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Administration to allow noncompliant health policies through 2017
The Obama Administration said that it will allow through 2016 renewals of health insurance policies that do not meet the minimum criteria established by the Affordable Care Act.
Each state has the final say on whether such policies can continue to be sold, but the move by the White House will help remove some of the hurdles, a senior administration official said March 5.
In November, President Obama said that, to avoid cancellations, the federal government would let insurers renew, for 1 year, policies that did not contain the essential health benefits outlined by the ACA. That would give policyholders who did renew time to find new coverage.
About half of the states agreed to allow renewals after the policy change, but some states with the largest number of such policyholders – including California, Washington, New York, and Maryland – refused to allow renewals.
Now, in a wide-ranging rule that covers many aspects of the ACA for 2015, the administration said that noncompliant policies can be renewed as late as Oct. 1, 2016. No new policies can be issued. States that chose not to allow the renewals before also can change their decisions, senior administration officials said.
In 2015, the administration also is giving consumers an additional month to shop for coverage on the federal and state health insurance exchanges for 2015: Open enrollment will run from Nov. 15, 2014, to Feb. 15, 2015.
The rule also reduces out-of-pocket limits for individuals and families who buy coverage through the exchanges. Depending on income, individuals will pay a maximum of $2,250 to $5,200, and families will pay $4,500 to $10,400.
"These policies implement the health care law in a common-sense way by continuing to smooth the transition for consumers and stakeholders and fixing problems wherever the law provides flexibility," HHS Secretary Kathleen Sebelius said in a statement. "This comprehensive guidance will help ensure that consumers, employers and insurers have the information they need to plan for next year and make it easier for families to make decisions to access quality, affordable coverage."
The administration said that it had worked on the guidance for 2015 with input from consumers, states, businesses, health professionals, insurance commissioners, insurers, and members of Congress.
On Twitter @aliciaault
The Obama Administration said that it will allow through 2016 renewals of health insurance policies that do not meet the minimum criteria established by the Affordable Care Act.
Each state has the final say on whether such policies can continue to be sold, but the move by the White House will help remove some of the hurdles, a senior administration official said March 5.
In November, President Obama said that, to avoid cancellations, the federal government would let insurers renew, for 1 year, policies that did not contain the essential health benefits outlined by the ACA. That would give policyholders who did renew time to find new coverage.
About half of the states agreed to allow renewals after the policy change, but some states with the largest number of such policyholders – including California, Washington, New York, and Maryland – refused to allow renewals.
Now, in a wide-ranging rule that covers many aspects of the ACA for 2015, the administration said that noncompliant policies can be renewed as late as Oct. 1, 2016. No new policies can be issued. States that chose not to allow the renewals before also can change their decisions, senior administration officials said.
In 2015, the administration also is giving consumers an additional month to shop for coverage on the federal and state health insurance exchanges for 2015: Open enrollment will run from Nov. 15, 2014, to Feb. 15, 2015.
The rule also reduces out-of-pocket limits for individuals and families who buy coverage through the exchanges. Depending on income, individuals will pay a maximum of $2,250 to $5,200, and families will pay $4,500 to $10,400.
"These policies implement the health care law in a common-sense way by continuing to smooth the transition for consumers and stakeholders and fixing problems wherever the law provides flexibility," HHS Secretary Kathleen Sebelius said in a statement. "This comprehensive guidance will help ensure that consumers, employers and insurers have the information they need to plan for next year and make it easier for families to make decisions to access quality, affordable coverage."
The administration said that it had worked on the guidance for 2015 with input from consumers, states, businesses, health professionals, insurance commissioners, insurers, and members of Congress.
On Twitter @aliciaault
The Obama Administration said that it will allow through 2016 renewals of health insurance policies that do not meet the minimum criteria established by the Affordable Care Act.
Each state has the final say on whether such policies can continue to be sold, but the move by the White House will help remove some of the hurdles, a senior administration official said March 5.
In November, President Obama said that, to avoid cancellations, the federal government would let insurers renew, for 1 year, policies that did not contain the essential health benefits outlined by the ACA. That would give policyholders who did renew time to find new coverage.
About half of the states agreed to allow renewals after the policy change, but some states with the largest number of such policyholders – including California, Washington, New York, and Maryland – refused to allow renewals.
Now, in a wide-ranging rule that covers many aspects of the ACA for 2015, the administration said that noncompliant policies can be renewed as late as Oct. 1, 2016. No new policies can be issued. States that chose not to allow the renewals before also can change their decisions, senior administration officials said.
In 2015, the administration also is giving consumers an additional month to shop for coverage on the federal and state health insurance exchanges for 2015: Open enrollment will run from Nov. 15, 2014, to Feb. 15, 2015.
The rule also reduces out-of-pocket limits for individuals and families who buy coverage through the exchanges. Depending on income, individuals will pay a maximum of $2,250 to $5,200, and families will pay $4,500 to $10,400.
"These policies implement the health care law in a common-sense way by continuing to smooth the transition for consumers and stakeholders and fixing problems wherever the law provides flexibility," HHS Secretary Kathleen Sebelius said in a statement. "This comprehensive guidance will help ensure that consumers, employers and insurers have the information they need to plan for next year and make it easier for families to make decisions to access quality, affordable coverage."
The administration said that it had worked on the guidance for 2015 with input from consumers, states, businesses, health professionals, insurance commissioners, insurers, and members of Congress.
On Twitter @aliciaault
Flexibility – but no passes – on meaningful use Stage 2
ORLANDO – The government can be a bit more flexible on physicians meeting Stage 2 of meaningful use of electronic health records, but won’t give blanket permission to slide on deadlines.
That’s according to Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), who spoke Feb. 27 at the annual meeting of the Healthcare Information and Management Systems Society.
Physicians have been seeking more leeway from CMS on participating in meaningful use this year, in part because they must purchase or upgrade to the 2014 edition of certified EHR (electronic health records) technology, and in part because they must get ready to switch over to the ICD-10 coding set on Oct. 1.
Physicians who participate in meaningful use get incentive payments from Medicare or Medicaid. If they don’t participate this year, they’ll be penalized starting in 2015.
On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
Ms. Tavenner said that CMS officials had heard many concerns about moving forward with Stage 2, and "are sensitive to those concerns." She noted that over the past few years, the agency had delayed the start of Stage 1 and Stage 2, and most recently pushed back implementation of Stage 3 to 2017.
"But now is not the time to stop moving forward," she said. Ms. Tavenner said that it was understood that some health care providers and vendors "may legitimately have issues with establishing Stage 2 reporting deadlines."
Because of that, the CMS has "decided to permit flexibility in how hardship exemptions will be granted in the 2014 reporting year," she said.
The agency will look at hardship requests case-by-case, as is required by law. And it is expected to issue further guidance on what qualifies as a hardship very soon.
But Ms. Tavenner said the agency would not give everyone a pass.
"I must stress to you that we do expect all eligible Stage 2 providers to fully meet all requirements in 2015," Ms. Tavenner said. "And I urge all of you to do everything you can to meet the Stage 2 requirements this year."
[email protected]
On Twitter @aliciaault
ORLANDO – The government can be a bit more flexible on physicians meeting Stage 2 of meaningful use of electronic health records, but won’t give blanket permission to slide on deadlines.
That’s according to Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), who spoke Feb. 27 at the annual meeting of the Healthcare Information and Management Systems Society.
Physicians have been seeking more leeway from CMS on participating in meaningful use this year, in part because they must purchase or upgrade to the 2014 edition of certified EHR (electronic health records) technology, and in part because they must get ready to switch over to the ICD-10 coding set on Oct. 1.
Physicians who participate in meaningful use get incentive payments from Medicare or Medicaid. If they don’t participate this year, they’ll be penalized starting in 2015.
On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
Ms. Tavenner said that CMS officials had heard many concerns about moving forward with Stage 2, and "are sensitive to those concerns." She noted that over the past few years, the agency had delayed the start of Stage 1 and Stage 2, and most recently pushed back implementation of Stage 3 to 2017.
"But now is not the time to stop moving forward," she said. Ms. Tavenner said that it was understood that some health care providers and vendors "may legitimately have issues with establishing Stage 2 reporting deadlines."
Because of that, the CMS has "decided to permit flexibility in how hardship exemptions will be granted in the 2014 reporting year," she said.
The agency will look at hardship requests case-by-case, as is required by law. And it is expected to issue further guidance on what qualifies as a hardship very soon.
But Ms. Tavenner said the agency would not give everyone a pass.
"I must stress to you that we do expect all eligible Stage 2 providers to fully meet all requirements in 2015," Ms. Tavenner said. "And I urge all of you to do everything you can to meet the Stage 2 requirements this year."
[email protected]
On Twitter @aliciaault
ORLANDO – The government can be a bit more flexible on physicians meeting Stage 2 of meaningful use of electronic health records, but won’t give blanket permission to slide on deadlines.
That’s according to Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), who spoke Feb. 27 at the annual meeting of the Healthcare Information and Management Systems Society.
Physicians have been seeking more leeway from CMS on participating in meaningful use this year, in part because they must purchase or upgrade to the 2014 edition of certified EHR (electronic health records) technology, and in part because they must get ready to switch over to the ICD-10 coding set on Oct. 1.
Physicians who participate in meaningful use get incentive payments from Medicare or Medicaid. If they don’t participate this year, they’ll be penalized starting in 2015.
On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
Ms. Tavenner said that CMS officials had heard many concerns about moving forward with Stage 2, and "are sensitive to those concerns." She noted that over the past few years, the agency had delayed the start of Stage 1 and Stage 2, and most recently pushed back implementation of Stage 3 to 2017.
"But now is not the time to stop moving forward," she said. Ms. Tavenner said that it was understood that some health care providers and vendors "may legitimately have issues with establishing Stage 2 reporting deadlines."
Because of that, the CMS has "decided to permit flexibility in how hardship exemptions will be granted in the 2014 reporting year," she said.
The agency will look at hardship requests case-by-case, as is required by law. And it is expected to issue further guidance on what qualifies as a hardship very soon.
But Ms. Tavenner said the agency would not give everyone a pass.
"I must stress to you that we do expect all eligible Stage 2 providers to fully meet all requirements in 2015," Ms. Tavenner said. "And I urge all of you to do everything you can to meet the Stage 2 requirements this year."
[email protected]
On Twitter @aliciaault
AT HIMSS14
CMS launches ICD-10 website for small physician practices
ORLANDO – A new resource is available for small practices as they prepare to switch to the ICD-10 coding system.
Officials from the Centers for Medicare & Medicaid Services (CMS) launched a new website – Road to ICD-10 – to provide a central source of basic information as well as a place to start transitioning to the new code set, which becomes mandatory on Oct. 1.
The site provides fact sheets, training videos, sample codes, and a variety of other resources. It also provides training modules that are specific to certain specialties.
Importantly, it gives physicians a template for building an action plan, said Denesecia Green, director of the Administrative Simplification Group at the CMS Office of eHealth Standards and Services.
So far, templates have been tailored for internal medicine, family practice, pediatrics, cardiology, obstetrics/gynecology, and orthopedics. The site also offers a more general path for other specialties.
According to Ms. Green, the action plan gives physicians a pictorial road map and lists the steps that might help pinpoint where diagnosis codes are used in the practice, how to identify the transition team, how to prepare a budget for the transition to ICD-10, and how to arrange for training.
The site was developed by physicians and came out of a series of listening sessions the agency held with a variety of physicians, said Dr. Ricardo Martinez, a member of the CMS’s small physician practice team, and an emergency physician.
"Physicians are concerned that everything is happening to them, rather than with them or for them," Dr. Martinez said.
However, many in the listening sessions said that they did see some potential benefits with ICD-10. In the end, Dr. Martinez said, physicians had a big question: "If there is a better world ahead, how do you get there?"
The Road to ICD-10 website is designed to help doctors make the journey, Dr. Martinez said.
The site was announced Feb. 26 at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS).
On Twitter @aliciaault
ORLANDO – A new resource is available for small practices as they prepare to switch to the ICD-10 coding system.
Officials from the Centers for Medicare & Medicaid Services (CMS) launched a new website – Road to ICD-10 – to provide a central source of basic information as well as a place to start transitioning to the new code set, which becomes mandatory on Oct. 1.
The site provides fact sheets, training videos, sample codes, and a variety of other resources. It also provides training modules that are specific to certain specialties.
Importantly, it gives physicians a template for building an action plan, said Denesecia Green, director of the Administrative Simplification Group at the CMS Office of eHealth Standards and Services.
So far, templates have been tailored for internal medicine, family practice, pediatrics, cardiology, obstetrics/gynecology, and orthopedics. The site also offers a more general path for other specialties.
According to Ms. Green, the action plan gives physicians a pictorial road map and lists the steps that might help pinpoint where diagnosis codes are used in the practice, how to identify the transition team, how to prepare a budget for the transition to ICD-10, and how to arrange for training.
The site was developed by physicians and came out of a series of listening sessions the agency held with a variety of physicians, said Dr. Ricardo Martinez, a member of the CMS’s small physician practice team, and an emergency physician.
"Physicians are concerned that everything is happening to them, rather than with them or for them," Dr. Martinez said.
However, many in the listening sessions said that they did see some potential benefits with ICD-10. In the end, Dr. Martinez said, physicians had a big question: "If there is a better world ahead, how do you get there?"
The Road to ICD-10 website is designed to help doctors make the journey, Dr. Martinez said.
The site was announced Feb. 26 at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS).
On Twitter @aliciaault
ORLANDO – A new resource is available for small practices as they prepare to switch to the ICD-10 coding system.
Officials from the Centers for Medicare & Medicaid Services (CMS) launched a new website – Road to ICD-10 – to provide a central source of basic information as well as a place to start transitioning to the new code set, which becomes mandatory on Oct. 1.
The site provides fact sheets, training videos, sample codes, and a variety of other resources. It also provides training modules that are specific to certain specialties.
Importantly, it gives physicians a template for building an action plan, said Denesecia Green, director of the Administrative Simplification Group at the CMS Office of eHealth Standards and Services.
So far, templates have been tailored for internal medicine, family practice, pediatrics, cardiology, obstetrics/gynecology, and orthopedics. The site also offers a more general path for other specialties.
According to Ms. Green, the action plan gives physicians a pictorial road map and lists the steps that might help pinpoint where diagnosis codes are used in the practice, how to identify the transition team, how to prepare a budget for the transition to ICD-10, and how to arrange for training.
The site was developed by physicians and came out of a series of listening sessions the agency held with a variety of physicians, said Dr. Ricardo Martinez, a member of the CMS’s small physician practice team, and an emergency physician.
"Physicians are concerned that everything is happening to them, rather than with them or for them," Dr. Martinez said.
However, many in the listening sessions said that they did see some potential benefits with ICD-10. In the end, Dr. Martinez said, physicians had a big question: "If there is a better world ahead, how do you get there?"
The Road to ICD-10 website is designed to help doctors make the journey, Dr. Martinez said.
The site was announced Feb. 26 at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS).
On Twitter @aliciaault
AT HIMSS14
Stage 2 of meaningful use: Expect tougher objectives, pre-payment audits
ORLANDO – Expect a more rigorous process of certification for Stage 2 of meaningful use and be prepared for audits that will withhold incentive payments until all issues are resolved, federal officials advised.
This year is the first that physicians can work to meet the requirements for Stage 2 of meaningful use. Stage 1 was about data capture, but Stage 2 is about sharing information across care settings and between patients and providers, Robert Anthony, deputy director of the Health IT Initiatives Group at the Centers for Medicare and Medicaid Services’ Office of E-Health Standards and Services, said at the annual meeting of the Healthcare Information and Management Systems Society.
Among the core requirements for Stage 2 are establishing a patient portal and ensuring and using secure messaging between patients and providers. Physicians must be able to link to imaging results, report to a registry, and record electronic progress notes.
Mr. Anthony said that CMS purposely set what he called a "low bar" for patient engagement in Stage 2. To demonstrate meaningful use, 5% of patients must use the practice’s patient portal and 5% must participate in secure messaging beyond appointment booking, he said.
Even so, meeting that target might not be easy. Mr. Anthony said that he had heard from some physicians that they are sitting down with patients at the end of a visit and walking them through use of the portal or the messaging process. Those encounters, he added, can be counted toward the target.
Requirements for documenting care transitions are stricter as well, Mr. Anthony said.
"In Stage 1, ‘transitions of care’ was a menu objective, and virtually none of you selected transitions of care," he said. "We know why everybody didn’t select it – because it’s a difficult objective to achieve."
Care transitions, though, are "the Holy Grail" for showing that systems and clinicians can talk to each other, so the measure was moved into the core objectives for stage 2, he said.
Under Stage 1, physicians could send a summary of care to the next provider by any method, as long as it arrived, said Mr. Anthony. Under Stage 2, summaries must be electronically transmitted 10% or more of the time. At least some have to be sent to clinicians using a different electronic health record system.
Finally, CMS will be performing more audits under Stage 2. The agency must be accountable for the $21 billion spent on incentive payments so far, he said. In stage 1, the audits for Medicare were primarily post payment. Now, payments will be withheld until the audits are resolved. Some 5%-10% of physicians will be subject to an audit. They will be chosen at random or through risk profiling.
And, "no, we’re not going to talk about what raises a red flag, because that’s the point of an oversight program," he added.
So far, documentation has been the primary deficiency found through the audit process, Mr. Anthony said.
"I am shocked by the number of people who do not retain any documentation related to their attestation figures," he said. Physicians need to document the numerators and denominators they use for attestation and then keep that documentation for 6 years.
There are no consultants or companies that have any special knowledge about how to avoid audits or resolve an audit more quickly. They also don’t know anything special about the appeals process. "The process is the same for everybody and is transparent and public for everybody," he said.
"Anybody who is telling you separately that they have some kind of inside line to CMS is drumming up business and nothing more," Mr. Anthony said.
He also said that there is no secret process to getting an appeal. The agency spells out what it is looking for in the appeals documentation available on the CMS ICD-10 website. There’s also a sample audit letter from the CMS contractor, Figliozzi and Co.
On Twitter @aliciaault
ORLANDO – Expect a more rigorous process of certification for Stage 2 of meaningful use and be prepared for audits that will withhold incentive payments until all issues are resolved, federal officials advised.
This year is the first that physicians can work to meet the requirements for Stage 2 of meaningful use. Stage 1 was about data capture, but Stage 2 is about sharing information across care settings and between patients and providers, Robert Anthony, deputy director of the Health IT Initiatives Group at the Centers for Medicare and Medicaid Services’ Office of E-Health Standards and Services, said at the annual meeting of the Healthcare Information and Management Systems Society.
Among the core requirements for Stage 2 are establishing a patient portal and ensuring and using secure messaging between patients and providers. Physicians must be able to link to imaging results, report to a registry, and record electronic progress notes.
Mr. Anthony said that CMS purposely set what he called a "low bar" for patient engagement in Stage 2. To demonstrate meaningful use, 5% of patients must use the practice’s patient portal and 5% must participate in secure messaging beyond appointment booking, he said.
Even so, meeting that target might not be easy. Mr. Anthony said that he had heard from some physicians that they are sitting down with patients at the end of a visit and walking them through use of the portal or the messaging process. Those encounters, he added, can be counted toward the target.
Requirements for documenting care transitions are stricter as well, Mr. Anthony said.
"In Stage 1, ‘transitions of care’ was a menu objective, and virtually none of you selected transitions of care," he said. "We know why everybody didn’t select it – because it’s a difficult objective to achieve."
Care transitions, though, are "the Holy Grail" for showing that systems and clinicians can talk to each other, so the measure was moved into the core objectives for stage 2, he said.
Under Stage 1, physicians could send a summary of care to the next provider by any method, as long as it arrived, said Mr. Anthony. Under Stage 2, summaries must be electronically transmitted 10% or more of the time. At least some have to be sent to clinicians using a different electronic health record system.
Finally, CMS will be performing more audits under Stage 2. The agency must be accountable for the $21 billion spent on incentive payments so far, he said. In stage 1, the audits for Medicare were primarily post payment. Now, payments will be withheld until the audits are resolved. Some 5%-10% of physicians will be subject to an audit. They will be chosen at random or through risk profiling.
And, "no, we’re not going to talk about what raises a red flag, because that’s the point of an oversight program," he added.
So far, documentation has been the primary deficiency found through the audit process, Mr. Anthony said.
"I am shocked by the number of people who do not retain any documentation related to their attestation figures," he said. Physicians need to document the numerators and denominators they use for attestation and then keep that documentation for 6 years.
There are no consultants or companies that have any special knowledge about how to avoid audits or resolve an audit more quickly. They also don’t know anything special about the appeals process. "The process is the same for everybody and is transparent and public for everybody," he said.
"Anybody who is telling you separately that they have some kind of inside line to CMS is drumming up business and nothing more," Mr. Anthony said.
He also said that there is no secret process to getting an appeal. The agency spells out what it is looking for in the appeals documentation available on the CMS ICD-10 website. There’s also a sample audit letter from the CMS contractor, Figliozzi and Co.
On Twitter @aliciaault
ORLANDO – Expect a more rigorous process of certification for Stage 2 of meaningful use and be prepared for audits that will withhold incentive payments until all issues are resolved, federal officials advised.
This year is the first that physicians can work to meet the requirements for Stage 2 of meaningful use. Stage 1 was about data capture, but Stage 2 is about sharing information across care settings and between patients and providers, Robert Anthony, deputy director of the Health IT Initiatives Group at the Centers for Medicare and Medicaid Services’ Office of E-Health Standards and Services, said at the annual meeting of the Healthcare Information and Management Systems Society.
Among the core requirements for Stage 2 are establishing a patient portal and ensuring and using secure messaging between patients and providers. Physicians must be able to link to imaging results, report to a registry, and record electronic progress notes.
Mr. Anthony said that CMS purposely set what he called a "low bar" for patient engagement in Stage 2. To demonstrate meaningful use, 5% of patients must use the practice’s patient portal and 5% must participate in secure messaging beyond appointment booking, he said.
Even so, meeting that target might not be easy. Mr. Anthony said that he had heard from some physicians that they are sitting down with patients at the end of a visit and walking them through use of the portal or the messaging process. Those encounters, he added, can be counted toward the target.
Requirements for documenting care transitions are stricter as well, Mr. Anthony said.
"In Stage 1, ‘transitions of care’ was a menu objective, and virtually none of you selected transitions of care," he said. "We know why everybody didn’t select it – because it’s a difficult objective to achieve."
Care transitions, though, are "the Holy Grail" for showing that systems and clinicians can talk to each other, so the measure was moved into the core objectives for stage 2, he said.
Under Stage 1, physicians could send a summary of care to the next provider by any method, as long as it arrived, said Mr. Anthony. Under Stage 2, summaries must be electronically transmitted 10% or more of the time. At least some have to be sent to clinicians using a different electronic health record system.
Finally, CMS will be performing more audits under Stage 2. The agency must be accountable for the $21 billion spent on incentive payments so far, he said. In stage 1, the audits for Medicare were primarily post payment. Now, payments will be withheld until the audits are resolved. Some 5%-10% of physicians will be subject to an audit. They will be chosen at random or through risk profiling.
And, "no, we’re not going to talk about what raises a red flag, because that’s the point of an oversight program," he added.
So far, documentation has been the primary deficiency found through the audit process, Mr. Anthony said.
"I am shocked by the number of people who do not retain any documentation related to their attestation figures," he said. Physicians need to document the numerators and denominators they use for attestation and then keep that documentation for 6 years.
There are no consultants or companies that have any special knowledge about how to avoid audits or resolve an audit more quickly. They also don’t know anything special about the appeals process. "The process is the same for everybody and is transparent and public for everybody," he said.
"Anybody who is telling you separately that they have some kind of inside line to CMS is drumming up business and nothing more," Mr. Anthony said.
He also said that there is no secret process to getting an appeal. The agency spells out what it is looking for in the appeals documentation available on the CMS ICD-10 website. There’s also a sample audit letter from the CMS contractor, Figliozzi and Co.
On Twitter @aliciaault
AT HIMSS14
Doctors seek to delay 2014 meaningful use deadlines
ORLANDO – Several dozen physician organizations are imploring the Department of Health and Human Services to slow down implementation of the meaningful use program for electronic health records, saying that the pace is overwhelming doctors’ ability to keep up.
The request comes as more than 35,500 attendees gather for the annual meeting of the Healthcare Information and Management Systems Society to learn more about government and private efforts to digitize the U.S. health care system.
In a letter to HHS Secretary Kathleen Sebelius, the physician groups said that doctors are struggling to make the investments needed to meet the federal targets. The groups want the government to give physicians through 2015 to transition to new EHR software and to meet stage 1 and 2 meaningful use requirements. They are also seeking more flexibility in how physicians meet those requirements.
Under the meaningful use program, eligible providers – physicians, nurse practitioners, and physician assistants who meet specific criteria – can receive incentive payments from Medicare and Medicaid. In 2014, the Medicare payment can be up to $23,520.
Centers for Medicare & Medicaid Services (CMS) officials at the HIMSS meeting said that 267,029 eligible providers have received Medicare incentive payments and 142,801 have received Medicaid payments since the program began in 2011, amounting to some $21 billion in payouts.
Providers will be penalized in 2015 if they do not sign up to be a meaningful user by March 31, said Elizabeth Holland, director of the HIT initiatives group at the CMS Office of E-Health Standards and Services. That date was recently extended by a month. Doctors who have never participated in the meaningful use program have until Oct. 1 to sign up to avoid penalties next year, and many physicians may be eligible for hardship exemptions that give them even more time to sign up, Ms. Holland said.
The physician groups still want more leeway. A big sticking point: Currently, eligible professionals have to adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and also meet more stringent meaningful use standards by the end of the year. Most providers are still working with the last edition – the 2011 CEHRT. The Office of the National Coordinator for Health Information Technology (ONC) created the CEHRT program to guide providers to EHRs that contain all the elements necessary to achieve meaningful use. The 2014 edition supports stage 2 of meaningful use, which started this year.
"With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers," according to the letter from the physician groups. If doctors can’t easily move on to the 2014 edition, they might "either abandon the possibility of meeting meaningful use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case."
While physicians worry about the 2014 edition, the ONC on Feb. 21 proposed to move forward again, spelling out standards for the 2015 edition of the CEHRT.
The ONC said that compliance with the 2015 edition would be voluntary – providers would not have to upgrade to be able to get incentive payments.
"This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace," Dr. Karen DeSalvo, national coordinator for health IT, said in a statement.
The rule on the 2015 edition will be published in the Federal Register on Feb. 26, and the ONC will take comments at www.regulations.gov until April 28. The final rule will be published this summer.
On Twitter @aliciaault
ORLANDO – Several dozen physician organizations are imploring the Department of Health and Human Services to slow down implementation of the meaningful use program for electronic health records, saying that the pace is overwhelming doctors’ ability to keep up.
The request comes as more than 35,500 attendees gather for the annual meeting of the Healthcare Information and Management Systems Society to learn more about government and private efforts to digitize the U.S. health care system.
In a letter to HHS Secretary Kathleen Sebelius, the physician groups said that doctors are struggling to make the investments needed to meet the federal targets. The groups want the government to give physicians through 2015 to transition to new EHR software and to meet stage 1 and 2 meaningful use requirements. They are also seeking more flexibility in how physicians meet those requirements.
Under the meaningful use program, eligible providers – physicians, nurse practitioners, and physician assistants who meet specific criteria – can receive incentive payments from Medicare and Medicaid. In 2014, the Medicare payment can be up to $23,520.
Centers for Medicare & Medicaid Services (CMS) officials at the HIMSS meeting said that 267,029 eligible providers have received Medicare incentive payments and 142,801 have received Medicaid payments since the program began in 2011, amounting to some $21 billion in payouts.
Providers will be penalized in 2015 if they do not sign up to be a meaningful user by March 31, said Elizabeth Holland, director of the HIT initiatives group at the CMS Office of E-Health Standards and Services. That date was recently extended by a month. Doctors who have never participated in the meaningful use program have until Oct. 1 to sign up to avoid penalties next year, and many physicians may be eligible for hardship exemptions that give them even more time to sign up, Ms. Holland said.
The physician groups still want more leeway. A big sticking point: Currently, eligible professionals have to adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and also meet more stringent meaningful use standards by the end of the year. Most providers are still working with the last edition – the 2011 CEHRT. The Office of the National Coordinator for Health Information Technology (ONC) created the CEHRT program to guide providers to EHRs that contain all the elements necessary to achieve meaningful use. The 2014 edition supports stage 2 of meaningful use, which started this year.
"With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers," according to the letter from the physician groups. If doctors can’t easily move on to the 2014 edition, they might "either abandon the possibility of meeting meaningful use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case."
While physicians worry about the 2014 edition, the ONC on Feb. 21 proposed to move forward again, spelling out standards for the 2015 edition of the CEHRT.
The ONC said that compliance with the 2015 edition would be voluntary – providers would not have to upgrade to be able to get incentive payments.
"This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace," Dr. Karen DeSalvo, national coordinator for health IT, said in a statement.
The rule on the 2015 edition will be published in the Federal Register on Feb. 26, and the ONC will take comments at www.regulations.gov until April 28. The final rule will be published this summer.
On Twitter @aliciaault
ORLANDO – Several dozen physician organizations are imploring the Department of Health and Human Services to slow down implementation of the meaningful use program for electronic health records, saying that the pace is overwhelming doctors’ ability to keep up.
The request comes as more than 35,500 attendees gather for the annual meeting of the Healthcare Information and Management Systems Society to learn more about government and private efforts to digitize the U.S. health care system.
In a letter to HHS Secretary Kathleen Sebelius, the physician groups said that doctors are struggling to make the investments needed to meet the federal targets. The groups want the government to give physicians through 2015 to transition to new EHR software and to meet stage 1 and 2 meaningful use requirements. They are also seeking more flexibility in how physicians meet those requirements.
Under the meaningful use program, eligible providers – physicians, nurse practitioners, and physician assistants who meet specific criteria – can receive incentive payments from Medicare and Medicaid. In 2014, the Medicare payment can be up to $23,520.
Centers for Medicare & Medicaid Services (CMS) officials at the HIMSS meeting said that 267,029 eligible providers have received Medicare incentive payments and 142,801 have received Medicaid payments since the program began in 2011, amounting to some $21 billion in payouts.
Providers will be penalized in 2015 if they do not sign up to be a meaningful user by March 31, said Elizabeth Holland, director of the HIT initiatives group at the CMS Office of E-Health Standards and Services. That date was recently extended by a month. Doctors who have never participated in the meaningful use program have until Oct. 1 to sign up to avoid penalties next year, and many physicians may be eligible for hardship exemptions that give them even more time to sign up, Ms. Holland said.
The physician groups still want more leeway. A big sticking point: Currently, eligible professionals have to adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and also meet more stringent meaningful use standards by the end of the year. Most providers are still working with the last edition – the 2011 CEHRT. The Office of the National Coordinator for Health Information Technology (ONC) created the CEHRT program to guide providers to EHRs that contain all the elements necessary to achieve meaningful use. The 2014 edition supports stage 2 of meaningful use, which started this year.
"With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers," according to the letter from the physician groups. If doctors can’t easily move on to the 2014 edition, they might "either abandon the possibility of meeting meaningful use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case."
While physicians worry about the 2014 edition, the ONC on Feb. 21 proposed to move forward again, spelling out standards for the 2015 edition of the CEHRT.
The ONC said that compliance with the 2015 edition would be voluntary – providers would not have to upgrade to be able to get incentive payments.
"This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace," Dr. Karen DeSalvo, national coordinator for health IT, said in a statement.
The rule on the 2015 edition will be published in the Federal Register on Feb. 26, and the ONC will take comments at www.regulations.gov until April 28. The final rule will be published this summer.
On Twitter @aliciaault
AT HIMSS14
States look to continue Medicaid pay boost on their own
Lawmakers in Maryland and California seek to extend the temporary Medicaid primary care pay increase included in the Affordable Care Act.
The health reform law increased Medicaid pay for primary care services to the higher rate Medicare pays for the same services; the pay bump runs for 2013 and 2014.
Physicians’ groups, including the American College of Physicians, the American Academy of Family Physicians, and the American Academy of Pediatrics, have sought unsuccessfully to get the pay raise extended, at least through 2016.
Maryland’s Gov. Martin O’Malley, a Democrat, proposed in his fiscal year 2014 budget to extend the higher pay rates through June 2015, whether or not the federal government extends the program. Maryland is different in other ways: In January 2013, state law extended the Medicaid pay bump to all physicians – not just primary care physicians – who billed evaluation and management codes.
More than 108,000 Maryland residents are expected to gain Medicaid coverage in fiscal 2014 under the Affordable Care Act (ACA), bringing the state’s total number of Medicaid and Children’s Health Insurance Program recipients to about 1,077,000.
Gene Ransom, the chief executive officer of MedChi, The Maryland State Medical Society, says that Gov. O’Malley’s proposals are likely to be approved by the majority Democrat state legislature, which is in session until early April.
A MedChi survey conducted last fall showed that the pay increase was encouraging physicians to accept more Medicaid patients, Mr. Ransom said. Forty-six percent of the Maryland doctors who did not accept Medicaid said they were reconsidering, and 57% of those who did accept Medicaid said they planned to increase the number of Medicaid patients they would see.
The initial pay boost was covered by an increase in the tobacco tax, Mr. Ransom said.
Physicians in California are hoping that state legislation will help increase Medi-Cal rates in that state. Dr. Richard Pan, a Democrat representing the state’s 9th district, has introduced AB-1759, which would extend Medicaid pay parity indefinitely, as long as the federal government extends Medicaid parity.
"Without adequate payment, Medi-Cal becomes an empty promise of coverage without actual access to care," Dr. Pan said in a statement. Dr. Pan also serves as chairman of the assembly’s Health Committee.
According to Dr. Pan’s office, more than 8.5 million Californians are on Medi-Cal. That number is expected to rise with new enrollees under the ACA.
"Patients in our communities are already having a difficult time finding access to care," said Dr. Richard Thorp, president of the California Medical Association, in a statement. Dr. Pan’s legislation "will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal," he said.
On Twitter @aliciaault
Lawmakers in Maryland and California seek to extend the temporary Medicaid primary care pay increase included in the Affordable Care Act.
The health reform law increased Medicaid pay for primary care services to the higher rate Medicare pays for the same services; the pay bump runs for 2013 and 2014.
Physicians’ groups, including the American College of Physicians, the American Academy of Family Physicians, and the American Academy of Pediatrics, have sought unsuccessfully to get the pay raise extended, at least through 2016.
Maryland’s Gov. Martin O’Malley, a Democrat, proposed in his fiscal year 2014 budget to extend the higher pay rates through June 2015, whether or not the federal government extends the program. Maryland is different in other ways: In January 2013, state law extended the Medicaid pay bump to all physicians – not just primary care physicians – who billed evaluation and management codes.
More than 108,000 Maryland residents are expected to gain Medicaid coverage in fiscal 2014 under the Affordable Care Act (ACA), bringing the state’s total number of Medicaid and Children’s Health Insurance Program recipients to about 1,077,000.
Gene Ransom, the chief executive officer of MedChi, The Maryland State Medical Society, says that Gov. O’Malley’s proposals are likely to be approved by the majority Democrat state legislature, which is in session until early April.
A MedChi survey conducted last fall showed that the pay increase was encouraging physicians to accept more Medicaid patients, Mr. Ransom said. Forty-six percent of the Maryland doctors who did not accept Medicaid said they were reconsidering, and 57% of those who did accept Medicaid said they planned to increase the number of Medicaid patients they would see.
The initial pay boost was covered by an increase in the tobacco tax, Mr. Ransom said.
Physicians in California are hoping that state legislation will help increase Medi-Cal rates in that state. Dr. Richard Pan, a Democrat representing the state’s 9th district, has introduced AB-1759, which would extend Medicaid pay parity indefinitely, as long as the federal government extends Medicaid parity.
"Without adequate payment, Medi-Cal becomes an empty promise of coverage without actual access to care," Dr. Pan said in a statement. Dr. Pan also serves as chairman of the assembly’s Health Committee.
According to Dr. Pan’s office, more than 8.5 million Californians are on Medi-Cal. That number is expected to rise with new enrollees under the ACA.
"Patients in our communities are already having a difficult time finding access to care," said Dr. Richard Thorp, president of the California Medical Association, in a statement. Dr. Pan’s legislation "will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal," he said.
On Twitter @aliciaault
Lawmakers in Maryland and California seek to extend the temporary Medicaid primary care pay increase included in the Affordable Care Act.
The health reform law increased Medicaid pay for primary care services to the higher rate Medicare pays for the same services; the pay bump runs for 2013 and 2014.
Physicians’ groups, including the American College of Physicians, the American Academy of Family Physicians, and the American Academy of Pediatrics, have sought unsuccessfully to get the pay raise extended, at least through 2016.
Maryland’s Gov. Martin O’Malley, a Democrat, proposed in his fiscal year 2014 budget to extend the higher pay rates through June 2015, whether or not the federal government extends the program. Maryland is different in other ways: In January 2013, state law extended the Medicaid pay bump to all physicians – not just primary care physicians – who billed evaluation and management codes.
More than 108,000 Maryland residents are expected to gain Medicaid coverage in fiscal 2014 under the Affordable Care Act (ACA), bringing the state’s total number of Medicaid and Children’s Health Insurance Program recipients to about 1,077,000.
Gene Ransom, the chief executive officer of MedChi, The Maryland State Medical Society, says that Gov. O’Malley’s proposals are likely to be approved by the majority Democrat state legislature, which is in session until early April.
A MedChi survey conducted last fall showed that the pay increase was encouraging physicians to accept more Medicaid patients, Mr. Ransom said. Forty-six percent of the Maryland doctors who did not accept Medicaid said they were reconsidering, and 57% of those who did accept Medicaid said they planned to increase the number of Medicaid patients they would see.
The initial pay boost was covered by an increase in the tobacco tax, Mr. Ransom said.
Physicians in California are hoping that state legislation will help increase Medi-Cal rates in that state. Dr. Richard Pan, a Democrat representing the state’s 9th district, has introduced AB-1759, which would extend Medicaid pay parity indefinitely, as long as the federal government extends Medicaid parity.
"Without adequate payment, Medi-Cal becomes an empty promise of coverage without actual access to care," Dr. Pan said in a statement. Dr. Pan also serves as chairman of the assembly’s Health Committee.
According to Dr. Pan’s office, more than 8.5 million Californians are on Medi-Cal. That number is expected to rise with new enrollees under the ACA.
"Patients in our communities are already having a difficult time finding access to care," said Dr. Richard Thorp, president of the California Medical Association, in a statement. Dr. Pan’s legislation "will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal," he said.
On Twitter @aliciaault
ICD-10: CMS to hold end-to-end testing
To address concerns about the upcoming transition to ICD-10, the Centers for Medicare and Medicaid Services announced Feb. 20 that it would conduct full end-to-end testing this summer.
End-to-end testing will allow selected physicians, health care providers, hospitals, clearing houses, and billing agents to submit claims with ICD-10 codes, have those claims processed, and receive accurate remittance advice regarding payment.
The test will be conducted by a statistically significant sample of providers gleaned from a pool of volunteers, CMS officials said during a webinar on ICD-10.
Providers can apply to participate through one of the 16 Medicare Administrative Contractors (MACs) in March; the agency will announce those selected sometime in April. More details will be available on the CMS ICD-10 website in a few weeks, CMS officials said.
Physician groups have sought such thorough testing and heralded the CMS announcement.
"The AMA believes end-to-end testing is essential for ensuring the health care industry will not suffer massive disruptions in claims and payment processing and ultimately risk physicians’ ability to care for their patients," said Dr. Ardis Dee Hoven, president of the American Medical Association, in a statement. "The AMA urges CMS to conduct the testing as soon as possible and to ensure that there is an adequate sample which includes a variety of different-sized medical practices and specialties."
The Medical Group Management Association also supports end-to-end testing, according to Dr. Susan Turney, president and CEO. However, the MGMA would like to see the CMS expand the scope of the testing "to include any provider who wishes to test with them," Dr. Turney said in a statement. That would minimize the possibility of "potential operational problems similar to what was experienced with the rollout of healthcare.gov," and "help to decrease the potential of catastrophic cash flow disruption that could impact the ability of practices to treat patients."
The AMA said that it continues to seek a delay in the Oct. 1 implementation of the new coding set, but CMS officials said that would not happen.
"I want to make really clear that the Oct. 1, 2014, date is firm," said Robert Tagalicod, director of the Office of eHealth Standards and Services at the CMS. "If you are a medical practice and haven’t talked with your vendors, clearing houses, and payers, now is the time to act."
CMS officials also noted that acknowledgment testing for interested providers starts soon. The first official period will be March 3-7. The test will let physicians determine whether their ICD-10 coded claims would be accepted or rejected. The claims will not be adjudicated. Doctors can apply through their MAC website for the testing; so far, some 2,500 have signed up for the March dates.
The agency will offer more official test periods, and will provide information on those soon, officials said. Physicians also can request unofficial testing with their MAC any time between March and October. The results of those tests won’t be included as part of the CMS’s official statistics.
Denesecia Green, of the CMS Office of eHealth Standards and Services, said that the agency wanted to reach out more to small physician practices. The agency is collaborating with state medical societies and national physician organizations to do so.
She also said that the CMS offers specific training for physician offices, and free billing software. More information about those programs can be found on the ICD-10 website.
Both the AMA and the MGMA also provide tools to help physicians make the transition.
But, Dr. Hoven said, although adopting the new code set "may provide benefits to others in the health care system, [it] is unlikely to improve the care physicians provide their patients and takes valuable resources away from implementing delivery reforms and health information technology."
On Twitter @aliciaault
To address concerns about the upcoming transition to ICD-10, the Centers for Medicare and Medicaid Services announced Feb. 20 that it would conduct full end-to-end testing this summer.
End-to-end testing will allow selected physicians, health care providers, hospitals, clearing houses, and billing agents to submit claims with ICD-10 codes, have those claims processed, and receive accurate remittance advice regarding payment.
The test will be conducted by a statistically significant sample of providers gleaned from a pool of volunteers, CMS officials said during a webinar on ICD-10.
Providers can apply to participate through one of the 16 Medicare Administrative Contractors (MACs) in March; the agency will announce those selected sometime in April. More details will be available on the CMS ICD-10 website in a few weeks, CMS officials said.
Physician groups have sought such thorough testing and heralded the CMS announcement.
"The AMA believes end-to-end testing is essential for ensuring the health care industry will not suffer massive disruptions in claims and payment processing and ultimately risk physicians’ ability to care for their patients," said Dr. Ardis Dee Hoven, president of the American Medical Association, in a statement. "The AMA urges CMS to conduct the testing as soon as possible and to ensure that there is an adequate sample which includes a variety of different-sized medical practices and specialties."
The Medical Group Management Association also supports end-to-end testing, according to Dr. Susan Turney, president and CEO. However, the MGMA would like to see the CMS expand the scope of the testing "to include any provider who wishes to test with them," Dr. Turney said in a statement. That would minimize the possibility of "potential operational problems similar to what was experienced with the rollout of healthcare.gov," and "help to decrease the potential of catastrophic cash flow disruption that could impact the ability of practices to treat patients."
The AMA said that it continues to seek a delay in the Oct. 1 implementation of the new coding set, but CMS officials said that would not happen.
"I want to make really clear that the Oct. 1, 2014, date is firm," said Robert Tagalicod, director of the Office of eHealth Standards and Services at the CMS. "If you are a medical practice and haven’t talked with your vendors, clearing houses, and payers, now is the time to act."
CMS officials also noted that acknowledgment testing for interested providers starts soon. The first official period will be March 3-7. The test will let physicians determine whether their ICD-10 coded claims would be accepted or rejected. The claims will not be adjudicated. Doctors can apply through their MAC website for the testing; so far, some 2,500 have signed up for the March dates.
The agency will offer more official test periods, and will provide information on those soon, officials said. Physicians also can request unofficial testing with their MAC any time between March and October. The results of those tests won’t be included as part of the CMS’s official statistics.
Denesecia Green, of the CMS Office of eHealth Standards and Services, said that the agency wanted to reach out more to small physician practices. The agency is collaborating with state medical societies and national physician organizations to do so.
She also said that the CMS offers specific training for physician offices, and free billing software. More information about those programs can be found on the ICD-10 website.
Both the AMA and the MGMA also provide tools to help physicians make the transition.
But, Dr. Hoven said, although adopting the new code set "may provide benefits to others in the health care system, [it] is unlikely to improve the care physicians provide their patients and takes valuable resources away from implementing delivery reforms and health information technology."
On Twitter @aliciaault
To address concerns about the upcoming transition to ICD-10, the Centers for Medicare and Medicaid Services announced Feb. 20 that it would conduct full end-to-end testing this summer.
End-to-end testing will allow selected physicians, health care providers, hospitals, clearing houses, and billing agents to submit claims with ICD-10 codes, have those claims processed, and receive accurate remittance advice regarding payment.
The test will be conducted by a statistically significant sample of providers gleaned from a pool of volunteers, CMS officials said during a webinar on ICD-10.
Providers can apply to participate through one of the 16 Medicare Administrative Contractors (MACs) in March; the agency will announce those selected sometime in April. More details will be available on the CMS ICD-10 website in a few weeks, CMS officials said.
Physician groups have sought such thorough testing and heralded the CMS announcement.
"The AMA believes end-to-end testing is essential for ensuring the health care industry will not suffer massive disruptions in claims and payment processing and ultimately risk physicians’ ability to care for their patients," said Dr. Ardis Dee Hoven, president of the American Medical Association, in a statement. "The AMA urges CMS to conduct the testing as soon as possible and to ensure that there is an adequate sample which includes a variety of different-sized medical practices and specialties."
The Medical Group Management Association also supports end-to-end testing, according to Dr. Susan Turney, president and CEO. However, the MGMA would like to see the CMS expand the scope of the testing "to include any provider who wishes to test with them," Dr. Turney said in a statement. That would minimize the possibility of "potential operational problems similar to what was experienced with the rollout of healthcare.gov," and "help to decrease the potential of catastrophic cash flow disruption that could impact the ability of practices to treat patients."
The AMA said that it continues to seek a delay in the Oct. 1 implementation of the new coding set, but CMS officials said that would not happen.
"I want to make really clear that the Oct. 1, 2014, date is firm," said Robert Tagalicod, director of the Office of eHealth Standards and Services at the CMS. "If you are a medical practice and haven’t talked with your vendors, clearing houses, and payers, now is the time to act."
CMS officials also noted that acknowledgment testing for interested providers starts soon. The first official period will be March 3-7. The test will let physicians determine whether their ICD-10 coded claims would be accepted or rejected. The claims will not be adjudicated. Doctors can apply through their MAC website for the testing; so far, some 2,500 have signed up for the March dates.
The agency will offer more official test periods, and will provide information on those soon, officials said. Physicians also can request unofficial testing with their MAC any time between March and October. The results of those tests won’t be included as part of the CMS’s official statistics.
Denesecia Green, of the CMS Office of eHealth Standards and Services, said that the agency wanted to reach out more to small physician practices. The agency is collaborating with state medical societies and national physician organizations to do so.
She also said that the CMS offers specific training for physician offices, and free billing software. More information about those programs can be found on the ICD-10 website.
Both the AMA and the MGMA also provide tools to help physicians make the transition.
But, Dr. Hoven said, although adopting the new code set "may provide benefits to others in the health care system, [it] is unlikely to improve the care physicians provide their patients and takes valuable resources away from implementing delivery reforms and health information technology."
On Twitter @aliciaault
FROM A CMS WEBINAR ON ICD-10
FDA stops sale of four tobacco products
For the first time since it was granted the authority to regulate tobacco in 2009, the Food and Drug Administration has used its powers to stop the sale and distribution of a particular tobacco product.
On Feb. 21, the agency ordered the manufacturer of Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone, and Sutra Bidis Menthol Cone to cease sales and distribution of the products, saying that they are not substantially equivalent to other tobacco products on the market. According to the FDA, the manufacturer, Jash International, did not meet the requirements of the Tobacco Control Act.
The company did not provide the FDA the necessary information for an agency review. The law prohibits manufacturers from introducing a new or changed tobacco product unless they can prove to the FDA that it is either appropriate for the protection of public health or substantially equivalent to a marketed product.
"Companies have an obligation to comply with the law – in this case, by providing evidence to support a substantial equivalence application," Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in a written statement. "Because the company failed to meet the requirement of the Tobacco Control Act, the FDA’s decision means that, regardless of when the products were manufactured, these four products can no longer be legally imported or sold or distributed through interstate commerce in the United States."
The agency has given retailers 30 days to sell off remaining stocks of the four tobacco products. The FDA said it has the right to seize the existing inventory of the products at distributors and noted that companies that continue to sell and distribute them may be subject to enforcement actions.
"Today’s action sends a strong message to tobacco companies that the FDA will seriously enforce this critical provision of the law, which is aimed at preventing manufacturers from introducing products that are even more harmful, addictive or appealing to children," Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in a written statement.
"We commend the FDA and hope this is the first of many actions to stop the marketing and sale of tobacco products that violate the law."
On Twitter @aliciaault
For the first time since it was granted the authority to regulate tobacco in 2009, the Food and Drug Administration has used its powers to stop the sale and distribution of a particular tobacco product.
On Feb. 21, the agency ordered the manufacturer of Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone, and Sutra Bidis Menthol Cone to cease sales and distribution of the products, saying that they are not substantially equivalent to other tobacco products on the market. According to the FDA, the manufacturer, Jash International, did not meet the requirements of the Tobacco Control Act.
The company did not provide the FDA the necessary information for an agency review. The law prohibits manufacturers from introducing a new or changed tobacco product unless they can prove to the FDA that it is either appropriate for the protection of public health or substantially equivalent to a marketed product.
"Companies have an obligation to comply with the law – in this case, by providing evidence to support a substantial equivalence application," Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in a written statement. "Because the company failed to meet the requirement of the Tobacco Control Act, the FDA’s decision means that, regardless of when the products were manufactured, these four products can no longer be legally imported or sold or distributed through interstate commerce in the United States."
The agency has given retailers 30 days to sell off remaining stocks of the four tobacco products. The FDA said it has the right to seize the existing inventory of the products at distributors and noted that companies that continue to sell and distribute them may be subject to enforcement actions.
"Today’s action sends a strong message to tobacco companies that the FDA will seriously enforce this critical provision of the law, which is aimed at preventing manufacturers from introducing products that are even more harmful, addictive or appealing to children," Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in a written statement.
"We commend the FDA and hope this is the first of many actions to stop the marketing and sale of tobacco products that violate the law."
On Twitter @aliciaault
For the first time since it was granted the authority to regulate tobacco in 2009, the Food and Drug Administration has used its powers to stop the sale and distribution of a particular tobacco product.
On Feb. 21, the agency ordered the manufacturer of Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone, and Sutra Bidis Menthol Cone to cease sales and distribution of the products, saying that they are not substantially equivalent to other tobacco products on the market. According to the FDA, the manufacturer, Jash International, did not meet the requirements of the Tobacco Control Act.
The company did not provide the FDA the necessary information for an agency review. The law prohibits manufacturers from introducing a new or changed tobacco product unless they can prove to the FDA that it is either appropriate for the protection of public health or substantially equivalent to a marketed product.
"Companies have an obligation to comply with the law – in this case, by providing evidence to support a substantial equivalence application," Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in a written statement. "Because the company failed to meet the requirement of the Tobacco Control Act, the FDA’s decision means that, regardless of when the products were manufactured, these four products can no longer be legally imported or sold or distributed through interstate commerce in the United States."
The agency has given retailers 30 days to sell off remaining stocks of the four tobacco products. The FDA said it has the right to seize the existing inventory of the products at distributors and noted that companies that continue to sell and distribute them may be subject to enforcement actions.
"Today’s action sends a strong message to tobacco companies that the FDA will seriously enforce this critical provision of the law, which is aimed at preventing manufacturers from introducing products that are even more harmful, addictive or appealing to children," Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in a written statement.
"We commend the FDA and hope this is the first of many actions to stop the marketing and sale of tobacco products that violate the law."
On Twitter @aliciaault
Medicare to cover cardiac rehab for some HF patients
Medicare will begin covering cardiac rehabilitation for patients with stable, chronic heart failure with a left ventricular ejection fraction of 35% or less.
The Centers for Medicare & Medicaid Services announced the new policy on Feb. 18.
About 5 million Americans have heart failure, but only half have an ejection fraction of less than 35%, Dr. Joseph A. Hill, chief of cardiology at the University of Texas Southwestern Medical Center, Dallas, said in an interview. Dr. Hill is chairman of the Heart Failure Society of America’s advocacy committee.
The HFSA, along with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA), submitted a formal request to the CMS to add heart failure to the list of approved indications for coverage for cardiac rehabilitation. The agency began its analysis process in June 2013.
At that time, cardiac rehab was covered only for acute myocardial infarction within the preceding 12 months, coronary artery bypass surgery, current stable angina pectoris, heart valve repair or replacement, percutaneous transluminal coronary angioplasty or coronary stenting, and a heart or heart-lung transplant. Cardiac rehab includes physician prescribed exercise; risk factor modification, including education, counseling, and behavioral intervention; psychosocial assessment; and outcomes assessment.
Physician supervision is required for coverage.
The CMS said it had reconsidered coverage for some heart failure patients as a result of the HF-Action study, published in 2009 (JAMA 2009;301:1439-50). That study "provided the best evidence of benefit" in the HF patient group, but in particular for patients with an ejection fraction of 35% or less and New York Heart Association (NYHA) class II-IV symptoms.
Specifically, the coverage is extended to "beneficiaries with stable, chronic heart failure defined as patients with left ventricular ejection fraction of 35% or less and [NYHA] class II to IV symptoms despite being on optimal heart failure therapy for at least six weeks." The decision defines stable patients as those who have not had recent (within the past 6 weeks) or planned (within the past 6 months) major cardiovascular hospitalizations or procedures.
"We conclude that the evidence that supports the clinical benefits of the individual components of CR programs is sufficient to determine that participation in these programs improves health outcomes for Medicare beneficiaries with chronic HF," the CMS noted in its analysis.
"We’re very pleased," with the CMS decision, said Dr. Hill.
The ACC said it was still evaluating the decision. But Dr. M. Eugene Sherman, chairman of the ACC’s Advocacy Steering Committee, added that "we are pleased to see Medicare expand coverage of cardiac rehabilitation services, as the ACC requested, to a new patient population where medical and scientific literature demonstrates a medical benefit."
Dr. Hill said that the HFSA and others were hopeful that the CMS would eventually expand coverage of rehab to the remainder of HF patients.
On Twitter @aliciaault
Medicare will begin covering cardiac rehabilitation for patients with stable, chronic heart failure with a left ventricular ejection fraction of 35% or less.
The Centers for Medicare & Medicaid Services announced the new policy on Feb. 18.
About 5 million Americans have heart failure, but only half have an ejection fraction of less than 35%, Dr. Joseph A. Hill, chief of cardiology at the University of Texas Southwestern Medical Center, Dallas, said in an interview. Dr. Hill is chairman of the Heart Failure Society of America’s advocacy committee.
The HFSA, along with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA), submitted a formal request to the CMS to add heart failure to the list of approved indications for coverage for cardiac rehabilitation. The agency began its analysis process in June 2013.
At that time, cardiac rehab was covered only for acute myocardial infarction within the preceding 12 months, coronary artery bypass surgery, current stable angina pectoris, heart valve repair or replacement, percutaneous transluminal coronary angioplasty or coronary stenting, and a heart or heart-lung transplant. Cardiac rehab includes physician prescribed exercise; risk factor modification, including education, counseling, and behavioral intervention; psychosocial assessment; and outcomes assessment.
Physician supervision is required for coverage.
The CMS said it had reconsidered coverage for some heart failure patients as a result of the HF-Action study, published in 2009 (JAMA 2009;301:1439-50). That study "provided the best evidence of benefit" in the HF patient group, but in particular for patients with an ejection fraction of 35% or less and New York Heart Association (NYHA) class II-IV symptoms.
Specifically, the coverage is extended to "beneficiaries with stable, chronic heart failure defined as patients with left ventricular ejection fraction of 35% or less and [NYHA] class II to IV symptoms despite being on optimal heart failure therapy for at least six weeks." The decision defines stable patients as those who have not had recent (within the past 6 weeks) or planned (within the past 6 months) major cardiovascular hospitalizations or procedures.
"We conclude that the evidence that supports the clinical benefits of the individual components of CR programs is sufficient to determine that participation in these programs improves health outcomes for Medicare beneficiaries with chronic HF," the CMS noted in its analysis.
"We’re very pleased," with the CMS decision, said Dr. Hill.
The ACC said it was still evaluating the decision. But Dr. M. Eugene Sherman, chairman of the ACC’s Advocacy Steering Committee, added that "we are pleased to see Medicare expand coverage of cardiac rehabilitation services, as the ACC requested, to a new patient population where medical and scientific literature demonstrates a medical benefit."
Dr. Hill said that the HFSA and others were hopeful that the CMS would eventually expand coverage of rehab to the remainder of HF patients.
On Twitter @aliciaault
Medicare will begin covering cardiac rehabilitation for patients with stable, chronic heart failure with a left ventricular ejection fraction of 35% or less.
The Centers for Medicare & Medicaid Services announced the new policy on Feb. 18.
About 5 million Americans have heart failure, but only half have an ejection fraction of less than 35%, Dr. Joseph A. Hill, chief of cardiology at the University of Texas Southwestern Medical Center, Dallas, said in an interview. Dr. Hill is chairman of the Heart Failure Society of America’s advocacy committee.
The HFSA, along with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA), submitted a formal request to the CMS to add heart failure to the list of approved indications for coverage for cardiac rehabilitation. The agency began its analysis process in June 2013.
At that time, cardiac rehab was covered only for acute myocardial infarction within the preceding 12 months, coronary artery bypass surgery, current stable angina pectoris, heart valve repair or replacement, percutaneous transluminal coronary angioplasty or coronary stenting, and a heart or heart-lung transplant. Cardiac rehab includes physician prescribed exercise; risk factor modification, including education, counseling, and behavioral intervention; psychosocial assessment; and outcomes assessment.
Physician supervision is required for coverage.
The CMS said it had reconsidered coverage for some heart failure patients as a result of the HF-Action study, published in 2009 (JAMA 2009;301:1439-50). That study "provided the best evidence of benefit" in the HF patient group, but in particular for patients with an ejection fraction of 35% or less and New York Heart Association (NYHA) class II-IV symptoms.
Specifically, the coverage is extended to "beneficiaries with stable, chronic heart failure defined as patients with left ventricular ejection fraction of 35% or less and [NYHA] class II to IV symptoms despite being on optimal heart failure therapy for at least six weeks." The decision defines stable patients as those who have not had recent (within the past 6 weeks) or planned (within the past 6 months) major cardiovascular hospitalizations or procedures.
"We conclude that the evidence that supports the clinical benefits of the individual components of CR programs is sufficient to determine that participation in these programs improves health outcomes for Medicare beneficiaries with chronic HF," the CMS noted in its analysis.
"We’re very pleased," with the CMS decision, said Dr. Hill.
The ACC said it was still evaluating the decision. But Dr. M. Eugene Sherman, chairman of the ACC’s Advocacy Steering Committee, added that "we are pleased to see Medicare expand coverage of cardiac rehabilitation services, as the ACC requested, to a new patient population where medical and scientific literature demonstrates a medical benefit."
Dr. Hill said that the HFSA and others were hopeful that the CMS would eventually expand coverage of rehab to the remainder of HF patients.
On Twitter @aliciaault
Surgeon general report links smoking to many diseases
While smoking rates have dropped precipitously since the landmark 1964 surgeon general’s report, "Smoking and Health," smoking is still the leading cause of preventable disease and death in the United States and is now causally linked to additional diseases and conditions across most organ systems.
A new surgeon general’s report, "The Health Consequences of Smoking – 50 Years of Progress," released at a White House event last month, synthesizes original and review evidence in an effort to further federal antismoking efforts.
The report causally links cigarette smoking to type 2 diabetes, rheumatoid arthritis, ectopic pregnancy, and erectile dysfunction. Secondhand smoke is now causally linked to cancers, respiratory diseases, and cardiovascular diseases, as well as adverse effects on the health of children, the authors wrote.
In addition, the 980-page report establishes that secondhand smoke is a cause of stroke, and that smoking increases the risk of dying in cancer patients and cancer survivors.
Another finding: Cigarette smokers today have a higher risk of lung cancer than did those who smoked in 1964, because of the higher number of chemical additives now used.
Women smokers now have the same risk of death from lung cancer as that of men and a higher relative risk of dying from coronary heart disease than that of men. Because of smoking, the number of women dying from chronic obstructive pulmonary disease (COPD) is now higher than in men.
With this report, the federal government launches a new effort to prevent children from using tobacco.
"Today, we’re asking Americans to join a sustained effort to make the next generation a tobacco-free generation," Health & Human Services Secretary Kathleen Sebelius said in a statement. "This is not something the federal government can do alone. We need to partner with the business community, local elected officials, schools and universities, the medical community, the faith community, and committed citizens in communities across the country to make the next generation tobacco free."
The report finds that youth smoking rates declined by 50% between 1997 and 2011, but 3,200 children under age 18 still start smoking each day, and an additional 2,100 youth and young adults become daily smokers. The report places most of the blame for continued interest in smoking on the tobacco industry, saying it has used "aggressive strategies" to deliberately mislead the public about the harms of smoking.
Acting Surgeon General Boris Lushniak noted that smoking rates are disproportionately higher among people with less education and lower incomes, among the mentally ill, and among gay, lesbian, bisexual, and transgender individuals.
Dr. Lushniak and other officials at the White House event called for greater tobacco control efforts, including stricter regulation. The Food and Drug Administration was given the power to regulate tobacco through the 2009 Family Smoking Prevention and Tobacco Control Act.
Dr. Lushniak noted that for current and about-to-start smokers, "the clock is ticking – they can’t wait for slow and steady progress to end the epidemic. Enough is enough."
Dr. Daniel Ouellette, FCCP, comments: Americans received a wake-up call in 1964 when the Surgeon General announced that smoking cigarettes was dangerous to one’s health. The current report links cigarette smoking and secondhand smoke exposure to a number of nonrespiratory diseases. Findings also include the fact that cigarettes today are more toxic than those of 50 years ago, associated with a higher risk of lung cancer than previously . The rates of many smoking-related diseases in women now equal those in men, and children continue to start smoking at alarming rates. What should physicians do? Counsel all of your patients to quit smoking!
On Twitter @aliciaault
While smoking rates have dropped precipitously since the landmark 1964 surgeon general’s report, "Smoking and Health," smoking is still the leading cause of preventable disease and death in the United States and is now causally linked to additional diseases and conditions across most organ systems.
A new surgeon general’s report, "The Health Consequences of Smoking – 50 Years of Progress," released at a White House event last month, synthesizes original and review evidence in an effort to further federal antismoking efforts.
The report causally links cigarette smoking to type 2 diabetes, rheumatoid arthritis, ectopic pregnancy, and erectile dysfunction. Secondhand smoke is now causally linked to cancers, respiratory diseases, and cardiovascular diseases, as well as adverse effects on the health of children, the authors wrote.
In addition, the 980-page report establishes that secondhand smoke is a cause of stroke, and that smoking increases the risk of dying in cancer patients and cancer survivors.
Another finding: Cigarette smokers today have a higher risk of lung cancer than did those who smoked in 1964, because of the higher number of chemical additives now used.
Women smokers now have the same risk of death from lung cancer as that of men and a higher relative risk of dying from coronary heart disease than that of men. Because of smoking, the number of women dying from chronic obstructive pulmonary disease (COPD) is now higher than in men.
With this report, the federal government launches a new effort to prevent children from using tobacco.
"Today, we’re asking Americans to join a sustained effort to make the next generation a tobacco-free generation," Health & Human Services Secretary Kathleen Sebelius said in a statement. "This is not something the federal government can do alone. We need to partner with the business community, local elected officials, schools and universities, the medical community, the faith community, and committed citizens in communities across the country to make the next generation tobacco free."
The report finds that youth smoking rates declined by 50% between 1997 and 2011, but 3,200 children under age 18 still start smoking each day, and an additional 2,100 youth and young adults become daily smokers. The report places most of the blame for continued interest in smoking on the tobacco industry, saying it has used "aggressive strategies" to deliberately mislead the public about the harms of smoking.
Acting Surgeon General Boris Lushniak noted that smoking rates are disproportionately higher among people with less education and lower incomes, among the mentally ill, and among gay, lesbian, bisexual, and transgender individuals.
Dr. Lushniak and other officials at the White House event called for greater tobacco control efforts, including stricter regulation. The Food and Drug Administration was given the power to regulate tobacco through the 2009 Family Smoking Prevention and Tobacco Control Act.
Dr. Lushniak noted that for current and about-to-start smokers, "the clock is ticking – they can’t wait for slow and steady progress to end the epidemic. Enough is enough."
Dr. Daniel Ouellette, FCCP, comments: Americans received a wake-up call in 1964 when the Surgeon General announced that smoking cigarettes was dangerous to one’s health. The current report links cigarette smoking and secondhand smoke exposure to a number of nonrespiratory diseases. Findings also include the fact that cigarettes today are more toxic than those of 50 years ago, associated with a higher risk of lung cancer than previously . The rates of many smoking-related diseases in women now equal those in men, and children continue to start smoking at alarming rates. What should physicians do? Counsel all of your patients to quit smoking!
On Twitter @aliciaault
While smoking rates have dropped precipitously since the landmark 1964 surgeon general’s report, "Smoking and Health," smoking is still the leading cause of preventable disease and death in the United States and is now causally linked to additional diseases and conditions across most organ systems.
A new surgeon general’s report, "The Health Consequences of Smoking – 50 Years of Progress," released at a White House event last month, synthesizes original and review evidence in an effort to further federal antismoking efforts.
The report causally links cigarette smoking to type 2 diabetes, rheumatoid arthritis, ectopic pregnancy, and erectile dysfunction. Secondhand smoke is now causally linked to cancers, respiratory diseases, and cardiovascular diseases, as well as adverse effects on the health of children, the authors wrote.
In addition, the 980-page report establishes that secondhand smoke is a cause of stroke, and that smoking increases the risk of dying in cancer patients and cancer survivors.
Another finding: Cigarette smokers today have a higher risk of lung cancer than did those who smoked in 1964, because of the higher number of chemical additives now used.
Women smokers now have the same risk of death from lung cancer as that of men and a higher relative risk of dying from coronary heart disease than that of men. Because of smoking, the number of women dying from chronic obstructive pulmonary disease (COPD) is now higher than in men.
With this report, the federal government launches a new effort to prevent children from using tobacco.
"Today, we’re asking Americans to join a sustained effort to make the next generation a tobacco-free generation," Health & Human Services Secretary Kathleen Sebelius said in a statement. "This is not something the federal government can do alone. We need to partner with the business community, local elected officials, schools and universities, the medical community, the faith community, and committed citizens in communities across the country to make the next generation tobacco free."
The report finds that youth smoking rates declined by 50% between 1997 and 2011, but 3,200 children under age 18 still start smoking each day, and an additional 2,100 youth and young adults become daily smokers. The report places most of the blame for continued interest in smoking on the tobacco industry, saying it has used "aggressive strategies" to deliberately mislead the public about the harms of smoking.
Acting Surgeon General Boris Lushniak noted that smoking rates are disproportionately higher among people with less education and lower incomes, among the mentally ill, and among gay, lesbian, bisexual, and transgender individuals.
Dr. Lushniak and other officials at the White House event called for greater tobacco control efforts, including stricter regulation. The Food and Drug Administration was given the power to regulate tobacco through the 2009 Family Smoking Prevention and Tobacco Control Act.
Dr. Lushniak noted that for current and about-to-start smokers, "the clock is ticking – they can’t wait for slow and steady progress to end the epidemic. Enough is enough."
Dr. Daniel Ouellette, FCCP, comments: Americans received a wake-up call in 1964 when the Surgeon General announced that smoking cigarettes was dangerous to one’s health. The current report links cigarette smoking and secondhand smoke exposure to a number of nonrespiratory diseases. Findings also include the fact that cigarettes today are more toxic than those of 50 years ago, associated with a higher risk of lung cancer than previously . The rates of many smoking-related diseases in women now equal those in men, and children continue to start smoking at alarming rates. What should physicians do? Counsel all of your patients to quit smoking!
On Twitter @aliciaault