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AMA asks for further eRx rule changes

The AMA, while being complimentary of some steps taken by CMS, has asked that the agency expand exemptions and further modify the rules and penalties surrounding e-prescribing.

Read more in the article below from Modern Physician.

AMA asks for further eRx rule changes


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Posted: July 28, 2011 - 2:45 pm ET

Tags: American Medical Association (AMA), Electronic Health Records (EHR), Information Technology, Physicians

The American Medical Association, joining 91 state and specialty medical societies, has called for further modifications of proposed changes to the CMS' physician electronic-prescribing incentive program.

"The AMA has continually advocated for changes to the e-prescribing program to ensure it's fair for all physicians and that as many physicians as possible are able to successfully participate," AMA immediate past President Dr. Cecil Wilson said in a news release announcing the submission of the associations' nine-page comment letter to CMS Administrator Dr. Donald Berwick (PDF). "While we appreciate the modifications CMS presented in the proposed rule, they don't go far enough. More changes are needed, including establishing an additional reporting period in 2012 and not applying penalties until 2013."

The proposed rule changes, which were released by the CMS in May, provide that eRx incentives continue through 2011 but that penalties for noncompliance would begin in 2012.

In their letter, the groups state that physicians "are working hard to adopt e-prescribing and other health IT and should not be unfairly penalized for practice patterns that do not fit neatly within the current, limited exemption process." They note: "(The) CMS is proposing to modify the 2011 eRx measure for the 2011 incentive and 2012 penalty programs; provide additional significant-hardship exemption categories for eligible providers and group practices so they can request an exemption during 2011 to avoid the 2012 eRx payment adjustment; and extend the deadline for submitting requests for consideration for the two significant-hardship exemption categories for the 2012 eRx payment adjustment, which was finalized in the 2011 Medicare Physician Fee Schedule final rule."

The proposed steps to immediately modify the eRx program "are helpful," the groups state. However, they assert, "It is important to keep in mind that requiring reporting the year before the penalty program starts, not creating adequate exemption categories, and last-minute modifications create confusion and do not allow enough time to educate physicians on steps they need to take to avoid eRx penalties in 2012."

The joint letter also praises the CMS for considering electronic health-record systems certified for the Medicare and Medicaid health IT incentive payment programs as dually eligible for use in the Medicare e-prescribing program.

"This recognition is an example of the importance of synchronizing the overlapping eRx and EHR programs so that physicians do not have to purchase an eRx system just to avoid penalties and can invest in EHR technology that does more than just enable eRx," the letter states.

Texas Dental Legislation - Governor Perry Signs SB 554 Into Law

The Texas Dental Association (TDA) is very pleased to report that on June 17, 2011 Governor Rick Perry signed into law Senate Bill 554, the TDA’s legislation which prevents insurance companies from setting fees on non-covered dental services.  The legislation will go into effect September 1, 2011.

This historic legislation protects Texas dentists from state-regulated insurance companies dictating fees for dental services they do not cover. Dentists and patients will now be able to determine appropriate treatment options without interference from insurance. Additionally, dentists will be able to charge the usual and customary fee for services rendered and will not be coerced into accepting a lower fee so that insurance companies may benefit.

The TDA’s legislative consultants diligently worked hand in hand with the TDA’s legislative staff to skillfully guide the bill throughout the entire legislative process. The TDA also thanks the Texas Academy of General Dentistry and the Texas Academy of Pediatric Dentistry for their support as well as the grassroots efforts of TDA dentists whose calls to legislators were instrumental in securing the bill’s final passage in the House and Senate and subsequent approval by Governor Perry.

Be on the lookout for a summary of all the session’s activities in both the July issue of the TDA Today and the October Texas Dental Journal.

Senators Request Probe of Surgeons

In an article published today in the Wall Street Journal, five US Senators have asked the Department of Health and Human Services to open an investigation on physician-owned distributorships and entities that profit from the sale of medical devices to their patients.

At the heart of the issue are repeated studies that indicate an increase in utilization, and subsequent reimbursements from Medicaid and insurance companies, in cases where physicians have a direct financial benefit for referring patients to a particular center, product or service.

In some cases, these procedures have been proven to be unnecessary.  As in all cases, we encourage our clients to provide full disclosure to patients when recommending or referring them to a specific product or service facility in which they financially participate in. 

You can read more in the link below and we will continue to follow this issue as it develops. http://online.wsj.com/article/SB10001424052702304778304576373592455703056.html#

More Family Docs Charging Patients Administrative Fee

A growing number of primary-care physicians are hitting their patients with another charge: an annual "administrative fee" of $100 to $250 to help the doctors defray the costs of running their practice. The fees generally cover the amount of time they spend giving medical advice over the phone, e-mailing patients, maintaining medical records and talking with insurers to argue coverage denials or get certain prescription drugs.

The physicians themselves point out that while the administrative costs of operating a doctor's office have risen and the demands on them have increased, reimbursement rates from insurers have stagnated. But some doctors have paid a price in lost patients. And some health insurers say the fee practice violates their contracts with the doctors, who argue they are charging for services not covered by these contracts.

Dr. Curtis Robinson in California instituted the fee concept two years ago: $120 per individual and $210 for a family. Existing patients received a 10 percent discount off the fee. But even a modest administrative fee is not without risks. Its biggest detractors are health insurers, who have accused some doctors of violating the terms of their contracts by charging for services already included under the terms of the health policies. Robinson said Anthem Blue Cross has accused him of fraud. But Robinson stands by the legality of the fee, explaining that his contract applies only to covered services. He said the services he includes in the fee are clearly not covered because insurers have denied payment.

James Doherty, a Maryland health care attorney who has delved into the fee issue, said physicians can charge patients for uncovered services. But he advises doctors to charge for services their patients receive rather than require a flat fee for all of them. That way, they would avoid any legal ambiguity and the possibility of charging patients for services they may not need or want. The doctors interviewed for this story all said they preferred an annual fee because charging individual patients for each letter or form would add to administrative costs and make patients feel as though they're being nickel-and-dimed. (San Francisco Chronicle

IRS has contingency plans for the possible governmental shut down

IRS Commissioner Doug Shulman announced Wednesday that the IRS has contingency plans for the possible governmental shut down. 

 

As such, they offer the following advice:

 

-        The due date for filing or extending remains April 18th.

-        E-Filed returns will continue to be processed normally and he encouraged e-filing regardless of a shut down.  (We are required as paid tax preparers to file all returns electronically, so this is being done for you already.)

-        Paper return processing may be delayed in the event of a shut down.

-        Refunds should not be delayed for E-Filers, but would for paper filers.

 

To read the complete article, see the link below.

 

http://www.journalofaccountancy.com/Web/20114038.htm

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