Hurricane Harvey – Disaster Exceptions/Exemptions for Medicare Certified Providers Affected by Severe Storms & Flooding

The Centers for Medicare & Medicaid Services (CMS) is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to acute care hospitals, PPS-exempt cancer hospitals, inpatient psychiatric facilities, skilled nursing facilities, home health agencies, hospices, inpatient rehabilitation facilities, outpatient dialysis facilities, long-term care hospitals, and ambulatory surgical centers located in areas affected by Hurricane Harvey due to the devastating impact of the storm. These providers will be granted exceptions without having to submit an extraordinary circumstances exception request if they are located in one of the Texas counties or Louisiana parishes, all of which have been designated by the Federal Emergency Management Agency (FEMA) as a major disaster county.

The scope and duration of the exception under each Medicare quality reporting program is described in the memo posted on 8-31-17; however, all of the exceptions are being granted to assist these providers while they direct their resources toward caring for their patients and repairing structural damages to facilities.

If FEMA expands the current disaster declaration for Hurricane Harvey to include additional counties or parishes, CMS will update this memo to expand the list of providers eligible to receive an exception without submitting a request to include the hospitals, PPS-exempt cancer hospitals, inpatient psychiatric facilities, skilled nursing facilities, home health agencies, hospices, inpatient rehabilitation facilities, long-term care hospitals, and ambulatory surgical centers located in the additional counties and parishes.

In addition, CMS will continue to monitor the situation and adjust exempted reporting periods and submission deadlines accordingly.

Additional details and materials are available on the CMS Hurricane webpage. Please check back frequently for updates.

2018 CMS Quality Payment Program (QPP) Proposed Rule Webinar

2018 CMS Quality Payment Program (QPP) Proposed Rule Webinar on August 17th

Dear Centricity Practice Solution and Centricity EMR Customers:

Mark Segal, GE Healthcare Vice President Government and Industry Affairs, and Chad Dodd, General Manager of Ambulatory Practice Solutions, would like to invite you to attend an important session on 2018 CMS Quality Payment Program (QPP) Proposed Rule on Thursday August 17, 2017.

Read this communication to learn more and to register.

Quatris Health Announces Acquisition of HealthSystems

BEDFORD, TX – March 1, 2017 – Quatris Health (“Quatris”), a provider of specialized healthcare software and database solutions, as well as hosting, software maintenance and support services for small and medium sized physician practices, announced today that it has acquired Atlanta based HealthSystems. Quatris, a portfolio company of Seaport Capital, is the largest indirect channel provider of services, products and software maintenance for GE Healthcare’s Centricity Practice Solution to small and medium sized physician practices. The senior HealthSystems management team, Maurice Rosenbaum and Larry Stoumen, invested in the transaction and will remain with Quatris going forward. Terms of the transaction were not disclosed.

“We believe that Quatris and HealthSystems are a great fit for each other,” said Quatris CEO Mark Spates. “Maurice and Larry have built a company with an impressive roster of customers and a tremendous organization to support those customers. With the combination of Quatris Health’s and HealthSystems’ proprietary software and expert services, our physicians will have direct access to the full range of cutting edge solutions available to Centricity users. We aim to exceed expectations for all our customers so that those practices continue to have a foundational IT solution that keeps pace with our ever-changing industry.”

“We believe Quatris provides an excellent solution for our customers,” said HealthSystems CEO Maurice Rosenbaum. “Our two organizations have known each other for a number of years and Quatris has a very similar philosophy to HealthSystems – the importance of our customers and the singular focus of providing the best product and service experience.”

“We believe Quatris provides an excellent solution for our customers,” said HealthSystems CEO Maurice Rosenbaum. “Our two organizations have known each other for a number of years and Quatris has a very similar philosophy to HealthSystems – the importance of our customers and the singular focus of providing the best product and service experience. We look forward to maintaining and growing that level of support in the future for all our customers and are enthusiastic about working with the Quatris team going forward.”

Seaport Capital Partner Bob Tamashunas agreed, saying, “The HealthSystems acquisition provides added scale for Quatris as the company pursues additional growth initiatives. Quatris’ management team, strong service oriented organization, relationships with its technology partners and industry reputation will continue to provide a foundation for the company to grow in the future.”

ABOUT QUATRIS

Quatris Health, headquartered in Bedford, Texas, provides software and database solutions for medical practices, as well as the training and support needed to maximize the benefit of a physician practice’s technology investment. Quatris Health is the largest independent seller of GE Healthcare’s Centricity Practice Solution to small and medium sized physician practices.

Quatris Health is a partner for physician practices, providing clinicians, administrators and office staff software support and services. The company also provides hosting services, enabling physician practices to manage their data through the company’s cloud services.

For additional information, visit www.quatris.com.

ABOUT HEALTHSYSTEMS

HealthSystems provides software and services that help physicians streamline office processes, manage EMR and practice better medicine. HealthSystems has partnered with GE Healthcare in the southeast since 1998.

For additional information, visit www.healthsystems.net.

ABOUT SEAPORT CAPITAL

Founded in 1997, Seaport Capital provides equity capital to middle market companies in the communications, business services and media sectors. Seaport works with talented management teams to create valuable companies that are leaders in their market segments. Seaport’s extensive investing experience enables it to develop successful strategies; its relationships and resources help achieve them. The firm seeks to invest $10 to $25 million of equity capital in private companies with enterprise values of between $20 and $100 million.

For additional information, visit www.seaportcapital.com.

STEADI Fall Risk Assessment Form

STEADI Fall Risk Assessment Form

The Centers for Disease Control and Prevention (CDC), American College of Preventive Medicine (ACPM), a team of national experts, and PatientLink worked together to design and build a free fall risk clinical decision support (CDS) encounter form. This tool will help you incorporate fall risk assessment and fall prevention into your clinical practice – and enhance your efforts to help older adults stay healthy and independent. You can download the STEADI Fall Risk Assessment tool for free here!

Clinical Decision Support Tool to Decrease Fall Risk in Older Adults

CDC Article Falls are preventable and can be considerably reduced if high risk patients are identified through screening and receive appropriate follow-up care.

If your practice serves adults 65 and older, you should already be doing fall risk assessments. However, many doctors don’t due to time constraints.

While time is limited at an appointment, it’s crucial for doctors to help patients develop a plan to decrease their fall risk. The Center for Disease Control and Prevention (CDC) recommends that doctors incorporate fall prevention into their regular practice. Doctors should be informed on what they can do to prevent falls among their older adult patients, such as recommending vitamin D, reducing medications that might increase falls, and referring patients to community programs or physical therapy to improve their balance.

“I continue to use the tool in my daily practice.”

The CDC developed the Stopping Elderly Accidents, Deaths and Injuries (STEADI) initiative to make fall prevention a routine part of clinical care. STEADI includes a clinical algorithm, adapted from the American and British Geriatric Societies’ Clinical Practice Guideline, which helps sort patients by fall risk level. Although doctors found the algorithm useful, they wanted it integrated into their Electronic Health Record (EHR) systems. The CDC partnered with the American College of Preventive Medicine and PatientLink to create an EHR Clinical Decision Support Tool based on the STEADI toolkit that would work within the GE Centricity EHR.

Creating a Clinical Decision Support Tool to Assess Fall Risk

A national team of doctors and researchers set out to create the content of the tool, and worked with PatientLink to build it. The team met regularly to review what Debi Willis, technical engineer on the project and owner of PatientLink, was building and to provide feedback through the entire process.

In the first stage, PatientLink created a tool based on the complete CDC STEADI algorithm. Once ready to be tested in a real-life setting, PatientLink connected with physicians at Oklahoma University (OU) Medicine to test the tool. It was integrated into OU primary care practices where it was evaluated for its usability, technical soundness, convenience and modified based on feedback from doctors.

Dr. Robert Salinas, family physician and geriatrician at OU, was part of the national advisory committee and also the lead physician in testing the tool within Centricity. He found the tool to be incredibly helpful. “I continue to use the tool in my daily practice,” said Dr. Salinas. “It helps me and my patients create an easy-to-follow plan for optimal care.”

The tool has multiple sections, divided into tabs for easy toggling. The first tab is the patient’s 12-question self-assessment, which they can fill out prior to entering the office. Based on their answers, the EHR tool auto calculates a fall risk score for the doctor. If the patient is at increased risk for falls, further assessment and preventive measures are recommended, which are facilitated by the EHR.

CDC ArticleFor those that fail the initial screen, the doctor is guided through tabs including assessments (e.g., gait and balance), medication review, and a physical examination and plan of care tab, where the doctors can perform additional assessments if needed and develop a plan for follow-up care. For instance, if the patient had poor muscular strength, the doctor may suggest physical therapy. Then, the doctor can plan to meet with the patient again in six weeks to observe improvement and hopefully find that the patient has better balance and is at a lower risk for falls.

Dr. Salinas shared that not only did he and his fellow doctors enjoy the tool’s ability to better assist and assess for fall risk, his patients appreciated the tool, as well. The patients interviewed provided positive feedback and felt the doctor really cared and wanted to help, versus only asking questions and moving on regardless of the response.

After the first-round testing phase was complete, the doctors confirmed the tool was very helpful but had one overriding recommendation. They wanted the tool to automatically identify which of the patient’s medications might affect their fall risk.

Updating and Improving the Clinical Decision Support Tool

During the second stage of development, the national team got together to identify the medication categories that were associated with higher fall risk. The team wanted to provide doctors a way to easily identify whether their patients were taking medications that increased their risk of falling, in order to assist them in determining whether these medications should be stopped, switched, or reduced.

Once the new tool was completed, the team sent it back to the doctors, who tested the tool with more than 500 patients, providing multiple rounds of feedback to the software development team along the way. The doctors found the new tool to be very useful. The only remaining problem was the time needed to fully assess a patient for fall risk and recommend interventions.
Fitting fall prevention into a typical office visit remains a challenge. The Centers for Medicare and Medicaid Services (CMS) encourages fall screening by making it a component of the Welcome to Medicare Visit and the Medicare Annual Wellness Visit; however, these visits are not universally used and fall prevention is just one of many parts. Falls-related quality measures are also included in CMS incentive programs which provide an additional incentive for fall prevention.

“We certainly hope that a lot of doctors will use this tool and find it useful,” said Erin Parker, PhD, Health Scientist at CDC. “We know that doctors are aware of falls in older adults and want to help but don’t have all the needed resources, but now they do. We want them to use this tool and help patients decrease their risk.”

More Reasons to Perform Proper Risk Assessment

The numbers provided by the CDC speak for themselves:

    1. Falls are the leading cause of fatal and nonfatal injuries among older adults (aged 65 years and over).
    2. Every second of every day in the U.S. an older American falls
    3. 1 out of 5 falls cause a serious injury such as a fracture or head trauma.
    4. In 2014 over 27,000 older Americans died because of falls, 2.8 million were treated in emergency departments (EDs) for fall-related injuries and >800,000 of these patients were subsequently hospitalized
    5. By integrating fall prevention into clinical practice physicians have the potential to reduce future falls by nearly 25%.

What do you think about the Fall Risk Assessment tool? Would your practice use it? Let us know!

Insurance Carrier Setup Neglect: A Costly Oversight – Part 2 of 2

Article Featured on Hayes Management

In last week’s blog Angela Hunsberger outlined the importance of cleaning up the insurance carrier list to ensure efficiency to maximize payor reimbursement.  More than consolidating an old list, she explained the nuances of paper vs. electronic claim submission and suggested partnering with the billing team to tackle the list.

Continued in Part 2 of a two piece post, Angela provides an instructional roadmap detailing six steps of insurance carrier cleanup.   This article will provide the knowledge and tools needed to revamp carrier settings and revel in the financial payoff of a job well done.

6 Steps to Insurance Carrier Cleanup

Step 1: Run Reports to find paper setup

As Lao Tzu said “The journey of a thousand miles begins with a single step”. A good starting point is to run a report to find carriers setup as paper. Some systems will allow you to export this data into Excel. Filter out the carriers that must go paper including Worker’s Comp or Automobile. Work with your billers to learn why carriers are set up on paper and get a clean list of carriers thatcould go electronically but are not yet set up.

Read more

Insurance Carrier Setup Neglect: A Costly Oversight – Part 1 of 2

Article by Angela Hunsberger | Featured on Hayes Management

Insurance submission and processing has evolved over the past decade transitioning from printing paper claim forms to an electronic workflow. Adaptations include the NPI implementation, using a new standard paper claim form, sending more electronic claims as payors offer connections (or even refuse paper claims), moving to the ANSI 5010 electronic claim submission format, and most recently transitioning to ICD10. Considering those changes, along with the flurry of your other projects, have you audited your insurance carrier setup lately to ensure it is configured to maximize revenue cycle efficiency? By efficiency, I am referring to leveraging technology you are already paying for to get the most bang for your buck and maximize payor reimbursement.

Read more

ACTION ALERT: Ask your legislator to Co-Sponsor HR 3940 – the MU Hardship Relief Act

Message from AAOE:

You may have seen in the last issue of “Coffey Talk” that AAOE and similar organizations are pushing to have a new exception to the meaningful use program added into the omnibus budget legislation currently being negotiated in the halls of Congress. While staff is working with members of the House Committee on Appropriations to get this included, we need your help. The more co-sponsors the legislation creating the new exception has, the more likely it is to be included in the omnibus.

PLEASE, write your Representative and ask that they co-sponsor HR 3940 – The Meaningful Use Hardship Relief Act of 2015. Simply follow this link and TAKE ACTION.

Thank you for taking a few minutes to write your legislators. AAOE will keep you updated through Coffey Talk from the Hill and The OrthoActivist on this issue as it continues to develop.

Thank you!
Bradley Coffey, MA
Government Affairs Specialist
American Association of Orthopaedic Executives
3925 River Crossing Pkwy Suite 300
Indianapolis, IN 46240

Senate passes legislation to repeal SGR!

Notice from AAOE:
April 14, 2015

The United States Senate passed legislation to repeal the flawed Medicare Sustainable Growth Rate (SGR) today. The legislation will now go to President Barack Obama for his signature, having been passed by the House of Representatives on March 26, 2015. The President has indicated that he will sign the legislation.

With passage of HR 2 – Medicare Access and CHIP Reauthorization Act of 2015, providers will avoid a 21 percent cut that was set to be implemented at midnight on Wednesday, April 15, 2015.

Votes on six amendments to the legislation began at 7:10 pm ET. All six amendments failed. Voting on the House passed legislation began at 9:35 pm ET following a challenge from Senator Jeff Sessions (R-AL) to the legislation not being fully paid for.

The Senate voted 92-8 to repeal the SGR.

Bradley Coffey, MA
Government Affairs Specialist

American Association of Orthopaedic Executives
3925 River Crossing Parkway, Suite 300, Indianapolis, IN 46240

Stage 3 NPRM Comment Period Now Open: Submit by May 29th

CMS and ONC invite the public to submit comments on the recently released notices of proposed rulemaking (NPRMs) on Stage 3 requirements and 2015 Edition certification criteria for the Medicare and Medicaid EHR Incentive Programs. Comments must be received by May 29th to be considered.

How To Submit Comments
The public can submit comments in several ways, including via electronic submission or mail:

1. Electronically
* You may submit electronic comments to http://www.regulations.gov Follow the “Submit a comment” instructions.
2. By regular mail.
3. By express or overnight mail.
4. By hand or couier.

View the Stage 3 and 2015 Edition certification criteria proposed rules online for more information. Submissions must be received by 11:59pm ET on May 29, 2015 in order to be considered.

For More Information
For more information on the Stage 3 and 2015 Edition certification criteria proposed rules, review the press release and fact sheet.

SGR Repeal – Contact your Senator – ACT NOW!

Earlier today the US House of Representatives overwhelmingly passed bipartisan legislation that would permanetly repeal the sustainable growth rate (SGR) formula before the March 31 deadline.

Now it is the US Senate’s turn to act, and TIME IS RUNNING OUT before they adjourn later tonight for a two-week recess. That’s why we need you NOW, more than ever, to contact your senators to remind them that they have unfinished business here in Washington, DC.

The president has stated publically that he would sign this bipartisan legislation IF it got to his desk, leaving the Senate as the last hurdle to passing Medicare reform and repealing the SGR once and for all.

We’ve NEVER been this close – let’s make sure SGR reform finally gets across the finish line by contacting your senators through every means available and asking them to pass H.R. 2 (formerly H.R. 1470/S. 810).

1. Call your senators using the AMA’s toll-frr grassroots hotline: 800-833-6354.
2. Send an urgent email to your senators reinforcing the need for SGR repeal now.
3. Contact key senators still undecided on this most critical issue directly through their social media channels and share with your own Facebook friends and Twitter followers as well.

This is urgent. These is still time for Congress to pass meaningul SGR reform before the deadline, BUT IT HAS TO ACT NOW!

For more information on the legislation please read the bill summary and be sure to check out fixmedicarenow.org for all the latest.

Notice from: Washington State Medical Association 2001 Sixth Avenue, Suite 2700 Seattle, Washington 98121

Merit-based Incentive Payment System: Summary & Analysis

Notice from AAOE:
HR 1470, the SGR Repeal and Medicare Provider Payment Modernization Act of 2015 creates the Merit-based incentive Payment System (MIPS) which will combine the three quality incentive payment programs (PQRS, VBM, and EHR MU) into one quality incentive payment program. This sheet summarizes the planned MIPS program as it appears in the proposed legislation. Changes to the program are likely as the legislation makes its way through Congress. This should not be viewed as a final summary of the program.

Click HERE to read the rest of the summary and analysis.

HR 1470 – SGR Repeal & Medicare Provider Payment Modernization Act of 2015

Notice from AAOE:
On Thursday, March 19, 2015 legislation was introduced in Congress to permanently repeal the Medicare Sustainable Growth Rate. AAOE understands that this is an exciting development for our members who are eager to avoid a 21% cut in physician payments on April 1, 2015. Below, readers will find AAOE’s section-by-section analysis of the legislation and what is means for their practices.

This legislation is likely to change as it makes its way through the legislative process. AAOE will continue to update its members on changes to the legislation as they occur.

Click HERE to read the full article by AAOE.

PQRS UPDATE: Simplified workflow for 2014

Notice from GE Healthcare:

Customers who have not yet finished applying SOP codes may now use the following workflow.
Part 1: Please review the following required and optional steps

(a) Assign initial SOP codes:
1. Required:  Apply Medicare FFS SOP code.
2. Optional:  Apply any other non-Medicare SOP codes.
Remember, if you have already applied any other Medicare codes (including “Medicare Non-managed Care other” code), we recommend you map those to “Unavailable/Unknown” before proceeding.

(b) Send data to CQR (via new script to reset subscription) and Calculate.
(c) Filter by Insurance: Medicare.
(d) Select measures to meet the CMS Medicare FFS reporting guidance.
(See instructions in Measure Selection & Provider Authorization webinar slides and recording.)

Part 2: Please review the following required and optional steps.
a) Optional: Assign remaining SOP codes:
1. Apply remaining Medicare SOP codes.
2. If in Part 1(a) you had mapped non-FFS Medicare plans to “Unavailable/Unknown”, you may re-map those to the appropriate non-FFS Medicare code before proceeding.
b) If you performed Part 2(a), send data to CQR (via script to reset subscription) and Recalculate.
a) Required: Authorize (See instructions in Measure Selection & Provider Authorization webinar slides and recording.)

BREAKING NEWS: CMS relaxes PQRS 2014 requirement to apply all SOP codes

Notice from GE Healthcare:

Dear Quality Submission Service Participant:

We have some important news about the PQRS 2014 SOP code program requirements that we believe will provide significant relief for customers who are still in the process of applying SOP codes. This news includes updated guidance from CMS in addition to the creation of a new CQM script.

RELAXED SOP CODE REQUIRMENTS FOR 2014

GE Healthcare has been working with CMS over the last months to clarify the application of SOP codes for health plans. In our recent communications with you (webinars on 1/22 & 2/3; email on 2/4), we outlined GE’s interpretation of the PQRS 2014 requirements. CMS confirmed our interpretation but also acknowledged that there has been confusion among vendors in the use of the detailed SOP codes for PQRS submissions.

Yesterday, CMS stated an important change to the PQRS guidelines that adds customer flexibility:

• It is now acceptable, at your discretion, to ONLY apply SOP codes to the Medicare FFS (Part B) plans for PQRS 2014 reporting and to categorize the remaining health plans in a single broad health plan “Category D – Other.”
• Our customers may leave the non-Medicare FFS plans uncoded and these will be mapped by CQR to broad health plan “Category D – Other” without any intervention on your part.
• Please see the attached document for details on applying this guidance.
Please note: Our guidance to report on at least 9 measures across 3 domains that each represent a significant Medicare FFS initial patient population remains unchanged.

CUSTOMERS WHO HAVE ALREADY FULLY COMPLETED THEIR SOP CODE MAPPINGS:

CMS advised us to inform our customers that the requirement to apply SOP codes for all payers will be reinstated for PQRS submissions for the 2015 reporting year. Therefore, if you have already fully completed your SOP code mappings, according to our previously issued workflow for the 2014 program year, rest assured that you do not need to un-map any previously assigned SOP codes with this CMS clarification. You are well positioned for the 2015 program year when the requirement goes into effect.

New “Reset CQM Subscription” Script 

In addition to the welcome news from CMS, we are pleased to announce the availability of the “Reset CQM Subscription” script, as discussed on our February 3rd. CPS and CEMR customers will be able to download the script from the service portal once it is posted later today. After applying SOP codes in Part 1 (a), you must reset the Clinical Quality Measures subscription to transmit the data to CQR, and this new script automates that subscription reset process.

We welcome yesterday’s response from CMS and hope this news helps you more easily meet the requirement to authorize your providers by February 13, 2015. If you have any questions, please contact Centricity Support at 888-436-8491 (Option 2, Option 3).  If you have specific questions on the SOP rules, you can also contact the Sage Growth Partners SOP Hotline at 667-217-3650. For expedited service, please request that the support representative record “PQRS” at the beginning of the description of the support ticket.

Sincerely,
Peter Kinhan
Vice President & General Manager,
Ambulatory Practice Solutions
GE Healthcare IT

Get Involved – CMS potential EHR Incentive Changes for 2015

Notice from the CHUG Board:

Dear CHUG Members,

Are your providers tired, overworded and struggling to meet meaningful use measures? Have staff starting asking “What is the point”?

Yesterday CMS announced a potential EHR Incentive Program Change for 2015! These proposed changes will reduce program complexity and ease the administrative burden on physician practices.

The CHUG Board is strongly recommending that you DON’T WAIT – GET INVOLVED….if you did not respond before NOW IS THE TIME! Reach out to Congress and let your voice be heard. MGMA members can also use this link.

The Centers for Medicare & Medicaid Services (CMS) intends to engage in rulemaking this spring to help ensure providers continue to meet meaningful use requirements.

In response to input from health care providers and other stakeholders, CMS is considering the following changes to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

  1. Shortening the 2015 reporting period to 90 days to address provider concerns about their ability to fully deploy 2014 Edition software.
  2. Realigning hospital reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other quality programs.
  3. Modifying other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burden.

Please note: these modifications must still be finalized through formal rulemaking, expected to occur this spring. While CMS intends to pursue these changes through rulemaking, they will NOT be included in the pending Stage 3 proposed rule. CMS intends to limit the scope of the pending proposed rule to Stage 3 and meaningful use in 2017 and beyond.

For further information, please read Dr. Conway’s blog on the announcement. For more information on the EHR Incentive programs visit CMS.

SAVE THE DATE: FALL CHUG Conference, New York Marriott Marquis in Times Square, New York City, October 1 – October 3, 2015