The Bulletin of theDelaware County Medical Society

Volume LXXXXVI Number 1I

January/February 2014

Official Publication of the Delaware County Medical Society ~ www.delcomedsoc.org

ICD-10 Tips for Small Provider Practices

All health care providers covered by HIPAA must make the transition from ICD-9 to ICD-10 codes by the October 1, 2014, compliance dead-line.

ICD-10 will affect every aspect of how your organization provides care, from software upgrades and patient registration and referrals, to clinical documentation and billing.

Key Steps to Prepare for ICD-10With adequate planning and prepara-tion, you can ensure a smooth transi-tion for your practice. Whether you are just starting the planning process, or ahead of schedule, the checklist below can help make sure you keep your efforts on track.

1. Inform and educate staff about the transition to ICD-10.

Appoint an ICD-10 coordination manager

Tell your staff about upcoming changes and your transition plan

Educate staff on changes in documen-tation requirements from health plans

Seek resources from CMS and profes-sional and membership organizations to help with the transition

2. Perform an impact assessment. Identify potential changes to existing work flow and business processes by looking at your current use of ICD-9.

Make a list of staff members who need ICD-10 resources and training, such as billing and coding staff, clini-cians, management, and IT staff

Evaluate the effect of ICD-10 on other planned or ongoing projects (e.g.,electronic health records)

What is LEIE & What Does it Mean to Your Practice?

By Julie Sheppard, BSN, JD,CHC

The Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) is a database that is updated monthly. Healthcare providers have a duty to screen prospective and current employees against the LEIE.

The Rule

Sections 1128 and 1156 of the Social Security Act provide authority to the OIG to exclude individuals and entities from federal health care programs like Medi-care and Medicaid. Individuals may be excluded for reasons that fall into one of two categories: permissive or mandatory. However, exclusions are applied broadly in both categories. Excluded individuals are prohibited from furnishing all types of services including administrative and management services.

The Patient Protection and Affordable Care Act of 2010 along with other statutory amendments have strengthened and expanded the OIG’s authority to exclude individuals and entities from the federal health care programs.

On May 8, 2013, the OIG issued an updated special advisory bulletin on the effect of exclusion from federal health care programs. The publication of the original Bulletin in 1999 coincided with the beginning of significant and ongo-ing OIG initiatives to ensure compliance with and enforcement of exclusions.

The Screening

Providers need to routinely check the LEIE to ensure that new hires and current employees are not on the excluded list. Providers have an obligation to screen current and potential employees against the OIG’s LEIE, and a monthly screen-ing is the best way to minimize potential overpayment and CMP liability.

Screening is a relatively simple process that involves entering an individual’s name and completing a search on the OIG Web site http://exclusions.oig.hhs.gov. In the event that a provider determines they have employed an individual on the list, they must disclose to the government that they have employed an

continued page 3 continued page 2

Delaware County Medical Society

Officers

President Richard V. Buonocore, MD

President ElectRonald B. Anderson, MD

Vice PresidentPramod S. Lele, MD

SecretaryStephen N. Clay, MD

TreasurerSalvatore A. Lofaro, MD

Past PresidentFredric N. Hellman, MD

Board of Directors

George K. Avetian, DO

John M. Colombo, MD

Maria C. DeMario, DO

Linda D. Green, MD

Margaret T. Hessen, MD

Charles D. Hummer, III, MD

David R. Kalodner, DO

Gurpreet S. Kochar, MD

Joyann A. Kroser, MD

Justin M. Lazaroff

Chike N. Okechukwu, MD

Mary Jo Shields, MBA

Marc I. Surkin, MD

Mary Ann Tyler, CMM

Rekha P. Yagnik, MD

Delaware County Medical Society600 North Jackson Street, Suite 201A Media, PA 19063-2563

email: roemcneal@comcast.net

The Bulletin of the Delaware County Medical Society is published bi-monthly by the Delaware County Medical Society (ISSN 1044-4653). Material for publication must be received by the tenth of the month for the following month’s issue.

The publisher reserves the right to accept or reject any advertising. Advertisements do not represent approval or recommnedation of the Delaware County Medical Society. The opinions expressed in The Bulletin do not reflect official policy or proceedings unless so stated. Printed on re-cycled paper by The Country Press in Lima, PA Annual subscription rate: $50.00 Second class postage paid at Media, PA 19063

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3. Plan a comprehensive and realistic budget.

Estimate and secure a budget, including costs such as software, hard-ware, staff training, and production costs.

4. Contact system vendors, clearinghouses, and/or billing services to assess their readiness and evaluate current contracts.

Ask your vendors how they will support you in the transition to ICD-10

Request a timeline and cost estimate

Getting Ready for Testing

Once you have completed the planning steps, prepare to test ICD-10. It is im-portant to conduct internal testing of ICD-10 within a clinical practice as well as external testing with payers and other external business partners.

Resources

The CMS ICD-10 website at www.cms.gov/ICD10 offers resources and guidance to help plan for the ICD-10 transition. Tailored guidance and tips for planning are available on the provider resources page. To keep up to date on the latest news, sign up for weekly ICD-10 email update messages and follow @CMSGov on Twitter.

ICD-10 Tips (continued from page 1)

Also - remember to rely on DCMS and PAMED staff with your questions! Consult www.pamedsoc.org for much more information!

Call the DCMS staff at (610) 892-7750 or PAMED at (800) 228-7823

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excluded person. The OIG’s Self-Disclosure Protocol (SDP) may be followed to disclose and resolve the potential of liability.

The Liability

Providers that employ an individual that the provider knows or should know is excluded may be subject to Civil Mon-etary Penalties (CMPs) of up to $10,000 for each claimed item or service furnished to a federal health care program. An assessment of up to three times the amount claimed for each item or service may be applied. Additionally, a provider may face exclusion from participating in federal health care programs. More information is available online at http://oig.hhs.gov/exclusions/background.asp.

What is LEIE (continued from page 1)

Julie Sheppard, BSN, JD, CHC, is President and Founder of First Healthcare Compliance.

Ms. Sheppard is an Adjunct Professor at Widener University School of Law, where she serves as the course instructor for Healthcare Compliance & Ethics. A nurse, an attorney, certified in Healthcare Compliance by the Compliance Certification Board, and a physician’s spouse, Julie intersected her professional understanding of compliance issues with her personal motivations when establishing First Healthcare Compliance.

First Healthcare Compliance (http://1sthcc.com/) addresses the challenges created by the recent compliance mandates of the Affordable Care Act (ACA) for healthcare providers, specifically those applying to physi-cian practices, by developing a timely, comprehensive, and practical solution to meet the ongoing compliance needs of physician practices.

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Year-Round Academy Geared Toward Leadership Candidates

The Pennsylvania Medical Society (PAMED) is hosting year-round education for physicians and other health care leaders in practices, groups, hospitals, and health systems who are candidates for comprehensive leadership training. The program provides physicians with broad, practical leadership training; facilitates networking and mentoring for participants; and helps them resolve challenges within their practice settings.

The 10-month program will include six online courses, four day-long live sessions, and an optional team-based proj-ect addressing a current issue within a physician’s practice environment. Facilitators are ACPE faculty and, for some online discussions, PAMED staff. Participants in the 2014 learning group will be able to earn 61.5 CME credits and 57.5 credits towards the Certified Physician Executive (CPE) certification (21 core credits and 36.5 elective credits) if they complete the full comple-ment of courses. 2014 classes are forming now. Enroll today to be part of the 2014 learning group. We encourage you to register as soon as possible as each learning group is limited to 30 participants. To learn more, contact Leslie Howell at (800) 228-7823, ext. 2624, or email - lhowell@pamedsoc.org.

Course Schedule:

-Project Management (Jan. 2014, online)-You’re Not Just a Doctor Anymore (Feb. 28, 2014, live)-Strategic Thinking and Decision-Making (March 2014, online)-Physician in Management: Effective Physician Leadership (Apr. 25, 2014, live)-Physician in Management: Quality Improvement (May, online)-Coaching and Mentoring Physicians to a Higher Performance (June 27, 2014, live)-Physician in Management: Finance (July 2014, online) -Physician in Management: Communication (Aug. 2014, online)-Physician in Management: Negotiation (Sept. 2014, online)-Physician Engagement (Oct. 24, 2014, live)

Competencies:

-Engaging Others/Relationship Building -Influence and Credibility -Leading Change and Innovation -Motivating and Managing Performance -Promoting Continuous Improvement and Quality -Strategic Planning and Implementation -Teamwork and Collaboration

Cost per person (covers educational materials, CME credits, and food/beverages at live programs) is $2,900 for PA-MED member physicians and non-physicians and $4,000 for physicians who are not members of PAMED. CME All courses are accredited for CME through the ACPE. Certified Physician Executive (CPE)The courses in this program qualify for credit toward the CPE designation and for ACPE’s master’s degree programs with Carnegie Mellon University, Thomas Jefferson University, University of Massachusetts Amherst, and University of Southern California.

For more information about the graduate programs, visit www.acpe.org/Degrees. Questions? Call Leslie Howell at (800) 228-7823, ext. 2624, o email lhowell@pamedsoc.org.

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Accreditation and Designation Statements The American College of Physician Executives (ACPE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The American College of Physician Executives designates these live and enduring material activities for a maximum of 61.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activities.

- See more at: http://www.pamedsoc.org/academyregistration#sthash.cTgnEZcO.dpuf

DCMS Public Health Fund

As many of our members are aware, the Delaware County Medical Society Public Health Fund, Inc. was founded in 1964 following the medical society’s “Victory Over Polio” drive. To date, the fund has contributed nearly five-hundred thousand dollars to local charities. The Fund’s Board of Directors meets annually in November to review the yearly earnings on investments and to make recommendations on the distribution of awards.

The Delaware County Medical Society Public Health Fund Inc. is led by John M. Rosecky, CFP, President; David M. Smilk, Esq., Treasurer; and Robert F. Plotkin, MD. Other board members of the fund include: Fredric N. Hellman, MD; David Kramer, CPA; David A. McKeighan; Richard C. Nelson, DDS and Rehka P. Yagnik, MD.

Organizational Grant Awards for the 2014 calendar year

The following organizations were awarded grants for 2014: The American Red Cross; BeatCancer.org; Community Action Agency of Delco; CASA Youth Advocates; CHEO – Community Health and Education; ChesPenn Health Services; Clarke PA School for the Deaf; the Foundation of the Delaware County Medical Society; Delco Memo-rial Foundation; Domestic Abuse Project of Delaware County; Family Support Line; GPAC AAMN; Learning Ally; Pathways PA; Philabundance; Planned Parenthood of SE PA; Riddle Healthcare Foundation; the Salvation Army; SE PA AHEC; Senior Community Services; Surrey Services; Thresholds; Volunteers in Action; Wayne Senior Center; Women’s Resource Center.

2013-2014 Medical Office Staff Salary & Benefits Report Now Available

It’s that time of year again, when countless physicians and practice managers have medical office staff salaries and benefits on their minds. The Pennsylvania Medical Society (PAMED) can help to address this important practice man-agement challenge.

The 2013-2014 Medical Office Staff Salary and Benefits Report is now available. This report, which serves as a benchmarking tool for practices, compares salaries and benefits for 26 job positions from 33 specialty areas of prac-tice in eight regions across the state. It compiles data gathered in surveys from approximately 500 medical practices.

PAMED members can either download the PDF or order the printed booklet at no cost from the PAMED website.

If you are a nonmember of PAMED, the cost to get the booklet is $89.50. However, nonmembers may be eligible for an introductory dues cost of $95. By becoming a member, you would have access to this report for free, in addition to a variety of other benefits exclusive to PAMED members. Learn more about membership and join today.

- See more at: http://www.pamedsoc.org/Right-Side-Nav/Succeed-Practice-Tools/2013-2014-Salary-Benefits-Rpt.html#sthash.t5yUh507.dpuf

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