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CMS Office is a resource for physician offices as they pursue EMR

By Karen Wendland

During April and May, the Capital Medical Society provided a two-part series of meetings to assist members as they look to implement Electronic Medical Records (EMR) in their offices. In Tallahassee, we have medical practices at every point of the way –some have fully implemented EMR and some have not yet started the process. No matter where you are – this is a challenging and frustrating undertaking for physician offices. However, the CMS meetings were meant to educate and encourage.

At the meeting in May, we accomplished several important things. We conducted a panel discussion with local medical staff, physicians and experts sharing their experience and advice for those who were not as far along. This collegial spirit is really a testimony to the special medical community we have here in Tallahassee. The meeting was meant to send the message loud and clear that "we are in this EMR thing together."

Second, we introduced participants to most of the EMR vendors who already have their product at work in local medical offices. The EMR vendors had tables at the meeting where they could demonstrate and discuss their product.

Third, we distributed two very important documents that have been created by CMS, with help from Dr. Dan Kaelin, Zach Finn and Tom Harrison. We distributed a "Worksheet". This worksheet gives you a very helpful overview of the important steps to take as you prepare, research, select and implement an EMR. If you are saying to yourself, "I don't know where to start!", this worksheet is the starting place. We also distributed our "Tallahassee EMR Vendor List". We have compiled a list of the EMR vendors who are in Tallahassee, indicating which groups in town are using the EMR. This is a "work in progress" and we will continue to update the list for you. Call us for a copy and let us know if we have left you off!

If you missed the meeting and would like copies of the worksheet or vendor list, please call the CMS office. We are here for you and we are "in this together"!

FMA Update

By Dr. Miguel Machado MD, Chairman, Council on Legislation

The 2010 Florida Legislative Session is finally over, and it was summed up best by Sen. Don Gaetz, who said, "This is the year we averted disaster."

There were an unprecedented number of bills filed this year that, had they passed, would have been harmful to physicians and adversely affected the practice of medicine. From meetings that were held months before session began, to amendments that were filed in the session's final days, special interest groups with interests inimical to ours filed a constant barrage of legislative proposals. Through a tremendous amount of work, the FMA Governmental Affairs team was able to defeat or neutralize these proposals, ensuring a successful session.

No issue exemplified the adversity physicians faced this year more than Medicaid reform. With the leadership of both chambers committed to expanding the managed care reform pilot project statewide, a massive change in Medicaid appeared inevitable. The low point came with the insertion of language in the House Medicaid proposal requiring certain physicians to not only treat Medicaid patients, but to do so through a managed care plan they would have to contract with. The FMA, in concert with the Florida Academy of Family Physicians and other groups, was able to delete this provision, avert a full-scale managed care takeover, and ensure the preservation of the Medipass system and fee-for-service in Medicaid. In addition, we were able to avert the expansion of the managed care pilot project into Miami-Dade County, which appeared certain to occur.

While every session sees an attempt by allied health professionals to expand their scope of practice, the battles were especially fierce this year. Optometrists, ARNPs and physical therapists pulled out all the stops to be able to do what physicians are trained to do, but without first going to medical school for the proper training. I am happy to announce that the FMA was able to defeat all of these proposals, and that not one scope-of-practice bill passed.

Not only was the practice of medicine under assault, but so was the Department of Health (DOH), an entity the FMA fought to create almost 15 years ago. Despite a determined effort, the FMA was able to ensure that the Florida Surgeon General will continue leading a department committed to ensuring the public health, and that the Board of Medicine will continue being overseen by the DOH, not the Department of Business and Professional Regulation.

The FMA also defeated the following:

• Legislation that would have prevented physicians from collecting full payment from out-of-network PPO patients;
• Legislation that would have ended the use of binding arbitration agreements by physicians;
• Legislation that would have ensured higher malpractice insurance premiums by repealing the wrongful death exemption;
• Legislation that would have imposed unreasonable reporting requirements on physicians in relation to impaired drivers;
• Legislation that would have provided an unreasonable standard for the treatment of foster children with psychotropic medications;
• Legislation that would have allowed social workers and marriage and family therapists to diagnose autism; and
• Legislation that would have ensured that physicians were paid less in automobile injury cases.

In addition to "averting disaster," the FMA was able to pass its priority legislation for the session. Today, the Senate unanimously approved HB 7217 (by Sen. Carey Baker and Rep. Bryan Nelson), which, if signed by the governor, will exempt medical malpractice insurance premiums from any emergency assessment levied by the Hurricane Catastrophe Fund for three more years. This bill will save physicians thousands of dollars in the event that the CAT fund incurs a deficit. Every legislator, with the exception of Rep. Pat Patterson, voted in favor of this bill. Please take the time to thank them for their support. Special thanks also goes to FPIC, our endorsed malpractice insurance carrier, for its assistance in passing this bill.

Also passing with FMA assistance was SB 2272, a bill that will make it extremely difficult for illicit pill mills to continue operation. The FMA was able amend a provision that would have limited dispensing physicians to a 72-hour supply of controlled substances. With the cooperation of Rep. John Legg, the bill's sponsor, we were able to restrict this 72-hour limitation to registered pain clinics, and then only to patients who pay by cash, check or credit card.

There were many, many other bills and legislative language that the FMA was instrumental in passing, changing or stopping. A detailed list of all items of interest will be forthcoming in the coming weeks.

As I conclude my last report for the 2010 session, I would like to thank the county medical societies, the specialty societies, the FMA PAC, the FMA Alliance, and everyone else who worked so hard to make this session a success. The entire FMA staff, led by our Executive Vice President Tim Stapleton, along with our Governmental Affairs team of Jeff Scott, Michelle Jacquis, Holly Miller, Director of Medical Economics Linda McMullen, and our outstanding team of contract lobbyists, did a great job in ensuring that the 2010 session was extremely successful.

FMA's New Green Doctor Office Program Lowers Office Expenses and Improves Health

The FMA recently launched its new Green Doctor Office Program (GDOP) at MyGreenDoctor.org. The GDOP is an easy-to-use, free program that guides doctors' offices through creating a Green Team and making changes that can save their practices money by using energy, water, and other materials more efficiently. The program offers more than a hundred Action Steps that offices can take. There are seven workbooks that walk you through topics that include energy and water efficiency, solid waste and recycling, chemicals in the workplace, pharmaceuticals disposal, landscape management, renewable energy, and healthy foods. A big part of the program is sharing ideas with the office staff, families and patients; in this way, important improvements are possible for the health of the community. In just a few months, a practice can qualify to receive a GDOP Certificate from the FMA.

The program was written by FMA member Todd L. Sack, MD, and Sarah A. Boren, experts in office environmental issues and is administered by the FMA Environment & Health Section. There is no fee for using the program. To register for the GDOP or to learn more about the program, go to MyGreenDoctor.org. The "Quick Start Now" shows you how to get started today.

CMS Changes Effective Date for Ordering/Referring Providers to be in PECOS to July 1, 2010

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) delayed the requirement to have all Ordering/Referring Providers in the PECOS system to Jan. 1, 2011. They have now issued an interim final rule published in the May 5 Federal Register pushing the date forward to July 1, 2010. This will now greatly reduce the time physicians and nonphysician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to phase 2 implementation.

Although enrolled in Medicare, many physicians and nonphysician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and contains the national provider identifier (NPI). Under phase 2, a physician or nonphysician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected.

CMS continues to urge physicians and nonphysician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and nonphysician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS. To check if a provider is enrolled in PECOS, get a report you can dowload at this site: http://www.cms.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp

REMINDER: RED FLAGS RULE is Effective JUNE 1, 2010

All medical practices should be compliant with the Federal Trade Commission (FTC) "Red Flags Rule." Those without adequate policies and procedures may face a penalty of up to $2,500 per "knowing violation." Go to the FMA website for more information and resources. www.fmaonline.org

Spirituality and Medicine Seminar and Community Presentation

Big Bend Hospice is excited to present Dr. Glenda F. Hodges, Ph.D., J.D., M.Div., Director of the Howard University Medical School's Spirituality and Medicine Program as the keynote speaker on June 10th when we host our first Spirituality and Medicine Seminar. The purpose of this seminar is to explore and enhance the partnership between the spiritual and medical communities, promote the important relationship between science and faith, and further the understanding of patients as whole integrated beings. There will be a one hour presentation by Dr. Hodges on Thursday, June 10th at TMH on "Using Spiritual Assessments to Improve Patient Care" where CME's will be available. Following that will be the Spirituality and Medicine: Walking Together Conference which is open to the entire community. The cost is $10 which includes dinner.

Thursday, June 10, 2010
1:00 – 2:00 PM
Tallahassee Memorial Hospital
CMEs are offered
Please contact Debbie Herrell at TMH at debbieherrell@tmh.org

Thursday, June 10, 2010
Spirituality and Medicine: Walking Together
3:00 – 9:00 PM
New Mt. Zion AME Church
1401 Old Bainbridge Rd, Tallahassee, FL
CEUs are offered

For more information on the Spirituality in Medicine presentations, please call Diane Tomasi at 878-5310 ext. 708. Sponsorship opportunities are available.

The Rotary Club of Tallahassee Donates to We Care Network

The Rotary Club of Tallahassee made a generous $1,500 donation to the Capital Medical Society Foundation's We Care Network. The Club has a long-standing tradition of supporting the We Care Network. Shannon Dent, CMS Communications and Marketing Coordinator attended the Club's meeting on May 12th at the Leon County Civic Center, as the guest of Dr. Nelson Kraeft and accepted the Club's check on behalf of the CMS Foundation.

Many CMS members belong to the Rotary Club of Tallahassee including Dr. Larry Deeb, Dr. Lee Elgin, Dr. Mike Forsthoefel, Dr. Nelson Kraeft, Dr. John Mahoney, Dr. Nancy Van Vessem, Dr. Ron Saff and Dr. Tom Wood. Also, Dr. Walt Colón, a dentist volunteer in the We Care Dental Network is a member.

Frueauff Foundation Reception

Local charities throughout Tallahassee gathered at a reception on May 14 at Faith Presbyterian Church, to honor the Board of Trustees of the Charles A. Frueauff Foundation. The Frueauff Foundation has a 25+-year history of being particularly generous to charities in Tallahassee. It is located in Little Rock, Arkansas. Pictured at right: (l-r) Jim Fallon; Chief Financial Investment Officer; Anna Kay Frueauff Williams; Vice President of Communications & Programs; Sue Frueauff; Chief Administrative Officer; David Frueauff, President & Chief Executive Officer; Dr. Al McCully; and Rosemary Evans, We Care Network Program Coordinator. Dr. McCully is President Emeritus and long-time board member for The Frueauff Foundation.

Since 1992, the Charles A. Frueauff Foundation has provided financial support for the We Care Network. The Capital Medical Society Foundation is so very grateful to the Frueauff Board of Trustees and to Dr. McCully for their longtime support of our physicians' charitable program.