MLMIC Updates FAQs With Latest on Berkshire Hathaway Transaction
https://www.mlmic.com/blog/physicians/latest-info-berkshire-hathaway-transaction/
Open Access, located at 1350 University Ave in Rochester, officially opened yesterday with a ribbon cutting ceremony. Open Access began in August with limited hours, hours have since been expanded to seven days a week from 4-10pm. By next year Open Access will be staffed 24/7.
This first of its kind collaborative staffing model will provide an immediate evaluation for individuals walking in with a Substance Use Disorder determining their appropriate level of care. Staff will then identify the first available treatment slot and assist with any insurance or transportation barriers. The goal is to get more rapid access to treatment services.
Patients can walk in during open hours or call Open Access at (585) 627-1777.
Physicians can provide patients with a copy of the Monroe County Opioid Task Force Resource Brochure, they can encourage their patients to seek help through Open Access if patient is in need of immediate treatment. The physician can also share both treatment resources via NCADD-RA’s Monroe County Treatment Provider listing and recovery resources via NCADD-RA’s Recovery Services in Monroe County. All resources may be downloaded from the NCADD-RA website at: https://ncadd-ra.org/news-resources/resources-advocacy-research .
The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.
You will be notified in November when registration opens for Board-authorized medical providers. Authorized providers are asked to register with the Board and update their office address(es) and contact information by December 29, 2017. This registration process will be an ongoing initiative every two to three years.
Medical providers who have not registered by December 29, 2017 will:
The Board will use the existing New York State Health Commerce System (HCS) for this registration process. For the initial registration and for future updates to your practice information, you will need to have an HCS account. If you don’t already have one, you can view directions to create an account on the New York State Department of Health website.
Need Help?
If you are not sure if you already have an HCS account, contact the Commerce Account Management unit (CAMU) at (866) 529-1890 and select option 1. For general questions about health care provider registration, please contact the Board’s Customer Support at (844) 337-6305.
MCMS invites nominations for its 2018 Edward Mott Moore Awards. This highest honor bestowed annually by the Medical Society is given to both a physician and a layperson in recognition of outstanding and dedicated service to the medical profession and the community. Please see attached nomination form for details. Deadline for nominations is December 29, 2017.
2018 Edward Mott Moore Nomination Form.pdf
This past week, MSSNY staff joined representatives of the New York State Radiological Society to meet with the New York Department of Financial Services to express strong concerns with Anthem’s new policy imposing new prior authorization requirements as a precondition of patients receiving hospital-based imaging services. In particular,
MSSNY expressed concerns regarding the additional administrative hassles imposed on referring physicians seeking to assure their patients can receive needed MRIs or CTs in a timely manner. Moreover, concerns were expressed regarding the likely continuity of care issues for some patients, as well as the fact that such additional criteria for accessing these services of particular radiologists may not be clearly identified when a patient is looking at which physicians participate in a particular health insurer’s network.
To aid in its investigation, DFS representatives asked MSSNY and NYSRS for examples of instances where patients have been unable to receive the care they need, or have had their care unduly delayed, as a result of this new prior authorization requirement. Please contact rmcnally@mssny.org if you would like to share your story.
Similar prior authorization requirements have been imposed in other states by Anthem. As a result, the American Medical Association EVP Dr. James Madara wrote a letter to Anthem EVP Dr. Craig Samitt urging Anthem to reconsider this policy given the “potential adverse impact on patients’ timely access to medically necessary care”, and concerns that the “new policy interferes with the patient-physician relationship and may disrupt ongoing care coordination”.
2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their practice’s 2018 Value Modifier payment adjustment. The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule (https://federalregister.gov/d/2017-14639). If the policies are not finalized as proposed, CMS will provide an update to report recipients.
Access and review your 2016 PQRS feedback report and 2016 Annual QRUR now to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment.
If you believe your payment adjustment status was made in error, you may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period from now until 8:00 pm Eastern Time (ET) on December 1, 2017.
· 2016 PQRS: 2018 Downward Payment Adjustment - Informal Review Made Simple Guide
· 2018 Value Modifier Informal Review Request Quick Reference Guide
An Enterprise Identify Management (EIDM) account with the appropriate role is required for participants to obtain their 2016 PQRS Feedback Reports and 2016 Annual QRURs. Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.
To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An EIDM account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.
For more information on your PQRS feedback report:
· Analysis and Payment webpage
· 2016 PQRS Feedback Report User Guide
For more information on your Annual QRUR:
· 2016 QRUR and 2018 Value Modifier webpage
For the 2016 reporting period, the majority of eligible professionals (EPs) successfully reported to PQRS and avoided the downward payment adjustment. CMS anticipates that successful trend to continue under the new Quality Payment Program. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for EPs. The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.
Questions:
· For assistance with Enterprise Identity Management or PQRS feedback reports, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715- 6222) orqnetsupport@hcqis.org.
· For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).
2017 Influenza Vaccine Status Form
On Thursday, October 26, 2017, at 2:00pm ET/1:00pm CT, a Centers for Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) call titled, “Primary Care Providers’ Role in Supporting Children, Families, and Professional Self-Care Following Hurricanes and Other Disasters”, will take place. During this COCA Call, clinicians will learn to identify common adjustment difficulties in children, practical strategies to promote effective coping skills in children and their parents, and the importance of professional self-care and strategies to address this need.
Please consider sharing information about this webinar on your electronic mailing lists. Additional information can be found below:
Title: Primary Care Providers’ Role in Supporting Children, Families, and Professional Self-Care Following Hurricanes and Other Disasters
Date: Thursday, October 26, 2017 Time: 2:00-3:00 pm (Eastern Time)
Call Access Information Coming Soon!
Additional Webinar Information: https://emergency.cdc.gov/coca/calls/2017/callinfo_102617.asp
Overview
Primary care providers are essential for promoting children’s mental health and well-being throughout the recovery process following hurricanes. Disasters such as Hurricanes Harvey, Irma and Maria can cause short and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. Additionally, disasters often impact healthcare providers to at least the same degree they impact others in the community, and being with suffering children and families can be distressing for providers. During this COCA Call, clinicians will learn to identify common adjustment difficulties in children, practical strategies to promote effective coping skills in children and their parents, and the importance of professional self-care and strategies to address this need.
Objectives
At the conclusion of the session, the participant will be able to accomplish the following:
Presenters
Robin H. Gurwitch, Ph.D Professor, Center for Child and Family Health Duke University Medical Center
Fall 2017 issue of MLMIC’s Dateline® newsletter
Published twice a year (spring and fall), Dateline® focuses on risk management issues and improving patient safety, as well as keeping MLMIC policyholders apprised of changes in underwriting procedures, legal matters, legislative affairs, and many other matters of interest to physicians and healthcare facilities.
Some of the highlights of the Fall 2017 Dateline® are:
Use of Unlicensed Medical Assistants in the Physician’s Office A significant number of physicians inappropriately use medical assistants or other unlicensed staff to assist in treating their patients in clinical settings and private offices and are unaware of the dangers of doing so. Case Study: Dermatologist Sued for Employee’s Negligent Laser Treatment Vicariously liable for the acts of his employees, it was determined that settlement on behalf of the insured dermatologist was in order. Social Media: Responding to Unflattering Online Reviews Used for social networking, professional networking, media sharing, blogging, and research and information gathering, the number of patients and healthcare professionals using social media has exploded in recent years. Risk Management Tip #22 The Proper Use of Patient Portals.
Use of Unlicensed Medical Assistants in the Physician’s Office A significant number of physicians inappropriately use medical assistants or other unlicensed staff to assist in treating their patients in clinical settings and private offices and are unaware of the dangers of doing so. Case Study: Dermatologist Sued for Employee’s Negligent Laser Treatment Vicariously liable for the acts of his employees, it was determined that settlement on behalf of the insured dermatologist was in order. Social Media: Responding to Unflattering Online Reviews Used for social networking, professional networking, media sharing, blogging, and research and information gathering, the number of patients and healthcare professionals using social media has exploded in recent years. Risk Management Tip #22 The Proper Use of Patient Portals
Support our next generation of physicians on Oct 25 at the MCMS Scholarship Fund's Silent Auction Fundraiser. Contact us for tickets! See Flyer.
