NWAO Winter Newsletter

January 3, 2012

Don't forget to Register!

NWAO Winter Conference, January 6-7, 2012
Bell Harbor International Conference Center, Seattle, WA
Register Online
Meeting Schedule

back to top

Pay Your 2012 Membership Dues

The NWAO Board of Directors would like to invite you to renew your membership in the Northwest Academy of Otolaryngology. The Northwest Academy of Otolaryngology plays an essential role in the local medical community by providing a variety of programs and services. 

What NWAO Brings To You:

• Reduced registration for our annual winter CME program
• Collegiality through educational, political and social gatherings, including our biannual dinner meetings each spring and fall
• e-Newsletter focusing on timely local, regional or national health issues affecting your practice
• Student support through scholarships, leadership development, and reduced CME fees
• Patient & physician advocacy through relationships with the state legislators and the WSMA
• Resources for general information relating to medical practice
• Interactive website with extensive membership benefits  including:
• online membership directory (www.nwao.org, Log in: nwao, Password: Ents1)
• calendar of events
• positions available

Pay your dues online now!

back to top

Medicare Pay Cut Averted; Two-Month Patch

On December 23, President Obama signed the “Temporary Payroll Tax Cut Continuation Act of 2011” which includes a two-month delay of the 27.4 percent SGR Medicare physician payment cut scheduled for Jan. 1. The rationale for the short-term extension is to avoid disruptions on Jan. 1 and provide time for further negotiations on a larger legislative package.

Notwithstanding this short-term effort to avert the 27.4 percent cut, the AMA along with all specialty medical associations will continue to advocate for Congress to repeal the SGR and eliminate the uncertainty this policy creates for physician practices.

back to top

CMS Says You Can Have More Time to Decide About Medicare Participation

In a prescient move – CMS, anticipating Congressional action to avert the negative update for the 2012 Medicare Physician Fee Schedule (if only for two months) – announced that it has extended its 2012 Annual Participation Enrollment Period through February 14, 2012.

Interestingly, the effective date for any participation status change during the extension, however, remains January 1, 2012, and will be in force for the entire year.  No word on what happens to claims filed between January 1 and a physician’s decision to no longer participate in the program later in the month or before February 14.

Medicare contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are post-marked on or before February 14, 2012.

Review the Medicare Participation Kit:  www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/medicare/medicare-participation-guide

back to top

Initial list of Pioneer ACOs Announced

Last week CMS announced that 32 organizations (PDF) have been selected to participate in the Pioneer ACO Model. The first performance period will begin on January 1, 2012 for three calendar years. None are from Washington State. Whether any applied and were denied is not known.

The Pioneer ACO Model is designed for health care organizations and providers already experienced in coordinating care for patients across care settings. Reports CMS, it will allow these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with, but separate from, the Medicare Shared Savings Program (the quality measures specified in the Medicare Shared Savings Program will also apply to the Pioneer ACO Model). And, it is designed to work in coordination with private payers by aligning provider incentives, to gain cost savings for Medicare, employers and patients. Providers cannot be a part of an ACO under the Pioneer ACO Model and the Shared Savings Program concurrently.

back to top

CMS Will Not Provide 2012 eRx Payment Adjustment Feedback Reports

Due to receiving an overwhelming number of hardship exemption requests, CMS has announced that it is not technically feasible to provide 2012 Electronic Prescribing Incentive Program payment adjustment feedback reports to providers as originally intended. Instead, CMS encourages providers to review their remittance advices for claims submitted for dates of services on or after Jan. 1, 2012 to determine if they have received a payment adjustment. For more information, please see the CMS announcement.

back to top

CMS Rule Would Make Gifts to Docs Transparent

The Physician Payment Sunshine Act, proposed by the Centers for Medicare & Medicaid Services, targets gifts and is designed to reveal potential conflicts of interest between drug and medical device companies and providers.

Full Article: http://www.healthleadersmedia.com/content/PHY-274345/CMS-Rule-Would-Make-Drug-Device-Makers-Payments-to-Docs-Transparent

back to top

AAO Releases CPT Code Updates for 2012

The Academy has put together a list of current procedural terminology (CPT) code changes for 2012 applicable to otolaryngology. To see the list, click here (login required).

back to top

AAO-HNS/F Committee 2012 Application Cycle Now Open!

Get more involved with the AAO by applying to become a committee member! You can join an education committee to be involved in the Academy's education activities, the Board of Governors (BOG) committee to become more involved in the grassroots arm of the Academy, or one of our Academy or Foundation committees that fits your area of expertise. Apply now!

back to top

Washington State Report: Special Legislative Session Adjourns

The 17-day special session concluded December 14, 2011 with medicine coming out relatively unscathed—in large part due to the fact the legislature chose to leave most of the tough budget decisions until January. What was agreed upon by a bipartisan majority was approximately $480 million in what have been characterized as mostly administrative cuts. The chairman of Senate Ways & Means Committee informed WSMA that this was simply a down payment on addressing the state's approximately $2 billion budget gap and that come January all health care cuts remain on the table (BHP, disability lifeline, interpreter services, critical access hospitals, public health, etc.).

Though the debate during the special session was helpful, the legislature has much to do when they return on January 9th. There will be a push to come to agreement on a tax/revenue package that they can bring to the voters to help limit the impact of what would be an all-cuts-budget hitting health care, education and corrections disproportionally hard. If they can come to an agreement on a new taxes/revenues package in time to limit some of those cuts, and if the public will approve the package, only time will tell.

As for policy bills—the WSMA was successful in keeping the Medicaid fraud expansion bill with its problematic "qui tam" provisions in the Senate Health Care Committee. We were also successful stopping a bill that would have increased your licensure fees in order to fund the state's Prescription Monitoring Program. The WSMA was instrumental in getting the PMP enacted into statute. However, we don’t support an increase in physicians’, or anyone else’s, licensing fees as the funding source. The WSMA remains committed to working with the state and other interested stakeholders in finding an appropriate funding source for the program.

Interpreter program continues for now. While the governor’s budget includes termination of the interpreter program, the special session ended without action on the program and the legislature has not yet indicated it will agree with the proposed termination of funding. So, at the moment, the Health Care Authority is not expecting the program to end on January 1 and the HCA reports it is negotiating another extension of the previous interpreter broker contracts.

back to top

MQAC Pain Rules Go Into Effect Today – Are You Ready?

The MQAC rules for the management of chronic non-cancer pain go into effect today, January 2. The goal: reduce the high number of opioid-related deaths in Washington State. The enabling legislation, HB 2876, required the MQAC (and other commissions/boards for other health care professionals with prescribing authority) to establish a dosage amount that must not be exceeded unless the physician first consults with a pain management specialist – unless there were exigent or special circumstances present, or the physician was exempt from the consultation requirement. The law also called for guidance on when to seek consultation, tracking clinical progress, and tracking the use of opioids. 

As we know, the commission instead drafted rules which read like mandates – you “shall” do this and you “shall” do that, despite repeated remonstrations and alternate suggestions by the WSMA and the WAFP. MQAC has repeatedly said the new rules are guidelines, but until the mandatory language in the rules is changed, that will be a question still up for debate.

If you have questions or are unfamiliar with the new rules, review the detailed summary. You can also download this question and answer summary [PDF].

back to top