ACS/ASPS Announce 2012 Joint Scholarship Winner
Physicians Must Act by June 30, 2012 to Avoid 2013 Medicare E-Prescribing Penalty
HHS Announces Postponement of ICD-10 Compliance Date by One Year to Oct.1, 2014
Independent Payment Advisory Board (IPAB)
HIPAA Version 5010 Electronic Billing Transactions Enforcement Extended Again, Until June 30, 2012
HHS Releases Proposed Rule on Stage 2 Requirements for Meaningful Use of EHR
ASPS Needs Your Help in Washington, D.C.
Physicians Face 27% Payment Cut on December 31
ACS/ASPS Announce 2012 Joint Scholarship Winner
The American Society of Plastic Surgeons and the American College of Surgeons are pleased to announce the recipient of their Joint 2012 Health Policy Scholarship as Dr. Robert Havlik of Indianapolis, IN.
The $8,000.00 scholarship will cover tuition, travel, housing and subsistence costs while attending the Executive Leadership Program in Health Policy and Management slated for May 20-26, 2012 at Brandeis University in Waltham, MA. Congratulations to Dr. Havlik on this award.
Physicians Must Act by June 30, 2012 to Avoid 2013 Medicare E-Prescribing Penalty
Medicare providers who want to avoid a 1.5% penalty for the 2013 electronic prescribing incentive program must report code G8553 on at least 10 eligible Evaluation and Management (E/M) codes through their claims between January 1 and June 30, 2012. Otherwise, providers must apply here for the significant hardship exemption by June 30, 2012. Providers who successfully reported e-prescribing in 2011 will be exempt from a 1.5% penalty in 2013.
"I would like ASPS members to know that getting an exemption is not that difficult. I applied for my 2013 exemption on April 1, 2012 and received an email confirmation that I was exempt on April 2, 2012, and they actually did most of the calculations," said ASPS Vice President of Finance Scot Glasberg, MD.
It is important to note that physicians and not the office staff must submit the hardship exemptions request and provide satisfactory justification. There will be no appeal process allowed if your request is denied. The requests will be reviewed on a case-by-case basis and will need to be reapplied annually to keep the exemption, if the request is approved.
There is no formal appeal process for physicians who have been assessed the e-prescribing penalty in 2012; however, CMS urges physicians with questions about their individual situations to email the QualityNet Help Desk at Qnetsupport@sdps.org or call (866) 288-8912. View a tip sheet on how to avoid the penalty.
HHS Announces Postponement of ICD-10 Compliance Date by One Year to Oct.1, 2014
On April 9, Health and Human Services (HHS) released a proposed rule to postpone compliance deadline for implementation of International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10-CM/PCS) until October 1, 2014. The postponement decision was in response to physicians' concerns on meeting the Oct. 1, 2013 compliance date and difficulties with implementing the federally mandated HIPAA Version 5010 electronic transactions that must be accomplished before the ICD-10 implementation.
The rule also proposes to establish a unique health plan identifier (HPID) that would simplify administrative work and reduce time and costs for health plans and physicians. The proposed rule will be published April 17 in the Federal Register and will have a 30-day comment period. The final rule is expected Oct. 1, 2012.
Independent Payment Advisory Board (IPAB)
The House voted on the IPAB repeal legislation March 22, after PSN press time. Repealing the IPAB is expected to cost $3.1 billion, and House Republicans recommend using the cost savings from H.R. 5 - which would impose significant medical liability reforms - to pay for the repeal. The legislation passed the House by a vote of 223-181, with four members voting present, and 23 not voting. Seven Democrats crossed the aisle to support the bill, while 10 Republicans opposed it. While the legislation passed the House easily, it is not expected to pass the Senate.
HIPAA Version 5010 Electronic Billing Transaction Enforcement Extended Again, Until June 30, 2012
The compliance deadline for switching to HIPAA 5010 was January 1, 2012. Later the CMS announced that it would not enforce the rule until March 31, 2012. The CMS just announced another delay of HIPAA 5010 enforcement for an additional three months until June 30, 2012. However, you should make sure to convert to HIPAA 5010 as soon as possible. Beginning July 1, 2012, electronic claims will be rejected if they are not submitted with HIPAA 5010. All entities involved in your electronic claims submissions must use Version 5010 as of July 1, 2012.
HIPAA 5010 is a new set of standards regulating electronic transactions, including claims, eligibility, referrals and remittances. One new requirement of HIPAA 5010 is that all electronic and paper claims will have to use actual physical addresses. P.O. Box numbers will no longer be acceptable. Another new requirement is to use a 9-digit ZIP code on all electronic and paper claims for providers and facilities.
For more information, please see AMA's HIPAA 5010 Toolkit - The Physician's Practical Guide to Implementing HIPAA Version 5010.
Do not delay! You must begin planning and implementation now to meet the compliance deadline.
HHS Releases Proposed Rule on Stage 2 Requirements for Meaningful Use of EHR
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) has recently released the meaningful use of the electronic health record (EHR) Stage 2 proposed rule with public comments due by May 7, 2012. The final rule on Stage 2 is expected late summer 2012.
Stage 2 is proposed to be delayed for an additional year -- for hospitals beginning on Oct. 1, 2013 and for physicians on Jan. 1, 2014. Physicians could earn incentives of up to $44,000 over five years from Medicare or $63,750 over six years from Medicaid. In addition, physicians would need to adopt EHR systems and begin a 90-day EHR reporting period no later than July 2, 2014 to avoid Medicare penalties in 2015. The reporting period for physicians participating in their first year is 90 consecutive days within the calendar year and one full calendar year (January 1 - December 31) for the subsequent years (second year and beyond).
The proposed Stage 2 requirements include increased thresholds, more rigorous measures and new measures. This proposal is subject to change and ASPS will be working with other societies to make improvements to the Stage 2 requirements. We will continue to update members as the requirements evolve.
ASPS Needs Your Help in Washington, D.C.
The dates for the 2012 Regional Advocacy Programs in Washington, D.C. have been announced. This year poses many challenges. The need to meet your colleagues in Washington, learn about the key issues facing the plastic surgery community, and take our message directly to your lawmakers on Capitol Hill has never been more critical.
Our specialty continues to face serious regulatory and legislative challenges. Many portions of the Patient Protection and Affordable Care Act (PPACA) take effect. In addition to PPACA, Congress has yet to find a permanent fix for the Sustainable Growth Rate (SGR); address medical liability; repeal the Independent Payment Advisory Board (IPAB); ensure access to insurance coverage for children with congenital deformities; and more. Congress needs to hear from you on these issues and how they threaten patient access to care. Your participation could make the difference!
Registration is free for the events, and ASPS will provide dinner Tuesday as well as breakfast and lunch on Wednesday. You are responsible for your airfare, hotel and other incidentals. Please RSVP to Kristin Murphy at 202-672-1519 or via email at kmurphy@plasticsurgery.org.
Please locate your state/region and mark your calendar for the 2012 program:
Southeast and Midwest (May 15-16, 2012): Alabama, Arkansas, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Virginia, West Virginia, Wisconsin. RSVP by April 1, 2012
Northeast and West (Sept 11-12, 2012): Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Kansas, Maine, Massachusetts, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont, Washington, Wyoming. RSVP by August 1, 2012
Physicians Face 27% Payment Cut on December 31
Congress has reached a temporary resolution to the SGR (included in payroll tax legislation). The deal extends the current reimbursement rates through the end of the year.
ASPS does not support short term "band-aids" to the SGR and we continue to urge Congress to address this issue once and for all.
