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The scoop for ISMS practice management professionals

April 2016
In this Issue

  • Relief for Medical Practices Experiencing Unpaid State Employee Health Claims


    Illinois' current budget situation has left a $2.8 billion backlog of payments owed to health insurers and to physicians who treat state government workers and retirees covered by the State Employees Group Insurance Program (SEGIP). However, there is a small dose of good news! 

    ISMS, along with Cigna, successfully advocated that the Rauner Administration use available funds from the Health Insurance Reserve Fund (HIRF) to begin to pay physicians and insurers a small portion of what is owed to them.

    While Illinois' budget for fiscal year 2016 has not been enacted, the governor's office has indicated that it will work with practices adversely affected by unpaid SEGIP claims. ISMS will also work to facilitate meetings with members of the executive branch for these physicians and medical practices.

    If your office is struggling as a result of unpaid SEGIP claims, you may wish to consider:

    1. Seeking assistance from the state certifying accounts receivable that can be used to access individual lines of credit.
    2. Contacting ISMS for help conveying concerns to the state.

    Call the ISMS Governmental Affairs team at 800-782-4767 or send an email to arrange a meeting with state officials.  

  • 'Ask ISMS' and Get Your Questions Answered


    Welcome to "Ask ISMS," a new feature in Off the Charts dedicated to your questions.

    Of course, as a practice management professional of an ISMS member, you may contact the ISMS advocacy team with your questions at any time by calling 800-782-4767 ext. 1470, or by sending an email.

    Here are a couple of recent questions:

    Q  Our practice currently participates in Medicare's physician quality reporting system (PQRS). When will performance programs (such as the value-based payment modifier (VBM); meaningful use (MU); and PQRS) be replaced by the merit-based incentive payment system (MIPS)?

    A  Payment adjustments for the separate performance programs will be replaced by MIPS in 2019. The last year of payment adjustments associated with PQRS, VBM and MU will be 2018. But keep in mind that the Centers for Medicare and Medicaid Services (CMS) has traditionally used a two-year "look back" period to determine payment adjustments. So, for example, your participation in PQRS this year will determine the payment adjustment in 2018. 

    If CMS sticks with convention, your practice will likely need to start meeting MIPS performance standards as early as 2017 to avoid financial penalties in 2019.

    Final MIPS rules haven't been released yet, so there are still a lot of unanswered questions about requirements and timelines. Watch ISMS publications for more details as they become available.

    Q  A father called our office requesting medical records for his minor child, but the mother has custody of the child. What is the best way to handle this? 

    A  Both parents have a legal right to access a child's medical records - unless there is a legal document from a court stating that a parent does not have a right to access the health information of the child.

    An unmarried father who is listed on the birth certificate of a child is considered a legal parent of that child, and has a right to the child's medical records (again, unless there is legal documentation restricting that right).

    For more information, access ISMS' medical legal guideline, Parental Powers/Minors.

    This ISMS resource is password protected. If you wish to access this guideline and need to request a username and password as a practice management professional of an ISMS member, please contact us.

  • Medicaid's Revalidation Deadline Pushed Back to August 31

    extended Does your medical office treat Medicaid patients? If so, please note that the deadline for individual physicians to revalidate their existing Medicaid enrollment data online has been extended to Aug. 31, 2016.

    ISMS urges medical offices to be sure that any entities with which they are affiliated revalidate or enroll first. In other words, Facility/Agency/Organizations (FAOs) must enter the IMPACT system before associated doctors can revalidate their individual enrollment data.

    To revalidate in the new Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system, log in here.

    If the August 31 deadline is not met, your physician(s) may have to re-enroll. Also, your medical practice will likely experience payment delays.

    Need assistance? Call the IMPACT Hot Line at 877-782-5565, and select option #1.

    For a general overview, access ISMS' IMPACT Issue Brief.

    This ISMS resource is password protected. If you wish to access this Issue Brief and need to request a username and password as a practice management professional of an ISMS member, please contact us.

  • Window Closing April 30 for Medicaid EHR Incentives

    If at least 30 percent of your 2015 patient volume included Medicaid patients, your office may be eligible to participate in Illinois' EHR Medicaid Incentive Payment Program (eMIPP).

    The final deadline to participate is April 30, 2016.

    What are the benefits of eMIPP?

    • Grants up to $63,750 in incentive payments (per eligible physician).
    • Prepares practices for the imminent value-based payment systems.
    • Helps practices avoid potential penalties associated with Medicare's meaningful use program.

    Please note: If your physicians receive EHR incentives from Medicare, they are not eligible to also participate in eMIPP.

    At no cost, the Illinois Health Information Technology Regional Extension Center (ILHITREC) will help you determine eligibility for eMIPP. Contact ILHITREC by email or complete the eligibility survey.

    Questions? Call your ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email.

  • Flu Shot Pre-Ordering Season is Here

    flushot Believe it or not, it's time to pre-order vaccines for next year's flu season! 

    Pre-ordering is the best way to ensure that your medical office will have vaccine in stock when the 2016-2017 flu season arrives. Manufacturers determine the quantity of influenza vaccine they will produce based on orders they receive each spring. 

    To pre-order seasonal influenza vaccines, contact your regular suppliers.

    You may also access our 2015-2016 Influenza Formulation and Coding Guide, a handy one-look reference chart that organizes important vaccine information based on manufacturer, dosage, demographics, billing and diagnosis codes and more.

    This ISMS resource is password protected. If you wish to access this flu resource and need to request a username and password as a practice management professional of an ISMS member, please contact us.

  • Public Service Announcements Aim to Boost Hep C Screening


    ISMS seeks to raise awareness about Hepatitis C screening via public service announcements (PSAs), now airing on 63 stations in 21 cities across Illinois. Many Illinoisans are infected with Hepatitis C and don't know it. That's because only a quarter of those patients have been diagnosed.

    Listen to a PSA; access ISMS' online Hep C patient materials

  • There is No Risk-Free Level of Exposure to Tobacco Smoke

    cigarette Help remind patients that tobacco use is the single most preventable cause of disease, disability and death in Illinois. Download ISMS' patient education infographic and distribute to patients or hang in your office.  

  • Boost Your Bottom Line, Create Office Efficiencies with CareVitality

    carevitality CareVitality offers care management and technology consulting to improve patient outcomes, create office efficiencies and increase revenue. 

    Member offices receive discounted pricing for services to assist with Medicare's chronic care management (CCM) program; meaningful use reporting; privacy/security; physician quality reporting system (PQRS); and more!

    Watch a video overview of chronic care management.

    Learn more about CareVitality, one of ISMS' Benefit Partners.

    CareVitality is a subsidiary of EHR & Practice Management Consultants, Inc. 

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