Legislative Session Update: Deadlines Loom As End of Session Nears

STAT

May 1, 2009 – Volume 39, No. 5

• FTC Extends Red Flag Rules Deadline to August 1 – OMA Offers Resources to Help Offices Comply
• Legislative Session Update: Deadlines Loom as End of Session Nears
• CMS Resources for the 2009 Physician Quality Reporting Initiative
• EHR Users – CCHIT Needs Your Help
• Office-Based Surgery Accreditation Deadline August 1, 2009
• Multi-District Litigation Update
• Latest AMA Therapeutic Insights Newsletter Focuses on Parkinson Disease
• New Attorney General Consumer and Prescriber Education Grant Program Website Now Available
• Upcoming OMA Educational Programs
• Need a Venue for Your Summer Meeting or Event?
• Member Deaths
• Special STAT Insert:MEDICAL ISSUES BRIEF on American Recovery and Reinvestment Act of 2009
• Classified Ads

FTC Extends Red Flag Rules Deadline to August 1 – OMA Offers Resources to Help Offices Comply

The American Medical Association has announced today that the Federal Trade Commission has voted to extend the compliance deadline for the Red Flag Rules to August 1, 2009.

The AMA and the OMA will work to use this time to convince the FTC and Congress that physicians are not "creditors" and therefore should not be subject tothis rule. As you know, this regulation requires financial institutions and creditors (including physicians and physician offices) to establish an identity theft protection program.

Because it is still uncertain whether or not the FTC will make physicians exempt from the requirement, the OMA offers numerous resources to help you comply with the regulation. Visit to obtain these tools, which includes a Red Flag Rules overview and program requirement as well as template policies and procedures that your office can customize. These resources are on the members-only section of the OMA website and a member login will be needed for access. For login instructions, visit or contact Stephanie at or (503) 619-8000 for further login information.

Legislative Session Update: Deadlines Loom as End of Session Nears

There are still two months left in the legislative session, and bills are starting to make their way to the Governor’s desk for signing. However, there is still much work to be done and many more bills to consider before the Legislature adjourns on June 30. As the end of the session draws closer, there are important dates and deadlines to keep in mind.

April 28 marked the last day for committees to consider bills in their chamber of origin. That means, for example, the Senate Health Care Committee can no longer consider bills that were introduced in the Senate.

The last day to schedule a work session for any bill is May 20, and most committees close on May 28. Only the Joint Ways and Means, Senate and House Rules Committee, and the Senate Finance and House Revenue committees will continue to operate. All business for the 2009 session must be concluded by adjournment on June 30, or it will be left for future sessions or simply fall by the wayside.

Keep tabs on legislative activity this session, including the progress of OMA’s bills, with News from Salem, OMA’s biweekly legislative update. Watch for News from Salem in your email inbox every other Monday, or go online to

to read all of this session’s issues.

CMS Resources for the 2009 Physician Quality Reporting Initiative:

Fact Sheet Highlights Important Changes for the 2009 PQRI

The Centers for Medicare & Medicaid Services has produced a fact sheet titled What’s New for the 2009 Physician Quality Reporting Initiative, which highlights important changes for the 2009 PQRI, including a 2 percent incentive payment for participating eligible professionals who satisfactorily report at least three applicable quality measures. The fact sheet also outlines the 2009 PQRI individual quality measures/measure groups and reporting options and criteria for satisfactory reporting. This publication is available at .

MLN Matters Provides Overview of E-Prescribing Incentive Program

CMS also recently published an MLN Matters that provides an overview of the 2009 Electronic Prescribing Incentive Program as well as the 2009 PQRI, available online at . As of January 1, 2009, eligible professionals can participate in the E-Prescribing Incentive Program by reporting on their adoption and use of an e-prescribing system by submitting information on one e-prescribing measure on their Medicare Part B claims. For the 2009 e-prescribing reporting year, to be a successful e-prescriber and to qualify to receive an incentive payment, an eligible professional must report one e-prescribing measure in at least 50 percent of the cases in which the measure is reportable by the eligible professional during 2009. There is no sign-up or pre-registration to participate in the E-Prescribing Incentive Program. For more information, on the CMS website.

Electronic Health Record Specifications for 2009 PQRI Now Posted on the QualityNet Website

The Centers for Medicare & Medicaid Services has announced that the 2009 Data Submission Specifications for use in the 2009 PQRI Electronic Health Record test are now posted on the QualityNet website.

As described in the Medicare Physician Fee Schedule 2009 Final Rule, CMS is testing EHR data submission in cooperation with electronic health record vendors. These vendors were selected from those who self-nominated per a process described in the 2008 final PFS rule. The 2009 testing process will be similar to the testing process used for 2008. EHR vendors that are successful with the 2009 testing process will be “qualified” for possible PQRI data submission via EHRs if this means of data submission is used in a future PQRI reporting year. There is no incentive payment available through EHR-based data submission for 2009.

The Measure Specifications for the 2009 EHR test measures are also available on the QualityNet website by clicking on “PQRI” from the dropdown menu under the “Physician Offices” tab; then, click on the EHR Specifications link from the left navigation bar. The following link will take you to the QualityNet website: .

Detailed information on the 2009 PQRI program requirements may be found in the final 2009 Medicare PFS rule with comment period that was published in the Federal Register on November 19, 2008. A copy of the final rule with comment period is on display at the Federal Register and can be viewed at: on the internet. Additionally, the CMS PQRI web page, , on the CMS website is the primary resource for FAQs, helpful tools, and information on the PQRI program.

EHR Users – CCHIT Needs Your Help

The Certification Commission for Healthcare Information Technology, a non-profit, federally-recognized certification body for electronic health records products, is seeking to compile a catalog of case histories of physicians who have implemented EHRs. President Obama is focused on speeding the adoption of health IT, and as interest in EHRs escalates, CCHIT wants to provide specific examples of how EHR usage improves both patient care and practice management.

CCHIT would like to hear from large and small practices, in both urban and rural geographies, which have made tangible improvements to their practice by adopting EHRs. Since implementing EHRs have you:

• Contained or reduced costs?
• Provided better patient care?
• Kept more complete records?
• Increased revenue for your practice?
• Made safer and more informed decisions regarding the diagnosis, clinical treatment and ongoing health management of patients?

If you use EHRs and feel that they have improved your patient care and/or practice, CCHIT wants to hear from you. Please contact John Morrissey, Communications Manager, CCHIT at .

Office-Based Surgery Accreditation Deadline August 1, 2009

The deadline to comply with the requirement to certify medical offices where surgical procedures are performed is August 1, and time is running out to enroll in the program. OMA has offered an Office-Based Surgery Accreditation Program since 2007.

The service enables Oregon physicians who perform conscious sedation in the medical office setting to comply with the Oregon Medical Board mandate (OAR 847-017-0005, October 2006). This requirement states that physicians performing office surgery that requires conscious sedation must receive accreditation from a Board recognized entity; the OMB recognizes the OMA Office-Based Surgery Accreditation Program as such an entity.

The OMA program includes a review by peers who are familiar with issues specific to Oregon medical practices, and offers both telephone and on-site educational consultation and assistance. In addition, the OMA program offers outpatient facilities a practical, meaningful, and economical method for improving health care quality.

OMA’s rates are substantially below those of other accrediting bodies for this purpose and OMA members are eligible for a 20 percent discount. As the deadline approaches, available ‘slots’ for clinics to schedule the review will become more scarce. Information about the service is posted on OMA’s website at . For questions about becoming accredited or to enroll in the program, please contact D’arcy Renhard at , or call (503) 619-8000.

Multi-District Litigation Update

AMA Files Class Action Lawsuit Against WellPoint Inc.

On March 25, the AMA, along with several other medical societies, filed a class action lawsuit against WellPoint Inc., the largest health insurer in the U.S. The lawsuit, which is similar to lawsuits filed last month against Aetna Health Inc. and Cigna, alleges that WellPoint relied on skewed data provided by UnitedHealth Group subsidiary Ingenix to set payment rates for out-of-network care, underpaying physicians for out-of-network medical services and forcing patients to pay an excessive portion of the costs.

AMA President, Nancy Neilsen, MD, PhD, indicated that the lawsuits also sought relief for physicians who were seriously harmed by WellPoint, Aetna and CIGNA through the insurers’ long-term use of the flawed Ingenix database.

The OMA will continue to inform members of any developments in regard to these three class action lawsuits. For more general information about these and other settlements, visit .

UnitedHealthcare Regulatory Settlement Update

On August 27, 2007, twenty-six UnitedHealthcare plans settled with 37 states through the UHC Regulatory Settlement. The OMA and the AMA continue to remain hopeful that this settlement, focused on UHC’s UNET and COSMOS platform systems, reflects a commitment by UHC to transparency, accuracy and fairness in its payment practices and medical policies. The first report to the state insurance commissioners was due on April 1. While this report is confidential, according to the settlement terms, a public version of this report will be made available in May. Once this report has been made public, you can visit the AMA’s Web site at to view the report..

Visit for a complete listing of the settling health plans and the lead and signatory regulators, found in the UHC Regulatory Settlement fact sheet. This Web site also provides the settlement’s original frequently asked questions and a copy of the settlement agreement.

Latest AMA Therapeutic Insight Newsletter Focuses on Parkinson Disease

The American Medical Association has announced the release of “Management of Early Parkinson Disease,” the latest AMA Therapeutic Insights newsletter.

While most treatment-oriented CME programs focus solely on disease management, AMA Therapeutic Insights takes it one step further. The program delivers the actual prescribing patterns for the disease. Never before have physicians been able to see exactly which medications are being prescribed for the featured conditions.

AMA Therapeutic Insights is a free online newsletter written by top disease experts in collaboration with the AMA. One disease condition is highlighted each issue, featuring state and national prescribing data* and evidence-based treatment guidelines. AMA PRA category 1 creditTMis also available.

*The prescribing data in AMA Therapeutic Insights are provided by IMS Health. The AMA does not collect or have access to physician prescribing data in any form.

Visit to read this issue, as well as previous newsletters covering BPH (enlarged prostate), pediatric asthma and overactive bladder.

New Attorney General Consumer and Prescriber Education Grant Program Website Now Available

The Attorney General Consumer and Prescriber Education Grant Program is complete, and a summary and the curricula are now available on the CPGP web site, .

The Attorney General Consumer and Prescriber Education Grant Program was created to educate health care professionals about pharmaceutical industry marketing practices and to provide tools for accessing unbiased sources of information about prescription drugs. The program is funded through the 2004 Attorney General settlement resolving allegations that Warner Lambert violated state consumer protection laws when promoting Neurontin, an epilepsy drug, for off-label uses.

The CPGP website offers access to free online CME modules as well as other educational resources developed during the grant. All materials are available either in an interactive

Upcoming OMA Educational Programs

Did You Miss the HIPAA and Red Flag Rules Audio Conference Series? Recordings are Now Available for these Popular Courses!

You may have missed the HIPAA Audio Conference series that was held several weeks ago. The series was full of timely topics to help physician offices prepare for and comply with upcoming governmental regulations. These courses included information on the clinical and business impacts of updated electronic transaction standards and the transition from ICD-9 to ICD-10; Red Flag Rules regulation from the FTC; electronic claims attachment tool; and impending CMS HIPAA audits and how physicians can prepare.

If you missed these great courses, you can still order a recording for a reasonable price. For audio conference descriptions and ordering information, visit or contact Christi Donaugh at or (503) 619-8000.

HIPAA How-To’s: Practical Tools to Improve Privacy & Security Programs and Comply with HIPAA:

May 5, 8:00 am-12:00 pm (OMA Headquarters)

Practice Management Webinar Series

Register now for this upcoming Webinar – presented by the Practice Performance Group – that will offer vital information on recession-era planning for practices.

Appealing Unfair PaymentsSM: Recession-era claims follow-up tactics

May 7, 10:00-11:30 am or May 27, 1:30-3:00 pm

Spring Medical Collections: Slow Pay? No Pay? Keeping Up When the Economy Is Down

In these challenging economic times, more and more medical offices are experiencing delays in payment or no payment at all from patients.

May 12, 1:00 pm-5:00 pm (Bend)

May 28, 8:30 am-12:30 pm (OMA Headquarters)

For more information and to register, visit , or contact Christi Donaugh at or (503) 619-8000.