Sept. 22, 2017
Legislative alert: Oppose the Graham-Cassidy amendment to the ACHA
The Colorado Medical Society strongly opposes the Graham-Cassidy-Heller-Johnson Amendment to the American Health Care Act and urges physician members to contact Colorado senators Michael Bennet and Cory Gardener to reinforce this opposition.
 
CMS opposes legislation that does not ensure that patients will have access to affordable, meaningful health insurance. Any new federal health care reform proposal should:
  1. Not cause individuals currently covered to become uninsured, and should stabilize and strengthen the individual insurance market;
  2. Ensure that low/moderate income patients are able to secure affordable and meaningful coverage; and,
  3. Provide adequate funding for safety net programs like Medicaid.
The Graham-Cassidy-Heller-Johnson Amendment to the American Health Care Act fails to meet those expectations for many reasons including:
  • Elimination of the individual and employer mandates;
  • Elimination of premium and cost-sharing subsidies;
  • Enabling the elimination of pre-existing conditions protections;
  • Significant Medicaid cuts, the elimination of the Medicaid expansion and underfunded move to block grants and per capita caps that will make it essentially impossible for Colorado to continue to cover current Medicaid populations.
Contact Sen. Bennet by email here (bottom of page) or call his Washington, D.C. office at 202-224-5852. Contact Sen. Gardner by email here or call his Washington, D.C. office at 202-224-5941.
Medicaid payment update: CMS continues dialogue with HCPF director
On Sept. 1, the Colorado Medical Society and 16 other state and regional physician organizations sent a letter to Sue Birch, MBA, BSN, RN, executive director of the Colorado Department of Health Care Policy and Financing, expressing doctors' frustrations with lengthy payment delays for the care and treatment of Medicaid enrollees. CMS asks for payment as soon as possible plus interest payments on overdue amounts, citing statutes to support this request.
 
Director Birch responded on Sept. 6, apologizing for the billing problems doctors have experienced and committing to resolving these issues, as it is the agency's responsibility to provide timely reimbursement for properly submitted claims. Birch's response left unanswered questions, however, and CMS submitted a follow-up letter on Sept. 18 asking for clarification and additional information.
 
"The payment system conversion has caused practice disruption for many of our members and the patients they serve," wrote CMS President M. Robert Yakely, MD, in the Sept. 18 letter. "We continue to hear from more member physicians regarding burdensome and costly steps that they are having to take in order to cope with payment problems associated with the conversion. Importantly, we are also hearing from more physicians that have exhausted their efforts and opted to just quit being Medicaid providers."
 
CMS will work to keep a spotlight on this issue to ensure physicians receive answers for the delays and, ultimately, fair payment.
Medical students enjoyed an Annual Meeting reception Friday evening.
Incoming CMS president Robert Yakely, MD, was sworn in by outgoing president Katie Lozano, MD, FACR.
Annual Meeting report: Fun and education in Breckenridge

Physicians and guests who attended the 2017 Colorado Medical Society Annual Meeting in Breckenridge had a wonderful time socializing at great events, learning in general session and small-group workshops, and enjoying the beautiful fall colors of the Rocky Mountains. Watch for full coverage and photos from the meeting in the November/December issue of Colorado Medicine.
 
Concurrent with CME for physicians on health care policy, physician wellness, the opioid crisis and more, was the first-ever medical student track. This tailored education connected students with advocacy experts - including special invited guests Rep. Bob Rankin (R), Rep. Jonathan Singer (D), messaging expert Kim Ross and moderator Joe Gagen, JD -- to learn how to make a difference in the public policy realm. Speaker slides and resources are available on the Annual Meeting webpage
 
The highlight of the annual meeting was the black-tie President's Inaugural Gala, with dinner, dancing and the sumptuous COPIC dessert bar. Outgoing president Katie Lozano, MD, FACR, gave her final address and incoming president M. Robert Yakely, MD, was sworn in.
 
Save the date for the 2018 CMS Annual Meeting, Sept. 14-16, at the Vail Marriott.
Free two-part webinar: "The Feds Are Coming! Reducing Physician Risk When Prescribing Pain Medication" - Oct. 17 and Nov. 1, 11 a.m. - 12:15 p.m. MT
Concerns with the opioid crisis are at a fever pitch - understandable given that opioid overdose led to the deaths of 33,000 people in the United States in 2015, almost half of which involved prescription opioids.
 
Governmental and health related agencies are devoting significant energy and resources to reduce the quantity of controlled substances being prescribed. Concurrently, the DEA and Department of Justice have made enforcement relating to opioid prescribing a top priority by focusing on clinics, pharmacies and prescribing physicians.
 
Practicing physicians need useful guidance in caring for patients for whom the use of prescription pain control is absolutely essential. A free two-part webinar series - The Feds Are Coming! Reducing Physician Risk When Prescribing Pain Medication - will provide practical guidance from health care lawyers at Polsinelli and the physician education experts at the Center for Personalized Education for Physicians (CPEP). The webinars will be held on Oct. 17 and Nov. 1, 11 a.m. - 12:15 p.m. Click here for more information and to register.
Two AMA webinars: MIPS and quality improvement: Oct. 18 and Nov. 29
With many feeling overwhelmed by the complexity of the Quality Payment Program (QPP), physicians struggle to answer one key question - Where do I start? To help assuage this issue, the AMA will hold a webinar on Wednesday, Oct. 18, 11 a.m. - 12 p.m. MT to go through a new customizable resource - the MIPS Action Plan - that breaks down the complexity of the Merit-based Incentive Payment System (MIPS) track of QPP into specific actionable steps. In this one-hour webinar, Thriving Under MIPS - Where to start? Breaking down the complexity of MIPS, attendees will learn how to use this tool to create and/or validate their strategies for MIPS implementation in 2017. Chris Botts, AMA care delivery and payment manager, will be the presenter. Click here to register.
 
Without an understanding of what is really driving poor quality or performance, it is difficult to improve. Root-cause analysis is a critical tool in the quality improvement toolbox that allows professionals to understand what's at the heart of the problem, and then develop improvement ideas that can make a difference. How can you improve if you do not understand the challenge and the contributing factors?
 
In this 1-hour webinar, Root-cause analysis: Digging deep to improve, on Wednesday, Nov. 29, 11 a.m. - 12 p.m. MT, PCPI Director of Quality Improvement Stephen L. Davidow, MBA-HCM, CPHQ, APR, will cover three common forms of root-cause analysis, discuss the advantages of applying these methods to different circumstances and environments, and how root-cause analysis is used as the basis for creating and implementing ideas that lead to robust improvement. Click here to register.
Oct. 2: Last call for improvement activities
Oct. 2nd is the deadline to start participating in MIPS to avoid a penalty in 2019. To attest to completion of an Improvement Activity(ies), clinicians must start implementing the activity no later than Oct. 2 to allow for the minimum 90 days of implementation. This means that if you haven't done so already, it is important to decide now which activity you will implement and determine how to gather the required documentation you will keep for six years in the event of an audit.
 
A guide from the federal CMS, "MIPS Data Validation Criteria," will walk you through the supporting documentation requirements. Use the spreadsheet to find documentation examples for each activity. And review the activity's description in full detail to ensure there's enough time to implement (for example, annual registration in the prescription drug monitoring program requires six months).
Register for the FREE DoWC 2017 fall discussions/training sessions
Registration is open for the 2017 discussions/training sessions presented by the Division of Workers Compensation. There are three main topics to participate in:
  • 2017 Medical Fee Schedule rule changes;
  • Getting Set Up for Telemedicine; and
  • Introduction to the Medical Treatment Guidelines.
DoWC is continuing the "Universe" registration process to create and track event tickets. Please print these out and bring to your session. Eight sessions remain, with the main topics highlighted in the event title -- all are free to attend.

If you opt for a session that is webinar-based, AND you plan to attend via the webinar, there is a link within the event to complete the "GoToWebinar" registration as well (view able after clicking the "+More" link). Please complete both.

Registered by visiting: https://www.universe.com/users/cdle-division-of-workers-compensation-5Y8KF1. Questions? Contact Jim Becker at james.becker@state.co.us.
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