News & Updates: November 2022 |
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South Carolina Election News |
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SC House Elections: In the 124 member House, Republicans now hold 88 – 36 majority after a net gain of 7 seats. 27 new members: 25 Republicans, 2 Democrats. There are at least 6 vacancies to be filled on House Ways and Means Committee and a new Chairman will be elected Dec 6 -7. The lone Republican to lose was SCOA ally Kirkman Finlay in Columbia. Notable retirements from the House include former Speaker Jay Lucas and longtime Majority Leader Gary Simrill who spoke at the SCOA annual meeting.
Changes on House Medical Affairs (3-M) Committee: 9 out of 18 Members on House 3-M either retired or were defeated for re-election including longtime Subcommittee Chair Ann Parks of Greenwood and US Senate candidate Krystle Matthews of Charleston. Expect lots of new faces on this Committee in 2023.
Statewide and Congressional Election Takeaways: Republicans won every statewide office and by wider margins than anticipated. Governor Henry McMaster with 58% carried 34 of 46 SC counties and won by the 2nd widest margin of any Republican Governor since the reconstruction era. Senator Tim Scott’s 63% of the vote is a historically high number when facing major party opposition.
Upcoming Dates for 2023 Session of the General Assembly
Nov 29-30 House Freshman Orientation
Nov 30 & Dec 7 Senate Prefiling Bills
Dec 8 & 15 House Prefiling Bills
December 6th House Organizational Session
January 10th Full General Assembly Session Begins
January 11th Inauguration Day for Governor and Constitutional Officers
January 25th Governor McMaster State of the State Address
New Members of the 2023 SC House of Representatives
Click here to review a list of newly Elected SC House Members
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The drafted Notices of Final Regulation (NFRs) for Regulation 61-15, Certification of Need for Health Facilities and Services and Regulation 61-64, X-Rays (Title B) are scheduled to be presented to the S.C. Board of Health and Environmental Control during the Thursday, Dec. 8, 2022, Board meeting, which will begin at 10 a.m. Each NFR presentation will be followed by a public hearing where members of the public can sign up to speak about the drafted NFR.
The DHEC Board meeting will take place in the Board Room of the DHEC Building, located at 2600 Bull Street, Columbia, S.C. 29201. All visitors must enter through the main Bull Street entrance and go to the front desk for further instructions. The DHEC Board meeting agenda and supplemental materials will be published at least twenty-four (24) hours in advance with the drafted NFRs and the order and times of the presentations here: DHEC Board Meeting - Thursday, December 8, 2022 | SCDHEC.
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We Help You Put All The Pieces Together. |
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The Sharecare platform offers an innovative stand-alone or unified solution suite designed to solve multiple intersecting challenges for the healthcare ecosystem, including health information management, value-based care, payment integrity (claims denial management), and chronic condition management. Differentiate your care by integrating these services with the most powerful digital health platform available with the ability to generate care gap reminders that are seamlessly integrated into the patient’s digital healthcare journey.
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Upcoming Events & Webinars |
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Stocking Stuffers from CMS and Other New Year’s Surprises |
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Webinar Opportunity to Share with Your Coding & Billing Teams! |
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Thursday, December 1st | 1:00-2:00 PM (ET) |
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Get the latest information on CPT® code changes that affect orthopaedic offices related to E/M guideline changes and musculoskeletal codes. During the webinar, we will also review relevant information in the 2023 Final Rule Physicians Fee Schedule, to include what is going to happen with telehealth and shared/split visits. |
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The webinar is a free educational offering for our members.
Please follow the instructions to register for the event.
After registering, you will receive a confirmation email containing information about joining the webinar
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KZA Educational Opportunity for Surgeons |
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Price Transparency & the No Surprises Act: What's Next? |
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Wednesday, December 7th | 2:00 PM (ET) |
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Mike Havig, MD and Matthew Roberts participated in our Good Faith Estimates Webinar in February 2022. Our members are invited to join them and Marni Jameson, President of Power to the Patients, for a follow-up discussion as enforcement of the No Surprises Act continues. |
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Doctor Sentenced for Accepting Illegal Kickback Payments in Return for Writing Prescriptions for Compounded Drugs |
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A doctor licensed in Virginia, Maryland, and elsewhere was sentenced to 3 years for writing and referring compounded drug prescriptions in return for illegal kickback payments. The doctor previously entered into a civil settlement with the Government that requires him and the company he owned to pay $3.1 million.
According to court documents, Dr. Thomas Raley, Jr., 53, of Baltimore, Maryland, was a physician specializing in orthopedic surgery, spine surgery, and comprehensive pain management services, who has practiced in Virginia, Maryland, and elsewhere since 1998. Raley was also the owner of a medical practice, which had offices in both Virginia and Maryland. In 2013, Raley and Seth Michael Myers, 53, of Crystal Lake, Illinois, began soliciting pharmacists to pay them kickbacks in return for Raley referring expensive compounded medications to the pharmacies. Click here to read the full DOJ release.
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CDC Updates Guideline for Prescribing Opioids for Chronic Pain |
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The 2022 Clinical Practice Guideline includes 12 recommendations for clinicians providing pain care for outpatients aged 18 years or older with acute pain (duration less than 1 month), subacute pain (duration of 1-3 months), or chronic pain (duration of more than 3 months). The recommendations are grouped into four areas of consideration:
- Determining whether or not to initiate opioids for pain
- Selecting opioids and determining dosages
- Deciding duration of initial opioid prescription and conducting follow-up
- Assessing the risk and addressing potential harms of opioid use
The CDC Guideline is not a replacement for clinical judgment or individualized, person-centered care; rather, it is intended to be flexible and enable person-centered decision-making, taking into account an individual’s expected health outcomes and well-being.
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Review & Dispute Reminder: Program Year 2021
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Program Year 2021 Open Payments data is available for review and dispute through December 31, 2022.
On June 30, 2022, the Centers for Medicare & Medicaid Services (CMS) published Program Year 2021 Open Payments data along with updated and newly submitted data from previous program years (2015-2020). The Program Year 2021 records are available for review and dispute in the Open Payments system through December 31, 2022, so be sure to review data attributed to you as soon as possible!
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Updated Medicare Provider Compliance Tips Webpage |
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The Medicare Learning Network has an updated Provider Compliance Tips webpage that is very user friendly. Click here to access.
While it includes many non-MSK topics, the following topics may prove useful to your billing teams: Canes & Crutches, Chiropractic Services, Commodes, Diabetic Shoes, Lower Limb Orthoses, Negative Pressure Wound Therapy, Physical Therapy, Podiatry, Spinal Orthoses, Surgical Dressings and TENS Units.
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Doctors and Clinicians Preview Period Is Now Open |
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The Doctors and Clinicians Preview Period is open November 21 – December 20, 2022. You can preview your 2021 Quality Payment Program (QPP) performance information before it will appear on clinician and group profile pages on Medicare Care Compare and in the Provider Data Catalog (PDC). You will be able to access the secured Preview through the QPP website.
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Confirm 2022 and 2023 MIPS Eligibility |
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You can now use the Quality Payment Program (QPP) Participation Status Tool to review final 2022 provider eligibility status and to check initial 2023 provider eligibility status for the Merit-based Incentive Payment System (MIPS). CMS updates provider eligibility statuses based on enrollment and claims data. Simply enter any provider’s NPI and select the performance year to confirm if that provider is required to participate in MIPS.
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Impact Players: How to Take the Lead, Play Bigger and Multiply Your Impact
by Liz Wiseman
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Liz Wiseman, author of Multipliers, defines Impact Players as standout contributors who create extraordinary value everywhere they work. She suggests that two people with similar talent, skills and drive may have markedly different levels of impact. Impact players share 5 characteristics:
- Doing the job that’s needed while others simply do their jobs.
- Stepping up to lead while others wait for direction.
- Moving things across the finish line while others escalate problems.
- Learning and adapting to change while others attempt to minimize change.
- Making heavy demands feel lighter while others add to the load.
This resource is equally valuable to individuals seeking to perform at their peak as Impact Players and those leaders seeking to identify and cultivate impact players in their organizations.
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Summary submitted by:
AnnMargaret McCraw
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Have a Book that was Meaningful to your Professional Journey?
Please consider sharing a short paragraph about lessons learned from a book that has shaped you as a leader. Send your summary to Sarah Thompson.
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Webinar Recordings Include: |
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Information Sharing Under the Information Blocking Regulations: What Healthcare Providers Need to Know
- Lunch, Laugh, Learn & Lead featuring comedian Robert Mac!
- Replay AI in MSK Care Delivery: Potential vs Risk
- Marketing, Social Media, & The Physician Practice: Legal Implications
- Physician Financial Relationships & Conflict of Interest Policies
- And more!
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Member Benefit: Discover OrthoEvidence |
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Our members receive complimentary access to OrthoEvidence (OE), which is the global online source for high quality and timely orthopaedic-only evidence-based summaries, pre-appraised by orthopaedic medical experts. |
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Thank You To Our Corporate Partner: |
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South Carolina Orthopaedic Association www.scoanet.org
844-234-7800
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