July 5, 2006

2006 Annual Meeting and Legislative Session & Capitol Hill Visits

The ASIPP 8th Annual Meeting, SIPMS 1st Annual Meeting, along with the Legislative Session and Capitol Hill Visits were a great success. Conference participants gathered on Capitol Hill on Tuesday morning where they were honored by 11 dynamic congressional speakers. Those addressing the ASIPP members were Rep. Ed Whitfield (R-KY), Sen. Jeff Sessions (R-AL), Rep. Sherrod Brown (D-OH), Rep. Rodney Alexander (R-LA) Rep. Anne Northup (R-KY), Rep. Bar Stupak (D-MI), Rep. Bobby Jindal (R-LA), Sen. David Vitter (R-LA), Rep. Frank Pallone (D-NJ), Rep. Geoff Davis (R-KY), and Rep. Nancy Johnson (R-CT).

2006 Capitol Hill Visits and Legislative Agenda

Following the legislative session, ASIPP members representing 32 states, visited with multiple members of congress and representatives from their respective states. During these visits, participants presented ASIPP’s legislative issues for 2006; Physician Payment Reform, Outpatient Interventional Procedures in ASCs, and NASPER Funding.

ASIPP CEO presenting Sen. Vitter with the Distinguished Service award prior to Vitter’s speech.

Annual Meeting Awards

The annual ASIPP awards ceremony was held on Monday with a luncheon honoring the 2006 awards recipients.

Lifetime Achievement - John D. Loeser, MD

Outstanding Achievement - Joseph D. Fortin, DO

Distinguished Service - Bert Fellows, MA and Sen. David Vitter

Legislator of the Year - Rep. Ed Whitfield

Jury Orders Lawyer to Pay $450,000 – Doc’s Win May Fight Frivolous Suits

After fighting and winning five malpractice lawsuits, a Louisville orthopedic surgeon decided to fight back by filing his own lawsuit. Frank Bonnarens, MD, filed suit against the moonlighting state government attorney who sued him the fifth time.

In May of this year, a Jefferson Circuit Court jury unanimously found that attorney Walter Bedford Jr. sued Bonnarens for the single purpose of harassing him into paying a settlement. The jury ordered Bedford to pay Bonnarens $450,000, including $200,000 in punitive damages.

Read this story in the courier-journal.com.

Judge Drops Last Holdout HMO in Landmark Class Action Suit

In June a federal judge tossed out claims of unfair payment practices that more than 700,000 physicians brought against UnitedHealth Group and Coventry Healthcare but doctors said the long-running battle with the managed care organizations is far from over.

The judge's order in favor of the last two defendants in a class-action lawsuit that began in 1999 could leave the door open to future litigation against United and Coventry, according to a recent American Medical News report.

Subscribers can read more at AMNews.com

Insurers Using More Physician Profiling

Payers push to measure physician efficiency, but experts say economic profiling can be inaccurate.

Insurers increasingly are profiling doctors on how cost-effectively they provide care despite major methodological limitations, a panel told delegates at the American Medical Association Annual Meeting in June according to the AMA Medical News.

Physician profiling by private health plans is happening right now, Nancy Nielsen, MD, speaker of the AMA House of Delegates told physicians who attended a session, "Efficiency Measures: Necessary, Necessary Evil, or Just Evil? The Centers for Medicare & Medicaid Services also is pilot-testing privately developed physician efficiency measures.

CMS Reminder for Providers and Physicians Billing Medicare Contractors

CMS sent out a reminder today that a brief hold will be placed on Medicare payments for all claims during the last 9 days of the Federal fiscal year (September 22 through September 30, 2006). These payment delays are mandated by section 5203 of the Deficit Reduction Act of 2005. No interest will be accrued and no late penalties will be paid to an entity or individual by reason of this one-time hold on payments.  All claims held during this time will be paid on October 2, 2006.

This policy only applies to claims subject to payment. It does not apply to full denials, no-pay claims, and other non-claim payments such as periodic interim payments, home health requests for anticipated payments, and cost report settlements.

Please note that payments will not be staggered and no advance payments will be allowed during this 9-day hold.

For more information, please view the MLN Matters Article at

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5047.pdf

The Art of Practice Management

The healthcare industry has moved into the age of increasingly complex technology, information and regulation making the job of medical-group-practice administrator a new and greater challenge than in previous years.

While hundreds of office managers at small practices of two to three physicians manage finances, maintain operating systems and oversee human resources, a growing number of practice administrators at larger groups are also responsible for a variety of tasks that may include strategic planning, purchasing, reviewing utilization, billing and collecting, negotiating managed-care contracts and maintaining patient and physician satisfaction.

But according to a recent Modern Physician article, the most important responsibility of a practice administrator-and possibly the trickiest-is maintaining the bridge between the clinical and business world. As physicians become overwhelmed by the sometimes conflicting demands of patients, payers and regulators, they are delegating more responsibilities to the practice administrator, experts say.

Read the full story on modernphysician.com

Doctors vote to fight Medicare imaging cuts and audit project

Physician delegates from the American Medical Association last month voted to actively oppose two elements of the Medicare system that so far have unfairly impacted only a minority of doctors.

The AMA will work with Congress to rescind Medicare's recovery audit contractor program, under which private firms comb through physician claims data to find instances in which the federal government overpaid doctors and to recoup those dollars. In a separate action at the Annual Meeting, the House of Delegates also decided to support the repeal or delay of medical imaging cuts that are due to start in January 2007.

http://www.ama-assn.org/amednews/2006/07/03/gvsb0703.htm

Physicians Push to Delay Move to New ICD Code Set

The looming transition to the ICD-10 system would increase the number of possible codes from roughly 24,000 to more than 200,000. Health information technology legislation that the House started considering last month would require hospitals and physician offices to upgrade from the ICD-9 coding system to ICD-10 by October 2009. Using a much richer set of codes corresponding to patient conditions, health care professionals could more accurately diagnose medical problems and pass the information along to both public and private payers, supporters of the bill said.

Hospitals use ICD codes to record both the diagnosis of a patient and any medical procedures that he or she receives. Physician offices use the ICD system for the diagnosis phase but employ CPT codes to identify any procedures that they provide.

The timeline established by one version of the Health Information Technology Promotion Act of 2005 and backed by hospitals and device manufacturers is much too ambitious, according to physicians, health plans and practice managers. A coalition of these groups is calling for Congress to push back implementation from 2009 to 2012 to give doctors more time to get up to speed on the new system.

Subscribers can read more on this topic at http://www.ama-assn.org/amednews/2006/07/10/gvsb0710.htm

Or for more information on issues surrounding the purposed ICD-10 system go to CMS uploads.

State Society News

If your state society would like to announce meetings or share news stories with our readers, send your new items to Melinda Martin - mmartin@asipp.org

Please…Save the Date!!!

The New Hampshire Society of Interventional Pain Physicians Annual Meeting

The New Hampshire Society of Interventional Pain Physicians Annual Meeting will take place on Wednesday, September 27, 2006 at 6:00 p.m.CR Sparks, Bedford, NH

Your nursing and management staff are encouraged to attend as well. Guest speaker to be announced.

To register or for more information, contact:

Kacey Guay 603-577-3003 x31

kguay@painsolutionsusa.com

Second Annual GSIPP Summer Meeting - July 21-23

The second annual summer meeting for the Georgia Society of Interventional Pain Physicians "Pain Summit At Lake Oconee” will be held on July 21-23 at Lake Oconee in Greensboro, GA.

It is strongly suggested that all physicians attending the meeting should stay at the Ritz Carlton (800-241-3333) in the reserved GSIPP block of rooms. If this becomes full, or if you’re seeking an alternate to the Ritz, there are two nearby hotels: Jameson Inn, Greensboro, 706-453-9135; and The Lodge, Greensboro, 706-485-7785. Both are about six miles from the meeting facility.

See the GSIPP brochure for registration and meeting information. Please mail your registration form and check early – we anticipate this meeting WILL fill up