2.22.17: Federal Judge Blocks Anthem-Cigna Merger
On February 8, in a significant win for organized medicine and the nation’s patients, federal judge Amy Berman Jackson blocked the proposed Anthem-Cigna merger. The judge found that the merger would have substantially lessened competition for the sale of health insurance to national employers resulting in higher prices and diminished prospects for innovation. Judge Jackson concluded that an enhanced ability to coerce physicians to accept lower reimbursement is not a merger efficiency defense. She determined that it would not benefit consumers and “would erode the relationship between insurers and providers” and “reduce the collaboration” that is essential to innovation in payment and delivery. As of February 13, Anthem has filed a notice of appeal to reverse Judge Jackson's decision. Aetna and Humana also announced on February 14 that they will not appeal a judge’s decision to block their merger on antitrust grounds.
2.22.17: CMS Final Rule on Medicare Part B Payment Policies: Find Out What's Changed
The Centers for Medicare and Medicaid Services (CMS) published in the Federal Register the CY 2017 Medicare Physician Fee Schedule Final Rule on November 15, 2016. This final rule updates payment policies, payment rates, and other provisions for services supplied under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017. These include additional codes for chronic care management, prolonged services, and more. ACP's summary of the physician fee schedule rule includes the key Medicare policy changes that physicians should know for 2017.
2.22.17: CMS Extends Meaningful Use Attestation Deadline to March 13, 2017
CMS has extended the deadline to attest to meaningful use for the EHR Incentive Programs for 2016 performance until March 13, 2017. Clinicians must attest by the deadline to avoid a 2018 payment adjustment. To help providers prepare for the 2016 EHR Incentive Programs attestation period, CMS has released an attestation worksheet for eligible clinicians. Physicians can log their meaningful use measures for each objective in the worksheet and use it as a reference when attesting for the 2016 Medicare EHR Incentive Program in CMS’ Registration and Attestation System.
If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the negative Medicare payment adjustment. You may demonstrate meaningful use under either Medicare or Medicaid, depending on your patient mix.
2.22.17: Submit PQRS Reporting for 2016 Before It's Too Late!
The Physician Quality Reporting System (PQRS) is open for submission of quality reporting data for the 2016 performance period. Physicians must submit PQRS data on their 2016 performance to avoid receiving negative payment adjustments in 2018. Submission dates vary based on how physicians choose to report, so practices should check with submission vendors for deadlines. Additional details are available on ACP’s PQRS page.
2.3.17: CMS Open Payments System Update
The Open Payments system will be updated shortly. Physicians must register first in order to review any payments and other transfers of value attributed to them. If physicians registered last year, they do not need to register again. If it has been over 180 days since a physician has logged onto the Enterprise Identity Management System (EIDM), the account has been deactivated for security purposes. If an account must be reactivated, physicians and teaching hospitals can contact the Help Desk. Beginning today, the Help Desk has extended hours from 7:30 a.m. – 6:30 p.m. (EST).
The review and dispute period is targeted to start in April 2017, following the close of data submission (the Program Year 2016 data submission window begins on February 1, 2017 and ends on March 31, 2017).
You can learn more about the Open Payments system enhancements by viewing the Open Payments Overview and Enhancements presentation. Additional updated resources are located at: https://www.cms.gov/OpenPayments/About/Resources.html.
2.3.17: Ransomware: What to Do When Your Systems are Hijacked
Electronic healthcare security systems were put to the test in 2016, as record numbers of hospitals, facilities and physician practices fell victim to ransomware attacks. The increasing number of ransomware attacks on providers is particularly troublesome because hackers can essentially lock out users from their EHR systems. Once a system is infected, providers feel compelled to pay the ransom rather than sustaining an interruption to patient care. For these reasons, providers should learn about the risks of ransomware and develop strategies to prevent and manage such malicious cyber-attacks.
Preventing ransomware is a complex undertaking, as this particular strain of malware is constantly evolving and infiltrating even those systems that follow recommended security measures. HHS guidance recommends that providers follow the HIPAA security rule to prevent ransomware infections. In particular, providers should implement a robust and frequent data backup plan, which would enable providers to restore previous "infection-free" versions of their electronic data. Providers should also invest in reputable security software (e.g., firewalls, e-mail filters, anti-virus programs) and promptly install updates, which periodically update the software's ability to recognize and detect new ransomware attacks.
2.3.17: New York DOH Weekly Influenza Report
The New York State Department of Health (NYSDOH) collects, compiles, and analyzes information on influenza activity year round in New York State (NYS) and produces this weekly report during the influenza season (October through the following May).
During the week ending January 28, 2017:
2.3.17: SAMHSA Updates Rules on the Sharing of Identifiable Substance Use Disorder Patient Information
On January 18, 2017, the Substance Abuse and Mental Health Service Administration published its final rule implementing changes to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. These changes promote data sharing in order to allow patients to access new care delivery models in the evolving health care industry and encourage much-needed research of substance abuse disorders.
2.3.17: ACP’s High Value Care Initiative
High Value Care improves health, avoids harm, and eliminates wasteful practices or procedures. The ACP’s High Value Care initiative has developed 5 new modules to help physicians understand the and apply the core concepts of high value care. As a member you have free access to these modules that are available online and eligible for CME and MOC credits.
To learn more about how to eliminate unnecessary health care costs and improve patient outcomes while earning free CME and ABIM MOC patient safety and medical knowledge points, visit High Value Care.
2.3.17: Quality Payment Program Listserv Available Now Through CMS
Have you subscribed to the CMS Quality Payment Program (QPP) Listserv? The QPP listserv will provide news and updates on:
To subscribe, visit the Quality Payment Program portal and select “Subscribe to Email Updates” in the footer. The Education & Tools page includes program resources to help you learn more about eligibility and how to participate.
1.23.17: Track Important Mandates with ACP's Physician & Practice Timeline
Do you need help keeping track of all the important dates associated with government mandates, system changes and requirements? The ACP's Physician & Practice Timeline provides a summary of upcoming important dates to help you keep up with the many government mandates related to regulatory, payment, and delivery system changes and requirements.
The College is providing a new feature, an opt-in text alert service that notifies you of regulatory deadlines. To sign-up for these alerts, simply text ACPtimeline (no space) to 313131 from your mobile phone.
1.18.17: CMS Attestation System For 2016 EHR Incentive Program Now Open Until February 28
The Centers for Medicare & Medicaid Services Registration and Attestation System is now open.
Payment Adjustments and Hardship Exceptions
In January 2018, CMS will begin to apply payment adjustments for providers that did not successfully demonstrate meaningful use of EHR technology or apply for and receive a hardship exception for the 2016 program year. CMS will send a separate announcement with more information on the hardship exception application process, once available.
1.18.17: Physicians Billing Medicaid: Your Ordering/Prescribing/Referring Providers Must Revalidate for Claims to be Paid
Federal regulation requires State Medicaid agencies to revalidate the enrollment of all providers every five years. For many providers Medicaid payment is contingent on the ordering/prescribing/referring (OPR) provider also revalidating their enrollment in Medicaid. OPR providers who do not comply with the revalidation requirement will be terminated from the Medicaid Program.
The required revalidation form and instructions are available at https://www.emedny.org/info/ProviderEnrollment/index.aspx. The completed form must be mailed, with all required documentation and fee (if required), to the address provided on page 2 of the form.
1.18.17: Healthcare is Among the Top Three Sectors Facing the Highest Risk of a Targeted Hacking Attack, a Recent ICIT Report Found
With its high dependency on digital records, network connectivity, accessible information, and real-time communication, healthcare is one of the sectors at greatest risk for a Distributed Denial of Service (DDoS) attack, the Institute for Critical Infrastructure Technology (ICIT) explained in a recent publication.
“Obstructions to even an email server could cause delays in treatment, while widespread attacks that holistically render a critical service unavailable, such as an IoT DDoS attack, would pose a serious risk to patient and staff safety,” wrote ICIT Senior Fellow James Scott and ICIT Researcher Drew Spaniel.
Citing research from a previous ICIT brief, the duo explained that healthcare is incorporating, and interacting with connected devices that are often designed without necessary security measures. Previously, this has led to instances such as MRI machines or pacemakers being infected with ransomware.
More organizations are utilizing the internet and IoT devices, but device manufacturers will sometimes “negligently avoid incorporating security-by-design into their systems.” This happens because the manufacturers have not been properly incentivized, and instead pass the potential risk onto the end-user.
12.19.16: End-of-Rotation Handoffs Associated with In-hospital Mortality, Study Finds
End-of-rotation transitions may heighten mortality risk in internal medicine inpatient care, a study found.
To examine the association of end-of-rotation house staff transitions with mortality among hospitalized patients, researchers conducted a multicenter cohort study of 230,701 patients admitted to internal medicine services in 10 Veterans Affairs hospitals. Patients who were admitted prior to an end-of-rotation transition and died or were discharged within 7 days following transition were stratified by type of transition (intern only, resident only, or intern and resident) and compared with all other discharges (control). An alternative analysis comparing admissions within 2 days before a transition with admissions on the same 2 days 2 weeks later was also conducted.
The primary outcome was in-hospital mortality. Secondary outcomes included 30-day and 90-day mortality and readmission rates. A difference-in-difference analysis assessed whether outcomes changed after 2011 Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulation changes. The study was published by JAMA on Dec. 6.
Last Updated 2.22.17
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