Practice Management

Latest News:

10.20.16: What Physicians Need to Know:
How the New Federal Overtime Rule Effective December 1 Impacts Your Employees

In May, the Department of Labor announced an update to overtime regulations that increased the threshold below which employees must receive overtime pay to $47,476 - more than double its current $23,660. The new regulations mean that both hourly and salaried workers are entitled to time and a half pay when they put in more than 40 hours a week.

The new rules makes millions of full-time healthcare workers eligible for overtime pay, but is not limited to the healthcare industry. These rules emanate from the Federal Department of Labor and cross all industries. These changes go into effect December 1, and the threshold will automatically adjust every three years, based on wage growth over time.

On September 28, the House of Representatives passed legislation H.R 6094, possibly delaying the implementation of the new federal overtime pay rule until June 1, 2017. There is a possibility that the Senate will act on the bill or another version after the Presidential election.

To explain these overtime rules and how specifically they affect physician practices, NYACP is hosting a lunch hour webinar. With the deadline approaching this webinar is essential in the event Congress does not act.

October 27, 2016:  Updates on Changes to the Federal Overtime Rules
12:00 PM • Registration Link

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: MACRA Quality Payment Program Final Rule Provides a More Definitive Path
for Transformed Medicare Payments

On October 14, 2016, Centers for Medicare and Medicaid Services (CMS) issued a final rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (the “Final Rule”). The Final Rule intends to simplify quality reporting requirements for physicians, as well as to incentivize participation in Alternative Payment Models (APMs). Attempting to heed calls for simplicity and flexibility, CMS made changes to the April 2016 proposed rule. CMS anticipates that the Final Rule’s Quality Payment Program will eventually transform Medicare reimbursement for over 600,000 clinicians.

MACRA repealed the Sustainable Growth Rate formula and created two quality-based programs: the Merit-Based Incentive Payment System (MIPS) and the Advanced APMs. MIPS incentivizes clinicians by measuring performance in four categories: quality, resource use, clinical practice improvement activities and meaningful use of certified electronic health records (EHR) technology. MACRA also provides that clinicians participating in certain Center for Medicare and Medicaid Innovation payment models, certain Medicare Shared Savings Programs (MSSP) or other federal demonstration projects qualify for incentive payments under the Advanced APM structure.

<<To read the full article and how it affects MIPS and Advanced APMs, please click here.

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

10.20.16: EHR Incentive Programs: Review Resources on 2016 Program Requirements

The Center for Medicaid and Medicare Services (CMS) has created materials to help providers attest successfully to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in 2016. Below are a few of the resources they offer:

10.6.16: ACP Leads Collaborative Effort to Allow Students Meaningful Access to Electronic Health Records

Almost all medical schools and their affiliated hospitals and clinics now use an electronic health record (EHR).  But as a student:

  • Have you been taught how to use it?
  • Are you allowed full access to the EHR?
  • Can you write meaningful notes in it?
  • Are you able to write orders using the EHR?

If you answered “No” to any of these questions, you may be worried that you might not be fully prepared to care for patients when you reach residency.  This is the concern of ACP and other medical education organizations involved with student and resident training.

With the advent of EHRs, many hospitals and health systems began restricting student access to the medical chart or significantly limiting what students are able to do within the EHR.  Surveys show extremely wide variability in student use of the EHR, ranging from read-only access to full documentation and ordering privileges, with very few institutions providing specific teaching about how to effectively and appropriately use the EHR.

The ACP believes that limited medical student access to or limited use of the EHR threatens development of important skills needed for continued training and the lifelong practice of medicine.  

This belief led to a resolution introduced by the Education and Publications Committee of the American College of Physicians to develop a set of medical student competencies related to charting in the EHR, including the specific competencies to be documented at each stage of training.  The resolution was ultimately endorsed by the ACP Board of Governors and passed by the Board of Regents, which is the highest level of leadership in ACP and the one that ultimately determines College policy.

To read more about this collaborative effort, 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 10.20.16

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

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