Action: Jan. 15, 2013

TMA Action Jan. 15, 2013   
 News and Insights from Texas Medical Association  

 INSIDE: One Month Left to Make Medicare Decision 

ICD-10: What Should I Do Now?
Medicare in 2013: Are You In or Out?
Flu Spreading Quickly
Winter Conference Explores Medicaid, ACOs
TMLT Adds $30 Million to Trust Rewards
Feb. 28 Is Medicare EHR Attesting Deadline

TMA Offers Grants for Vaccination Clinics
TMA Outreach Events Promote Health
New Member Discounts Available
This Month in Texas Medicine
Texas Health/Medical Home Summit in April

ICD-10: What Should I Do Now?

Although ICD-10 implementation doesn't kick in until Oct. 1, 2014, you can take steps now to help minimize your stress level in the months leading up to it. Time is on your side, but you must begin preparations to transition your practice soon.

In a recent video interview, TMA Practice Management Consultant Heather Bettridge sat down with Steve Arter, the chief executive officer of Complete Practice Resources (CPR), and CPR President Denny Flint to get their take on the necessary steps physicians should be taking now.

For an in-depth look at how to get started, TMA offers a new webinar entitled ICD-10 Starts With Physicians: A Primer for Beginning the Process to give an overview of the new coding standard, explain the differences from ICD-9, and provide direction for the first steps you should take. This continuing medical education program will give you a head start for the planning process and includes an interactive Q&A session with Mr. Flint.

Starting preparations now, delegating responsibilities, and developing a month-by-month plan will help ensure that your practice is not overwhelmed when the implementation date finally arrives. For additional questions or services, contact TMA's certified coders by email or by telephone at (800) 880-1300, ext. 1414.

Medicare in 2013: Are You In or Out?

You have a month to decide if you will participate in Medicare this year. Feb. 15 is the deadline to make a decision. The Texas Medical Association will help you decide with a new webinar discussing your three options.   

The Centers for Medicare & Medicaid Services extended the deadline earlier this month after Congress passed and President Obama signed last-minute legislation to avert the so-called "fiscal cliff." Part of the deal stopped the scheduled 28.5-percent cut in Medicare payment to physicians and froze fees through Dec. 31, 2013.

Your three options in deciding whether to participate in 2013 are:

  1. Sign a participation (PAR) agreement and accept Medicare's allowed charge as payment in full for all Medicare covered services for your Medicare patients.
  2. Elect nonparticipation (non-PAR), which permits you to make assignment decisions on a case-by-case basis and to bill patients up to the Medicare limiting charge for unassigned claims.
  3. Opt out and become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare. To become a private contractor, PAR physicians must give 30 days' notice before the first day of the quarter the contract takes effect. For non-PAR physicians, the opt-out effective date is the date the affidavit is signed, provided it is filed within 10 days after you sign your first private contract with a Medicare beneficiary.

Novitas has several resources on its website. They include an overview of Medicare assignment, participation, and the opt-out process. A separate page on the Novitas website offers more detailed information on the opt-out process. The page also includes a sample affidavit a physician must file if he or she decides to opt out. 

Flu Spreading Quickly

Levels of influenza-like illness – both A and B strains – continue to increase across Texas and the nation. At least five Texas children have died.

The Centers for Disease Control and Prevention (CDC) offers guidance and resources for physicians on clinical information, diagnostic testing, and antiviral medications.

The Texas Department of State Health Services provides detailed, weekly summaries of flu activity at The Texas Pediatric Society created a summary of antiviral treatment guidelines for children.

More flu-related resources are available on the TMA website.

In addition, CDC's new influenza mobile application allows you and your staff to keep up with the latest flu news and recommendations on your iPads, iPhones, or iPod touch devices.  

You can:

  • View updated information on national flu activity;
  • Find influenza vaccination recommendations endorsed by CDC and the Advisory Committee on Immunization Practices (ACIP);
  • Obtain information on diagnosing and treating influenza, including antiviral treatment recommendations by CDC and ACIP;
  • Obtain information on laboratory testing for influenza;
  • Find CDC recommendations on influenza infection control;
  • View videos of CDC subject matter experts discussing influenza topics; and
  • Order official CDC-designed print products to post in your office or distribute to patients.

For more information, contact CDC-INFO


Winter Conference Explores Medicaid, ACOs

The future of the state's Medicaid program and how the changing face of Texas will impact health care highlight the agenda for the 2013 TMA Winter Conference, Feb 1-2, at the AT&T Conference Center in Austin.

The conference's Saturday schedule begins at 7:30 am with a session on accountable care. The General Session begins at 8:45 am with opening remarks by TMA President-Elect Stephen L. Brotherton, MD, followed by an update on the American Medical Association from AMA President Jeremy A. Lazarus, MD.

Then at 9:15 am, former state demographer Steve Murdock, PhD, will talk about changes in the state's demographics and what they mean for medicine. In addition, San Antonio Mayor Julián Castro is tentatively scheduled to discuss the future of health care in Texas in a presentation at 9:50 am.

Finally, at 10:45 am, Texas Health and Human Services Commissioner Kyle Janek, MD, and a panel of physicians and legislators will discuss the Medicaid program in Texas and the progress TMA's Physician Medicaid Congress is making in suggesting ways to improve the program.

TMLT Adds $30 Million to Trust Rewards

The Texas Medical Liability Trust (TMLT) Board of Governors dedicated $30 million to the Trust Rewards Program for 2013, raising the program's total to $130 million. TMLT says this is its way of rewarding policyholders for their loyalty. 

The Trust Rewards Program sets up an account for policyholders. Each year you renew your policy, funds are set aside in your account. They will be allocated to you upon retirement or if you become disabled, or to your family when you die.

"The additional $30 million demonstrates the board's enthusiastic support for Trust Rewards," said TMLT President and Chief Executive Officer Charles R. Ott Jr. "We stand by our Texas physicians and provide them with more benefits than our out-of-state competitors."

Policyholders enrolled in the program will find their fourth-quarter statement in the mail in January. It will show the amount already dedicated to their accounts for 2012. The new $30 million allocation will appear on future statements in 2013. If you enrolled in the program in 2012, you need not enroll again. Your portion of the $30 million will automatically be allocated to your account.

TMLT policyholders who have questions or want to enroll may contact TMLT's customer service team by telephone at (800) 580-8658, ext. 5050, or by email. Policyholders may also enroll online.

TMLT is the largest medical liability insurance provider in Texas, serving more than 15,000 TMA members. Rated "A (Excellent)" by A.M. Best Company, TMLT is the only medical professional liability insurance provider created and exclusively endorsed by TMA. 

Feb. 28 Is Medicare EHR Attesting Deadline

Physicians participating in the Medicare electronic health record (EHR) incentive program have until Feb. 28 to complete their meaningful use attestation. TMA recommends you attest as soon as possible to avoid any potential glitches that could delay, or worse, prevent payment. Physicians participating in the Medicaid EHR incentive program have until March 16 to attest. 

The Centers for Medicaid & Medicare Services (CMS) published some helpful resources for physicians: 

TMA's EHR Incentive Program Resource Center provides a compilation of resources to help physicians.  

TMA recognizes the complexities of compliance with the EHR incentive program and recommends physicians contact their local regional extension center (REC), established by the Office of the National Coordinator for Health Information Technology to help specifically with program compliance. The RECs are able to help all physicians, but may be able to discount services for primary care physicians. Details about the REC program are available on the TMA website in the Texas REC Resource Center

For more information, call the TMA Health Information Technology Department at (800) 880-5720 or email HIT.

Medicare E-Prescribing 
Physicians who were unable to file for a Medicare e-prescribing hardship exemption by the original deadline have until Jan. 31 to avoid the 1.5-percent payment penalty in 2013.

CMS reopened the Communications Support webpage to allow physicians who missed the June 30, 2012, deadline to file for an exemption.

Physicians may request a waiver of the 2013 penalty under any of the following categories:

  • The physician is unable to e-prescribe as a result of local, state, or federal law or regulation.
  • The physician wrote fewer than 100 prescriptions between Jan. 1 and June 30, 2012.
  • The physician practices in a rural area that doesn't have sufficient high-speed Internet access.
  • The physician practices in an area that doesn't have enough pharmacies that can do e-prescribing.

Visit the CMS e-prescribing webpage to learn more. Physicians can contact the CMS QualityNet Help Desk at (866) 288-8912 or via email with questions or for assistance submitting their hardship exemption requests. Support is available from 7 am to 7 pm CST Monday through Friday.



TMA Offers Grants for Vaccination Clinics

Physicians, medical students, alliances, and county medical societies: You can receive up to $2,000 to support local vaccination events in 2013. TMA's Be Wise — ImmunizeSM will offer local impact grants for clinics that target children, adolescents, or adults.

You can use the money for a new shot clinic or an expanded event. Grant applications are due March 1. Awardees have up to 12 months to use the funds.

To help plan your free or low-cost vaccination event, check out the Be Wise — Immunize Quick Start Manual: A Step-by-Step Vaccination Outreach Guide and Be Wise Event Ideas. Contact Tammy Wishard, TMA's outreach coordinator, at (512) 370-1470 to find out how the grants program can benefit your community.

Be Wise — Immunize is a joint initiative led by TMA physicians and the TMA Alliance. Funding for Be Wise —Immunize is provided by the TMA Foundation, thanks to generous support from H-E-B, and gifts from physicians and their families.  

Be Wise — Immunize is a service mark of the Texas Medical Association. 

TMA Outreach Events Promote Health

If "giving back" made your list of New Year resolutions, TMA's outreach programs — Hard Hats for Little Heads bicycle helmet giveaway program and Be Wise — ImmunizeSM — are a perfect fit. Help your community stay healthier by offering free or low-cost vaccinations or free helmets in 2013.

TMA provides all you need for a successful outreach event, including customizable promotional tools, educational materials in English and Spanish, and giveaway items for children and adults that feature the TMA brand. Hard Hats for Little Heads even gives you free helmets with your purchase of helmets.  

To find out more, visit the updated webpages for both programs; they're more user-friendly and make planning an event easier. Or contact Tammy Wishard, TMA's outreach coordinator, at (512) 370-1470, for help planning your event.

The TMA Foundation funds TMA's outreach programs through generous grants from Blue Cross and Blue Shield of Texas, H-E-B, Prudential, two anonymous foundations, and gifts from physicians and their families.

New Member Discounts Available

TMA's discount programs give you exclusive discounts on everyday products and services.

TMA members may  shop a great selection of high-quality, professional S.C.R.U.B.S. and lab coats from SmartScrubs and receive 15 percent off all orders. As an extra bonus, enjoy free TMA logo embroidery through March 1.

TMA members are also eligible for a 90-day trial of turnkey websites, mobile sites, and applications for medical practices from mobiManage. Call (888) 355-6624, ext. 718, or visit the TMA website for more information.

Access below-market rates on car rentals using TMA's worldwide hotel discount program. Any hotel, any car, anywhere, anytime. Call (800) 892-2136, or log in by using TMA (all caps) for both the username and password to book online.

Log on to TMA's Group Discount Programs page on the TMA website for more great deals.  


What Can Practice Production Numbers Tell You?

 Consider these factors if your production isn't consistent. 

 A practice management tip from
 TMA Practice Consulting 

This Month in Texas Medicine

The February issue of Texas Medicine advises physicians on things they need to consider when deciding whether to join a practice or go solo. It also explains how TMA Practice Consulting can help with practice set-up, outlines the Public Health Coalition's priorities for the 2013 legislative session, and delves into changes in the workers' compensation drug formulary.    


Texas Medicine RSS Feed

Don't want to wait for Texas Medicine to land in your mailbox? You can access it as an RSS feed, the same way you get the TMA Practice E-Tips RSS feed. 

E-Tips RSS Feed

 TMA Practice E-Tips, a valuable source of hands-on, use-it-now advice on coding, billing, payment, HIPAA compliance, office policies and procedures, and practice marketing, is available as an RSS feed on the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases and for Blogged Arteries, the feed for Action. 

Texas Health/Medical Home Summit in April

The Texas Health/Medical Home Summit – April 4-5 in Austin – is the first statewide conference focused specifically on expanding access to a health/medical home for individuals and families in Texas. This summit offers interested parties the opportunity to learn about medical home models and best practices and to interact with program experts at various stages of implementation.

The Texas Medical Home Initiative (TMHI), a nonprofit organization, will host the summit. Its mission is to improve the health and health care of Texans through education and support of clinicians in new models of health care delivery. Established in 2008, TMHI leaders are physicians, nurse practitioners, consumers, business leaders, health insurers, and government representatives. TMHI's strategic partner in this event is Texas Health Institute, a nonprofit health care policy think-tank based in Austin.

TMHI created a program with offerings that will appeal to those who are considering transformation of their practices, as well as those whose practices are at various stages of transformation to the new models.

Summit topics will include:

  • Care Coordination: A Function, Not A Person;
  • Team-Based Care: Best Practices;
  • Engaging Patients and Families: Best Practices;
  • Information Technology: Health/Medical Home Essentials;
  • TMHI Practices Present Their Experiences on the Journey to the Health/Medical Home;
  • The Health/Medical Home: What the Evidence Tells Us; and
  • Health/Medical Home for Children and Young Adults With Special Health Care Needs.

For more information and to register, visit the summit website.  


This Just In ...

Want the latest and hottest news from TMA in a hurry? Then log on to  Blogged Arteries.  

TMA Education Center 

The TMA Education Center offers convenient, one-stop access to the continuing medical education Texas physicians need. TMA's practice management, cancer, and physician health courses are now easier than ever to find online. 

Physician Health and Rehabilitation, Ext. 1342  

Interventions for Health: PHR Training Session and 20th Annual Retreat 
2-22/23 Horseshoe Bay 

Healthy Physicians: Healthy Patients
4/6         Lubbock
4/27       Fort Worth