EDPMA Membership Newsletter 
February 2019
February 2019 Articles:
  1. Early Bird Registration for Solutions Summit Ends Friday (February 15th)
  2. Special Half-Day Program on Advocating for Emergency Departments
  3. Register Now for the Solutions Summit Golf Tournament in Scottsdale, AZ
  4. Reserve Your Exhibit Booth for EDPMA's Solutions Summit  
  5. New Member Spotlight: Equian 
  6. New Medicare Enrollment Application Issued By CMS  
  7. Join an EDPMA Committee!
  8. Urgent Matters Blog and More
  9. CMS News:
    Evaluation and Management Codes Listening Session
    Check Your Preliminary 2019 MIPS Eligibility on the QPP Website


Early Bird Registration for Solutions Summit Ends Friday (February 15th)

Don't delay, register today! Early bird registration rates end Friday for the Emergency Department Practice Management Association (EDPMA) Solutions Summit!

If you register for EDPMA's 2019 Solutions Summit before Early Bird ends on February 15th, you will save $100 as a member of EDPMA and $200 as a nonmember. 

REGISTER HERE!
 
Join us at the Scottsdale Resort at McCormick Ranch, Scottsdale, AZ, April 28-May 1, 2019!

The 2019 EDPMA Solutions Summit is  the premier conference for those in the business of emergency medicine. The Summit offers in-depth educational sessions on the issues facing those managing an Emergency Department, emergency physician group, billing company, or other business that supports the Emergency Department. Learn solutions to the issues you face every day and network with both new and familiar business partners.

This Year:
  • Do you golf? Arrive early and play in EDPMA's Golf Tournament. Please join us on Saturday, April 27th, for a round of golf at the McCormick Ranch Golf Club located adjacent to the resort property. After the tournament, all Summit registrants are invited to the Pre-Conference Reception for drinks, appetizers, and networking.
  • EDPMA's committee workshops will be held on Sunday, April 28th, and are open to all registrants (including nonmembers and exhibitors). Enjoy a small group setting where you can discuss federal and state policy issues, balance billing, the prudent layperson standard, downcoding policies, Medicaid waivers, quality payments, Medicare Administrative Contractors (MACs), and more.
  • Regular educational sessions begin on Monday, April 29, 2019. Session topics include leadership under pressure, contributions of women in Emergency Medicine, ED coding, Alternative Payment Models, and a musical.
  • New this year, on Wednesday morning, May 1st, we will offer sessions that prepare you to advocate for the business of emergency medicine. EDPMA encourages you not to schedule your return flight before 3:00pm, so that you don't miss out on this educational opportunity.  Presenters will not only give great advice on being a federal and state advocate, but will make sure you can comfortably address the issues the emergency business faces today. Learn about the 2019 advocacy landscape, tips and tricks, latest on out-of-network reimbursement, and more. A relaxing Resort Brunch will be served to help you wind down while learning some advocacy tips. 
Information about the 2019 Solutions Summit is available here.

In order to register at the member rate, you must first log into the EDPMA website as a member. You can register online or download, print, and send us the registration form and payment. Don't miss out!! You only have a few days left -until February 15th-  to get the Early Bird Rate ($749 for members of EDPMA and $949 for nonmembers)!  If you have forgotten your member password, please email Paul Gerard at [email protected].

Remember, you will only receive information on how to register in the EDPMA room block after you register for the Summit.  Don't miss out on a room in the block, register today as rooms are selling fast.

Learn more at www.edpma.org

WE LOOK FORWARD TO SEEING YOU IN APRIL!!  

Special Half-Day Program on Advocating for the
Business of Emergency Medicine

WEDNESDAY, MAY 1, 2019, 8:30AM - 12:30PM

Please make sure your travel plans allow you to stay through Wednesday morning's special focus on advocating for the business of emergency medicine.  We recommend scheduling your return flight after 3:00pm.  Presenters will not only give great advice on being an advocate, but also will make sure you can comfortably address the issues legislators are focusing on today.  Both the federal and many state legislatures are considering legislation that will impact your bottom line.  With just a small amount of effort, you can have a huge impact if you are willing to advocate.  

In the morning, there will be a presentation on the federal political landscape and the status of legislation impacting you.  Next, an esteemed panel of  emergency physicians will share their tips on being a physician advocate in particular.  While you wind down enjoying a resort brunch, EDPMA staff and audience members will take part in a role-playing presentation where you can learn just how easy it is to make a big difference if you are willing to do a little advocacy.  The afternoon will wind down with additional tips and a call to action from EDPMA members who are actively lobbying on federal and state issues.  

This half-day program is included as part of your Solutions Summit registration. Alternatively, you can purchase a Wednesday Half-Day Registration ($250 for EDPMA members and $300 for nonmembers).


Register Now for the Solutions Summit Golf
Tournament in Scottsdale, AZ 

Arrive early and join us for our Second EDPMA Solutions Summit Golf Tournament on Saturday, April 27, 2019. Whether or not you join us for golf, all registrants are invited to attend the Pre-Conference Reception as the afternoon winds down over the desert.
   
Golf Tournament:
The deadline to register for golf is April 1st .

Tournament Date: Saturday, April 27, 2019

Time: 1:00 PM Shotgun Start (different teams start from different holes) (arrive early!)

Format: 18-Hole Scramble - Each player on the team tees off on each hole. The best of the tee shots is selected and all players play their second shots from that spot. The best of the second shots is determined, and then all play their third shots from that spot, and so on until the ball is holed. Team scores for 18 holes will be compared for prizes.

Location: McCormick Ranch Golf Club | Pine Golf Course 7505 E. McCormick Parkway, Scottsdale, AZ 85258

Transportation: The hotel is next to the golf course. The hotel provides on-property resort transportation services that depart from the main hotel/lobby area and drop golfers off at the Golf Pro Shop. The hotel is in walking distance to the Pine's Course (-but you might get lost).

Eligibility: You must be a Summit registrant (you can register for the entire conference or just register for Sunday sessions) and register for the golf tournament.

Team Requests: If you would like to be placed on the same team with another Summit registrant, please email [email protected].

Pricing: $150 per person

Club Rentals: $55 (plus tax)

Clothing Restrictions: Golf attire is required: collared shirts are required; Denim/jeans are allowed, but cut off jean shorts are prohibited. Golf shoes are available for rent, but sizes and availability are very limited.  Tennis shoes may be worn.
   
Pre-Conference Reception:
The Pre-Conference Reception will be held at the McCormick Ranch Golf Course immediately following the tournament. All Summit registrants are welcome; you do not have to play golf.

Date: Saturday, April 27, 2019

Time: 5:30 PM to 7:00 PM

Location: Upper Terrace Patio at the McCormick Ranch Golf Club 7505 E. McCormick Parkway, Scottsdale, AZ 85258

Transportation: The hotel is next to the golf course. The hotel provides on-property resort transportation services that depart from the main hotel/lobby area and drop golfers off at the Golf Pro Shop. The hotel is in walking distance to the Pine's Course (-but you might get lost).

Pricing: Free for Summit registrants; $50 for guests who are not in the ED industry; guests in the ED business must, at minimum, register for Sunday sessions.

Contact Megan Van Dam at [email protected] if you are interested in sponsoring something for the golf event, like water bottles, golf contests, or food and beverages.

Contact [email protected], if you have questions about registration.


Reserve Your Exhibit Booth for EDPMA's
Solutions Summit  

Reserve your exhibit booth for the Emergency Department Practice Management Association's Solutions Summit in Scottsdale, AZ, from April 28-May 1, 2019!  EDPMA's Solutions Summit is the premier conference for those in the business of emergency medicine. Billing, coding, scribe, legal, staffing, computer software, and other consultants serving the emergency medicine community know that the Solutions Summit gives access to high-level decision makers in an intimate environment. And, unlike other conferences, an exhibitor pass provides access to educational sessions and events.

Once you have reserved and paid for your booth, you can select its location in the exhibit hall. So, the earlier you reserve, the better the space you can select. To reserve an exhibit booth, please fill out and return the attached Exhibitor Contract. To learn more about additional sponsorship opportunities, please check out our 2019 Sponsorship Prospectus.

For more information, please contact Megan Van Dam at (703) 245-8061 or [email protected]  or visit www.edpma.org.
  
New Member Spotlight: Equian    
 
Equian is a national leader in subrogation services (third party/other party liability) and a leading innovator in this specialized market. Equian was founded in 1988 and has grown steadily year-by-year. Equian manages over $500 billion in claims annually through an innovative platform designed to assist clients by avoiding, identifying, pricing, and analyzing clinical codes, and recovering inaccurate transactions in the complex environments of healthcare, workers compensation, and property and casualty markets. To learn more about Equian, please click here.

Excerpts from a conversation with Mary Beth Leist, Vice President, Account Management and Business Development
 
Ms. Leist joined Equian in 1999 in an account management role and, after a few years, moved into management. Mary Beth has always been in customer-facing sales and business development roles and enjoys working closely with her clients and prospective clients. Today, Ms. Leist leads a team of strategic account managers. Her main goals for her team are client satisfaction and growing the business. Mary Beth was involved in the company's entry into the emergency medicine healthcare market and has worked to develop this market and the company's understanding of its customer needs. This has resulted in steady growth over the years. In 2012, Equian had one emergency medicine client.  Today Equian s erves a multitude of ED clients and recovers over $200 million per year for these customers. Emergency medicine is one of the fastest growing business segments in the Equian portfolio.

Mary Beth has attended a few Solutions Summits and was aware that she had a number of clients who were EDPMA members. In deciding to join EDPMA, Ms. Leist realized that EDPMA offered a unique opportunity to connect with her existing clients and network with prospective clients on issues of importance to her emergency medicine client's. With executive management support, Equian decided to join ED PMA after the Fort Lauderdale 2018 Solutions Summit. Ms. Leist has found that, through EDPMA's networking opportunities, existing and new relationships are easily expanded and developed. EDPMA and its members' expertise and knowledge of regulatory, legislative and market challenges all contribute value to Equian's understanding of their customer's needs. EDPMA's mission, to support emergency medicine providers in their efforts to provide the highest-quality patient care and to be paid fairly (in addition to providing tools to highlight best business practices), resonated with Mary Beth. EDPMA's ongoing information and educational information (workshops, webinars and the Solutions Summit confe rence), help Equian understand when and why clients are shifting or are pushing into a new area or have new concerns.

Equian has exhibited at the previous two Solutions Summit conferences and plans to exhibit at the 2019 Solutions Summit (April 28-May 1 in Scottsdale, AZ). Mary Beth said, "the Summit is a great opportunity to connect with existing clients, meet prospects, and overall, just get a whirlwind update on all that is happening with emergency medicine. It is a valuable event for myself and my team."   

New Medicare Enrollment Application Issued By CMS

The Centers for Medicare and Medicaid Services (CMS) recently alerted physicians and non-physicians to a new Medicare Enrollment Application (CMS-855I dated 12/2018) that they must use after April 30, 2019. According to CMS, the new form will reduce burden on providers that seek to enroll in the program. For example, the new form:
  • Eliminates reporting for advanced diagnostic imaging, Clinical Laboratory Improvement Amendments number, and the Food and Drug Administration radiology certification number
  • Expands instructions for individual and group affiliations to simplify reporting
  • Makes it optional to list a contact person
  • Adds electronic storage information for those who no longer keep paper records
  • Creates a more logical data flow
The new form is available for use immediately.  A summary of the new form prepared by Hart Health Strategies is available here and a copy of the new form is available here.
 
Join an EDPMA Committee! 
 
We encourage you to join an EDPMA committee.  The real work at EDPMA is done at the committee level. Committee members work together in a variety of ways including:
  • discussing the impact of the ACA, its possible repeal, and changes to Medicaid that impact ED practice groups,
  • organizing meetings with CMS officials on provider enrollment,
  • drafting letters to state-level policymakers on balance billing,
  • identifying speakers on ED best practices,
  • meeting with commercial payers about problematic downcoding policies,
  • developing a toolbox to help survive an audit,
  • preparing for Medicare reimbursement under the Merit-Based Incentive Payment System, and
  • building strong business relationships.
Experts work side-by-side with newcomers, new leaders shine, and everyone's contribution is greatly appreciated.  Many members report that insight shared on committee conference calls is one of the most important and unique benefits of their EDPMA membership. We invite you to join one of EDPMA's committees. Information about each committee is available here.   (Don't be shy: if you want, you can just listen in.)

Membership Committee Update:
EDPMA would like to welcome one new member this month:

Core Clinical Partners, Atlanta, GA

We look forward to working with you! 

Urgent Matters Blog and More 

EDPMA is a member of the Urgent Matters Editorial Board and contributes webinars and other educational material to this important collaborative group.  As a member of EDPMA, you can access these resources for free.  You can access the blog, podcasts and more through the links below: 

Toolkit  

Greetings:

As part of ongoing communication efforts, CMS wants to listen to clinician stakeholders on the topic of Evaluation and Management codes, specifically on the implementation of the finalized policies and on potential alternative policies to achieve the goals that drove our finalized E/M policies. CMS is holding two identical listening sessions - the first on Wednesday, February 13 and again on Tuesday February 19 from 7:30 - 9:00 pm ET. The purpose is to hear from clinicians on this topic, and identify thoughts and trends in various professional settings, as well as ideas for strengthening the initiative. We will ask questions such as: 
  • What reactions do stakeholders have to the policies finalized for CY 2021? Do these policies reduce documentation burden and improve payment accuracy?
  • What aspects of our finalized proposals require clarification?
We are particularly interested in hearing from front line practitioners and also from their "front office" staff who are directly involved in claims and billing.  We want to listen to your thoughts on this topic - the conversation will be coming from the participants.

To participate, please respond to Tevin Warren at [email protected] with contact and date preference for the appropriate individual.  Reservations will be granted on a first come, first serve basis. We will close this out for each session after the first 25 have responded.

Warm regards,

Tevin Warren, MPH
Health Insurance Specialist
Partner Relations Group
Centers for Medicare & Medicaid Services
(410) 786-4381

Check Your Preliminary 2019 MIPS Eligibility
on the QPP Website
You can now check the Quality Payment Program (QPP) Participation Status Tool to view your eligibility status for the 2019 performance period under the Merit-based Incentive Payment System (MIPS).

Enter your National Provider Identifier (NPI), to find out if you need to participate in MIPS during the 2019 performance year.
  
How CMS Determines Your 2019 MIPS Eligibility Status

We review both PECOS data and Medicare Part B claims for services provided during two 12-month segments called the MIPS determination period.
  • First segment: October 1, 2017 through September 30, 2018.
  • Includes a 30-day claims run out period.
  • Second segment: October 1, 2018 through September 30, 2019.
  • Does not include a claims run out period.
Today' QPP Participation Status Tool update shows your preliminary 2019 eligibility status based on data from October 1, 2017 to September 30, 2018. 
Later this year, we will review PECOS and Medicare Part B claims data  from October 1, 2018 to September 30, 2019, and update the QPP Participation Status Tool to reflect your final 2019 MIPS eligibility status.
  
Note: If you joined a new practice and started billing to a new or different TIN after September 30, 2018, we will evaluate your eligibility under that practice during the second segment of the MIPS determination period.
  
Changes to the Low-Volume Threshold
We've updated the low-volume threshold criteria for the 2019 performance year. Clinicians and groups are excluded from MIPS in 2019 if, during either segment of the MIPS determination period, they:
  • Bill $90,000 or less in Medicare Part B allowed charges for covered professional services payable under the Physician Fee Schedule (PFS), OR
  • Furnish covered professional services to 200 or fewer Medicare Part B-enrolled beneficiaries, OR
  • Provide 200 or fewer covered professional services to Medicare Part B-enrolled beneficiaries.
Clinicians and groups who are currently identified as eligible (exceeding all three elements of the low-volume threshold) must exceed all three elements of the low-volume threshold in the second segment to remain eligible, unless they opt into MIPS participation as discussed below.
  
Opting In to MIPS Participation
Clinicians and groups can elect to "opt-in" to MIPS if they meet or exceed one or two, but not all, of the low-volume threshold criteria. Clinicians and groups who do not exceed any of the low-volume threshold criteria (in one or both segments of the MIPS determination period) may voluntarily report, but are not able to opt-in.
  • Clinicians and groups that opt-in will receive a MIPS payment adjustment in 2021.
  • Clinicians and groups that voluntarily report will receive a MIPS final score, but no payment adjustment will be applied.
Questions?
  • Contact the Quality Payment Program at [email protected] or 1-866-288-8292 (TTY: 1-877-715-6222).