NWAO Fall Newsletter
October 11, 2011
Don’t Forget to Register!
Fall Dinner Meeting - Fascinating Cases in Otolaryngology
Friday, October 14, 2011
Seattle Tennis Club
Register Here
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NWAO Winter Conference - Brochure Coming Soon
This year’s Winter Conference is fast approaching. Make sure your calendar is marked for January 6-7, 2012. Look for your registration brochure to arrive by the end of this month. We are looking forward to seeing you in Seattle for another great meeting!
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AAO Joins AMA in Opposition to MedPAC Recommended Cuts to Specialist Payment
In September, the Medicare Payment Advisory Commission (MedPAC) recommended cutting specialist pay for three years and freezing it for another seven in a proposal to replace the Sustainable Growth Rate (SGR) formula. The Academy signed onto a letter from the American Medical Association (AMA) opposing this proposal and asking for MedPAC to consider other approaches to repeal and replace the SGR.
More
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Medicare Update – Please Act Today
We urge you to contact Senator Patty Murray, co-chair of the Joint Select Committee charged with making its deficit reduction recommendations to Congress in November, urging its inclusion of a SGR solution. Please visit the following links for details:
Repeal of the SGR must be part of the committee's legislative package. Please take a few moments to respond to this issue, ask your staff and patients to do so as well.
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Questions About WA State’s New Pain Rules?
The WSMA Department of Legal Affairs has prepared a detailed question and answer summary of the new MQAC rules [PDF] for the management of chronic non-cancer pain. This summary discusses questions such as:
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Do the pain rules apply to me and my practice?
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What is chronic non-cancer pain?
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What does "MED" mean?
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Do I have to take CME in order to treat patients with chronic non-cancer pain?
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What must I do before treating a patient with chronic non-cancer pain?
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And many more...
The summary does not substitute for reading the rules and familiarizing yourself with the requirements. But the summary presents the most important information in a way that is easy to read and allows physicians to quickly identify topics of interest. To accompany the summary, a copy of the pain rules [PDF] (which become effective January 2, 2012) is also available.
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More Health Care Program Cuts on the State’s Horizon
The Health Care Authority (HCA) submitted its proposed 5 percent and 10 percent budget cuts to the Office of Financial Management last week. Included: termination of the Basic Health Plan (BHP), an Apple Health for Kids program that covers immigrant children, and the Disability Lifeline program, which covers temporarily disabled people who can’t qualify for Medicaid.
Due to the fact that most of Medicaid’s coverage is mandated by federal law, the HCA’s list is not really an across-the-board cut, rather a combination of state-only-funded programs and optional Medicaid programs. The 10 percent reduction target totals $446 million; the 5 percent reduction totals $223 million.
The agency reports it would be short an estimated $127 million (to make the 10% cut target) and would have to suspend its adult prescription drug benefit for up to 18 months to cover that shortfall. The pharmacy cut would impact about 500,000 adults — mostly seniors and people with disabilities among Medicaid’s 1.2 million clients.
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Medicare E-Prescribing: November 1 Exemption Deadline
Physicians have until November 1 to apply for an exemption and avoid financial penalties for failing to comply with Medicare's ePrescribing requirements. Physicians who are unclear about whether they met the program's requirements in the first six months of 2011 should review the allowed exemptions carefully and submit an online application for each of the exemption categories for which they qualify as soon as possible. Under the ePrescribing rule, physicians are required to have issued and reported at least 10 electronic scripts (e-scripts)
by June 30 to avoid being penalized. The penalty reduces all their Medicare Part B claims paid under the 2012 fee schedule by 1 percent. For details, go to www.cms.gov/ERxIncentive/.
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CMS Publishes ICD-10 Transition Guide
CMS has issued a seven-page guide [PDF] to help health care providers transition to new ICD-10 code sets. The guide provides information on how to handle claims for services that span the transition dates between when ICD-9 and ICD-10 codes are applicable, and rules requiring the use of most specific diagnostic codes possible based on available information.
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Medicaid to Require Online Authorization Process for Advanced Imaging October 1
Physician practices that order certain advanced imaging studies will need to obtain online authorizations for those tests performed as of October 1. Review Medicaid Memo 11-50: Prior Authorization Requirements for Outpatient Advanced Imaging. Physicians will need to be registered with OneHealthPort in order to perform the online authorization with Qualis Health. Instructions are available online
; see also the training manual on the Qualis Health website.
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