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wsma_reports_yakima_pediatrician_wants_to_make_her_city_the_healthiest_in_the_nationWSMA Reports: Yakima pediatrician wants to make her city the healthiest in the nationLatest_NewsShared_Content/News/Reports/2018/wsma_reports_yakima_pediatrician_wants_to_make_her_city_the_healthiest_in_the_nation<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/WSMA-Reports-Website-Graphic_645px.jpg" class="pull-right" /></div> <h5>September 24, 2018</h5> <h2>Yakima pediatrician wants to make her city the healthiest in the nation </h2> <p> BY KATIE HOWARD </p> <p> <em>The following Doctors Making a Difference column was featured in the September/October issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em> </p> <p> Yakima County is the jewel in Washington state's agricultural crown, as the leader in production of apples, cherries and pears, and as the country's top producer of hops. Pediatrician Yami Cazorla-Lancaster, DO, aims to make it No. 1 in something else: wellness. </p> <p> Yakima County often falls toward the bottom of the list of statistics on overall health of its population, with high rates of obesity, diabetes and mental health challenges, but Dr. Cazorla-Lancaster has a vision for the region's potential. Through her pediatrics practice, Nourish Health; interactive online courses via her Veggie Fit Kids program; and efforts to bring the Blue Zones Project to Yakima County, she is working to improve the health of children and adults across the region. </p> <p> The Blue Zones Project refers to "zones" of the world, such as Okinawa, Japan, and Sardinia, Italy, whose residents have been found to live the longest. The project partners with communities around the country to improve health by making changes to local policies and infrastructure that encourage healthier eating, higher rates of exercise and greater community involvement. If the county proceeds with implementation, it would be Washington's first designated Blue Zone. </p> <p> Dr. Cazorla-Lancaster talked to WSMA Reports about her approach to wellness and how the Blue Zones Project could jumpstart the region's transformation. </p> <p> <strong>In your pediatrics practice, you focus on overall wellness. What do you view as the components of that and how do you implement them in your approach to caring for kids?</strong> </p> <p> I believe that all children deserve the opportunity to live their very best lives and to live long, healthy and joyful lives. I know that the only way to achieve this is to focus on wellness, not sickness. First and foremost is the importance of nutrition, specifically eating more fruits, vegetables, whole grains, beans, and nuts and seeds. </p> <p> Although I am a primary care pediatrician and routinely encounter the typical childhood infections and medical problems, I am deliberate about discussing nutrition, sleep, joyful movement, and stress as often as possible. I live and breathe lifestyle medicine. I spend the most time discussing these topics during routine checkups, but sneak it in at any opportunity. </p> <p> I also take my passion online by creating content for Veggie Fit Kids via Facebook, YouTube and Instagram and am always quick to accept opportunities to talk to media or speak publicly about the principles of health. I want my families to feel that it is realistic and achievable for them to practice healthy lifestyle habits in our modern culture. By showing them what is possible, I can empower and inspire parents to adopt healthy habits for themselves and their families. </p> <p> <strong>Do you see an opportunity for your approach to be implemented on a larger scale in Washington? </strong> </p> <p> Yes, anybody can practice this way. They just have to find the routine and method that works for them. You develop your practice style like any other habit. You have to become deliberate about discussing these foundational principles that will help keep children healthy and happy for decades and could potentially help reverse chronic disease in adults. </p> <p> <strong>Tell us about the Blue Zones Project and why you think Yakima is a good candidate for it.</strong> </p> <p> I see Yakima as a hidden gem in the Pacific Northwest. Like a diamond in the rough, we have all the raw materials needed to become a thriving locus of health and well-being: plenty of sunshine, a plethora of produce, access to outdoor activities, and a growing desire for change. </p> <p> What we lack is the belief that we can become an epicenter of health and wellness and the organizational structure to get us there. The Blue Zones Project is described as "a community well-being improvement initiative designed to make healthy choices easier through permanent changes to environment, policy, and social networks, which ultimately promotes change in daily healthy habits so that everyone can live longer, feel better and be happier." It is currently active in 10 states and 43 communities and the outcomes have been outstanding. </p> <p> <strong>What kinds of programs or resources would Blue Zones bring to Yakima? </strong> </p> <p> The Blue Zones Project is specifically tailored to the needs and desires of each community, but the overall goal is to make the healthy choice the "easy" choice by changing the environment around community members. We know that people spend most of their time within a five- to 10-mile radius, which they call the "life radius." </p> <p> Although we spend a lot of time at home, we spend most our time at work, school, and other places around the community. Increasing the opportunity for healthy choices outside of the home nudges people into wellness. </p> <p> It would include things like optimizing city streets to improve walkability, working with grocery stores and restaurants to increase healthy offerings, working with schools, and engaging individuals with purpose workshops and connecting them with volunteer opportunities. </p> <p> They also help communities affect public policies. The great news is that the Blue Zones Project has seen great success so far. In the beach cities, the incidence of childhood obesity is now down 78 percent since the start of the project. This is incredibly powerful. </p> <p> <strong>What outcomes would you hope to see at the completion of the project? What would make it a success in your perspective?</strong> </p> <p> I like to dream big because why not? I would love for Yakima to become the healthiest city in the United States! I would love to see the prevalence of obesity and diabetes drop significantly, see an increase number of our community members walking and biking, eating more fruits and vegetables and our overall well-being index increase. I know it is possible and I know that we can do it. But I think the greatest success would be for Yakima to blossom into her true potential. </p> <p> <strong>What can physicians in other communities do to promote healthier lifestyles? </strong> </p> <p> Lead by example first and foremost. When you take care of yourself by nourishing your body with vibrant and health-promoting foods, make it a point to move joyfully, get plenty of sleep and decrease your stress, your own light shines brighter. You then begin to inspire and empower others. </p> <p> Learn how to bring more joy and wellness into your own life and you will see how those around you will believe that it is possible for them, too. The amount of influence you have as a health professional is more powerful than you realize, and you can affect your patients' lives just by being healthy and joyful yourself. </p> <p> <em>Katie Howard is WSMA's social media and content specialist.</em> </p> </div>9/24/2018 12:00:00 AM1/1/0001 12:00:00 AM
Practice_Alerts_September_20_2018Practice Alerts: September 20, 2018Latest_NewsShared_Content/News/Practice_Alerts/Practice_Alerts_September_20_2018<div class="col-md-12"> <div class="col-md-5 pull-right"><img alt="Practice Alerts logo" src="/images/Logos/Practice-Alerts-ArticleImage-Tagline_645x425.jpg" class="pull-right" /></div> <h5> September 20, 2018 </h5> <h2>Practice Alerts</h2> <p> In this issue, you'll find information on new Medicare payment codes for flu vaccines, education on value-based payment models and much more. </p> <p> For personal assistance, contact the <a href="https://wsma.org/WSMA/Services/Physician_Practice_Helpline/WSMA/Services/Physician_Practice_Helpline/Physician_Practice_Helpline.aspx?hkey=fc908a57-5820-41dc-8a1f-e2a7b1498e3b">WSMA Physician Practice Helpline</a> by emailing Bob Perna, MBA, FACMPE, at <a href="mailto:rjp@wsma.org">rjp@wsma.org</a> or Michelle Lott, CPC, CPMA at <a href="mailto:mml@wsma.org">mml@wsma.org</a>. </p> <p> To receive an email notification when a new issue of Practice Alerts is published, <a href="mailto:mml@wsma.org?subject=Subscribe%20to%20Practice%20Alerts">email Michelle Lott</a>. </p> <p>Jump to section:</p> <p> <a href="#help"> WSMA Physician Practice Helpline</a> </p> <p> <a href="#healthierwa"> State Agencies – Healthier Washington </a> </p> <p> <a href="#hca"> State Agencies – Health Care Authority </a> </p> <p> <a href="#coding"> Coding: Evaluation / Management Reform </a> </p> <p> <a href="#clinical"> Clinical Issues</a> </p> <p> <a href="#value"> Value-based Payment </a> </p> <p> <a href="#tricare"> TRICARE </a> </p> <p> <a href="#medicare"> Medicare</a> </p> <p> <a href="#qpp"> Medicare / MACRA Quality Payment Program / MIPS</a> </p> <a name="help"></a> <h3> <span style="color: #4bacc6;">WSMA PHYSICIAN PRACTICE HELPLINE (formerly the WSMA Coding Hotline) </span> </h3> <p><strong>– Michelle Lott, CPC, CPMA </strong>(<a href="mailto:mml@wsma.org">mml@wsma.org</a>)</p> <h3>New! Updated payment amounts and new influenza vaccine code</h3> <p>The Centers for Medicare & Medicaid Services has released information to Medicare administrative contractors (MACs) about payment allowances for influenza virus vaccines, which are updated on Aug. 1 of each year. The new amounts are <a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/VaccinesPricing.html">posted online</a>, and practices should make sure their billing staffs are aware that the payment allowances are being updated.</p> <p>Payment allowances for products not yet approved will be provided upon approval and once pricing information becomes available to CMS. MACs will reprocess any previously paid claims for the current flu season that were paid using allowances other those published in the influenza vaccine pricing website for the 2018-19 season that began on Aug. 1. This reprocessing should occur by Nov. 1, 2018.</p> <p>Effective for claims processed with dates of service (DOS) on or after Jan. 1, 2019, influenza virus vaccine code 90689 (influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25mL dosage, for intramuscular use) will be payable by Medicare.</p> <p>This new code will be included on the 2019 Medicare physician fee schedule database file update and the annual Healthcare Common Procedure Coding System (HCPCS) update. The new influenza virus vaccine code 90689 is not retroactive to Aug. 1, 2018. No claims should be accepted for influenza virus vaccine code 90689 between the DOS Aug. 1, 2018, and Dec. 31, 2018. If claims are received in Jan. 2019 with code 90689 for DOS between Aug. 1, 2018, and Dec. 31, 2018, MACs will follow their normal course of action for codes billed prior to their effective date.</p> <h3>Payment, coding or other practice issues? Let the WSMA help </h3> <p>WSMA's staff experts understand the unique challenges of medical practices. For your practice to succeed, your services need to translate into revenue. From simple to complex issues, we have the know-how, connections and expertise to help make that happen.</p> <h4>Physician Practice Helpline</h4> <p>The WSMA <a href="https://wsma.org/WSMA/Services/Physician_Practice_Helpline/WSMA/Services/Physician_Practice_Helpline/Physician_Practice_Helpline.aspx?hkey=fc908a57-5820-41dc-8a1f-e2a7b1498e3b">Physician Practice Helpline</a> is now available to help your practice run more efficiently while avoiding errors and ensuring that you receive accurate and appropriate payments. The helpline provides advisory services to resolve payment, coding or practice management issues.</p> <p>The helpline is a free service to WSMA member physicians and their practice staff. Get help today: Contact Michelle M. Lott, CPC, CPMA, at 206.441.9762, 800.552.0612 or <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <h4>Chart Review Service</h4> <p>For direct assistance on issues related to coding and documentation, use WSMA's <a href="https://wsma.org/WSMA/Services/Chart_Review_Service/WSMA/Services/Chart_Review_Service/Chart_Review_Service.aspx?hkey=871ad332-db71-42b0-abca-1cebfa3e724f">Chart Review Service</a>. This service provides expert review, recommendations and preventive post-review education to improve your coding and chart documentation; protect you against allegations of coding errors and inappropriate payments; and help you avoid costly refunds of payments received. As a component of your practice's compliance program, this service detects, corrects and ultimately prevents errors by helping you achieve significant improvement in your coding and documentation activities.</p> <p>For more information, contact Michelle M. Lott, CPC, CPMA, WSMA's health insurance coding specialist at 206.441.9762, 800.552.0612 or <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <a name="healthierwa"></a> <h3> <span style="color: #4bacc6;">STATE AGENCIES – HEALTHIER WASHINGTON</span> </h3> <h3>Public forums showcase Medicaid Transformation vision, progress, and why it matters</h3> <p>The Health Care Authority is convening public forums, both in-person and via webinar, to update the public about the progress of the Healthier Washington Medicaid Transformation project and provide opportunities for meaningful public comment. At this time, only the webinar date is still available:</p> <p>"Transforming Medicaid: Why it matters to all of us":</p> <ul> <li>Thursday, Oct. 11 webinar: noon to 1:30 p.m. <a href="https://register.gotowebinar.com/register/8066955576474714113">Register online</a>.</li> </ul> <a name="hca"></a> <h3> <span style="color: #4bacc6;">STATE AGENCIES – HEALTH CARE AUTHORITY</span> </h3> <h3>Online prior authorization submission now available in ProviderOne</h3> <p>The Health Care Authority has completed a system update to <a href="https://www.waproviderone.org/">ProviderOne</a> which allows physicians and other providers to submit prior authorization requests for medical services online.</p> <p>Until now, physicians had to submit requests via fax or paper submission. This update will increase efficiency by allowing physicians to submit direct data entry and include color photos, X-rays and all other required documentation. Physicians and providers may continue to submit requests by fax or mail. Visit HCA's <a href="https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/prior-authorization-pa#step-4-submit-pa">prior authorization webpage</a> for instructions on these processes.</p> <p>Reminder: For medical services covered by individual and small/large group health plans, new requirements are in effect this year streamlining insurer requirements and easing administrative burden. Make sure your practice is making the most of these new requirements by visiting the <a href="http://priorauth.wsma.org/">WSMA Prior Authorization Navigator</a>.</p> <a name="coding"></a> <h3> <span style="color: #4bacc6;">CODING: EVALUATION / MANAGEMENT REFORM</span> </h3> <h3>CMS proposal on E/M codes: WSMA joins with AMA and other organizations</h3> <p>The WSMA joined with the AMA and about 170 other medical organizations, signing onto <a href="https://www.ama-assn.org/170-groups-send-letter-proposed-changes-physician-payment-rule">a letter to the Centers for Medicare & Medicaid Services</a> that raised concerns about CMS' proposal to substantially revise the current framework of the evaluation and management codes.</p> <p>The proposed changes, contained in CMS' notice of proposed rulemaking for the 2019 Medicare physician payment rule, would collapse payment rates for eight office visit services for new and established patients down to two each. A key concern is that these changes would result in the underpayment of services to physicians who treat the sickest patients.</p> <p>The letter expressed appreciation for CMS' goal of seeking to reduce excessive E/M documentation requirements and urged immediate adoption of these principles:</p> <ol> <li>Changing the required documentation of the patient's history to focus only on the interval history since the previous visit.</li> <li>Eliminating the requirement for physicians to re-document information that has already been documented in the patient's record by practice staff or by the patient.</li> <li>Removing the need to justify providing a home visit instead of an office visit.</li> </ol> <p>To address these concerns, the letter recommended the AMA's creation of a work group of physicians and other health professionals to analyze E/M coding and payment issues, with recommended actions to be presented to CMS in time for implementation in the 2020 Medicare physician fee schedule.</p> <p>For additional background,watch the videos available on the CMS website.</p> <ul> <li><a href="https://www.youtube.com/watch?v=JvoRQfMtPo4&feature=youtu.be">Introduction</a> (3 minutes).</li> <li><a href="https://www.youtube.com/watch?v=B0BZmGYpYFU&feature=youtu.be">Office visits</a> (2 minutes).</li> <li><a href="https://www.youtube.com/watch?v=W2QBTQNxfSY&feature=youtu.be">Panel discussion</a> (22 minutes).</li> </ul> <a name="clinical"></a> <h3> <span style="color: #4bacc6;">CLINICAL ISSUES</span> </h3> <h3>Suicide rates in Washington continue rising: September is Suicide Prevention Month</h3> <p>In 2017, 1,300 Washingtonians died by suicide, and from 2006 to 2017 suicide in Washington state increased by an average of 2.5 percent annually. The national <a href="http://www.bethe1to.com/">#Bethe1to campaign</a> highlights five actions people can take to help prevent suicide:</p> <ol> <li>Be the one to ask.<br /> Ask the tough question. When somebody you know shows warning signs, ask them directly: "Are you thinking about killing yourself?" <a href="http://helpyourselfhelpothers.org/">Take an online screening</a>. </li> <li>Be the one to keep them safe.<br /> Do they have access to medications, firearms or other means of suicide? Ask if they've thought about how they would do it and separate them from anything they could use to hurt themselves. Learn more from <a href="https://depts.washington.edu/saferwa/">Washington's Safer Homes Coalition</a>. </li> <li>Be the one to be there.<br /> People thinking about suicide can feel a burden to their loved ones. If your friend is thinking about suicide, listen to their reasons for feeling hopeless and in pain. Listen with compassion and empathy and without judgement. <a href="https://www.nowmattersnow.org/skill/suicidal-thoughts">Now Matters Now</a> has videos from people who have experienced suicidal thoughts sharing what individuals can do to help manage those thoughts. </li> <li>Be the one to help them connect.<br /> Help your friend connect to a support system so they have a network to reach out to for help, whether it's 800.273.TALK (8255), the crisis text line (text "HEAL" to 741741) family, friends, faith-based leaders, coaches, co-workers, health care professionals or therapists. <a href="https://win211.org/search/">2-1-1's online database</a> is another way to find local resources. </li> <li>Be the one to follow up.<br /> Check in with the person you care about on a regular basis. Contacting a friend in the days and weeks after a crisis can make a difference in keeping them alive. <a href="https://zerosuicide.sprc.org/toolkit/treat/interventions-suicide-risk">Send a caring contact</a>. This could be a phone call, text, email or letter. </li> </ol> <p>If you want to connect with someone anonymously, call the <a href="https://suicidepreventionlifeline.org/chat/">National Suicide Prevention Lifeline</a> at 800.273.8255, <a href="https://suicidepreventionlifeline.org/chat/">chat</a>, or text "HEAL" to 741741 to text with a trained crisis counselor. More information on <a href="https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention">suicide prevention</a> in Washington and the state's <a href="https://www.doh.wa.gov/Portals/1/Documents/Pubs/631-058-SuicidePrevPlan.pdf">Suicide Prevention Plan</a> is online.</p> <a name="value"></a> <h3> <span style="color: #4bacc6;">VALUE-BASED PAYMENT</span> </h3> <h3>Succeeding in Value-Based Payment</h3> <p>The WSMA can help our members and their practice staff succeed with value-based payment models through our three tiers of guidance and services.</p> <h4>Tier 1: Reference materials</h4> <p>For foundational knowledge on value-based payment, review AMA's online module <a href="https://www.stepsforward.org/modules/value-based-care">Preparing Your Practice for Value-Based Care</a>.</p> <h4>Tier 2: Educational programs</h4> <p><a href="https://wsma.org/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx#vbptakeaction">Value-Based Payment, MACRA/MIPS, Healthier Washington – Take Action Now!</a></p> <p>Both Medicare's MACRA Quality Payment Program and the state's Healthier Washington initiatives are built around value-based payment models. This free 45-minute OnDemand webinar, presented by the WSMA and Attune Healthcare Partners, provides an overview of the value-based payment models currently in play and focuses on specific actions to consider.</p> <h4>Tier 3: Practice-specific engagements</h4> <p>The WSMA and Attune Healthcare Partners have partnered to offer practice-specific consulting engagements to our members on value-based transformation strategies.</p> <p>Attune's "5-Step Process" provides a path for practices to optimize earnings and simplify daily operations with a mix of traditional and value-based payment methods. Attune Healthcare Partners are experts in practice success under value-based payment and can help practices create a complete and individualized practice solution for mixed payment models.</p> <p>For more information on the new service, review our free OnDemand webinar <a href="https://wsma.org/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx#path">Mapping Your Path to Value-Based Care</a>. The webinar addresses: The Problem with Payment Change; The Solution: A Customized Map to Value based care; How the Process Works, Advantages & Results.</p> <p>For more information on WSMA's value-based payment guidance, contact Michelle Lott at <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <a name="tricare"></a> <h3> <span style="color: #4bacc6;">TRICARE</span> </h3> <h3>Health Net Federal Service and TRICARE: WSMA advocacy on reported problems</h3> <p>In January, Health Net Federal Services took over the contract for the TRICAREWest Region that was previously handled by United HealthCare. There were some significant challenges with the transition at the beginning of the year and it appears as if these challenges are still impacting practices. The WSMA has been working with HNFS on addressing the challenges impacting physicians and providers. As of July 1, HNFS ended waivers to facilitate this transition.</p> <p>At this time, we are hearing that problems are still occurring with the TRICARE program and that some of these issues are also impacting Medicare Advantage plans offered by Centene, the parent company of HNFS. The WSMA is communicating these practice-specific concerns to HNFS leadership for their direct intervention in resolving these problems. If you are encountering such issues, contact Michelle Lott at <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <a name="medicare"></a> <h3> <span style="color: #4bacc6;">MEDICARE</span> </h3> <h3>Noridian to end support of dial-up modem technology by Oct. 1</h3> <p>On April 3, Noridian Healthcare Solutions began efforts to sunset support of modem technologies. Any provider or vendor who uses modems for connectivity and data exchange with Noridian will need to find alternative methods for this transfer.</p> <p>Noridian notes that many alternative connectivity options are available. Network service vendors offer many affordable, user-friendly connectivity options which allow the use of secure internet connections for file transfers. A list of network service vendors conducting business with Noridian can be found on the <a href="http://www.edissweb.com/cgp/news/modem.html">website</a>. On that list, selecting a link will take you to the respective websites for more detailed information.</p> <p>Also, some billing services and clearinghouses who submit to Noridian already use network service vendor connectivity as part of their services. Contracting with one of these entities is also an option for any submitter impacted by the modem sunsetting. A list of billing services and clearinghouses is also available on the Noridian <a href="http://www.edissweb.com/cgp/vendors/">website</a>.</p> <h3>New Medicare card mailing: Update</h3> <p>CMS started mailing new Medicare cards to people with Medicare who live in "Wave 6" states: Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Texas, Utah, Washington and Wyoming. If your Medicare patients say they did not get a card, ask them to:</p> <ul> <li>Call 1.800.MEDICARE (1.800.633.4227). There might be something that needs to be corrected, such as updating their mailing address.</li> <li>Sign into <a href="https://www.mymedicare.gov/">MyMedicare.gov</a> to see if CMS mailed their card. If so, they can print an official card. They must create an account if they do not already have one.</li> </ul> <p>Your practice can also print out and give them a copy of <a href="https://www.cms.gov/Medicare/New-Medicare-Card/Outreach-and-Education/Tear-Off-for-After-Card-Mailing-Ends.pdf" target="_blank">Still Waiting for Your New Card?,</a> or you can <a href="https://productordering.cms.hhs.gov/">order copies online</a> to hand out.</p> <p>You can use either the former Social Security number-based health insurance claim number or the new alpha-numeric Medicare beneficiary identifier (MBI) for all Medicare transactions through Dec. 31, 2019.</p> <p>Check this <a href="https://www.cms.gov/Medicare/New-Medicare-Card/NMC-Mailing-Strategy.pdf" target="_blank">website</a> as the mailings progress. Direct your Medicare patients to <a href="https://www.medicare.gov/NewCard">Medicare.gov/NewCard</a> for information about the mailings and to sign up to get email updates on the status of card mailings.</p> <p>CMS is committed to mailing new cards to all people with Medicare by April 2019. For more information on the transition to the new MBI:</p> <ul> <li><a href="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18006.pdf" target="_blank">New MBI Get It, Use It</a> MLN Matters<sup>®</sup>Article.</li> <li><a href="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf" target="_blank">Transition to New Medicare Numbers and Cards</a> fact sheet.</li> <li><a href="https://www.cms.gov/medicare/new-medicare-card/nmc-home.html">New Medicare Card information</a> website.</li> </ul> <a name="qpp"></a> <h3> <span style="color: #4bacc6;">MEDICARE / MACRA QUALITY PAYMENT PROGRAM / MIPS</span> </h3> <h3>Guidance on Medicare's Quality Payment Program</h3> <p>To better your understanding of Medicare's Quality Payment Program (QPP) and its two payment pathways—the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), the WSMA, working in collaboration with Qualis Health, recommends these useful resources.</p> <h4>QPP Participation Status tool</h4> <p>CMS has updated its lookup tool to include 2018 Qualifying APM Participant (QP) and MIPS APM status. This update uses calculations from the first snapshot of data from APM entities, with data from Medicare Part B claims with dates of service between Jan. 1 and March 31, 2018. To view your status at the individual level, go to the <a href="https://qpp.cms.gov/participation-lookup">QPP Participation Status</a> webpage and enter your 10-digit National Provider Identifier (NPI) number.</p> <p>To check your group's 2018 eligibility at the APM entity level, log into the <a href="https://qpp.cms.gov/login">CMS Quality Payment Program website</a> with your <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-EIDM-User-Guide.pdf">EIDM credentials</a>. Then browse to the Taxpayer Identification Number affiliated with your group. You can then access the "details" screen to view the eligibility status of every clinician based on their NPI.</p> <h4>2017 MIPS performance feedback and payment adjustment update</h4> <p>If you submitted 2017 MIPS data through the <a href="https://qpp.cms.gov/login">Quality Payment Program website</a>, you can now view your performance feedback and MIPS final score. Access your 2017 MIPS performance feedback and final score by logging to the <a href="https://qpp.cms.gov/login">Quality Payment Program website</a> using your Enterprise Identity Management (EIDM) credentials. If you don't have an EIDM account, refer to <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Enterprise-Identity-Data-Management-EIDM-User-Guide.pdf" target="_blank">this guide</a>.</p> <p>Other resources:</p> <ul> <li> <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-Feedback-fact-sheet.pdf" target="_blank">2017 Performance Feedback Fact Sheet</a> and <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-feedback-user-guide.pdf" target="_blank">User Guide</a>. </li> <li> <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Resources.html">2017 Performance Feedback Instructional Videos</a>. </li> <li> <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-MIPS-Payment-Adjustment-fact-sheet.pdf" target="_blank">2019 MIPS Payment Adjustment Fact Sheet</a> and <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-MIPS-payment-adjustments-infographic.pdf" target="_blank">Infographic</a>. </li> </ul> <h3>MIPS Quality Payment Program exception applications due by Dec. 31</h3> <p>2018 Quality Payment Program applications for the Promoting Interoperability performance category and for Extreme and Uncontrollable Circumstances are available. Submit a hardship exception <a href="https://cmsqualitysupport.service-now.com/exception_application.do">application</a> by Dec. 31.</p> <p>For more information:</p> <ul> <li><a href="https://qpp.cms.gov/mips/exception-applications">Exception applications.</a></li> <li><a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-Exceptions-FAQs.pdf" target="_blank">2018 Exceptions FAQ. </a></li> <li><a href="https://qpp.cms.gov/">Quality Payment Program website.</a></li> <li>Contact the Quality Payment Program at <a href="mailto:QPP@cms.hhs.gov">QPP@cms.hhs.gov</a> or 866.288.8292 (TTY: 877.715.6222).</li> </ul> <h3>New webinar: How to Avoid a Negative Payment Adjustment in 2020</h3> <p>Join Qualis Health staff for an interactive webinar focusing on best practices for avoiding a MIPS penalty in 2020 based on performance in 2018. Become familiar with "year two" of the Quality Payment Program and get guidance on data collection and submission for each MIPS performance category. Also, Qualis will identify best practices for avoiding a negative MIPS payment adjustment in 2020, based on your MIPS performance for 2018.</p> <p>This free webinar will be held on Monday, Sept. 24 at noon PDT. <a href="https://t.e2ma.net/click/vxeiaf/nzedpb/nb0pu5">Register online</a> </p> <h3>New webinar: Submitting 2018 MIPS Data; Advice for Solo and Small Group Practices</h3> <p>This webinar will focus on the methods by which you can submit your 2018 MIPS data, including the CMS portal, an EHR vendor, and registries. You'll learn the step-by-step processes to submit your data for each performance category. This free webinar will be presented twice: on Tuesday, Oct. 16, 12:30 p.m. PDT (<a href="https://t.e2ma.net/click/vxeiaf/nzedpb/330pu5">register online</a>) and on Thursday, Oct. 18, 8 a.m. PDT (<a href="https://t.e2ma.net/click/vxeiaf/nzedpb/jw1pu5">register online</a>).</p> <h3>CMS updates 2017 MIPS performance feedback</h3> <p>CMS recently announced updates to the 2017 MIPS performance feedback reports to address several issues related to scoring. Those issues included the application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study, and the addition of the All-Cause Readmission (ACR) measure to the MIPS final score.</p> <p>CMS also extended the targeted review deadline to Oct. 15, 2018 at 5 p.m. PDT. If you believe an error still exists with your 2019 MIPS payment adjustment calculation, the targeted review process is available for you. Qualis Health can help you understand your feedback report! <a href="https://t.e2ma.net/click/vxeiaf/nzedpb/zo2pu5">Contact Qualis Health</a> with your questions.</p> </div>9/20/2018 12:00:00 AM1/1/0001 12:00:00 AM
Heal_the_business_of_care_with_fair_Medicaid_compensationHeal the business of care with fair Medicaid compensationLatest_NewsShared_Content/News/Latest_News/2018/September/Heal_the_business_of_care_with_fair_Medicaid_compensation<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/HeadShots/Hanscom.Jennifer_2018-645x425.png" class="pull-right" /> </div> <h5> September 18, 2018 </h5> <h2>Heal the business of care with fair Medicaid compensation</h2> <p><em>An opinion column by WSMA CEO Jennifer Hanscom, originally published in the Seattle Times on Sept. 12, 2018.</em> </p> <p> When a business is no longer financially viable, tough decisions must be made. That, regrettably, holds true for health care as well. Even though it is a caring profession, physicians must also care for the businesses they run, and that can even mean closing a practice.</p> <p> When a physician has to close a practice, we know that patients not only lose a doctor who knows their history, they also lose access to care, face longer wait times and potentially risk delayed diagnosis during that wait. While all patients in a community suffer when a physician closes the doors, those on Medicaid are further disadvantaged as they very likely will have a challenge finding another practice in their community willing to see them.</p> <p> Medicaid reimbursement rates don’t come close to covering the cost of providing care, and many practices—to keep their business afloat—must limit the number of Medicaid patients they can treat. Medicaid provides coverage for eligible low-income adults, children, pregnant women, elderly adults and people with disabilities, and is supported by state and federal dollars. Historically, Medicaid rates have been extremely low, covering just 66 percent of what Medicare, the other government sponsored program for seniors and the disabled, pays for the same service.</p> <p> Nationally, policymakers sought to address this conundrum with the Affordable Care Act. Expanding access to Medicaid coverage to more patients also created a need to make sure these patients had access to providers who would treat them. Hoping to sweeten the pot, the federal government agreed to fully cover the cost to increase Medicaid payments to the same rate as Medicare for primary-care services only, and only for the first two years of expansion—2013 and 2014. After 2014, the understanding was to continue at the higher payment rate, the state would have to pay a portion of those costs out of their own coffers. In 2015 the payment rate increase stopped.</p> <p> Except for that short-lived bump in rates, Medicaid rates receive only minor adjustments annually, and those are nowhere near on par with the cost of medical inflation. Last year, the state Legislature enacted an increase for pediatric services under the Medicaid program after they realized that the impact of a 35 percent reduction in rates was seriously reducing access to care for children. While a positive and appreciated step, this one-off increase doesn’t address the larger crisis looming. </p> <p> The average cost to a medical practice in Washington for a Medicaid visit is two to three times the amount it costs to provide the service. What business can survive when its receivables are lower than its expenses? </p> <p> This unhealthy consequence of impractical reimbursement rates is a shortage of physician availability for Medicaid patients. In a recent Washington State Medical Association survey of 872 physicians, more than a third of respondents—physicians of all specialty types—reported that they no longer see Medicaid patients, largely due to low reimbursement rates. And when it comes to accepting new Medicaid patients, 49 percent of physicians in small practices said they are less likely to accept new Medicaid patients. </p> <p> With more than 1.7 million Washingtonians enrolled in Medicaid and Children’s Health Insurance Program (CHIP), that affects a significant portion of our population. </p> <p> Even so, physicians do what they can to balance the business of care with caring for the business. They entered this profession to help and to heal. But the miserable reality is that some practices may not be able to bear the losses, which can compel the need to limit what insurance plans they will take—a further loss suffered by both physicians and their patients. </p> <p> There is a ready solution to this problem: Raise Medicaid rates to at least the level Medicare pays—for all physicians of all specialties—which would help ensure that the very real cost of delivering care is at least modestly covered. </p> <p>At the WSMA, we want all patients and communities to have access to care where and when they need it. Physicians must be able to viably practice, and fair Medicaid compensation would help. </p> <p><em> Jennifer Lawrence Hanscom is CEO of Washington State Medical Association.</em> </p> </div>9/18/2018 10:45:08 AM1/1/0001 12:00:00 AM
weekly_rounds_2018_09_17_a_time_to_care_a_time_to_speak_upWeekly Rounds: September 17, 2018 - A time to care, a time to speak upLatest_NewsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_09_17_a_time_to_care_a_time_to_speak_up<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>September 17, 2018</h5> <h2>A time to care, a time to speak up</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p> Perhaps, like me, you've seen numerous #SuicidePreventionMonth messages scrolling past on your social media feeds since the beginning of the month. I've been thinking a lot about this issue lately, and not only because I wrote about physician depression <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/physician_depression_its_time_to_care_for_our_own">in this column recently</a>. </p> <p> Knowing that an <a href="https://emedicine.medscape.com/article/806779-overview">estimated 400 physicians take their lives every year</a>, this topic weighs heavily on my mind and heart. Just last week, the statistics became more than mere numbers when I learned about the suicide of a physician known by many of our members. </p> <p> Physicians do die by suicide, but it is rarely discussed. And yet, as above, I imagine there are few degrees of separation between those who have taken this most tragic step and ourselves. In fact, when physician and author Abraham Verghese, MD, asked attendees <a href="https://med.stanford.edu/news/all-news/2017/10/good-leadership-self-compassion-key-to-tackling-physician-burnout.html">at a conference</a> if they knew fellow physicians who had killed themselves—nearly all raised their hands. He said: "We rarely expose our emotions. There's a fear of showing weakness." </p> <p> It's time for that to change, and we shouldn't need a special month to remind us to take care of ourselves and watch out for others. With suicide rates in Washington state rising, and knowing our very own members, friends and colleagues may be in pain, I urge you to be mindful not only of yourself and your patients, but also your colleagues. </p> <p> We also <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180912/september_is_suicide_prevention_month">covered this topic recently in our Membership Memo</a>. The statistics reveal a tragic irony: Physicians, who devote their lives to easing the suffering of others, die by their own hands at higher rates than the general population. </p> <p> We can take heart by taking action. </p> <p> A national campaign, <a href="http://www.bethe1to.com/">#Bethe1To</a>, centers on five steps people can take to help prevent suicide: </p> <ol> <li> ASK: Be the one to ask the tough question. If someone you know shows warning signs: "Are you thinking about killing yourself?" </li> <li> KEEP THEM SAFE: Do they have access to medications, firearms or other means of suicide? Ask if they've thought about how they would do it and separate them from anything they could use to hurt themselves. Learn more from Washington's <a href="https://makeitasafehome.org/">Safe Homes Coalition</a>. </li> <li> BE THERE: People thinking about suicide can feel they are a burden to their loved ones. Listen to their concerns with compassion and empathy and without judgement. <a href="https://www.nowmattersnow.org/">Now Matters Now</a> has videos from people who have experienced suicidal thoughts speaking about what friends can do to help manage those thoughts. </li> <li> HELP THEM CONNECT: Help your friend connect to a support system so they have a network for help, whether it's 800.273.TALK (8255), the crisis text line (text "HEAL" to 741741) family, friends, faith-based leaders, coaches, co-workers, health care professionals or therapists. The <a href="https://win211.org/">Washington 2-1-1 online database</a> is another way to find local resources. </li> <li> FOLLOW UP: Check in with the person you care about on a regular basis. Contacting a friend in the days and weeks after a crisis can make a difference in keeping them alive. </li> </ol> <p> And remember: If you want to connect with help anonymously, call the National Suicide Prevention Lifeline at 800.273.8255 or text "HEAL" to 741741 to text with a trained crisis counselor. More information on suicide prevention in Washington and the state's <a href="https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention/SuicidePreventionPlan">Suicide Prevention Plan</a> is online. </p> <p> Let's not only care for our patients, let's break through the culture of silence and the stronghold of stigma so we can care for each other. </p> </div>9/17/2018 12:00:00 AM1/1/0001 12:00:00 AM
countdown_to_the_2018_wsma_annual_meeting_heres_what_you_need_to_knowCountdown to the 2018 WSMA Annual Meeting: Here's what you need to knowLatest_NewsShared_Content/News/Membership_Memo/20180912/countdown_to_the_2018_wsma_annual_meeting_heres_what_you_need_to_know<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Events/2018-Annual-Meeting-Graphic-645px%20version%202.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>Countdown to the 2018 WSMA Annual Meeting: Here's what you need to know</h2> <p>The 2018 WSMA Annual Meeting, WSMA's premier policymaking and networking event, is nearly here. If you have yet to register for the meeting, scheduled for Oct. 13-14 in Spokane, <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">do so today</a>. The meeting is free for WSMA members and members of the Washington State Medical Group Management Association. Here's what members should know as the meeting approaches.</p> <ol> <li>Tomorrow (Thursday, Sept. 13) is the final deadline for WSMA delegates to submit resolutions (proposals asking the WSMA to take a position or act on an issue) to the WSMA Seattle office. <a href="https://wsma.org/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=0b33a619-8be9-4a6f-b5b8-7be298a616ee">Learn more about the “whats” and “whys” of resolutions</a>.</li> <li>The 2018 Delegate Handbook—the compilation of resolutions and other business to be considered by the House of Delegates at the meeting—is now available for <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f#handbook">download from the WSMA Annual Meeting webpage</a>. Delegates may order the handbook on flash drive by emailing <a href="mailto:hod@wsma.org">hod@wsma.org</a>. The handbook will be updated with additional items following Thursday's resolution deadline and the revised handbook will be available on <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f#handbook">the meeting webpage</a>.</li> <li>More than 30 resolutions, covering a wide swath of public health and professional affairs issues, are now available in our password-protected <a href="https://wsma.org/WSMA/Events/Annual_Meeting/Online_Reference_Committees_and_Forum/WSMA/Events/Annual_Meeting/Online_Reference_Committees_and_Forum/Online_Reference_Committees_and_Forum.aspx?hkey=4ea4ed56-61ce-4121-89b9-636415daa863">"virtual” reference committees</a>. WSMA members are encouraged to take a moment to review these proposals and provide input, which is crucial to shaping good policy.</li> </ol> <p>Find the full agenda, speaker and activity detail and register for the WSMA Annual Meeting <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">online</a>.</p> <p>The WSMA would like to thank our corporate partners for helping to make the meeting possible: exclusive premier partner <a href="http://www.phyins.com/">Physicians Insurance A Mutual Company</a>, and silver partners <a href="http://www.premera.com/">Premera Blue Cross</a>, <a href="https://www.fchn.com/">First Choice Health</a>, <a href="http://www.hallrender.com/">Hall Render</a> and <a href="https://www.wpmgcareers.org/index.html">Kaiser Permanente</a>. The WSMA also wishes to thank the following meeting sponsor for its generous contributions: platinum sponsor <a href="https://www.providence.org/">Providence Health & Services</a>.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
medical_commission_finalizes_opioid_prescribing_rulesMedical Commission finalizes opioid prescribing rulesLatest_NewsShared_Content/News/Membership_Memo/20180912/medical_commission_finalizes_opioid_prescribing_rules<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Rx_prescription_645x425.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>Medical Commission finalizes opioid prescribing rules</h2> <p>Culminating a year-long rulemaking effort, the Washington State Medical Commission has finalized and voted to approve new opioid prescribing rules for physicians and physician assistants treating all phases of pain (acute, subacute and chronic). The Medical Commission will release final rule language this fall, with the new prescribing requirements scheduled to go into effect on Jan. 1, 2019.</p> <p>Based on the draft language available at the final public hearing, the WSMA remains greatly concerned about the volume of administrative burden the new requirements would add to a physician's typically limited patient encounter and the lack to time afforded for related physician and public education. For more on our concerns, <a href="javascript://[Uploaded files/Resources/Clinical Quality/Opioids/WSMA_WSHA_commentsforsubmission_CR102opioidRxrules.pdf]">review formal comments</a> submitted on behalf of the WSMA and Washington State Hospital Association.</p> <p>Many thanks to the many physicians and providers who provided feedback during the rulemaking period and who responded to our calls to action on the issue. WSMA staff will review the final rule language in detail once available and will prepare to assist you and your patients in being successful under these new rules. If you have questions about the rules, contact Jeb Shepard <a href="mailto:jeb@wsma.org">jeb@wsma.org</a>.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
registration_now_available_for_fall_mindfulness_for_healthcare_professionals_online_trainingRegistration now available for fall Mindfulness for Healthcare Professionals online trainingLatest_NewsShared_Content/News/Membership_Memo/20180912/registration_now_available_for_fall_mindfulness_for_healthcare_professionals_online_training<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/MIndfulness_rocks_reflection_645px.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>Registration now available for fall Mindfulness for Healthcare Professionals online training</h2> <p>Physicians, physician assistants and other licensed providers in Washington are warmly invited to register for the upcoming teleconference series Mindfulness for Healthcare Professionals of Washington State. This four-week course, scheduled for Tuesday evenings beginning Sept. 25, is presented by Mindfulness Northwest in partnership with the WSMA and Washington Physicians Health Program. This activity has been approved for <em>AMA PRA Category 1 Credit<sup>TM</sup></em>.</p> <p>Mindfulness training for physicians and other providers has been shown to help with:</p> <ul> <li>Responding more skillfully in high stress situations, reducing risk factors for burnout.</li> <li>Creating positive peer support for mindful engagement in work and home situations that have previously triggered stress responses and unhelpful behaviors.</li> <li>Identifying helpful vs. unhelpful thought patterns, problem solving, emotional regulation and meaning-focused coping strategies.</li> <li>Re-connecting with intentions and meaning in the health care profession.</li> </ul> <p>For more information and to register, visit <a href="https://www.mindfulnessnorthwest.com/event-2926801">the Mindfulness Northwest website</a>.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
september_is_suicide_prevention_monthSeptember is Suicide Prevention MonthLatest_NewsShared_Content/News/Membership_Memo/20180912/september_is_suicide_prevention_month<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Suicide_Prev_Mo_BeThe1To_Blue-SocialMedia_20170630-Ask_645x425.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>September is Suicide Prevention Month</h2> <p>Suicide rates in Washington state <a href="https://www.doh.wa.gov/Newsroom/2018NewsReleases/18124SuicidePreventionNR">continue rising</a>: From 2006 to 2017 suicide increased by an average of 2.5 percent annually, with 1,300 Washingtonians dying by suicide in 2017 alone. And <a href="https://www.stepsforward.org/modules/preventing-physician-suicide">national data</a> reveal a tragic irony: physicians, who devote their lives to easing others' suffering, die by their own hands at higher rates than the general population.</p> <p>During this Suicide Prevention Month, some updates for physicians and patients alike on efforts to help address this public health issue:</p> <p><strong>The Physician and Advanced Practitioner Wellness Survey</strong> – The WSMA has partnered with the Washington State Hospital Association to launch a survey designed to help us understand how you are impacted by variables such as the EHR, leadership, and control over your schedule and workload. The information gathered will help drive our initiatives intended to improve your professional satisfaction and well-being. All members should have received an email from physician_wellness@stanford.edu with the survey. If you haven't yet done so, please take 15 minutes of your time to complete the survey. Email Jessica Martinson at <a href="mailto:jessica@wsma.org">jessica@wsma.org</a> with questions.</p> <p><strong>#Bethe1To campaign</strong> – The state Department of Health is drawing attention to the national <a href="http://www.bethe1to.com/">#Bethe1To campaign</a>, which centers on <a href="http://www.bethe1to.com/bethe1to-steps-evidence/">five simple, easy-to-remember steps</a> people can take to help prevent suicide (ask, keep them safe, be there, help them connect, follow up), as well as guidance and resources for those at risk or who know someone at risk. Visit the <a href="http://www.bethe1to.com/join/">campaign website</a> for resources for your practice or organization and to learn more.</p> <p><strong>Physician education:</strong></p> <ul> <li><a href="https://depts.washington.edu/saferwa/training/medical-providers/">All Patients Safe: Suicide Prevention for Medical Professionals</a> – This interactive self-paced online training course offered by Washington's Safer Homes Coalition is made by and for medical professionals and provides the necessary tools for preventing and educating patients about suicide.</li> <li><a href="https://www.stepsforward.org/modules/preventing-physician-suicide">Preventing Physician Distress and Suicide</a> – This online module from the AMA can help you identify at-risk physicians and help them access appropriate care.</li> </ul> <p>More information on <a href="https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention">suicide prevention</a> in Washington and the state's <a href="https://www.doh.wa.gov/Portals/1/Documents/Pubs/631-058-SuicidePrevPlan.pdf">Suicide Prevention Plan</a> is online. If you want to connect with someone anonymously, call the <a href="https://suicidepreventionlifeline.org/chat/">National Suicide Prevention Lifeline</a> at 800.273.8255, <a href="https://suicidepreventionlifeline.org/chat/">chat</a>, or text “HEAL” to 741741 to text with a trained crisis counselor.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
update_on_medicaid_reimbursement_increase_for_pediatric_servicesUpdate on Medicaid reimbursement increase for pediatric servicesLatest_NewsShared_Content/News/Membership_Memo/20180912/update_on_medicaid_reimbursement_increase_for_pediatric_services<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Stock.image_2018.youngFmdoctor_w_younggirl_645x425.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>Update on Medicaid reimbursement increase for pediatric services</h2> <p>One way the WSMA supports practice viability is to support fair Medicaid reimbursement, and this past legislative session we helped pass a funding provision, contained in <a href="http://apps2.leg.wa.gov/billsummary?BillNumber=6032&Year=2017&BillNumber=6032&Year=2017">Senate Bill 6032</a>, that took a small, but significant, step forward: an increase in reimbursement rates for Medicaid pediatric primary care and vaccine services. Health Care Authority staff has been working to determine allocation amounts across the identified codes and has announced it will make the individual codes with the enhanced reimbursement rates available on Sept. 24.</p> <p>Both physician and non-physician providers will be eligible for these increases, which are effective for dates of service beginning Oct. 1, 2018 and ending no sooner than June 30, 2019. For physicians and providers offering primary care for fee-for-service pediatric clients, the rate will increase 9.5 percent for evaluation and management services. For vaccine administration, the rates have increased to 77 percent of Medicare rates for vaccines administered through <a href="https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthSystemResourcesandServices/Immunization/VaccinesforChildren">Vaccines for Children</a> (VFC) and 100 percent of Medicare rates for vaccines administered outside of VFC. Physicians and providers serving clients covered by a contracted managed care organization should contact the individual MCO for the increase percentage. </p> <p>The HCA has added <a href="https://www.hca.wa.gov/about-hca/apple-health-medicaid/rate-increase-pediatric-primary-care">a webpage with information on these rate increases</a>.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
WSMA_joins_AMA_to_raise_concerns_on_proposed_changes_to_E_M_codesWSMA joins AMA to raise concerns on proposed changes to E/M codesLatest_NewsShared_Content/News/Latest_News/2018/September/WSMA_joins_AMA_to_raise_concerns_on_proposed_changes_to_E_M_codes<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/People%20non%20stock/Medicare_asclepius_lo-res_645x425.jpg" class="pull-right" /> </div> <h5> September 12, 2018 </h5> <h2>WSMA joins AMA to raise concerns on proposed changes to E/M codes</h2> <p>The WSMA joined with the AMA and about 170 other medical organizations, signing onto <a href="https://www.ama-assn.org/170-groups-send-letter-proposed-changes-physician-payment-rule">a letter to the Centers for Medicare & Medicaid Services</a> that raised concerns about CMS' proposal to substantially revise the current framework of the evaluation and management codes.</p> <p>The proposed changes, contained in <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180725/new_cms_rule_proposes_significant_changes_to_medicare_billing_and_documentation">CMS' notice of proposed rulemaking for the 2019 Medicare physician payment rule</a>, would collapse payment rates for eight office visit services for new and established patients down to two each. A key concern is that these changes would result in the underpayment of services to physicians who treat the sickest patients.</p> <p>The letter expressed appreciation for CMS’ goal of seeking to reduce excessive E/M documentation requirements and urged immediate adoption of these principles:</p> <ol> <li>Changing the required documentation of the patient’s history to focus only on the interval history since the previous visit.</li> <li>Eliminating the requirement for physicians to re-document information that has already been documented in the patient’s record by practice staff or by the patient.</li> <li>Removing the need to justify providing a home visit instead of an office visit.</li> </ol> <p>To help address these concerns, the letter recommended that AMA create of a work group of physicians and other health professionals to analyze E/M coding and payment issues, with recommended actions to be presented to CMS in time for implementation in the 2020 Medicare physician fee schedule.</p> <p>Sept. 10 was the deadline for comments on the proposed rule, with the final rule expected to be released by CMS in early fall. For additional background, watch the following CMS videos:</p> <ul> <li><a href="https://www.youtube.com/watch?v=JvoRQfMtPo4&feature=youtu.be">Introduction</a> (3 minutes).</li> <li><a href="https://www.youtube.com/watch?v=B0BZmGYpYFU&feature=youtu.be">Office visits</a> (2 minutes).</li> <li><a href="https://www.youtube.com/watch?v=W2QBTQNxfSY&feature=youtu.be">Panel discussion</a> (22 minutes).</li> </ul> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
wsma_testifies_against_proposed_scope_expansion_for_naturopathsWSMA testifies against proposed scope expansion for naturopathsLatest_NewsShared_Content/News/Membership_Memo/20180912/wsma_testifies_against_proposed_scope_expansion_for_naturopaths<div class="col-md-12"> <h5> September 12, 2018 </h5> <h2>WSMA testifies against proposed scope expansion for naturopaths</h2> <p>The WSMA joined several medical specialty societies in testifying against a proposal from the state naturopathic licensing board to allow naturopathic physicians to perform non-surgical cosmetic procedures, including the administration of botulinum toxin, dermal fillers or other inert substances. The WSMA believes naturopaths do not have the appropriate training for these types of procedures and this expansion of scope of practice would put patients at undue risk of harm. The WSMA also submitted formal comments to the Department of Health on the matter. To read the comments and for more information, see the <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_09_03_five_things_you_need_to_know_this_week">Sept. 3 issue of Weekly Rounds</a>, the newsletter from WSMA CEO Jennifer Hanscom.</p> </div>9/12/2018 12:00:00 AM1/1/0001 12:00:00 AM
Practice_Alerts__September_6__2018Practice Alerts: September 6, 2018Latest_NewsShared_Content/News/Practice_Alerts/Practice_Alerts__September_6__2018<div class="col-md-12"> <div class="col-md-5 pull-right"><img alt="" src="/images/Logos/Practice-Alerts-ArticleImage-Tagline_645x425.jpg" class="pull-right" /></div> <h5> September 6, 2018 </h5> <h2>Practice Alerts</h2> <p>In this issue, you'll find WSMA and AMA's response to proposed changes to E/M codes; practice resources for Suicide Prevention Month; education on value-based payment models and much more.</p> <p>For personal assistance, contact the <a href="https://wsma.org/WSMA/Services/Physician_Practice_Helpline/WSMA/Services/Physician_Practice_Helpline/Physician_Practice_Helpline.aspx?hkey=fc908a57-5820-41dc-8a1f-e2a7b1498e3b">WSMA Physician Practice Helpline</a> by emailing Bob Perna, MBA, FACMPE, at <a href="mailto:rjp@wsma.org">rjp@wsma.org</a> or Michelle Lott, CPC, CPMA at <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <p>Jump to section:</p> <p> <a href="#coding"> Coding: Evaluation / Management Reform </a> </p> <p> <a href="#clinical"> Clinical Issues</a> </p> <p> <a href="#value"> Value-based Payment </a> </p> <p> <a href="#healthierwa"> State Agencies – Healthier Washington </a> </p> <p> <a href="#hca"> State Agencies – Health Care Authority </a> </p> <p> <a href="#tricare"> TRICARE </a> </p> <p> <a href="#medicare"> Medicare</a> </p> <p> <a href="#qpp"> Medicare / MACRA Quality Payment Program / MIPS</a> </p> <p> <a href="#help"> WSMA Physician Practice Helpline</a> </p> <h3><a name="coding"></a> <span style="color: #4bacc6;">Coding: Evaluation / Management Reform</span> </h3> <h3>CMS proposal on E/M codes: WSMA joins with AMA and other organizations</h3> <p> The WSMA joined with the AMA and about 170 other medical organizations, signing onto <a href="https://www.ama-assn.org/170-groups-send-letter-proposed-changes-physician-payment-rule">a letter to the Centers for Medicare & Medicaid Services</a> that raised concerns about CMS’ proposal to substantially revise the current framework of the evaluation and management codes.</p> <p>The proposed changes, contained in CMS’ notice of proposed rulemaking for the 2019 Medicare physician payment rule, would collapse payment rates for eight office visit services for new and established patients down to two each. A key concern is that these changes would result in the underpayment of services to physicians who treat the sickest patients.</p> <p>The letter expressed appreciation for CMS’ goal of seeking to reduce excessive E/M documentation requirements and urged immediate adoption of these principles:</p> <ol> <li>Changing the required documentation of the patient’s history to focus only on the interval history since the previous visit.</li> <li>Eliminating the requirement for physicians to re-document information that has already been documented in the patient’s record by practice staff or by the patient.</li> <li>Removing the need to justify providing a home visit instead of an office visit.</li> </ol> <p>To address these concerns, the letter recommended the AMA’s creation of a work group of physicians and other health professionals to analyze E/M coding and payment issues, with recommended actions to be presented to CMS in time for implementation in the 2020 Medicare physician fee schedule.</p> <p>Individuals and organizations can provide comments to CMS on the proposed rule until Sept. 10 at <a href="https://www.federalregister.gov/documents/2018/07/27/2018-14985/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions">this link</a>.</p> <p>For additional background, watch the videos available on the CMS website.</p> <ul> <li><a href="https://www.youtube.com/watch?v=JvoRQfMtPo4&feature=youtu.be">Introduction</a> (3 minutes).</li> <li><a href="https://www.youtube.com/watch?v=B0BZmGYpYFU&feature=youtu.be">Office visits</a> (2 minutes).</li> <li><a href="https://www.youtube.com/watch?v=W2QBTQNxfSY&feature=youtu.be">Panel discussion</a> (22 minutes).</li> </ul> <h3><a name="clinical"></a> <span style="color: #4bacc6;">Clinical Issues</span> </h3> <h3>Suicide rates in Washington continue rising: September is Suicide Prevention Month</h3> <p>In 2017, 1,300 Washingtonians died by suicide, and from 2006 to 2017 suicide in Washington state increased by an average of 2.5 percent annually. The national <a href="http://www.bethe1to.com/">#Bethe1to campaign</a> highlights five actions people can take to help prevent suicide:</p> <ol> <li>Be the one to ask.<br /> Ask the tough question. When somebody you know shows warning signs, ask them directly: “Are you thinking about killing yourself?” <a href="http://helpyourselfhelpothers.org/">Take an online screening</a>.</li> <li>Be the one to keep them safe.<br /> Do they have access to medications, firearms or other means of suicide? Ask if they’ve thought about how they would do it and separate them from anything they could use to hurt themselves. Learn more from <a href="https://depts.washington.edu/saferwa/">Washington's Safer Homes Coalition</a>.</li> <li>Be the one to be there.<br /> People thinking about suicide can feel a burden to their loved ones. If your friend is thinking about suicide, listen to their reasons for feeling hopeless and in pain. Listen with compassion and empathy and without judgement. <a href="https://www.nowmattersnow.org/skill/suicidal-thoughts">Now Matters Now</a> has videos from people who have experienced suicidal thoughts sharing what individuals can do to help manage those thoughts.</li> <li>Be the one to help them connect.<br /> Help your friend connect to a support system so they have a network to reach out to for help, whether it’s 800.273.TALK (8255), the crisis text line (text “HEAL” to 741741) family, friends, faith-based leaders, coaches, co-workers, health care professionals or therapists. <a href="https://win211.org/search/">2-1-1’s online database</a> is another way to find local resources.</li> <li>Be the one to follow up.<br /> Check in with the person you care about on a regular basis. Contacting a friend in the days and weeks after a crisis can make a difference in keeping them alive. <a href="https://zerosuicide.sprc.org/toolkit/treat/interventions-suicide-risk">Send a caring contact</a>. This could be a phone call, text, email or letter.</li> </ol> <p>If you want to connect with someone anonymously, call the <a href="https://suicidepreventionlifeline.org/chat/">National Suicide Prevention Lifeline</a> at 800.273.8255, <a href="https://suicidepreventionlifeline.org/chat/">chat</a>, or text “HEAL” to 741741 to text with a trained crisis counselor. More information on <a href="https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention">suicide prevention</a> in Washington and the state’s <a href="https://www.doh.wa.gov/Portals/1/Documents/Pubs/631-058-SuicidePrevPlan.pdf">Suicide Prevention Plan</a> is online.</p> <h3><a name="value"></a> <span style="color: #4bacc6;">Value-based Payment</span> </h3> <h3>Succeeding in value-based payment</h3> <p>The WSMA can help our members and their practice staff succeed with value-based payment models through our three tiers of guidance and services.</p> <p><span style="text-decoration: underline;">Tier 1: Reference materials</span><br /> For foundational knowledge on value-based payment, review AMA’s online module <a href="https://www.stepsforward.org/modules/value-based-care">Preparing Your Practice for Value-Based Care</a>.</p> <p><span style="text-decoration: underline;">Tier 2: Educational programs</span><br /> <a href="https://wsma.org/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx#vbptakeaction">Value-Based Payment, MACRA/MIPS, Healthier Washington – Take Action Now!</a></p> <p>Both Medicare’s MACRA Quality Payment Program and the state’s Healthier Washington initiatives are built around value-based payment models. This free 45-minute OnDemand webinar, presented by the WSMA and Attune Healthcare Partners, provides an overview of the value-based payment models currently in play and focuses on specific actions to consider.</p> <p><span style="text-decoration: underline;">Tier 3: Practice-specific engagements</span><br /> The WSMA and Attune Healthcare Partners have partnered to offer practice-specific consulting engagements to our members on value-based transformation strategies.</p> <p>Attune’s “5-Step Process” provides a path for practices to optimize earnings and simplify daily operations with a mix of traditional and value-based payment methods. Attune Healthcare Partners are experts in practice success under value-based payment and can help practices create a complete and individualized practice solution for mixed payment models.</p> <p>For more information on the new service, review our free 60-minute OnDemand webinar <a href="https://wsma.org/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx#path">Mapping Your Path to Value-Based Care</a>. The webinar addresses: The Problem with Payment Change; The Solution: A Customized Map to Value-based Care; How the Process Works, Advantages & Results.</p> <p>For more information on WSMA’s value-based payment guidance, contact Michelle Lott at <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <h3><a name="healthierwa"></a> <span style="color: #4bacc6;">State Agencies – Healthier Washington</span> </h3> <h3>Public forums showcase Medicaid Transformation vision, progress, and why it matters</h3> <p>The Health Care Authority is convening public forums, in-person and remote, to update the public about the progress of the Healthier Washington Medicaid Transformation project and provide opportunities for meaningful public comment.</p> <p>Remaining dates for "Transforming Medicaid: Why it matters to all of us":</p> <ul> <li>Tuesday, Sept. 11 in-person event: 5:30 to 7 p.m. at the office of Better Health Together, 1020 W. Riverside, Spokane, 99201. No registration is required.</li> <li>Thursday, Oct. 11 webinar: noon to 1:30 p.m. <a href="https://register.gotowebinar.com/register/8066955576474714113">Register online</a>.</li> </ul> <h3><a name="hca"></a> <span style="color: #4bacc6;">State Agencies – Health Care Authority</span> </h3> <h3>Online prior authorization submission now available in ProviderOne</h3> <p>The Health Care Authority has completed a system update to <a href="https://www.waproviderone.org/">ProviderOne</a> which allows physicians and other providers to submit prior authorization requests for medical services online.</p> <p>Until now, physicians had to submit requests via fax or paper submission. This update will increase efficiency by allowing physicians to submit direct data entry and include color photos, X-rays and all other required documentation. Physicians and providers may continue to submit requests by fax or mail. Visit HCA’s <a href="https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/prior-authorization-pa#step-4-submit-pa">prior authorization webpage</a> for instructions on these processes.</p> <p><span style="text-decoration: underline;">Reminder</span>: For medical services covered by individual and small/large group health plans, new requirements are in effect this year streamlining insurer requirements and easing administrative burden. Make sure your practice is making the most of these new requirements by visiting the <a href="http://priorauth.wsma.org/">WSMA Prior Authorization Navigator</a>.</p> <h3>Medicaid interpreter services vendor: WSMA’s ongoing advocacy</h3> <p>Many practices have experienced significant issues with the Health Care Authority’s new interpreter services vendor, <a href="https://www.hca.wa.gov/billers-providers-partners/programs-and-services/interpreter-services">Universal Language Services</a>. The WSMA, working in close collaboration with WSMGMA, has been communicating with HCA leadership to address reported problems. In some areas, interpreters are not accepting the requested engagements or there is a shortage of interpreters for common languages.</p> <p>Now that most of the initial transition problems appear to have been addressed, we are asking practices to contact us with any ongoing issues specifically related to fulfilling the interpreter requests. We are seeking additional information on potential improvements or changes that can assist practices. Please contact Michelle Lott at <a href="mailto:mml@wsma.org">mml@wsma.org</a> with any recommendations or concerns regarding this system.</p> <h3><a name="tricare"></a> <span style="color: #4bacc6;">TRICARE</span> </h3> <h3>Health Net Federal Service and TRICARE: WSMA advocacy on reported problems</h3> <p>In January, Health Net Federal Services took over the contract for the TRICARE West Region that was previously handled by United HealthCare. There were some significant challenges with the transition at the beginning of the year and it appears as if these challenges are still impacting practices. The WSMA has been working with HNFS on addressing the challenges impacting physicians and providers. As of July 1, HNFS ended waivers to facilitate this transition.</p> <p>At this time, we are hearing that problems are still occurring with the TRICARE program and that some of these issues are also impacting Medicare Advantage plans offered by Centene, the parent company of HNFS. The WSMA is communicating these practice-specific concerns to HNFS leadership for their direct intervention in resolving these problems. If you are encountering such issues, contact Michelle Lott at <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <h3><a name="medicare"></a> <span style="color: #4bacc6;">Medicare</span> </h3> <h3>New Medicare cards may include QR codes</h3> <p>New Medicare cards may include a type of machine-readable code called a square code or QR (quick response) code. QR codes will allow the contractor who prints the cards to ensure the right card goes to the right Medicare or Railroad Retirement Board (RRB) beneficiary. Physicians and providers cannot use the code for any other purpose. RRB-issued cards may have a QR code on the front, while all other Medicare patients may get a new card with a QR code on the back. These are legitimate, official Medicare cards.</p> <p>Information on the transition to the new Medicare beneficiary identifier:</p> <ul> <li><a href="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18006.pdf">New MBI Get It, Use It</a> - MLN Matters<sup>®</sup> Article.</li> <li><a href="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf">Transition to New Medicare Numbers and Cards</a> - MLN Fact Sheet.</li> <li><a href="https://www.cms.gov/medicare/new-medicare-card/nmc-home.html">New Medicare card information</a> website.</li> <li><a href="https://www.medicare.gov/newcard/">New Medicare cards are in the mail</a> - website for Medicare patients.</li> </ul> <h3><a name="qpp"></a> <span style="color: #4bacc6;">Medicare / MACRA Quality Payment Program / MIPS</span> </h3> <h3>WSMA guidance on Medicare’s Quality Payment Program</h3> <p>To better your understanding of Medicare’s Quality Payment Program (QPP) and its two payment pathways—the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), the WSMA, working in collaboration with Qualis Health, recommends these useful resources.</p> <p><span style="text-decoration: underline;">Understanding Advanced Alternative Payment Models (APMs): Solo and Small Group Practices</span><br /> Qualis Health is offering this free webinar on two dates (registration required): Tuesday, <a href="https://t.e2ma.net/click/beaq7e/nzedpb/jsqmx4">Sept. 11</a> and Thursday, <a href="https://t.e2ma.net/click/beaq7e/nzedpb/zkrmx4">Sept. 13</a>.</p> <p><span style="text-decoration: underline;">QPP Participation Status tool</span><br /> CMS has updated its lookup tool to include 2018 Qualifying APM Participant (QP) and MIPS APM status. This update uses calculations from the first snapshot of data from APM entities, with data from Medicare Part B claims with dates of service between Jan. 1 and March 31, 2018. </p> <p>To view your status at the individual level, go to the <a href="https://qpp.cms.gov/participation-lookup">QPP Participation Status</a> webpage and enter your 10-digit National Provider Identifier (NPI) number.</p> <p>To check your group’s 2018 eligibility at the APM entity level: Log into the <a href="https://qpp.cms.gov/login">CMS Quality Payment Program website</a> with your <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-EIDM-User-Guide.pdf">EIDM credentials</a>. Then browse to the Taxpayer Identification Number affiliated with your group. You can then access the “details” screen to view the eligibility status of every clinician based on their NPI.</p> <p><span style="text-decoration: underline;">2017 MIPS performance feedback and payment adjustment update</span><br /> If you submitted 2017 MIPS data through the <a href="https://qpp.cms.gov/login">Quality Payment Program website</a>, you can now view your performance feedback and MIPS final score. Access your 2017 MIPS performance feedback and final score by logging to the <a href="https://qpp.cms.gov/login">Quality Payment Program website</a> using your Enterprise Identity Management (EIDM) credentials. If you don’t have an EIDM account, refer to <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Enterprise-Identity-Data-Management-EIDM-User-Guide.pdf">this guide</a>.</p> <p>Other resources:</p> <ul> <li><a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-Feedback-fact-sheet.pdf">2017 Performance Feedback Fact Sheet</a> and <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-feedback-user-guide.pdf">User Guide</a>. </li> <li><a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Resources.html">2017 Performance Feedback Instructional Videos</a>.</li> <li><a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-MIPS-Payment-Adjustment-fact-sheet.pdf">2019 MIPS Payment Adjustment Fact Sheet</a> and <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-MIPS-payment-adjustments-infographic.pdf">Infographic</a>.</li> </ul> <h3>Quality Payment Program exception applications due by Dec. 31</h3> <p>2018 Quality Payment Program applications for the MIPS Promoting Interoperability performance category and for Extreme and Uncontrollable Circumstances are available. Submit a hardship exception <a href="https://cmsqualitysupport.service-now.com/exception_application.do">application</a> by Dec. 31.</p> <p>For more information:</p> <ul> <li><a href="https://qpp.cms.gov/mips/exception-applications">About exception applications.</a></li> <li><a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-Exceptions-FAQs.pdf">2018 exceptions FAQ. </a></li> <li><a href="https://qpp.cms.gov/">Quality Payment Program website.</a></li> <li>Contact the Quality Payment Program at <a href="mailto:QPP@cms.hhs.gov">QPP@cms.hhs.gov</a> or 866.288.8292 (TTY: 877.715.6222).</li> </ul> <h3><a name="help"></a> <span style="color: #4bacc6;">WSMA Physician Practice Helpline</span> </h3> <h3>Payment, coding or other practice issues? Let the WSMA help</h3> <p>WSMA's staff experts understand the unique challenges of medical practices. For your practice to succeed, your services need to translate into revenue. From simple to complex issues, we have the know-how, connections and expertise to help make that happen.</p> <p><span style="text-decoration: underline;">Physician Practice Helpline</span><br /> The WSMA <a href="https://wsma.org/WSMA/Services/Physician_Practice_Helpline/WSMA/Services/Physician_Practice_Helpline/Physician_Practice_Helpline.aspx?hkey=fc908a57-5820-41dc-8a1f-e2a7b1498e3b">Physician Practice Helpline</a> is now available to help your practice run more efficiently while avoiding errors and ensuring that you receive accurate and appropriate payments. The helpline provides advisory services to resolve payment, coding or practice management issues.</p> <p>The helpline is a free service to WSMA member physicians and their practice staff. Get help today: Contact Michelle M. Lott, CPC, CPMA, at 206.441.9762, 800.552.0612 or <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> <p><span style="text-decoration: underline;">Chart Review Service</span><br /> For direct assistance on issues related to coding and documentation, use WSMA’s <a href="https://wsma.org/WSMA/Services/Chart_Review_Service/WSMA/Services/Chart_Review_Service/Chart_Review_Service.aspx?hkey=871ad332-db71-42b0-abca-1cebfa3e724f">Chart Review Service</a>. This service provides expert review, recommendations and preventive post-review education to improve your coding and chart documentation; protect you against allegations of coding errors and inappropriate payments; and help you avoid costly refunds of payments received. As a component of your practice’s compliance program, this service detects, corrects and ultimately prevents errors by helping you achieve significant improvement in your coding and documentation activities.</p> <p>For more information, contact Michelle M. Lott, CPC, CPMA, WSMA’s health insurance coding specialist at 206.441.9762, 800.552.0612 or <a href="mailto:mml@wsma.org">mml@wsma.org</a>.</p> </div>9/6/2018 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_2018_09_03_five_things_you_need_to_know_this_weekWeekly Rounds: September 3, 2018 - Five things you need to know this weekLatest_NewsShared_Content/News/Weekly_Rounds/2018/weekly_rounds_2018_09_03_five_things_you_need_to_know_this_week<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /></div> <h5>September 3, 2018</h5> <h2>Five things you need to know this week</h2> <p> Jennifer Hanscom, Executive Director/CEO </p> <p>"That's just crazy!" exclaimed an Overlake Medical Center physician I met at a meeting in Bellevue last week. She was referring to proposed changes to Medicare billing and documentation, proposed rate changes for evaluation and management (E/M) services.</p> <p>I'd been invited to share with Overlake's leadership about the advocacy and other work the WSMA does on behalf of the profession. A question came up about E/M and her comment came during the conversation as I explained the proposal. I was glad to share with her that just last week the WSMA, along with 100+ other health care organizations, signed on to a letter of opposition to the proposed rule. In fact, while our letter was 1 1/2 pages long, the list of signatories ran to 3 1/2 pages! You can read the letter <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180822/comments_due_sept_10_on_cms_proposal_for_physician_fee_schedule_and_quality_payment_program">here</a>.</p> <p>There's plenty more to say on that, but I'll keep it brief as I also wanted to highlight a few other things for you this week as well.</p> <ol> <li><strong>Medicare fee schedule mixed bag for physicians</strong><br /> At the WSMA, we agree with the physician's comment above, and that's why we signed on to the letter of opposition to the Centers for Medicare & Medicaid Services regarding the 2019 Medicare physician payment rule.<br /> <br /> The new rule proposes comprehensive and significant changes to Medicare billing and documentation, including the E/M single rate, provisions to incentivize EHR interoperability and telehealth services, and much more.<br /> <br /> In the letter, we praised CMS for its "Patients Over Paperwork" efforts, and notable efforts to alleviate administrative burden, but we also shared our opposition to collapsing payment rates for eight office visit services for new and established patients down to two each – noting the proposal could hurt physicians in specialties who treat the sickest patients, as well as those who provide comprehensive primary care. We urged that the new multiple service payment reduction policy in the proposed rule not be adopted, as the issue of multiple services on the same day of service was factored in to prior valuations of affected codes. The entire health care community appears to be on the same page on this issue, so we have hope that the CMS will listen and make necessary changes before the rule is finalized later this year. You can offer your comments on the proposed rule until Sept. 10 at <a href="https://www.federalregister.gov/documents/2018/07/27/2018-14985/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions">this link</a>.</li> <br /> <li><strong>Wanted: Experienced parliamentarian</strong><br /> Are you a leader who thrives on bringing order to chaos? Is Robert's Rules of Order on your nightstand? This volunteer position is for you! The WSMA has an unexpected vacancy on its board of trustees for the speaker of the House of Delegates. If you are an experienced parliamentarian and have attended the WSMA Annual Meeting in the past, we encourage you to apply.<br /> <br /> The speaker of the House of Delegates presides at the annual meeting of the House, serves on the WSMA board of trustees and performs other duties as required. The term of office begins after the conclusion of the 2018 WSMA Annual Meeting and continues through the 2019 meeting.<br /> <br /> A <a href="https://wsma.org/doc_library/about/leadership/nomination_form_2018.pdf" target="_blank">nomination form</a>, <a href="https://wsma.org/doc_library/about/leadership/disclosure_form_2018.pdf" target="_blank">conflict of interest disclosure statement</a> and <a href="https://wsma.org/doc_library/about/leadership/candidate_info_sheet_2018.pdf" target="_blank">candidate information sheet</a> along with a curriculum vitae must be submitted for all suggested nominations. Read about board of trustees qualifications <a href="https://wsma.org/doc_library/about/leadership/qualifications_2018.pdf" target="_blank">here</a>. Please email completed forms to Shannon Bozarth at <a href="mailto:slb@wsma.org">slb@wsma.org</a> (or fax to 206.441.5863) by Sept. 12.<br /> <br /> Many of you may know the WSMA's previous speaker, Dick Whitten, MD. Dr. Whitten has served in many capacities for the past 30 years. We will miss his thoughtful leadership as he wielded the speaker's gavel. Kudos and gratitude to you, Dr. Whitten. The WSMA is better for your dedication to our work and that of the profession.</li> <br /> <li><strong>Naturopath scope creep…again</strong><br /> Once again, the naturopathic licensing board at the Washington State Department of Health is proposing an amendment to an existing rule to add a new section that clarifies the practice of non-surgical cosmetic procedures performed by naturopathic physicians. The WSMA is on record opposing this attempt to allow the scope of practice for naturopaths to include administration of botulinum toxin, dermal fillers or other inert substances for cosmetic purposes, <a href="http://www.informz.net/WSMA/data/images/Documents/NaturoBotox_08142018.pdf" target="_blank">for numerous reasons</a>, not the least of which is that it puts patients at unnecessary risk of harm. Should this rule move forward, it may necessitate that the WSMA bring forward a legal or legislative remedy to ensure patient safety.</li> <br /> <li><strong>Great minds think alike</strong><br /> It's not often that our own flagship publication, WSMA Reports, gets scooped by national newspapers, but on Aug. 18, The New York Times <a href="https://www.nytimes.com/2018/08/18/health/opioid-addiction-treatment.html">published an article</a> on opioids and the hub-and-spoke model for treatment. If only they had waited a few more days, Reports could have scooped them! Even so, they didn't cover how Washington state is deploying the hub-and-spoke model to address opioids here, so don't miss the September/October issue of WSMA Reports, which will be in member mailboxes next week. Writer Marcia Frellick interviewed several WSMA members for the article, and I know you'll find the article of interest.</li> <br /> <li><strong>It's Women in Medicine Month</strong><br /> During the month of September we celebrate women in medicine. At the WSMA, we are proud to have Donna Smith, MD, as this year's president, along with numerous female members of our board of trustees. In fact, 37 percent of WSMA members are female.<br /> <br /> This month serves as a platform to showcase the accomplishments of women physicians. It also highlights advocacy needs related to professional concerns of women physicians and health issues impacting women patients.<br /> <br /> Take a moment to celebrate female physicians by viewing <a href="https://www.youtube.com/watch?v=ooTKLLN5bVo&feature=youtu.be">this historical profile</a> of pioneers who led the way for us today. The AMA also has activities and social media tools promoting September as <a href="https://www.ama-assn.org/women-medicine-month">Women in Medicine month</a>. The AMA's current president and president-elect are women, and we're excited that AMA President Barbara McAneny, MD, will speak at the <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">WSMA Annual Meeting</a> this October in Spokane.</li> </ol> <p>As I told the leaders gathered at Overlake last week, the WSMA is in this work for the long haul, serving your evolving needs as the profession changes. Soon our policymaking body, the House of Delegates, will meet in Spokane to debate a host of policy resolutions. All members are invited to share their thoughts on proposals being offered. You can join the discussion in our online <a href="https://wsma.org/WSMA/Events/Annual_Meeting/Online_Reference_Committees_and_Forum/WSMA/Events/Annual_Meeting/Online_Reference_Committees_and_Forum/Online_Reference_Committees_and_Forum.aspx?hkey=4ea4ed56-61ce-4121-89b9-636415daa863">virtual reference committees</a>.</p> </div>9/3/2018 12:00:00 AM1/1/0001 12:00:00 AM
opioid_overdose_pilot_program_designed_to_save_livesOpioid overdose pilot program designed to save livesLatest_NewsShared_Content/News/Latest_News/2018/August/opioid_overdose_pilot_program_designed_to_save_lives<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/EndOverdose-645px.png" class="pull-right" /> </div> <h5> August 31, 2018 </h5> <h2>Opioid overdose pilot program designed to save lives</h2> <p> Aug. 31, International Overdose Awareness Day, is an opportunity to remember those who have been affected by overdoses as well as offer education about how to prevent or reverse overdoses. Approximately 700 people die from overdoses in Washington state each year. This tragic loss of life impacts all aspects of our community, and it is something we can stop. </p> <p> To stop overdoses, the WSMA, the Washington State Department of Health and the Washington State Hospital Association have partnered with Collective Medical (developers of the Emergency Department Information Exchange, or EDIE) to launch an overdose notification program in Clallam and Jefferson counties. This pilot program will notify a primary care physician or other prescribing provider when their patient is brought to a hospital emergency department and confirmed to have experienced an overdose event. </p> <p>"More than 90 percent of patients who experience an overdose event go on to have a prescription for the same drug that almost killed them. This is because providers are not aware their patient almost died," says Olympic Medical Center Chief Medical Officer Scott Kennedy, MD. "The goal of this pilot is to stop this cycle and save lives." </p> <p> Physicians and providers need timely and meaningful information to support patient care. This notification program uses the EDIE platform to share critical information with providers, nearly in real time. Elya Prystowsky, executive director of Olympic Community of Health said, "We are excited to pilot this amazing notification program in the peninsula as it will help providers quickly coordinate care, get patients access to treatment services and work to reduce overall opioid prescriptions." </p> <p> The pilot will last for three months and then spread to the rest of the state at no cost to hospitals, physicians or providers. </p> <p> The WSMA worked with WSHA, DOH and Collective Medical Technology to advance legislation (HB 1427) in 2017 to establish this program. We have been working collaboratively over the past year to build the infrastructure, and we are excited to finally pilot the program and expand it in the coming months. </p> <p> For a closer look at the pilot overdose notification program, be sure to read the Legal Matters column in the September/October issue of WSMA Reports, now in the mail to WSMA members (<a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA_Reports_Archive/WSMA/News_Publications/Publications/WSMA_Reports_Archive/WSMA_Reports_Archive.aspx?hkey=d3cb4400-8f2b-4fd4-9e4f-f970296623b3">click here</a> for a pdf of the issue). Also in that issue, you'll find up-to-date coverage of other WSMA and state efforts to find clinically effective, long-term solutions to the opioid crisis. </p> <p> For more Washington state-specific information and resources on stopping overdoses, please visit <a href="http://stopoverdose.org">stopoverdose.org</a>. </p> </div>8/31/2018 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_2018_08_27_you_the_people_guide_wsma_policyWeekly Rounds: August 27, 2018 - You, the people, guide WSMA policyLatest_NewsShared_Content/News/Latest_News/2018/August/weekly_rounds_2018_08_27_you_the_people_guide_wsma_policy<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" class="pull-right" src="/images/Logos/Weekly_Rounds_Article_Image_645x425.jpg" /> </div> <h5> August 27, 2018 </h5> <h2> You, the people, guide WSMA policy </h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> The WSMA's House of Delegates was established back in 1889, and since that time it has served us well by being "of the people, for the people, by the people." This is a time-honored structure that allows policy to be shaped at a grassroots level. But the structure only works if members are aware of it and use it to advance patient-focused, physician-driven policy. The following is a primer to help you understand the role of the House in policymaking and to help you prepare for the <a href="https://wsma.org/WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f"> 2018 WSMA Annual Meeting</a> this Oct. 13-14, when WSMA members from across the state will join their delegate peers to debate and determine policy, elect officers and network with colleagues. </p> <h3> How it works </h3> <p> There are approximately 200 voting members of <a href="https://wsma.org/WSMA/About_Us/Leadership/House_of_Delegates/WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx?hkey=e2c50002-384d-4ff7-9116-5ce7a51116e7"> House of Delegates</a> (if all county medical and specialty societies send their allotted delegates). This is the entity that sets WSMA policy. </p> <p> The House convenes its opening session on Saturday morning of the WSMA Annual Meeting. In addition to addressing official business, at this time all reports and resolutions submitted by delegates are referred to reference committees. Reference committee hearings at the WSMA Annual Meeting are key to the deliberations of the House. The reference committees start hearing testimony once the full House recesses for the morning, typically around 10 a.m. on Saturday. </p> <p> WSMA has two reference committees: B and C. Each reference committee is made up of three members of the House who are appointed by the speaker and vice speaker. Typically, matters related to WSMA's advocacy agenda are heard in Reference Committee C. Most other matters are directed to B. (If you are interested in volunteering to serve as a reference committee member, contact Shannon Bozarth at <a href="mailto:slb@wsma.org"> slb@wsma.org</a>.) </p> <h3> What to know about reference committees </h3> <p> All WSMA members are welcome to attend and provide testimony at the reference committee hearings. The chair of each reference committee has the prerogative to permit nonmembers to present testimony. Committee meetings are open to the press. </p> <p> The reference committee meeting is the most appropriate place for you to express your opinions, and those of your constituents, on the resolutions and reports to be considered by the House. When offering testimony, identify yourself and the society or organization which you represent. You can also note that you are speaking on behalf of yourself. Unless raising a point of order or asking a question, it's helpful if you indicate whether you are speaking in favor of, or in opposition to, the resolution or report under discussion. </p> <p> Typically, a reference committee hearing runs two to three hours on Saturday. Once they have finished hearing testimony, reference committee members and staff sequester themselves to develop the official reference committee reports. These reports are published (under the direction of the speaker and vice speaker) on the WSMA website by Saturday evening and in hard copy by 7 a.m. on Sunday. </p> <p> The House then convenes for a second, final session on Sunday morning. During this final session, the reference committees present their reports for consideration by the House. </p> <h3> Your opinion matters </h3> <p> While the House is organized by delegates from county medical societies, state specialty societies and special sections, any member of WSMA can make their opinion known on proposals being considered by delegates for action—but they can't vote unless they serve in a delegate position. </p> <p> For members unable to attend the annual meeting and provide testimony at the reference committees, the WSMA website features <a href="https://wsma.org/WSMA/Events/Annual_Meeting/Online_Reference_Committees_and_Forum/Online_Reference_Committees_and_Forum.aspx"> "virtual" reference committees</a> : password-protected, members-only online discussion forums where members can review and discuss resolutions. Members of the reference committees will read these comments in advance of the annual meeting. </p> <h3> So, what's heard at a reference committee? A resolution! </h3> <p> A resolution is a proposal asking the WSMA to take a position or act on an important issue. Before authoring a resolution, we ask that you research existing WSMA policy by reviewing the <a href="https://wsma.org/WSMA/About/Policies/Policies.aspx"> WSMA Policy Compendium</a>. Current policy may already address the issue in question, negating the need for a resolution. However, if you are seeking to change or modify existing WSMA policy you can do so through the resolution process. </p> <p> A resolution typically consists of a series of "whereas" clauses that explain the reason for the resolution, in addition to one or more "resolved" clauses that state the specific action proposed. </p> <p> Whereas clauses carry a message and develop a set of statements that require a solution. Include a few relevant facts that help frame an outline of the problem. Statements of fact in whereas clauses should be cited with references. Resolved clauses address what the WSMA should do or what position should be taken on the identified issue. </p> <p> If adopted by the House, the resolution may become the foundation of a new WSMA program or policy. The resolved clauses must make sense as standalone statements—if a resolution is adopted by the House, only the resolved clauses become WSMA policy; the whereas clauses do not. </p> <h3> How should I format a resolution? </h3> <p> A resolution includes basic elements: </p> <ul> <li> A title, concisely reflecting the action for which it calls. </li> <li> An author (see "Who can introduce a resolution" below). </li> <li> Whereas clauses. </li> <li> Resolved clauses. Each resolved clause in a resolution must be followed by one of the following notations indicating its purpose: </li> <ul> <li> New House of Delegates (HOD) policy. </li> <li> Modify current HOD policy. </li> <li> Modify bylaws. </li> <li> Rescind HOD policy. </li> <li> Reaffirm HOD policy. </li> <li> Directive to take action. </li> </ul> <li> A fiscal note. The fiscal note will be determined by WSMA staff in consultation with the resolution author. </li> </ul> <h3> Who can introduce a resolution? </h3> <p> While any WSMA member can draft a resolution, all resolutions must be sponsored by a WSMA delegate, alternate delegate or member of the board of trustees to be considered by the House of Delegates at the annual meeting. If you are interested in authoring a resolution but you are not a delegate or a member of the board, the WSMA will work with you to develop your resolution idea and enable its introduction. Email <a href="mailto:hod@wsma.org"> hod@wsma.org</a> or call 206.441.9762 for assistance. </p> <h3> Resolution deadlines </h3> <p> The resolutions that were submitted prior to Aug. 17 will be included in the WSMA Delegate Handbook—the compilation of resolutions and other business to be considered by delegates at the annual meeting. Though that date has passed, there is still time for board members or delegates/alternates to submit resolutions via email ( <a href="mailto:hod@wsma.org"> hod@wsma.org</a> ) by the final deadline of Sept. 13. Resolutions received after Sept. 13 will be distributed to the House of Delegates at the opening session and require a two-thirds affirmative vote by the House to be accepted as official business. </p> <h3> Need help? </h3> <p> WSMA staff are here to help you develop your resolution idea. If you have questions or need assistance, help is just an email or phone call away at <a href="mailto:hod@wsma.org"> hod@wsma.org</a> or 206.441.9762. </p> <h3> WSMA delegate responsibilities </h3> <p> Serving as a delegate to the House carries responsibilities, including: </p> <ul> <li> Be familiar with <a href="https://wsma.org/WSMA/About/Who_We_Are/Who_We_Are.aspx"> the WSMA</a>. </li> <li> Learn about <a href="https://wsma.org/WSMA/About/Who_We_Are/Who_We_Are.aspx"> our strategic priorities</a>. </li> <li> Read <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA_Reports_Archive/WSMA_Reports_Archive.aspx"> WSMA Reports </a> and the <a href="https://wsma.org/WSMA/News_Publications/Newsletters/WSMA_Membership_Memo.aspx"> Membership Memo</a>. </li> <li> Review the <a href="https://wsma.org/WSMA/About/Policies/Policies.aspx"> official actions of the previous House of Delegates </a> and the <a href="https://wsma.org/WSMA/About/Policies/Policies.aspx"> WSMA Bylaws</a>. </li> <li> Alert your colleagues that you are a delegate to the WSMA. </li> <li> Seek their comments and recommendations on WSMA programs and policies. </li> <li> Communicate your society's or your individual recommendations for the establishment of WSMA policies or programs through the introduction of a resolution. </li> <li> Be thoroughly familiar with the reports and resolutions contained in the delegate handbook. </li> <li> Work with your delegation. Divide reference committee responsibilities so your members are represented in the deliberations of each of the reference committees. Encourage all members to attend and participate in reference committee hearings. </li> <li> Take action! If you have an issue or concern, write the president, call the executive director, introduce a resolution or volunteer for a WSMA committee. </li> </ul> <p> Policies influence the direction of any organization. And that direction is guided by the people—that's you! Make your voice heard today. </p> </div>8/27/2018 12:00:00 AM1/1/0001 12:00:00 AM
are_you_a_health_care_employer_take_this_survey_and_help_washington_gauge_workforce_challengesAre you a health care employer? Take this survey and help Washington gauge workforce challengesLatest_NewsShared_Content/News/Membership_Memo/20180822/are_you_a_health_care_employer_take_this_survey_and_help_washington_gauge_workforce_challenges<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/Dyad_Leadership_Course_stock_medical_team_645px.jpg" class="pull-right" /> </div> <h5> August 22, 2018 </h5> <h2>Are you a health care employer? Take this survey and help Washington gauge workforce challenges</h2> <p>The <a href="http://www.wtb.wa.gov/HealthSentinel/">Washington Sentinel Network</a> works with health care providers across the state to identify common occupational skills they need but can't always get, then provides that information to legislators, educators and others to inform policymaking. If you are a health care employer, please take a moment to provide feedback to the network on your workforce needs via this <a href="https://uwfamilymedicine.co1.qualtrics.com/jfe/form/SV_dhEJ4jEwJ1YwEWF">online survey</a> (feedback is particularly needed from primary care/specialty clinics and hospitals). </p> <p>Your feedback is confidential. The network is a collaboration of the state's Workforce Training and Education Coordinating Board and the UW Center for Health Workforce Studies. Visit the <a href="http://www.wtb.wa.gov/HealthSentinel/findings.asp">Sentinel Network's website</a> to review its findings to date, searchable by facility type and geographic region.</p> </div>8/22/2018 12:00:00 AM1/1/0001 12:00:00 AM
comments_due_sept_10_on_cms_proposal_for_physician_fee_schedule_and_quality_payment_programComments due Sept. 10 on CMS proposal for physician fee schedule and Quality Payment ProgramLatest_NewsShared_Content/News/Membership_Memo/20180822/comments_due_sept_10_on_cms_proposal_for_physician_fee_schedule_and_quality_payment_program<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/People%20non%20stock/Medicare_asclepius_lo-res_645x425.jpg" class="pull-right" /> </div> <h5> August 22, 2018 </h5> <h2>Comments due Sept. 10 on CMS proposal for physician fee schedule and Quality Payment Program </h2> <p>Physicians, providers and staff have until Sept. 10 to submit comments to the Centers for Medicare & Medicaid Services on its proposed rule updating Medicare's physician fee schedule and Quality Payment Program for 2019. The new rule proposes comprehensive and significant changes to Medicare billing and documentation, including a single new rate for evaluation and management (E/M) services, provisions to incentivize EHR interoperability and telehealth services, and much more.</p> <p>The WSMA earlier reported on <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20180725/new_cms_rule_proposes_significant_changes_to_medicare_billing_and_documentation">highlights of the proposed changes and the mixed reception to the proposal</a> from some in the medical community. The AMA is working with state and specialty medical societies to discuss and identify key concerns and recommendations to submit to CMS (see <a href="https://assets.ama-assn.org/sub/advocacy-update/2018-08-09.html#national">this AMA update for more information</a>). CMS has provided <a href="https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-3">a fact sheet covering the changes to the physician fee schedule</a> and one covering the <a href="https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-QPP-proposed-rule-fact-sheet.pdf" target="_blank">changes proposed for the Quality Payment Program</a>, as well as a <a href="https://www.youtube.com/watch?v=JvoRQfMtPo4&feature=youtu.be">series</a> of <a href="https://www.youtube.com/watch?v=B0BZmGYpYFU&feature=youtu.be">videos</a> providing a closer look at the changes to E/M coding, including a <a href="https://www.youtube.com/watch?v=W2QBTQNxfSY&feature=youtu.be">live telecast</a> of a panel discussion with CMS leaders. The proposed rule and instructions on how to provide feedback are available from the <a href="https://www.federalregister.gov/documents/2018/07/27/2018-14985/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions">Federal Register website</a>.</p> <p>(Update Aug. 27, 2018: The AMA has delivered <a href="javascript://[Uploaded files/News and Publications/Newsletters/2018/AMA_E_M_sign-on_letter_to_CMS.pdf]">its recommendations to CMS regarding proposed changes to the physician fee schedule</a>, with the WSMA cosigning, along with other state and specialty societies.) <br /> <br /> </p> </div>8/22/2018 12:00:00 AM1/1/0001 12:00:00 AM
health_care_authority_introduces_online_prior_authorization_for_apple_health_and_pebbHealth Care Authority introduces online prior authorization for Apple Health and PEBBLatest_NewsShared_Content/News/Membership_Memo/20180822/health_care_authority_introduces_online_prior_authorization_for_apple_health_and_pebb<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/doctor_tablet_steth-foreground_645px.jpg" class="pull-right" /> </div> <h5> August 22, 2018 </h5> <h2>Health Care Authority introduces online prior authorization for Apple Health and PEBB</h2> <p>Physicians and providers caring for patients enrolled in Apple Health or the Public Employees Benefits Board may now submit prior authorizations for medical requests online.</p> <p>The Health Care Authority has completed a system update to ProviderOne to allow electronic submissions of prior authorization requests and all backup documentation. Physicians and providers submitting requests may also use the ProviderOne portal to check the status of their request. For step-by-step instructions, visit the HCA's <a href="https://www.hca.wa.gov/billers-providers/prior-authorization-claims-and-billing/prior-authorization-pa">prior authorization webpage</a>. Prior authorization requests may still be submitted by fax or mail.</p> <p>Reminder: For medical services covered by individual and small/large group health plans, new requirements are in effect streamlining insurer requirements and easing your burden. Make sure you're making the most of these new requirements by visiting the <a href="http://priorauth.wsma.org/">WSMA Prior Authorization Navigator</a>.</p> </div>8/22/2018 12:00:00 AM1/1/0001 12:00:00 AM
join_wampac_for_fundraiser_in_support_of_dr_kim_schrierJoin WAMPAC for fundraiser in support of Dr. Kim SchrierLatest_NewsShared_Content/News/Membership_Memo/20180822/join_wampac_for_fundraiser_in_support_of_dr_kim_schrier<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/People%20non%20stock/Schrier_LS_2018_caption2_645px.jpg" class="pull-right" /> </div> <h5> August 22, 2018 </h5> <h2>Join WAMPAC for fundraiser in support of Dr. Kim Schrier</h2> <p><a href="https://www.drkimschrier.com/">Dr. Kim Schrier</a> (D-Issaquah), a Virginia Mason pediatrician and longtime WSMA member, was victorious in the primary election for the 8<sup>th</sup> Congressional District seat and will advance to the general election on Nov. 6. Following her victory, the board of directors of <a href="https://wsma.org/WSMA/Advocacy/WAMPAC/WSMA/Advocacy/WAMPAC/WAMPAC.aspx?hkey=269c3c03-cf72-4568-be5b-7893557300a7">WAMPAC</a>, WSMA's campaign arm, voted unanimously to support her campaign and will be hosting a luncheon fundraiser for her in Auburn on Friday, Aug. 31.</p> <p>The fundraiser will take place at Oddfellas Pub (102 W Main St., Auburn 98001) starting at noon; suggested donation levels are $250/friend; $500/sponsor; $1,000/co-host. Space is very limited for this small-group event, so if you are interested in attending please RSVP to Sean Graham as soon as possible at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. If you are not able to attend but would like to provide a contribution to Dr. Schrier's campaign in support of the event, <a href="https://act.myngp.com/Forms/-620291617758246144">you can do so here</a>.</p> </div>8/22/2018 12:00:00 AM1/1/0001 12:00:00 AM
learn_how_to_run_a_successful_campaign_at_the_2018_ampac_campaign_schoolLearn how to run a successful campaign at the 2018 AMPAC Campaign SchoolLatest_NewsShared_Content/News/Membership_Memo/20180822/learn_how_to_run_a_successful_campaign_at_the_2018_ampac_campaign_school<div class="col-md-12"> <!-- div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/People%20non%20stock/Schrier_LS_2018_caption2_645px.jpg" class="pull-right" /> </div--> <h5> August 22, 2018 </h5> <h2>Learn how to run a successful campaign at the 2018 AMPAC Campaign School</h2> <p>Ever wonder how doctors get elected to Congress or your state legislature? Considering a run for office yourself? Then the AMPAC Candidate School, held Dec. 8-9 in Washington, D.C., is for you.</p> <p>The AMPAC Candidate School is designed to give you the skills and strategic approach you will need out on the campaign trail. A select team of political experts will teach you everything you need to know to run a successful campaign or be a sought-after volunteer.</p> <p><a href="http://www.ampaconline.org/political-education/apply/">Registration is now open</a>. The deadline to register is Sept. 21—the program fills up quickly, so don't delay. The registration fee is $350 for AMA members, spouses and state medical society staff ($1,000 for non-AMA members). The fee is waived for students/residents; however, there are limited slots and the AMPAC Board will review and select from the pool of qualified applicants.</p> <p>For more information or to apply visit <a href="http://www.ampaconline.org/political-education/apply/">AMPAC online</a> or contact <a href="mailto:politicaleducation@ama-assn.org">politicaleducation@ama-assn.org</a>.</p> </div>8/22/2018 12:00:00 AM1/1/0001 12:00:00 AM
 

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