Practice Management

Latest News:

11.23.16: Late Breaking News Regarding Employee Overtime Rules

On November 22, 2016, the US District Court for the Eastern District of Texas issued a nationwide injunction preventing the US Department of Labor from implementing regulations revising employee overtime payment rules. Until resolved, this delays the federal regulatory changes from going into effect on December 1, 2016.

For New York however, the State Department of Labor has proposed a gradual charge in minimum salary levels defining exempt employees, expected to go into effect on December 31, 2016.

We will keep members informed as details change.


11.23.16: Do You Have an Interest In Asthma Control?

NYACP is looking for a physician volunteer to serve on the Asthma Partnership of New York (APNY). This Advisory Group to the NYS Department of Health meets three times per year (once in person and 2 webex) and will focus on the three priority issues for 2017:

  • Define the role of community health workers in supporting asthma control services
  • Increase coverage of and access to medications and devices
  • Develop recommendations for engaging Managed Care Organizations in supporting clinical-community linkages for asthma control services

If you are interested in an appointment representing the New York Chapter of ACP, contact Linda Lambert at llambert@nyacp.org.


11.23.16: In Need of Assistance Preparing for the New Value Based Payment Models?

Are you frazzled with your practice transformation efforts?  Could you use some help? Value based payments are just around the corner and the NY Chapter ACP is committed to helping you prepare:

The CMS Transforming Clinical Practice Initiative (TCPI) is designed to support clinician practice transformation over the next 4 years with support from Practice Transformation Networks (PTNS) and Support and Alignment Networks (SANS).

The NY Chapter is working with the ACPSAN to provide the tools and resources that eligible practices need. We can connect you to a Practice Transformation Network that will coach, mentor, and assist you in developing core competencies necessary to transform your practice and thrive in an emerging healthcare environment that emphasizes value of care. The PTN embraces and supports the "quadruple aim" of better care, better health, lower costs, and greater provider satisfaction.

If you are in need of assistance and currently use a 2014 Certified Electronic Health Record and are not currently participating in a Medicare Shared Savings Program, Pioneer ACO program, Multi-Payer Advanced Primary Care Program, or Comprehensive Primary Care Initiative please contact Lisa Noel, Mgr. Practice Support Services at lnoel@nyacp.org or 518-427-0366.


11.23.16: NYS Department of Health Releases Influenza Stat Sheet

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 a weekly report during the influenza season (October 1 through the following May 1)

Influenza Report During the Week Ending November 12, 2016;

  • Influenza activity level was categorized as geographically sporadic (Small numbers of lab-confirmed cases of influenza reported). Sporadic activity has been reported for six consecutive weeks.
  • There were 77 laboratory-confirmed influenza reports, a 15% decrease over the prior week.
  • Of the 1,199 specimens submitted to NYS WHO/NREVSS laboratories, 9 (0.75%) were positive for influenza.
  • Of the specimens tested at Wadsworth Center, none were positive for influenza.
  • Reports of percent of patient visits for influenza-like illness (ILI3) from ILINet providers was 0.55%, which is below the
  • regional baseline of 3.00%.
  • The number of patients hospitalized with laboratory-confirmed influenza was 38, a 31% increase over the prior week.
  • There have been no influenza-associated pediatric deaths reported this season.

To read the full report, please click here.


11.10.16: CMS Issues Final Rule for Updated Medicare Physician Fee Schedule Payment Policies

On Wednesday, November 2, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017. CMS finalized a number of new PFS policies that will improve Medicare payment for those services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment conditions.

In addition, the final rule addresses other topics related to the Medicare program, enrollment requirements for providers and suppliers in Medicare Advantage, and the Medicare Diabetes Prevention Program (MDPP) expanded model. For more details on the Diabetes Prevention Program model test, visit the fact sheet for that portion of the rule.

The CY 2017 PFS final rule is one of several rules that reflect a broader Administration-wide strategy to create a health care system that results in better care, smarter spending, and healthier people. Changes highlighted by CMS include:

  • Payment Accuracy for Primary Care and Care Coordination:  CMS created new codes that separately pay for chronic care management and transitional care management services, and solicited public comment on additional policies the Agency should pursue. After considering the public comments received, for CY 2017, CMS is finalizing a number of coding and payment changes to better identify and value primary care, care management, and cognitive services. To read the full list of coding and payment changes, click here.
  • Improvements to Mental and Behavioral Health Coding: The ability to make separate payments using new codes to pay primary care practices that use interprofessional care management resources to treat patients with behavioral health conditions is now an option. Several of these codes describe services within behavioral health integration models of care, including the Psychiatric Collaborative Care Model that involves care coordination between a psychiatric consultant or behavioral health specialist, behavioral health care manager, and the primary care clinician, which has been shown to improve quality of care.
  • Cognitive Impairment Care Assessment and Planning:  Separate payments using a new code to describe the comprehensive assessment and care planning for patients with cognitive impairment. (e.g., for patients with dementia or Alzheimer’s).

11.10.16: OCR Stresses Healthcare Authentication Importance
This article was originally posted in Health IT Smartbrief

One of the causes of healthcare data breaches over the past few years has been weak healthcare authentication measures, according to the Office for Civil Rights (OCR). As healthcare continues to be a top target for cyber attacks, organizations need to ensure that they are implementing the right security measures.

To read more, please click here.

11.10.16: Non-first-line Antibiotics Prescribed Half the Time for Otitis Media, Sinusitis, Pharyngitis

Physicians prescribed first-line recommended antibiotics only half of the time during visits for otitis media, sinusitis, and pharyngitis, and overuse of non-first-line agents, especially macrolides, was higher for adults than children, according to a recent study by Adam L. Hersh, MD, PhD, Katherine E. Fleming-Dutra, MD, and Daniel J. Shapiro, MD

To read more, click here


10.20.16: Medicare Deadline Looms for Review of Potential Payment Penalties and Physician Requests for Review of Errors

Late last month, the Centers for Medicare and Medicaid Services posted information on its web site that physicians can consult to determine whether they will be subject to 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and the Value Modifier.  Practices that have concerns about the findings in their report(s) have until November 30 to file for an informal review of their data.

The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act.  Failure to successfully complete required PQRS reporting will result in a 2% penalty.  Value Modifier penalties can range from 1% to 4% depending on the size of the practice and its performance on cost and quality measures.  PQRS penalties will be communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS web site.  Value Modifier penalties and bonuses can be found in Quality and Resource Use Reports (QRURs) posted on the web site only.

Additional information on accessing the reports and filing for an informal review can be found in the attached documents.  Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review.  Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data.


10.20.16: The Office for Civil Rights (OCR) Issues New Guidance on HIPAA
and Cloud Computing


The Office for Civil Rights (OCR) continues to issue guidance to covered entities and business associates on discrete arrangements that implicate the HIPAA Privacy and Security Rules (HIPAA Rules). Most recently, OCR released guidance on “HIPAA and Cloud Computing” accompanied by a series of frequently asked questions (FAQs).

The guidance affirms that a covered entity (or business associate ) may engage a cloud service provider (CSP) to store electronic protected health information (ePHI) or to create, receive or transmit ePHI on the covered entity’s (or business associate’s) behalf provided that the parties enter into a HIPAA-compliant business associate agreement. OCR cautions, however, that “a covered entity (or business associate) that engages a CSP should understand the cloud computing environment or solution offered by a particular CSP so that the covered entity (or business associate) can appropriately conduct its own risk analysis and establish risk management policies.”

OCR also clarifies that a CSP storing or maintaining encrypted ePHI on behalf of a covered entity or on behalf of a business associate is itself a business associate.

<<To read the full article, please click here


10.6.16: Physicians: You Can Now Access 2015 PQRS Feedback Reports and 2015 Annual Quality and Resource Use Reports 

The Center for Medicare and Medicaid Services (CMS) has made available the 2015 Physician Quality Reporting System (PQRS) Feedback Reports and 2015 Annual Quality and Resource Use Reports (QRURs).  The PQRS Feedback Reports show your program year 2015 PQRS reporting results, including payment adjustment assessment for calendar year 2017. The 2015 Annual QRURs show how physician groups and physician solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier as well as their 2017 Value Modifier payment adjustment.

How to Access the Reports:

  • An Enterprise Identity Management (EIDM) account with the appropriate role is required for participants to obtain 2015 PQRS Feedback Reports and 2015 Annual QRURs.
  • If you already have an EIDM account, then follow the instructions provided here to sign up for the appropriate role in EIDM.
  • To find out if there is already someone who can access your PQRS Feedback Report and QRUR, contact the QualityNet Help Desk.
  • To access both reports or sign up for an EIDM account, visit the CMS Enterprise Portal and click “New User Registration” under “Login to CMS Secure Portal.” Instructions for signing up for an EIDM account are provided here.

Access and review your 2015 PQRS Feedback Report and 2015 Annual QRUR now to determine whether you are subject to the 2017 PQRS negative payment adjustment and the 2017 Value Modifier payment adjustment.

To read more, click here.


Last Updated 11.23.16
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NYACP has resources to assist you in all of your ISTOP and E-Rx implementation efforts.

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Tel: 518-427-0366
Fax: 518-427-1991
Email: info@nyacp.org