- RESOURCES & EDUCATION
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LEGISLATIVE NEWS-ON THE HILL
ASCRS/ASOA WEBINAR SERIES ON QUALITY PROGRAMS
ICD 10/5010 NEWS
As we previously reported, the Ways and Means Committee Republicans requested input from 70 medical specialty organizations regarding reforms to the current Medicare physician payment system, with specific emphasis on the incorporation of quality and cost efficiency. The ASCRS response focuses on the repeal of the flawed Sustainable Growth Rate (SGR) formula with a clearly defined transition period to a new payment system that recognizes reasonable inflationary costs. Additional issues include maintaining a fee-for-service option and establishing a viable private contracting option, as well as raising concerns about the current quality and electronic health record programs. The letter also provides information regarding ophthalmology’s efforts and participation in quality improvement.
On May 24, the Senate overwhelmingly passed the FDA User Fee Reauthorization Bill by a vote of 96–1 (summary of bill). The bill, which authorizes $6.4 billion in fees from the medical device and pharmaceutical industries to the FDA to help cover the cost of ensuring that new products are safe and effective, also includes much-need FDA reforms that have been supported by industry and the physician community. The bill also authorizes new payments for generic and biosimilar product approvals, as well as for rare and pediatric disease development. ASCRS joined with the Alliance of Specialty Medicine and a larger coalition of medical specialties in advocating for many of the reforms. The House is expected to take up its version of the legislation on Wednesday, May 30, followed by an informal conference between members of Congress in both the House and the Senate to reconcile the differences between the two bills. The goal is to send the legislation to the President for his signature by the end of June.
During the Senate debate on the bill, amendments were considered with only a handful passing. Senators did agree, however, by unanimous consent to several less controversial amendments, most notably, an amendment that would require an independent assessment of the drug approval and review process. Other amendments would increase drug information for underrepresented patient populations, set a deadline for companies to comply with the FDA’s new sunscreen rules, protect information obtained from foreign inspectors, establish standards to facilitate exchange of drug information, require reports on small businesses and clinical trial funding disclosures, and increase drug information for underrepresented patient populations.
We will continue to keep you updated.
House Ways and Means Committee members Tom Price, MD, and Charles Boustany, MD, are developing a Medicare physician reform proposal addressing the SGR that includes five years of statutory payment updates, followed by a cliff, in addition to medical malpractice reforms, balance billing, and gain sharing. The effort is intended to motivate House Republicans to develop a consensus on Medicare physician payment legislation addressing the SGR long term.
ASCRS and ASOA to Hold Web Seminar Series on Medicare Incentive Programs: eRx, EHR, PQRS
Mark your calendar to attend the most anticipated web seminars of 2012. These educational sessions are complimentary for ASOA and ASCRS members and provide an overview of the CMS EHR Incentive, e-Prescribing, and PQRS programs, including details on how eligible professionals can maximize bonus payments and avoid payment adjustments. Additional details will be provided.
eRx Incentive Program
Wednesday, June 6, 2012
2:00-3:00 PM EDT
Wednesday, June 20, 2012
2:00-3:00 PM EDT
EHR Incentive Program
Date – TBD
2:00-3:00 PM EDT
Registration: All attendees must register at least 24 hours in advance of the web seminar.
ASCRS and ASOA Members–Complimentary Registration
On Thursday, May 24, the Government Accountability Office (GAO) announced the appointment of five new members to MedPAC and reappointed current MedPAC Chair Glenn Hackbarth to another three-year term. The newly-appointed members are: Alice Coombs, a critical care specialist and anesthesiologist at South Shore Hospital in Weymouth, MA; Jack Hoadley, a research professor at the Georgetown University Health Policy Institute; David Nerenz, director of the Center for Health Policy and Health Services Research at the Henry Ford Health System in Detroit; Rita Redberg, a professor of clinical medicine at the University of California at San Francisco Medical Center; and Craig Samitt, president and CEO of the Dean Health System in Madison, WI. Their terms expire in April 2015.
Former MedPAC commissioners whose terms expired in April of this year are former Vice-Chair Bob Berenson and Mitra Behroozi, Karen Borman, Ronald Castellanos, and Bruce Stuart.
Expanded Recall of Compounded Products From Franck’s Compounding Pharmacy
As the FDA and Centers for Disease Control and Prevention (CDC) continue to investigate the outbreak of fungal endophthalmitis, the agencies are urging providers that any product received from Franck's since November 2011 not be used and customer/physicians follow the instructions provided by Franck’s. The FDA also recommends that any adverse events suspected to be associated with use of the products be reported to the FDA:
The CDC has been working with the FDA, and in collaboration with state and local health departments, to determine the source of the contamination and extent of the outbreak. Several cases of fungal endophthalmitis have been reported following use of BBG dye during retinal surgery and after intraocular injection of triamcinolone. Franck’s recalled its BBG products on March 9.
REMINDER: Version 5010 Enforcement Discretion Period Ends June 30
As a reminder, the enforcement deadline for Version 5010 compliance ends June 30. The deadline for all HIPAA-covered entities to upgrade to Version 5010 electronic standards was January 1. However, CMS initiated an enforcement discretion period until June 30 to give the industry additional time to complete testing. The delay was partially because of medical specialty groups, including ASCRS and the AMA, expressing concerns regarding the timeline and requesting more time and additional help from health plans and clearinghouses in identifying errors in Version 5010 claims.
To avoid unnecessary rejections of 5010 claims, make sure to include:
If you have not yet finalized your Version 5010 upgrade, you should be working to complete this step as soon as possible. Make sure to view the Version 5010 section of the ICD-10 website to find helpful factsheets on the upgrade to Version 5010 and previous listserv messages discussing the Version 5010 upgrade.
CMS will hold a national provider call on Thursday, June 7; 1:30-3:00 PM EDT to discuss EHR incentive program basics for eligible professionals. Learn what steps you must take to receive an incentive payment, how to register, reassigning incentive payments, and how to get help.
Registration information will be provided soon on the CMS Upcoming National Provider Calls webpage.
Make Your 2012 eyePAC Contribution Today
On May 22, all ASCRS members who have not contributed to eyePAC in 2012 were asked to make their annual contribution. You can make your contribution online at the ASCRS web site by going to Government Relations and clicking on eyePAC in the drop-down box or clicking here to download a contribution form to fax back. Thank you in advance for making a contribution. If you have questions, please contact ASCRS PAC/Grassroots Specialist Gerrie Gray-Benedi at 703-591-2220 or by email at email@example.com.
To find out more about the articles in this communication or to read more about legislative and regulatory issues that affect you and your practice, visit the ASCRS and ASOA websites. You can also visit http://www.specialtydocs.org/, the web site of the Alliance of Specialty Medicine.
© 2012 ASCRS/ASOA