Health Information Technology (HIT)
Chronic Care Management
The American College of Physicians and the New York Chapter are asking members to help strengthen the organization by recommending ACP membership to colleagues. By joining the College, your colleagues will enrich their clinical knowledge and skills and have access to all of the ACP and Chapter member benefits that you enjoy.
To thank you for your dedication to our organization, ACP offers incentives to members and their chapters for recruiting new members through the Recruit-a-Colleague Chapter (RACC) Rewards Program.
The RACC Program rewards successful individual recruiters with dues credits for each new full Member or Physician Affiliate member recruited and a chance to win a trip to the annual Internal Medicine meeting. In addition, the RACC Program also provides rewards to the recruiter’s chapter, and complimentary registrations to the annual Internal Medicine meeting.
The 2015-16 Recruit-a-Colleague Chapter Rewards Program runs until March 1, 2016.
To participate, simply forward a membership application found at www.acponline.org/racc to your colleagues. To qualify for the program, your name must be listed on the recruiter line of the application, and the form must include the code “RACC”. We suggest you print the form and add that information to get credit!
Your help with membership recruitment, is a win-win for all!
While the Office of National Coodinator (ONC) and Centers for Medicare & Medicaid Services (CMS) already have online resources addressing many meaningful use and EHR concerns, a new form gives physicians a place to share their certified health IT-related issues with the federal government if they cannot find a resolution within existing ONC resources.
The ONC asks that physicians describe their issues relating to these areas when they complete the form:
- ONC health IT certification
- Information blocking
- Health IT safety
- Privacy and security
- Clinical quality measures
While the ONC may not always be able to step in and fix the problem, they may be able to help in other ways, such as beginning a dialogue between physicians and their EHR vendors/developers. Submitting concerns to the ONC also helps the agency better understand the extent of problems as they work with other federal agencies to develop solutions.
The New York State Department of Health is pleased to announce the availability of the online 4-hour medical use of marijuana education course. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must do the following:
- Be qualified, by training or experience, to treat patients with one or more of the serious conditions eligible for medical marijuana;
- Be licensed, in good standing as a physician and practicing medicine, as defined in article one hundred thirty one of the Education Law, in New York State;
- Possess a Health Commerce System (HCS) Medical Professions Account user ID and password;
- Possess an active Drug Enforcement Administration (DEA) registration number; and
- Complete the four hour Department-approved medical use of marijuana course.
The online course will be provided by The Answer Page, an established online medical education provider. The course content was created by physicians with contributions from academicians and will be fully referenced. The course will include the following topics:
- The pharmacology of marijuana;
- side effects and adverse reactions;
- overdose prevention, drug interactions, dosing, abuse and dependence;
- routes of administration, risks and benefits;
- warnings and precautions.
The cost to take the course is $249, and practitioners will earn 4.5 hours of CME credit upon successful completion.
The New York State Department of Health (NYSDOH) provides a document annually to summarize and assist healthcare providers, clinical laboratories, local health departments (LHDs), hospitals, nursing homes, and others with influenza reporting requirements.
INFLUENZA SURVEILLANCE AND REPORTING REQUIREMENTS
NYSDOH will conduct enhanced influenza surveillance beginning the first week in October 2015 through the third week in May 2016 (the week ending October 10, 2015 through the week ending May 21, 2016). Reporting requirements vary by setting and provider type and are detailed below.
Healthcare Providers in the Ambulatory or Outpatient Setting
- Healthcare providers must report outbreaks1 of influenza or influenza-like illness (ILI) to the LHD of the county in which the outbreak is occurring. Contact information for LHDs can be found at http://www.nysacho.org/i4a/pages/index.cfm?pageid=3713.
- Healthcare providers are not required to report to NYSDOH positive influenza diagnostic tests performed outside of a full-service clinical laboratory (see Clinical Laboratory section).
You can view the full report: https://apps.health.ny.gov/pub/ctrldocs/alrtview/postings/Notification_19253.pdf
The impending mandate to electronically prescribe all prescriptions, including prescriptions for controlled substances, is rapidly approaching. This webinar (co-hosted by Surescripts) will address the current state of pharmacy and physician adoption of electronic prescribing in New York, inform prescribers as to what steps they need to take to legally use E-prescribing for controlled substances by March 27, 2016, and provide an overview of how to obtain and verify software installation.
Webinar topics will:
- Summarize key aspects of the ISTOP bill as it relates to electronic prescribing (EPCS)
- Address the current adoption of EPCS by New York pharmacies and prescribers
- Review the steps to become enabled by EPCS in a short 5-minute video
- Establish the value of e-prescribing vs. paper scripts
You can register for these dates by following the links provided:
- Wednesday, December 9, 2015, 8:00 am - 9:00 am EST: Register Here
An article by W. David Bradford and Anne Mandich in the August issue of Health Affairs looks at how vaccine exemption laws affect immunization rates and outbreak of preventable disease. The article shows that policies such as requiring health department approval of non-medical exemption applications, physician signatures on applications and criminal or civil punishments for noncompliance significantly affects the reduction of vaccine exemptions.
An excerpt: "Vaccination exemption rates vary significantly across the United States. In 2012 exemption rates ranged from a low of approximately 0.45 percent in New Mexico to a high of 6.5 percent in Oregon. If an increasing number of parents do not vaccinate their children and instead opt for an exemption, the United States could experience a general increase in preventable disease. If this association holds, state public health officials may want to advocate reconsidering state laws and policies that ease the exemption process, to avoid unnecessary illness. Note that the rules governing when a child must be vaccinated may be included in laws, policies, or both."
Medicare / Medicaid and ICD-10
Chronic care management (CCM) is a unique physician fee schedule service designed to pay separately for non-face-to-face care coordination services furnished to part B Medicare beneficiaries with multiple chronic conditions. It applies to practices and patients that are not included in alternative payment models. The code (99490) fills a long-awaited void in treating patients with multiple chronic conditions and was included in the Centers for Medicare and Medicaid Services' final Physician Fee Schedule rule for 2015.
MLN Releases Chronic Care Management FAQ
MLN Matters® Special Edition Article #SE1516: "Chronic Care Management (CCM) Services FAQ" has been released to view and download. This article is designed to provide education on Medicare's requirement for 24/7 access by individuals furnishing CCM services to the electronic care plan, rather than the entire medical record. It includes FAQs regarding billing CCM services to the Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) under CPT code 99490.
Chronic Care Management Services Fact Sheet
The Chronic Care Management Services Fact Sheet (ICN 909188) was released and is available in downloadable format. This fact sheet is designed to provide background on the separately payable Chronic Care Management (CCM) Services for non-face-to-face care coordination services furnished to Medicare beneficiaries with multiple chronic conditions. it includes information on eligible providers and patients; Physician Fee Schedule billing requirements; and a table aligning the CCM Scope of Service Elements and billing requirements with the Certified Electronic Health Record or other electronic technology requirements.
Other CCM Resources
Practice Management Tools
Advance Care Decisions Materials Available from NYACP
Advance decision making and end-of-life care options are unfortunate but necessary conversations for patients to have with their physicians and families. New York Chapter ACP has gathered important resources to assist in making these difficult discussions a reality.
A recently released report from the Institute of Medicine of the National Academies entitled “Dying In America: Improving Quality and Honoring Individual Preferences Near the End of Life” details key findings and recommendations related to the realities of the clinician-patient relationship and how to effectively communicate and facilitate end of life wishes and directives. An excerpt of the recommendations:
“Most people nearing the end of life are not physically, mentally, or cognitively able to make their own decisions about care. The majority of these patients will receive acute hospital care from physicians who do not know them. Therefore, advance care planning is essential to ensure that patients receive care reflecting their values, goals, and preferences.”
You can read the document in its entirety here.
In addition, the Department of Health for New York State has a website of resources including the Medical Orders for Life-Sustaining Treatment (MOLST) form.
The DOH has created a portal that contains a wealth of information on advance care decisions, including legal requirements checklists, frequently asked questions, and guidance documents for physicians and patients.
MOLST legal requirements checklists and general instructions for adult patients are:
- MOLST Adult General Instructions and Glossary (3/2012) (PDF, 114KB, 6pg.)
- MOLST Checklist 1 - adult with capacity any setting (5/1/13) (PDF, 49KB)
- MOLST Checklist 2 – adult with health care proxy any setting (5/1/13) (PDF, 91KB)
- MOLST Checklist 3 - adult with FHCDA surrogate (3/2012) (PDF, 95KB, 4pg.)
- MOLST Checklist 4 - adult without FHCDA surrogate (12/1/10) (PDF, 58KB, 4pg.)
- MOLST Checklist 5 - adult without capacity in the community (12/1/10) (PDF, 59KB, 4pg.)
The MOLST legal requirements checklist for minor patients is:
- MOLST Checklist for Minor Patients and Glossary (3/2012) (PDF, 120KB, 7pg.)
Frequently Asked Questions regarding MOLST:
CMS Supports Advanced Care Planning With Medicare Payment!
The decision by CMS to approve payment for end-of-life counseling affirms advanced care planning is a critical component of clinical practice. Additionally, the value of thoughtful planning discussions between patients and clinicians is clearly recognized.
Shared medical decision-making must be well informed and cannot be presumed. With the increasing diversity of our population, clinicians and caregivers, there is only one way to know "what matters most" to the patient. You must ask them. This decision supports the National POLST Paradigm Program and New York's MOLST and eMOLST.
CMS will begin reimbursing for these conversations starting January 1, 2016. The two advanced care planning codes for Medicare are:
- 99497 for an initial 30 minute voluntary advance care planning consultation (Final RVU 1.5)
- 99498 as an add-on code for additional 30 minute time blocks needed (Final RVU 1.4)
New York has been a leader in advanced care planning and supports the IOM recommendation that encourages "financial incentives for improved shared decision making and advanced care planning." The actions taken by CMS align with this recommendation and should be followed by other insurers.
The CMS decision is applauded by CompassionAndSupport.org, the MOLST Statewide Implementation Team and the National Healthcare Decisions Day (NHDD) NYS Coalition.
Making Fall Prevention Part of Primary Care
Implementing CDC's STEADI Toolkit in a NYS County Health System (recorded webinar now available)
Falls among older New Yorkers (age 65 and over) are the leading cause of injury deaths, hospitalizations, and emergency room visits. To reduce falls, the CDC developed the STEADI (Stopping Elderly Accidents, Deaths, & Injuries) Toolkit. The STEADI Toolkit is a comprehensive resource designed to help healthcare providers incorporate fall risk assessment and proven interventions into clinical practice.
The Chapter is excited to offer this one hour CME accredited recorded webinar on "Implementing CDC's STEADI Toolkit in a NYS County Health System" .
Frank Floyd, MD, FACP, Associate Medical Director & STEADI Champion, United Health Services presented the webinar, which highlighted:
- Information on the burden of falls in older adults in New York State
- Resources in the CDC STEADI Toolkit
- Challenges of incorporating fall prevention into clinical care
- Tips for incorporating fall prevention into clinical care
Opportunity to Earn 20 ABIM Maintenance of Certification Credits
NYACP continues to serve as a partner to the New York State Department of Health (NYSDOH) Fall Prevention Program for Older Adults. NYSDOH is entering its final year of a 5-year grant with the Centers for Disease Control (CDC) to implement three evidence-based programs to help prevent falls – Tai Chi: Moving for Better Balance, Tai Chi for Arthritis, and Stepping On – in Broome, Chautauqua, and Suffolk Counties. These programs are also proven to reduce healthcare costs.
The NYACP Geriatrics Task Force, chaired by Eleanor Weinstein, MD, FACP, regularly monitors activities of the program and would like to bring attention to information and tools developed by the CDC to assess and address older patients’ fall risk.
Tool Kit: http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/index.html
Materials can be ordered or downloaded for free through the CDC website.
Physicians who adopt STEADI can earn 20 ABIM/ABFM Maintenance of Certification credits. These credits qualify for Category II AMA credits as well.
For more information on earning credits or these programs, please contact Harrison Moss (firstname.lastname@example.org) at the NYS Department of Health
ACP's High Value Care Coordination Toolkit features resources to improve referrals and care coordination between primary care physicians and specialists, eliminate waste and duplicative care, and create more efficiency in care delivery.
The toolkit was developed collaboratively through ACP's Council of Subspecialty Societies (CSS) and patient advocacy groups.
The High Value Care Coordination Toolkit includes 5 components:
- a checklist of information to include in a generic referral to a subspecialist practice,
- a checklist of information to include in a subspecialist's response to a referral request,
- pertinent data sets reflecting specific information in addition to that found on a generic referral request to include in a referral for a number of specific common conditions to help ensure an effective and high-value engagement,
- model care coordination agreement templates between primary care and subspecialty practices, and between a primary care practice and hospital care team, and
- an outline of recommendations to physicians on preparing a patient for a referral in a patient- and family-centered manner.
These resources are part of ACP's High Value Care initiative, which is designed to help doctors and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices.
Tobacco use is leading cause of preventable death in the U.S., and as health care professionals we are in a prime position to help our patients successfully quit tobacco, while simultaneously lowering their risk of heart disease, stroke, COPD and other diseases.
Recently, the NYC Health Department has developed an excellent and free online learning module to assist physicians by enhancing your knowledge on how to effectively assess, counsel, and treat tobacco use, greatly improving patients’ chances of successfully quitting. For medical residents, this module meets five of the six Accreditation Council for Graduate Medical Education core competencies and is able to be placed in your learning management system. For attending physicians, this module provides 1 CME credit.
Highlights of the module include:
- The “5 A’s” model of treating tobacco use
- Provider/Patient communication techniques
- Treatment options and guidance, including combination therapy
- New York State Medicaid Benefits
- Billing information for smoking cessation counseling
Prescribe Opioid's Safely with Pri-Med
ACP and its curriculum partner Pri-Med offer an online training program to educate clinicians about safety and efficacy when prescribing opioids. ACP's curriculum provides a comprehensive educational program for primary care clinicians to safely and effectively manage patients with chronic pain. The program is available through the Pri-Med website.. Find out more.
With approximately 100 million adults in the U.S. suffering from chronic pain, the nonmedical use of prescription opioids has become a public health issue, and prompted the U.S. Food and Drug Administration to establish the Risk Evaluation and Mitigation Strategy (REMS) mandate. A total of 26 Continuing Medical Education (CME) and Continuing Education providers, including ACP, have created educational initiatives to help prescribers ensure that the benefits of a drug outweigh the risks for patients receiving extended release and long acting opioids.
ACP developed online training modules with Pri-Med to educate clinicians about best practices when prescribing opioids to patients and to help prescribers manage risk for abuse and inappropriate use. The REMS training modules provide comprehensive educational information for primary care clinicians, and can be completed for CME credit. Access the online modules for additional information.
A brief video from Steven Weinberger, MD, FACP, executive vice president and CEO of ACP, highlights the initiative’s goal of reducing misuse, abuse and overdose deaths associated with prescription opioids.
Note: an ACP Username/password is required to login)
Laurie Cohen, Esq., Partner at Nixon Peabody and the Chapter's attorney provides members with support and direction through articles and answering questions relevant to general practice.
Managing Your Patients With Diabetes - Tools & Resources
- ACP Smart Medicine
- ACP Quality Connect
- American Diabetes Association
- Bridges to Excellence Diabetes Care
- NCQA Diabetes Recognition Program
- ACP Diabetes Monthly
- Improving Diabetes Through Patient Engagement Webinar (password required)
Learn about NY's information network, Meaningful Use, e-Prescribing, privacy and security and best practices.
The following patient-related resources provide guidance in effectively maintaining and enhancing the doctor-patient relationship.
- Patient Centered Medical Home - ACP has gathered a comprehensive collection of information, resources and demonstration projects to assist you in planning for a complete Patient-Centered Medical Home.
- Physician Quality Reporting System - tools and resources to help guide you through collecting and reporting quality measure data.
Last updated: 9.11.15