ASAP e-newsletter: Aug. 13, 2019
Gov. Jared Polis announces federal approval of Colorado reinsurance program; DOI projects 18.2 percent average decrease in 2020 premiums for individual market
On July 31, Gov. Jared Polis announced that the federal government approved Colorado’s application for a 1332 waiver to establish a reinsurance program. With the program in place, combined with other market factors, Colorado health insurance companies that sell individual plans expect to reduce premiums by an average of 18.2 percent over their 2019 premiums, and premiums could go down as much as 41 percent in some areas of the state, according to figures from the Colorado Division of Insurance. Read more here.
Hotel deadline approaching for CMS Annual Meeting
Don't forget to make your hotel reservations for the 2019 CMS Annual Meeting, Presidential Celebration and Inaugural Gala. You must book before Aug. 14, 2019, to receive the group rate of $99 per night per room. Courtyard Denver Cherry Creek, 1475 S. Colorado Blvd., Denver, CO 80222, is located just four miles from the Denver Museum of Nature & Science. There are many more entertainment options in the area -- including the Denver Zoo, Denver Botanic Gardens and Cherry Creek State Park -- as well as great dining and nightlife. Click here to register online for the annual meeting. Click here for more information, including the agenda, faculty, learning objectives and accreditation statement.
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DOI and HCPF hold series of stakeholder meetings on the legislature-directed state option for health insurance
Leaders from the Colorado Division of Insurance and Department of Health Care Policy and Financing are holding a series of stakeholder meetings around the state to discuss a state option for health care coverage as envisioned by House Bill 19-1004. Meetings have already been held with physicians at CMS headquarters (July 23), and with the general public in Pueblo (Aug. 8) and Alamosa (Aug. 9). Remaining public meetings will be held in Grand Junction (Aug. 14), Glenwood Springs (Aug. 15) and Durango (Aug. 27). Read more here.
DOI issues cease and desist orders for Trinity Healthshare and Aliera Healthcare
The Colorado Division of Insurance issued cease and desist orders for Trinity Healthshare and Aliera Healthcare on Aug. 12. Trinity represents itself as a health care sharing ministry. Aliera is the administrator, marketer and program manager for Trinity. According to a DOI news release, the division is concerned that they may be using misleading marketing practices, blurring the lines between health insurance that complies with the requirements of the Affordable Care Act and non-compliant insurance (like what is offered by health care sharing ministries). Because of this, the DOI says, the companies may be putting consumers at risk and violating Colorado insurance law. Read more here.
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Congress is working on surprise billing; engage your legislators during the August recess
Congress has taken significant steps in advancing legislation aimed at tackling the issue of surprise billing. This effort culminated in late July when the House Energy & Commerce Committee reported out H.R. 3630, the “No Surprises Act” -- legislation designed to protect patients from unanticipated medical bills for services provided by out-of-network physicians and facilities in emergencies and other situations where they had no opportunity to choose an in-network provider. While the majority of health care stakeholder groups support the patient protections included in H.R. 3630, the American Medical Association has expressed concerns about the bill because of provisions that would resolve payment disputes between physicians and insurers by setting out-of-network payments at the median amount each insurer pays for in-network care. The AMA urges physicians to engage their legislators during Congress's current six-week district work period, and provides tools and links to facilitate in-person meetings or event attendance, or letter writing. Read more here.
Federal CMS releases 1700-page proposed rule for the 2020 Medicare physician fee schedule; AMA to provide comments
On July 29, the Centers for Medicare and Medicaid Services released a proposed rule for the 2020 Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP). The rule covers diverse topics including evaluation and management (E/M) office visit services, a new participation framework in the Merit-based Incentive Payment System (MIPS), geographic payment adjustments and professional liability insurance relative values, and new payments for managing patients with opioid use disorder. View the AMA's summary document here. They will provide comments before the due date on Sept. 27, 2019. Read more here.
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FAQ: How CO APCD data will support out-of-network bill implementation
The Colorado General Assembly passed HB 19-1174 during the 2019 legislative session to help protect patients from surprise out-of-network bills. Included in the bill are specifications regarding provider reimbursements for
out-of-network emergency and non-emergency visits. The Colorado All Payer Claims Database is identified in the bill as a data source related specifically to the statewide commercial carrier median geographic payments specified in the bill, and CIVHC is working collaboratively with the Division of Insurance to finalize specifics regarding the methodology that will be used and the data elements that will be available to the DOI from the CO APCD. As they're working through the details, CIVHC has compiled a "frequently asked questions" document to provide some guidance to providers. Access the FAQ here.
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Access COPIC's resources on Colorado Candor Act
The recently passed Colorado Candor Act is a bipartisan effort that establishes a voluntary framework for health care providers and facilities to offer compassionate, honest, timely and thorough responses to patients who experience an adverse health care incident. It is designed to benefit patients, their families, clinicians, and health care systems by formalizing a non-adversarial process where there can be open communication about what happened, why it happened, and what can be done to prevent this in the future. COPIC has made available several resources that provide details about the act, the Candor process and sample templates of required forms.  Access the resources here.
Nominate a Colorado physician for the COPIC Humanitarian Award; deadline: Aug. 31
The COPIC Medical Foundation is accepting nominations for the 2019 COPIC Humanitarian Award, an annual award honoring a Colorado physician who has demonstrated outstanding volunteerism and contributed greatly to the Colorado health care community. The award bestows a $10,000 grant to the health-related 501(c)3 organization of the recipient's choice. The nomination deadline is Aug. 31. Find more information and the nomination form here.
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Provider Education Symposium: Call for abstracts for poster session on opioid epidemic work
The evening before the annual meeting of the Colorado Consortium for Prescription Drug Abuse Prevention on Wednesday, Oct. 23, the consortium's Provider Education Work Group will host an educational symposium on the Anschutz Medical Campus. Consider submitting an abstract for a poster session that highlights work related to the opioid crisis in Colorado. The deadline to submit an abstract is Sept. 6. Read more here.
Reserve your seats for "Trauma and Integrated Care: Best Practices for Treating Pain and Substance Use" in Lone Tree or Thornton
Join the Tri-County Overdose Prevention Partnership for an evening of learning, networking and food on Aug. 20 and Aug. 22 in Lone Tree and Thornton, respectively. Registration closes Friday, Aug. 16. The goals of these events are to provide training on best practices, and engage various types of medical, behavioral health and alternative treatment providers in each community to network and create connections. Read more here.
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AMA calls for meaningful action to address the public health crisis of firearms violence
The AMA is calling for meaningful action to address the public health crisis of firearms violence following two more mass shootings in El Paso, Texas, and Dayton, Ohio, that left 31 dead and more than 50 wounded. "The devastating gun-violence tragedies in our nation this weekend are heartbreaking to physicians across America," AMA President Patrice A. Harris, MD, MA, said in a statement following the shootings. "We see the victims in our emergency departments and deliver trauma care to the injured, provide psychiatric care to the survivors and console the families of the deceased. The frequency and scale of these mass shootings demands action." Read more here from the AMA.
CMS members: Don't forget to vote in the 2019 CMS election!
On Thursday, Aug. 1 all CMS members should have received an email containing a link to the ballot to vote in the 2019 CMS election. A reminder was sent on Aug. 6 to those who hadn't yet voted. Voting will be open until Aug. 31. You will need your CMS member number for your vote to be validated and counted. If you need your CMS member number or if you have trouble with the ballot, please reply to this email or contact CMS Membership Coordinator Susanna Barnett at 720-858-6312. Read more about the election and the candidates on the election page of CMS.org.
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