2009 Implementation Advice for 2009 PQRI and E-Prescribing available on the CMS Website

Wondering how to start reporting 2009 PQRI measures? This article, available on the CMS website, will help guide you step-by-step, pointing you to additional relevant documents on the website.
http://www.cms.hhs.gov/PQRI/Downloads/PQRI_Implementation_4_MR.pdf

FTC releases do-it-yourself “Red Flags” program for businesses at low risk of identity theft

The Federal Trade Commission (FTC) now offers an interactive document to help low-risk businesses comply with the Red Flags Rule, which requires creditors that maintain covered accounts to develop an identity theft prevention plan by Aug. 1. The FTC interprets the rule to apply to, among other entities, health care providers that bill a patient’s insurance before billing the patient or that allow patients to set up a payment plan.

The FTC directs businesses through an analysis to determine whether they are at low risk for identity theft. Factors to consider in the analysis include whether a business:

• Knows its clients personally;


• Provides services in customers’ homes;


• Has been in business for some time and has not had complaints of identity theft; and


• Operates a type of business in which identity theft is uncommon.

Businesses that determine they are at low risk for identity theft can use the FTC’s interactive tool to design their own identity theft prevention programs. http://www2.ftc.gov/bcp/edu/microsites/redflagsrule/get-started.shtm

Malpractice Update

Effective May 1, Cardiovascular Associates (CVA) elected to switch its malpractice coverage from SVMIC to Lexington Insurance.

Tim Attebery, CEO of CVA , conducted an extensive evaluation of Lexington and its relationship with AIG before discussing with CVA’s physicians and Board of Directors. His conclusion is that Lexington is financially sound, in fact quite strong. Furthermore, it is segregated and protected from the financial problems of AIG.

The recent formation of AIU Holdings, which includes Lexington and the other financially sound insurance company subsidiaries of AIG Commercial Insurance Group, adds further protection. Lexington’s financial soundness, plus the upfront savings of 25% of premium compared to SVMIC and the potential for a 50% profit share were the deciding factors. Tim said “CVA physicians, like many others, have strong loyalties to SVMIC but the savings was just too great to not change carriers. I also am impressed with the strong internal risk management program Lexington and HPI have established.”

CVA joins Bristol Surgical Associates (26% up-front savings) and Northeast TN Emergency Physicians (50% savings) in the HPI malpractice pool.

Several other practices have requested quotes. Our broker, Gary Rimler, is in town June 3 thru 5th and is available to meet with any practices that would like to learn more about the HPI/Lexington malpractice insurance option. Many medical groups have insurance renewals in July. Formal, customized quotes are available at no charge.

Please call Rhonda Hall at (423) 392-1920 to set up an appointment.

Medicare Secondary Payer Fact Sheet

A new Medicare Secondary Payer (MSP) Fact Sheet (April 2009), which provides a general overview of the MSP provisions for individuals involved in the admission and billing procedures at provider, physician, and other supplier settings is now available in downloadable format from the Medicare Learning Network at: http://www.cms.hhs.gov/MLNProducts/downloads/MSP_Fact_Sheet.pdf.

CMS publishes HIPAA 5010 information

CMS released a Medicare Learning Network (MLN) article outlining the transition to the new electronic transaction and pharmacy standards mandated as part of the Health Insurance Portability and Accountability Act (HIPAA).  The transactions, known as the “5010” transaction standards and “D.0” pharmacy standards, address electronic claims, electronic eligibility verification, electronic claim status, electronic referral certification and authorization, electronic remittance and more. Version D.0 of the pharmacy standards will facilitate both coordination-of-benefits claims processing and Medicare Part D claims processing. The government has set a compliance date of Jan. 1, 2012, for practices and others to begin using the new standards.
To read the full MLN Matters provider education article: click here
on the CMS website.

FTC Will Grant Three-Month Delay of Enforcement of ‘Red Flags’ Rule Requiring Creditors and Financial Institutions to Adopt Identity Theft Prevention

The Federal Trade Commission will delay enforcement of the new “Red Flags Rule” until August 1, 2009, to give creditors and financial institutions more time to develop and implement written identity theft prevention programs. For entities that have a low risk of identity theft, such as businesses that know their customers personally, the Commission will soon release a template to help them comply with the law. Today’s announcement does not affect other federal agencies’ enforcement of the original November 1, 2008 compliance deadline for institutions subject to their oversight.
To read the full FTC Press Release: click here