There are only two weeks left to submit comments pertaining to the proposed ICD-10 compliance date. The proposed rule recommends delaying the compliance date for ICD-10 from October 1, 2013 to October 1, 2014. Submitting a comment provides HHS with valuable feedback on an issue that will impact all medical professionals. The delay is a result of medical practices’ concerns about their ability to meet the October 1, 2013 ICD-10 compliance date, based in part on the implementation issues with Version 5010 standards. Comments are due by Thursday, May 17, 2012 by 5:00 pm. To submit a comment, click here.

The 60-day comment period for the Stage 2 Meaningful Use proposed rule ends Monday, May 7, 2012. This proposed rule outlines the requirements for the next stage of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program administered by CMS. To submit a comment, click here.  

The NCMS, along with other professional medical associations, will be submitting a comment letter pertaining to the implementation of Stage 2 Meaningful Use. More information will be provided after the submission.

NC HIE Roadshows, held by the North Carolina Health Information Exchange (NC HIE), will provide numerous sessions across North Carolina during the month of May to teach health care professionals about how NC HIE strives to implement the access, exchange and analysis of health information to improve the quality of care to patients. Click here to view the schedule and to register.

Upcoming ICD-10 Training Sessions for Practice Administrators: Area Health Education Centers (AHEC) across the state will be holding ICD-10 training and implementation sessions for medical practices. The sessions will assist practice administrators, managers, coders, billers and clinical staff understand ICD-10-CM diagnosis codes and identify documentation and implementation issues that may impact a practice. The program costs $135 for early registration and $150 up to ten days before the event. Click here for training session schedules, session agendas and to learn more about awarded continuing education credits.

First Spine Care Conference, offered by the Medical University of South Carolina (MUSC) Multidisciplinary Spine Center, will be held from Friday-Saturday, May 11-12, 2012 at Kiawah Island, South Carolina. The conference will focus on diagnostic and therapeutic strategies, both operative and non-operative, for patients suffering from spinal disorders. Click here to register. Questions can be directed to Pamela Benjamin, MUSC CME Program Coordinator, at 843-876-1925 or benjamin@musc.edu.

NCDA 2012 Summer Meeting, which is also sponsored by the Wake Area Health Education Center (Wake AHEC), will be held Friday-Sunday, July 13-14, 2012 at the Homestead Resort, Hot Springs, Virginia. Attendees can receive up to 10.75 AMA PRA Category 1 Credit(s)™. Click here for discussion topics; meeting schedule and fees; accommodations information and to register. Contact Nancy Lowe, NCMS Associate Director Specialty Society and Meeting Services, at 800-722-1350 or nlowe@ncmedsoc.org for more information.

‘Alcohol Misuse and Abuse Affects Us All’ Patient Resources: ACTnowNC has launched an initiative to build awareness and communication about alcohol issues. Visit http://www.actnownc.org/ or contact Tayna Roberts, MSW, ICPS, NC ABC Commission Contractor, at 252-665-3424 or taynaroberts@gmail.com for these alcohol education resources.

This week, Health and Human Services (HHS) Secretary Kathleen Sebelius announced a proposed rule, the third in a series of simplification rules in the new health care law, that can potentially save health care professionals and health plans up to $4.6 billion over the next ten years by reducing and simplifying administrative processes. View the entire announcement here.

In order to reduce physicians’ administrative burdens, the rule recommends that health plans have a unique identifier with a standard format to automate billing processes and other transactions. The rule also delays the compliance date for ICD-10, which has been a concern for many physicians, from October 1, 2013 to October 1, 2014 for new codes used to classify diseases and health problems. This delay will give physicians and their practices more time to prepare and coordinate the transition. View the proposed rule ICD-10 fact sheet for more information.

The deadline for comments is 30 days after the rule is published in the Federal Register, which will tentatively occur on Tuesday, April 17, 2012.

Area Health Education Centers (AHEC) across the state will be holding ICD-10 training and implementation sessions for medical practices. The sessions will assist practice administrators, managers, coders, billers and clinical staff understand ICD-10-CM diagnosis codes and identify documentation and implementation issues that may impact a practice. The program costs $135 for early registration and $150 up to ten days before the event.

Click here for training session schedules, session agendas and to learn more about awarded continuing education credits. The NCMS also offers Version 5010 and ICD-10 resources at www.ncmedsoc.org/icd10. The Centers for Medicare and Medicaid Services (CMS) recently released a fact sheet to assist health care professionals transition to Version 5010.

The NCMS would like to inform its members of the following events being held by the Centers for Medicare and Medicaid Services (CMS):

Version 5010 Webinar

CMS will be holding the “Version 5010 – Where Are We Now?” webinar on Tuesday, March 6, 2012, 10:00 am – 11:00 am. This webinar is helpful for those members who are interested in learning more about the transition to Version 5010. The webinar will address the following:

• Current conversion statistics
• Top 10 concerns impacting the 5010 transition
• Status of current Version 5010 Standard System Maintainer fixes
• Top 10 Version 5010 edits
• Medicaid updates

Click here to register. The NCMS also offers additional Version 5010 information and resources on our website.

Stage 2 Requirements for EHR Incentive Programs

CMS will be holding a national provider call on Monday, March 12, 2012, 12:30 pm – 2:00 pm, to discuss the changes and requirements in CMS’ proposed rule for Stage 2 for the Medicare and Medicaid Electronic Health Record (EHR) incentive programs. This provider call will help NCMS members understand what is needed to receive EHR incentive payments.

Registration for the call should be available shortly.

Questions regarding Version 5010 transition and EHR incentive programs can be directed to Franklin Walker (fwalker@ncmedsoc.org), NCMS Foundation Director of Programs and Practice Management, or Terri Gonzalez (tgonzalez@ncmedsoc.org), NCMS Foundation Practice Technical Assistance Coordinator, at 800-722-1350.

Health and Human Services (HHS) Secretary Kathleen Sebelius announced Thursday that HHS will initiate a process to postpone the compliance date for ICD-10 implementation. The announcement came two days after Acting CMS Administrator Marilyn Tavenner told the American Medical Association’s National Advocacy Conference in Washington, DC that CMS would consider extending the implementation timeline.

The announcement to delay ICD-10 implementation comes at a time when physicians are struggling to achieve meaningful use of electronic medical records, to increase their adoption of e-prescribing, to report data to CMS in the Physician Quality Reporting System (PQRS), and to incorporate new electronic transactions into their practice management systems.

A rulemaking proposal modifying the timing of the health industry’s transition to ICD-10 is expected to be announced in the next few days. The NCMS is closely watching this development and will provide updates in the Bulletin and on the NCMS Version 5010 & ICD-10 Resources webpage.  

Currently, physicians, other health care providers, and insurers have been under pressure to adopt new ICD-10 code sets by October 1, 2013, a process that requires changing from about 14,000 ICD-9 codes to 69,000 ICD-10 codes. The AMA House of Delegates approved a resolution in November 2011 that opposed the adoption of ICD-10 because of the increased burdens created by several health information technology (HIT) initiatives in the federal health care reform law. Among them are adoption of electronic health records (EHRs) and the Medicare meaningful use incentive program

See related articles:

AMA calls on Congress to block ICD-10 mandate on doctors (American Medical News, 2-6-12) 

AMA Adopts New Policies During Final Day of Semi-Annual Meeting (AMA News, 11-15-11)

For more news and resources concerning Version 5010 and ICD-10, visit the CMS ICD-10 website.

Big changes are coming to our workers’ compensation system. To help physicians and their practices understand and adjust to these changes, the North Carolina Medical Society (NCMS) has created a new webpage, Workers’ Comp: Information for Physicians. There you will find a physician’s guide to House Bill 709, along with other resources, helpful links, and news from the Industrial Commission.

Make the NCMS Workers’ Comp webpage your source for the latest news and resources as the NCMS Workers’ Compensation Task Force continues its long-standing mission to improve how doctors of all specialties treat injured workers and interact with the workers’ compensation system. NCMS Past President Richard Bruch, MD, chairs the Task Force, and Keith Kittelberger, MD, serves as Vice Chair.

The NCMS played a key role in the negotiations that led to the enactment of HB 709 – Protect and Put North Carolina Back to Work. This workers’ comp reform bill addressed many issues important to physicians, such as second opinions, independent medical exams, and access to medical information by employers. The law also directed the Industrial Commission to adopt rules that will require electronic billing and payment, standardize the medical documentation that accompanies claims to carriers, and require carriers to accept 5010 transactions and ICD-10 diagnosis codes.

NCMS members may contact the Member Resource Center with questions about workers’ compensation at kfreeman@ncmedsoc.org or by calling 800-722-1350.

See related Bulletin articles:

NC Industrial Commission Delivers on E-Billing and Electronic Payment in Workers Comp (6-17-11)

NCMS Efforts to Secure E-Billing Mandate in Workers’ Comp Gets National Attention (11-4-11)

Due to a high volume of questions coming in through the Member Resource Center, the NCMS will provide a Frequently-Asked-Question (FAQ) for its members each week to make them more aware of current medical and health care issues that their colleagues are having.

Q: What can I do if a clearinghouse, billing company, or third-party payor is not prepared for 5010, or is not following other federally-mandated standards for electronic transactions under HIPAA?

A: The North Carolina Medical Society recommends that you first contact the appropriate trading partner and/or third-party payor to learn more about the problem you are experiencing with your claims. It is important to ask a lot of questions and to gather as much information as possible about the issues you are having.

If the problem does not get resolved, you can file a complaint through the federal Office of E-Health Standards and Services (OESS), which enforces HIPAA’s Administrative Simplification provisions.  To file a complaint, access OESS’s online Administrative Simplification Enforcement Tool. The first time you file a complaint, you will need to create an account. Once you have done so, click on “New Complaint.”  The tool will then lead you through a series of prompts, asking for information about the entity that you are complaining about.

Taking such action will incentivize our vendor and payor partners to work to make industry-wide transitions like 5010 and ICD-10 much smoother.  The NCMS also offers Version 5010 and ICD-10 Resources that will help you with these transitions. Please contact the NCMS Member Resource Center at (919) 833-3836 with any questions or concerns regarding the transition.

NC Medicaid Offers Guidance on Grace Period for 5010 Implementation

The North Carolina Division of Medical Assistance (DMA) has issued a response to the recent announcement from the federal Office of E-Health Standards and Services that it will observe a 90-day grace period for compliance with 5010. (See 5010 Deadline Just Around the Corner, Bulletin, 12-9-2011) 

DMA will continue to process claims filed in 4010 and  5010 formats ONLY until March 31, 2012.  Providers who continue to submit 4010 claims after January 1, 2012 will be required to submit a transition plan documenting their plan to reach 5010 compliance by March 31, 2012. The transition plan must document the steps that have been completed, the remaining steps that need to be completed, the Medicaid provider numbers impacted and contact information, including email address and phone number. 

For questions or assistance regarding this information, please contact Hewlett Packard Enterprise Services (HPES), ECS at 800-688-6696 or 919-851-8888; press option 1.  Click here to read the official notice from DMA.

Physician Assistants, Please Continue to Hold your Medicaid Enrollment Applications

After receiving inquiries about Medicaid enrollment for physician assistants (PAs), the NCMS would like to remind all PAs and their medical practices to hold their Medicaid enrollment applications until the Centers for Medicare and Medicaid Services (CMS) approves the State Plan Amendment and the Division of Medical Assistance (DMA) clarifies details around billing, rates, and other applicable requirements for these practitioners. The North Carolina Medical Society will continue to provide updates on this issue as we receive them.

Please contact the NCMS Member Resource Center at (919) 833-3836 or kfreeman@ncmedsoc.org with any questions or concerns.

See related articles:

Physician Assistant Medicaid Enrollment Update (Bulletin, November 4, 2011)

Physician Assistants, Hold Your Medicaid Enrollment Applications! (Bulletin, October 7, 2011)

Reminder: Important EHR Incentive Program Deadlines Are Approaching

The NCMS would like to remind its members of the following deadlines approaching for the Medicare Electronic Health Record (EHR) Incentive Program:

• Providers have until Wednesday, February 29, 2012, to register and attest to meeting meaningful use in order to receive payment for calendar year (CY) 2011 through the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program Registration and Attestation System.
• Providers also have until Wednesday, February 29, 2012, to submit any pending Medicare Part B claims from CY 2011. Please notice: CMS allows 60 days after December 31, 2011, for all pending claims to be processed.

More Important Information:

• Medicare EHR incentive payments to providers are based on 75 percent of the Part B allowed charges for covered professional services furnished by the EP during the entire payment year.
• If providers do not meet the $24, 000 threshold in Part B allowed charges by the end of CY 2011, CMS expects to issue an incentive payment for providers in April 2012 for 75 percent of their Part B charges from 2011. Please contact the Division of Medicaid Assistance (DMA) at (866) 844-1113 for more details about payments.

Questions regarding the CMS EHR Incentive Program can be directed to Terri Gonzalez, Practice Technical Assistance Coordinator, at 919-833-3836 or tgonzalez@ncmedsoc.org.

CMS Offers Program to Assist Physician ID Theft Victims

The Centers for Medicare and Medicaid Services (CMS) has developed the provider victim validation/remediation initiative for physicians whose identification has been stolen and used to defraud federal health programs. Physicians can seek resolution from Medicare program safeguard and zone program integrity contractors, which operate according to region and state and can investigate instances of identity theft after being notified by a potential victim. The AMA lists information about the contractors at www.ama-assn.org/resources/doc/washington/identity-theft-victim-program-letter-oct2011.pdf. The Medicare program integrity contractor serving North Carolina is AdvanceMed.

Physicians who believe they are victims of identity theft but have not yet suffered any financial liability should contact Palmetto GBA, the Medicare administrative contractor (MAC) for North Carolina, or the federal Health and Human Services (HHS) Office of Inspector General hotline at 800-HHS-TIPS (800-447-8477).

Sign Up Today for ICD-10 Training

The North Carolina Health Information Management Association (NCHIMA) has partnered with North Carolina Area Health Education Centers (NC AHEC) to provide North Carolina physicians with ICD-10 training. The following Continuing Education class, “ICD-10-CM Training & Implementation Issues (Phase II) for the Provider Office” will be taught at:

Click here to sign up for any of the ICD-10 sessions. Questions or concerns regarding ICD-10 can be directed to Franklin Walker (fwalker@ncmedsoc.org), NCMSF Director of Programs and Practice Management, or Terri Gonzalez (tgonzalez@ncmedsoc.org), NCMSF Practice Technical Assistance Coordinator, at (919) 833-3836.

The North Carolina Medical Society can assist its members in the transition to 5010 and ICD-10. Click here for additional resources on the NCMS website regarding ICD-10.

As a follow-up to last week’s Bulletin story, “New HHS Rule Aims to Cut Paperwork, Saving Physicians Time and Money,” physicians and other Medicare providers are reminded that all Medicare provider and supplier payments must be made by Electronic Fund Transfer (EFT). Regulations require that at the time of enrollment, enrollment change request, or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through EFT. The requirement is mandated in the Social Security Act.

As part of the Center for Medicare and Medicaid Services’ (CMS) revalidation efforts, all suppliers and providers who are not currently receiving EFT payments are required to submit the CMS-588 EFT form with the Provider Enrollment Revalidation application, or at the time any change is being made to the provider enrollment record by the provider or supplier, or delegated official.

For more information about provider enrollment revalidation, click here.

The NCMS reminds physicians that they are required to be in compliance with the new HIPAA Transaction Standards (5010) by January 1, 2012. The Office of E-Health Standards and Services (OESS) encourages physician practices and other entities to work with their trading partners to determine their readiness to accept the new standards.

OESS recently announced that it would not initiate enforcement action until March 31, 2012; however, it will accept complaints associated with compliance during the 90-day Period of Enforcement Discretion (Jan. 1 – Mar. 31, 2012). If requested by OESS, covered entities that are the subjects of complaints must produce evidence of either compliance or a good faith effort to become compliant with the new standards during the 90-day period. (See CMS Announces 90-Day Enforcement Delay for New HIPAA Standards (Bulletin, 11-18-11)).

Additional resources and help are found on the NCMS Version 5010 & ICD-10 Resources webpage at: http://www.ncmedsoc.org/practice_management/icd10.html.

Assistance is also available from the NCMS Foundation’s PractEssentials Program. Please contact Franklin Walker, fwalker@ncmedsoc.org, or Terri Gonzalez, tgonzalez@ncmedsoc.org, or call 800-722-1350.

The NCMS reminds physicians that they are required to be in compliance with the new HIPAA Transaction Standards (5010) by January 1, 2012. The Office of E-Health Standards and Services (OESS) encourages physician practices and other entities to work with their trading partners to determine their readiness to accept the new standards.

OESS recently announced that it would not initiate enforcement action until March 31, 2012; however, it will accept complaints associated with compliance during the 90-day Period of Enforcement Discretion (Jan. 1 – Mar. 31, 2012). If requested by OESS, covered entities that are the subjects of complaints must produce evidence of either compliance or a good faith effort to become compliant with the new standards during the 90-day period. (See CMS Announces 90-Day Enforcement Delay for New HIPAA Standards (Bulletin, 11-18-11).

Additional resources and help are found on the NCMS Version 5010 & ICD-10 Resources webpage at: http://www.ncmedsoc.org/practice_management/icd10.html.

Assistance is also available from the NCMS Foundation’s PractEssentials Program. Please contact Franklin Walker, fwalker@ncmedsoc.org, or Terri Gonzalez, tgonzalez@ncmedsoc.org, or call 800-722-1350.

The Office of E-Health Standards and Services (OESS) within CMS announced Thursday that it would not initiate enforcement action until March 31, 2012, for any HIPAA covered entity that is not in compliance with new HIPAA Transaction Standards (5010). However, the compliance date for using the new standards remains January 1, 2012.

OESS is encouraging all covered entities to work with their trading partners to become compliant with the new HIPAA standards, and to determine their readiness to accept the new standards as of January 1, 2012. OESS will continue to accept complaints associated with compliance during the 90-Day Period of Enforcement Discretion (Jan. 1 – Mar. 31, 2012), but if requested by OESS, covered entities that are the subject of complaints must produce evidence of either compliance or a good faith effort to become compliant with the new HIPAA standard during the 90-day period.

Links to information on Version 5010 standards are available at: www.cms.gov/ICD10.

See also, the NCMS Version 5010 & ICD10 Resources webpage at: http://www.ncmedsoc.org/practice_management/icd10.html.

Meeting in New Orleans, the AMA House of Delegates this week adopted new policies covering a wide range of health care issues:

Guidelines for Health Insurance Exchanges created by Affordable Care Act

The new policies include support for using the open marketplace model for exchanges to increase competition and maximize patient choice, and the involvement of state medical associations in the legislative and regulatory processes concerning state health insurance exchanges.

Stop the Implementation of ICD-10

The House of Delegates voted to work vigorously to stop implementation of ICD-10 (The International Classification of Diseases and Related Health Problems, 10^th Revision), a new code set for medical diagnoses. ICD-10 has about 69,000 codes and will replace the 14,000 ICD-9 codes currently in use. AMA says the implementation of ICD-10 will create significant burdens on the practice of medicine with no benefit to individual patients’ care.

Virtual Medical IDs

New policy encourages the availability of portable medical identification alert systems for patients. Virtual medical identification systems allow emergency medical personnel to access a patient’s medical history and emergency contact phone numbers through a pin number that can be attached to clothing, a key, or stored in a wallet.

Combat National Drug Shortages

New AMA policy supports federal drug shortage legislation, such as HR 2245 and SB 296, that would require manufacturers to notify the FDA of any discontinuance, interruption, or adjustment to the manufacture of a drug that may result in a shortage. In the past few years, AMA reports that shortages of medically necessary drugs have worsened appreciably, with the number of FDA identified shortages tripling between 2005 and 2010.

For more on AMA House of Delegates Actions, visit:

http://www.ama-assn.org/ama/pub/news/news/2011-11-15-ama-adopts-new-policies.page, or

http://www.ama-assn.org/ama/pub/meeting/index.shtml.

The North Carolina Society of Eye Physicians and Surgeons (NCSEPS) presents Codequest Coding College 2012: Learn to Chart and Code Accurately and Effectively Transition to ICD-10, Saturday, February 4, 2012, at the Grandover Resort in Greensboro. Participants can earn 6 hours of CME, AAPC, or JCAHPO credits.

You can register one of three ways:

(1) Contact NCSEPS at 919-833-3836 to request a brochure

(2) Download a brochure

(3) Register securely online 

Rooms are available until December 31, 2011. Call the Grandover Resort at 800-472-6301 and ask for the NCSEPS rate of $163 single or double occupancy, plus tax.