

Designed for physicians and practice managers, this educational session will offer background and strategies on ICD-10 implementation. The presentation will cover the following topics:

  • Overview of ICD-10
  • Clinical/Business Impacts of ICD-10
  • Customizable Action Plan
  • Documentation Requirements for Common Health Conditions
  • Interactive Practice Clinical Scenarios
  • Resources

To register:

Contact the Pima County Medical Society at 795-7985 or email Dennis Carey at dcarey5199@gmail.com. Seating is limited, so early registration is recommended.  

ArMA RESPONDS AT ICA HEARING:  On Thursday, April 30, the Arizona Industrial Commission (ICA) held its annual physicians' fee schedule public hearing. The Arizona Medical Association (ArMA) submitted testimony. ArMA was part of a select work committee that developed a recommendation that all fees be reviewed annually (instead of the current four year cycle) which has been adopted by the Commission. This system still relies on developing fees based on a comparison of seven other states and the Commissioners remain concerned that an Arizona-specific system should be considered. In response to recommendations made by the work committee last year, the Commission is in the process of awarding a contract to an outside consultant to perform a study to evaluate the impact of moving to an RBRVS-based system that would use an Arizona-specific modifier to see how this compares with our current methodology. We anticipate the study will be performed this year. This is not meant to be adoption of the Medicare fee schedule, which ArMA and PCMS has steadfastly opposed. The ICA continues to work collaboratively with ArMA to preserve what most think is one of the best workers' compensation systems in the country.

ADHS NAMES NEW DIRECTOR:  Cara Christ, M.D has been named Director of Arizona Department of Health Services (ADHS) by Governor Doug Ducey. Dr. Christ replaces Will Humble, who left ADHS in March and now works for the University of Arizona's Health Sciences Center.

Most recently, Dr. Christ was Chief Medical Officer and Assistant Director of Licensing Services at ADHS. Before going to medical school, Dr. Christ worked in infectious disease epidemiology at ADHS, where she developed a passion for both medicine and epidemiology. She completed her Medical Degree at the University of Arizona College of Medicine in Tucson, and then returned to ADHS in 2008, where she worked in the Bureau of Epidemiology and Disease Control (EDC), eventually serving as EDC Bureau Chief. Dr. Christ completed her residency in Obstetrics and Gynecology at Banner Health, and also holds an M.S. in Microbiology and Virology from Arizona State University.

FROM ASHBY WOLFE, MD - CMS OPEN PAYMENTS PROGRAM:  The Centers for Medicare & Medicaid Services’ (CMS) Open Payments program collects data from drug and device manufacturers and group purchasing organizations (GPOs) about  payments  they make to physicians and teaching hospitals.  The program also reports information about ownership interests in drug and device manufacturers and GPOs held by physicians and their immediate family members.  It’s important that physicians and teaching hospitals confirm the accuracy of the financial relationships reported about them.

CMS encourages physicians to register and review any payments reported about them.  There are instructions and quick tips to help. The review period opened on April 6, 2015, and will be open for at least 45 days.  Reporting inaccuracies helps to make sure that the information posted to the Open Payments website is correct.  The only way for physicians and teaching hospitals to confirm that the data reported about them is correct is to register and review that data now during the current review period.

Last fall, CMS reported 4.45 million payments valued at $3.7 billion which were made in the last five months of 2013.  These payments were for items such as medical research, conference travel and lodging, gifts and consulting (along with physician ownership or investment interest in industry).  CMS will collect this data annually and continue to make it publicly available, downloadable, and searchable.  Data from the full 12 months of 2014 has been collected and will be released publicly by CMS on June 30, 2015.

Collaboration benefits physicians, teaching hospitals and drug/device manufacturers in the design and delivery of many life-saving drugs and devices.  Open Payments gives patients a tool to become more involved and informed health care consumers by empowering them to discuss these relationships with their physicians.  CMS has had nearly 6 million views of Open Payments data and we’re pleased with the continuing engagement of stakeholders on this important transparency initiative.

Learn more about the Open Payments program or send questions to: openpayments@cms.hhs.gov. 

TAX SCAM CONTINUES TO TARGET PHYSICIANS: The IRS tax scam that emerged during the 2014 tax season continues to plague physicians and other health care providers during 2015. Last year, more than 120 Arizona physicians were victims of the IRS tax scam. We have already had a number of Arizona physicians fall victim to the scam this year. According to reports, fraudulent federal income tax returns using physician names, addresses and Social Security numbers are being filed electronically. IRS officials believe this scam is an attempt to fraudulently collect tax refunds through a sophisticated electronic redirection of refunds to fraudulent bank accounts that can then be accessed by the perpetrators. Victims are unaware of the identity theft until they attempt to file their taxes electronically, at which time they discover that a return has already been filed under their Social Security number. The IRS is sending 5071C letters to suspected fraud victims with instructions to contact the IRS identity theft website or call the IRS at (800) 830-5084. At this time, physicians are encouraged to go to www.experian.com/fraud and place themselves on a 90-day credit fraud alert. This could potentially slow or halt further attempted identity theft activities. This is only suggested out of an abundance of caution - we have no reason to believe that every physician is at risk. We understand that Experian will feed this information and fraud alerts to the other two major credit reporting agencies. If you remain concerned, it is suggested that you go back onto www.experian.com/fraud after 89 days to initiate subsequent 90-day credit fraud alerts. If you are NOT affected, our IRS agent contact does not recommend filing paper returns. In fact, it is considered best to file electronically as early as possible so as to prevent the bad guys from getting there first.  

If you are a victim of this scam, please notify Bill Fearneyhough at billf5199@gmail.com. Please provide your full name, home address and phone number. The information will be shared with ArMA so please let us know in your email that you authorize release of your contact information, including email address.

Other recommendations:

IRS - If you are a victim of this scam, you'll note the IRS 5071C letter provides instructions about contacting the IRS through its identity theft website guide or by phone at (800) 830-5084 to let officials know you did not file the return referenced in their letter. If you are a victim, you will not be able to electronically file your return this year since a return with your Social Security number has already been filed. You'll need to file a paper return and attach an IRS 14039 Identity Theft Affidavit to describe what happened. Attach copies of any notices you received from the IRS, like the 5071C letter. Be sure to let your tax preparer know if this happens to you. Verify with the IRS and your tax preparer where to mail your paper tax return, based on the type of return you are filing and your geographic area. Work with your tax preparer to file paper returns with Form 14039 (identity theft affidavit) and Form 8948 (e-file opt-out). You will also need an affidavit and a government issued ID (driver's license or passport). The process of an individual filing the paper return with the Form 14039 notifies IRS that the paper return is the correct filing. IRS then removes the fraudulent filing from the taxpayers account, posts the correct tax return and if due a refund, issues the refund. The major way it impacts someone due a refund is that the process takes longer.


Federal Trade Commission (FTC) - File a complaint with the FTC here. This not only helps the FTC identify patterns of abuse, but the printed version becomes your Identity Theft Affidavit. Along with a police report, that affidavit becomes your Identity Theft Report, which you will need. The FTC recommends other immediate steps and provides helpful information at www.consumer.ftc.gov/topics/repairing-identity-theft.

Police report - Consider filing a report with the local police where you reside. Bring all documentation available, including any state and federal complaints you filed. This will likely be necessary if there is financial account fraud as a result of the identity theft. However, if the only fraud is tax fraud, the police report will be necessary only if requested by the IRS.

Social Security - Call the Social Security Administration's fraud hotline at (800) 269-0271 to report fraudulent use of your Social Security number. In case your number is being used for fraudulent employment, you can also request your Personal Earnings and Benefit Estimates Statement at www.ssa.gov/ or call (800) 772-1213. Check it for accuracy.

Credit Bureaus - Contact a fraud unit at one of three credit bureaus: Equifax, TransUnion and Experian

Office of the Arizona Attorney General - Physicians affected can find additional guidance through the office of the Attorney General. Their website lists resources and steps for identity theft victims to take at https://www.azag.gov/identity-theft.
If you have not received a notification from the IRS but believe your personal information may have been used fraudulently or are concerned about whether you may have been victimized, call the IRS Identity Protection Specialized Unit at (800) 908-4490. Find more information from the IRS, including forms, at the IRS website

ArMA and PCMS will keep you informed of further developments and information.

NOMINATE A COLLEAGUE FOR “PHYSICIAN OF THE YEAR”:  A highlight of every PCMS/Alliance Stars on the Avenue event is the presentation of several recognition awards including “Physician of the Year.”  If you would like to single out a colleague for the prestigious 2015 POY Award please forward a brief letter or email outlining why they should be 2015’s Physician of the Year and mail it to 5199 E. Farness Drive, Tucson, AZ 85712 or email to Executive Director Bill Fearneyhough at billf5199@gmail.com. For more information call Bill at 795-7985.

AMB UPDATE:  Eighteen months after the initial Arizona Ombudsman-Citizens' Aide report that launched a firestorm surrounding practices at the Arizona Medical Board, the Arizona Auditor General has now issued its own report. The medical board has already responded to the Auditor General findings by revising applications, updating a licensing manual, and developing additional policies and procedures. The backlog of new licenses was a serious issue on which the Arizona Medical Association, PCMS, and MCMS advocated to correct through passage of SB1149, which eliminated background checks for currently licensed physicians, and which appropriated funds to reimburse physicians who had already paid the $50 fee for fingerprinting on their license renewals. The signing into law last week of SB1258, the follow-up bill to resolve the AMB's licensing backlog, gives the AMB emergency rulemaking authority to clean up some outdated regulations. It is our belief that these bills will remove all known roadblocks to normal credentialing.

PRACTICES PENALIZED UNDER NEW MEDICARE QUALITY METRICS:  The government's new quality of care payment system that will soon apply to all physicians who accept Medicare has dealt an unpleasant surprise for many practices. The quality metrics used to judge physicians vary by specialty. There are 250 quality measures, of which groups and physicians must report a selection of their choice, generally nine different measures - or else be automatically penalized. This year, 319 large medical groups are having their reimbursements reduced by 1% because they did not meet Medicare's reporting standards. According to Medicare, out of 1,010 large physician groups that the government evaluated, just 14 are getting payment increases this year. Within three years, the Obama administration wants quality of care to be considered in allocating nine of every 10 dollars.

ADHS HEALTH NOTICE:   Along with tick season, Rocky Mountain spotted fever (RMSF) season has begun. There have already been six cases of RMSF in Arizona this year. RMSF is difficult to clinically diagnose in Arizona. Cases here present NEITHER classically NOR consistently, and patients often lack a rash or history of a tick bite. Unfortunately, without immediate treatment, RMSF can have fatal outcomes. Empiric treatment with DOXYCYCLINE MUST NOT BE DELAYED for patients with febrile illnesses or sepsis that live on or have visited tribal lands. Children, in particular, have good outcomes with early doxycycline, and have not been shown to have teeth staining from this treatment dose and indication. All suspected cases of RMSF must be reported to public health: www.azdhs.gov/phs/oids/contacts.htm#L. More information on RMSF is available at www.azdhs.gov/phs/oids/vector/rocky-mountain-spotted-fever/, www.cdc.gov/rmsf, or www.cdc.gov/rmsf/doxycycline/index.html.

PCMS MEMBER APPOINTED TO AMB: Gary Figge MD, an emergency physician at Northwest Medical Center, won Senate confirmation to the Arizona Medical Board last week. He joins fellow PCMS and AMB member R. Screven Farmer.

AMB APPOINTS NEW EXEC DIRECTOR:  The Arizona Medical Board has appointed Patricia McSorley as executive director. Ms. McSorley has been employed by the Arizona Medical Board since 2005. For more than eight years, she managed the Investigations Department. On two occasions, she has been asked by the Board, and has served, as the Acting Interim Executive Director. Ms. McSorley holds a Juris Doctorate from Brooklyn Law School. Previously, she served as the Assistant Commissioner for the Bureau of Investigations and Trials with the New York City Fire Department. On February 26, the Board's Executive Director Committee appointed her as the Executive Director of the Arizona Medical Board and the Arizona Regulatory Board of Physician Assistants.

SCOTUS SETS TROUBLING PRECENDENT:  In the case of North Carolina Board of Dental Examiners v. Federal Trade Commission, the U.S. Supreme Court ruled that the dental regulatory board illegally suppressed competition when it issued an edict against non-dentists offering teeth-whitening services. In effect, the ruling sets a precedent that state boards can be sued for antitrust. As it is common practice for regulatory boards to consist mostly of members of the profession, the case was of interest to physicians. The American Medical Association (AMA) had filed an amicus brief in support of North Carolina Board of Dental Examiners. There are serious concerns that this ruling could blur the line on determining whether certain medical procedures might be inappropriately undertaken by non-physicians, as dissent from the regulatory board of professionals can now be interpreted as an antitrust issue rather than a patient safety issue. The Arizona Medical Board has 12 members; it requires that four be non-physicians, one of which must be a licensed practical or professional nurse. The implications of this case for Arizona are both unclear and of concern.

CDC RECOGNIZES ARIZONA DESIGNATED EBOLA CENTER:  This week, the Centers for Disease Control and Prevention (CDC) identified Maricopa Integrated Health System and University of Arizona Health Network as two of the 55 Ebola Treatment Centers in the United States. These two systems had already been designated Infectious Disease Treatment Centers of Excellence by the Governor's Council on Infectious Disease Preparedness and Response in fall of 2014. The Council was formed in response to concerns during the Ebola outbreak of 2014. CDC has posted a brand new list of all designated facilities and determined, because more than 80% of returning travelers from West Africa are within 200 miles from a designated treatment center, they will no longer be adding additional centers to their list. The plan and support from the Council allowed the Arizona facilities to be visited early by the CDC Rapid Ebola Preparedness Team and meet the requirements under a very short time period.

ARIZONA ADHS / VACCINE NEWS: ADHS Immunization Program Office released the latest edition of Arizona Vaccine News today. The publication provides an overview of vaccine news, new literature and resources. This edition covers topics in pertussis, measles and influenza, and recommendations for pneumococcal immunization of patients over 65 years of age, as well as CMS policy on Medicare payments. The edition also includes information on the efficacy of a new dengue vaccine.  

CMS SHIFTING MEDICARE PAYMENT MODELS: The Department of Health and Human Services (HHS) has announced goals and timelines for Medicare related to quality and the use of alternative methods of healthcare delivery. By 2016, HHS intends that 30 percent of Medicare fee-for-service payments will tie to alternative payment models, such as Accountable Care Organizations (ACOs) and bundled payments, and 85 percent will be based on quality. These percentages will increase to 50% and 90%, respectively, by 2018. The HHS goals are intended to increase value and promote care coordination across the healthcare continuum by focusing on three areas:

  • Payment incentives - rewarding value and care coordination, rather than volume and duplication of care
  • Care delivery improvement and innovation - supporting providers to find ways to coordinate and integrate care with an emphasis on prevention and wellness
  • Sharing information - creating more transparency on cost and the quality of health care; using electronic health information to inform care; and having the most recent scientific evidence available to help providers in clinical decision making.

HHS plans to work with state Medicaid agencies, private payers, providers, and others to expand alternative payment models into their programs. For additional information, visit the HHS website.

ADHS RELEASES OPIOID PRESCRIBING GUIDLEINES:  The Division of Public Health Services at the Arizona Department of Health Services has released the final version of the state’s Opioid Prescribing Guidelines.  They are the result of input and expertise of practitioners from across the state representing professional associations, health plans, academic institutions, federal health care providers and others.

The objective of the guidelines is to balance the appropriate treatment of pain with approaches to more safely prescribe opioids and complements other statewide “best practice” guidelines for Emergency Department Controlled Substance Prescribing and Dispensing Controlled Substances.

An important next step to encourage use of the Arizona Opioid Prescribing Guidelines is training that will help prescribers implement Arizona’s guidelines.  The University of Arizona is in the process of putting together free, online training that is expected to be available in January.  We will notify you when the training is available.

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.