February 3, 2010

Breaux Assumes LSMS Presidency

The Louisiana State Medical Society (LSMS) installed its 130th president, Dr. Patrick C. Breaux of New Orleans, Louisiana, at the 2010 Annual Meeting of the House of Delegates. The meeting was held January 29-30 at the L’Auberge du Lac Casino Resort in Lake Charles.

First of all, I would like to thank the membership of the LSMS in bestowing on me the honor of serving as President in 2010. Having been given the privilege of the practice of medicine, I feel the need, as most of you, to give back. Katrina opened my eyes to the deeply flawed health care system we had in New Orleans. Charity Hospital, while providing care for millions and training for most doctors and many of the nurses in the state, also was the embodiment of a two tiered health care system and its many disparities. While my intention was to be just a helper in health care reform process, I now find myself as your President.

As a medical society we will need to anticipate and respond better to the changes in practice patterns and physician demographics by offering value to the professional lives of all physicians. As President, I want to focus on expanding membership; defending Act 817 and the medical malpractice cap; opposing any cuts in Medicaid and Medicare; and training our next generation of physicians to be effective leaders.

While health care reform has been temporarily derailed by the Massachusetts Senatorial election, LSMS remains opposed to increased government control and incremental steps toward a single payer system. We support a market based approach to provide health care services and the ability to privately contract. Health care is at its best when it is patient centered and physician guided.

Our next generation of physicians should be active in the reform process. They have the most to gain or lose. In a time of challenge and change there are also opportunities. Let’s rise with a renewed purpose to lead the fight for health care that benefits our patients and provides hope for a promising and rewarding career for future generations of physicians.

Patrick C. Breaux, M.D.

New Orleans, LA

DHH Cuts Physician Reimbursement

On January 20, 2010, new emergency rules were published in the Louisiana Register outlining cuts to physician services, specifically reimbursement rate reductions. Some physicians may see their rates go down to 80% of Medicare rates. Click here to read the emergency rule. Additional changes and revisions to existing emergency rules are forthcoming, and the LSMS continues to work on your behalf to stop or limit these cuts before their implementation. Louisiana Department of Health and Hospitals Secretary Alan Levine announced mid-year reductions in department spending of state general funds, and proposed utilization of other means of financing, in order to offset a $108 million deficit in available funding. DHH's reductions are part of an overall across the board mid-year reduction plan for each agency to help address the state's mid-year budget deficit.

Louisiana Medicaid Announces Radiology Utilization Management (RUM) Program

Louisiana Medicaid will implement Radiology Utilization Management (RUM) to promote the health of Medicaid recipients by ensuring appropriate utilization of Department-defined high-tech imaging studies by Medicaid providers and recipients. Medicaid will partner with MedSolutions Inc. (MSI), to provide prior authorization, monitoring and management of medical imaging services. Beginning with date of service February 1, 2010, primary care and specialty care providers will be required to request prior authorization for non-emergency outpatient Magnetic Resonance (MR), Computed Tomography (CT), and Nuclear Cardiac imaging. Reimbursement to the rendering provider will be contingent on prior authorization. Providers will be receiving information from MedSolutions, Inc. detailing the prior authorization procedures along with invitations to attend webinars to learn more about the program. Information will also be available for providers via a link on the Louisiana Medicaid website, www.lamedicaid.com, remittance advice messages, and other forms of communication. Providers should continue to monitor the Medicaid website for the most up to date information regarding this program.

AMA, Others Petition FTC for Relief from Red Flags Rule

Following a recent federal court decision, four national organizations including the AMA called on the Federal Trade Commission (FTC) today to exclude health professionals from controversial new regulation intended to combat identity theft. A letter sent to FTC Chairman Jon Leibowitz by leaders of the American Dental Association (ADA), American Medical Association (AMA), American Osteopathic Association (AOA) and American Veterinary Medical Association (AVMA) is the latest challenge to the so-called “red flags” rule. The FTC’s interpretation of the regulation imposes a mandate on health professionals for detecting and responding to identity theft. The organizations asked the FTC to make it clear that the rule will not apply to their members given the result of recent litigation brought by the American Bar Association against the FTC. In that case, the U.S. District Court for the District of Columbia ruled that lawyers should be excluded from the requirements imposed by the red flags rule. The court decision follows wide criticism that the FTC’s overly broad interpretation of the Fair and Accurate Credit Transactions Act of 2003 (FACT) led the commission to create a rule that oversteps its authority. In response to these concerns, the FTC postponed the rule’s effective date to June 1, but it has never changed the position that the rule will apply to health professionals. For a copy of the joint letter to the FTC, please visit the AMA website at: http://www.ama-assn.org/ama1/pub/upload/mm/399/ftc-letter-red-flags.pdf

Call for Comment: Continuing Medical Education

The Accreditation Council for Continuing Medical Education (ACCME) has received feedback from some providers and other stakeholders that pure knowledge-based CME activities are vital to physicians' continuing education and professional development, and that the ACCME should revisit this issue and consider rewording the Criteria. The ACCME is asking the CME community: Should the word knowledge be added into Criteria 1, 3, and 11? The ACCME posted a Call for Comment on its website regarding a possible change in the wording of its Updated Criteria for CME. Please visit their website to post your comment by March 8, 2010: 

§  http://www.accme.org/dir_docs/doc_upload/5aa47c6d-3e95-48c9-916b-18bbaa080f86_uploaddocument.htm

Payment for Claims to be Held Until Jan 15

Annual Participation Enrollment Period Extended

In the last weeks of 2009, Congress acted to avert the 21.2% Medicare physician payment cut and on December 19, the President signed into law the Department of Defense Appropriations Bill (H.R. 3326) which will stop the cuts until March 1, 2010. Other changes reflected in the 2010 Medicare Physician Fee Schedule final rule will still take effect on January 1, 2010 and may have a slight impact on the conversion factor used for the first two months of 2010. For more information visit www.lamedicare.com/provider/viewarticle.aspx?articleid=8034. Consequently, CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010, therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010. The effective date for any Participation status change during the extension, however, remains January 1, 2010, and will be in force for the entire year.

LSMS Expands Member Benefits with Venyu’s AmeriVault Backup Service

The LSMS has partnered with leading offsite data backup and recovery provider, Venyu to bring you secure patient and practice data backup through their proven AmeriVault backup service. LSMS members will receive discounts on Venyu’s competitive subscription rates. As an independent subsidiary of healthcare IT services provider, PHNS, Venyu leverages vast experience and capabilities that enable deep understanding of the needs specific to the medical field. From HIPAA compliance to military-grade security controls, Venyu’s backup solution will ensure rapid recovery of information in the event of an outage or data-loss event.

Venyu is the official backup provider of the LSMS – join the growing number of healthcare providers who depend on Venyu for reliable and secure data backup. Setup is easy with the ‘hands-on’ assistance of Venyu’s support team, there is no hardware to buy, and you can start with a 30-day trial evaluation. Call or email Andy Piner to schedule a trial or to learn more: 225-214-3800 or apiner@venyu.com.