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The scoop for ISMS practice management professionals

July 2016
In this Issue

  • Free Practice Management Help Available to Professionals Working for an ISMS Member

    As a practice management professional for ISMS members, you have access to numerous resources, too! 

    Need help with MACRA, medical records, HIPAA privacy and security policies, credentialing or reimbursement snafus? Are you experiencing difficulties or hassles with various government agencies and third party payers including Medicaid, Medicare, Blue Cross and Blue Shield of Illinois, HMOs, PPOs and the like?

    ISMS can help you resolve these issues.

    The ISMS Division of Health Policy Research and Advocacy assists members and their staffs by decoding the myriad of rules and regulations that apply to the medical profession.  

    Check out our full stable of Issue Briefs, designed to equip you with practical information.

    ISMS also created the Practice Manager's Network just for you.  

    If you don't see what you need online or have a particularly difficult practice issue, contact us. The advocacy team is available to assist you at 800-782-4767 ext. 1470, or by email.

    You don't have to go it alone; we are here by your side.

    To access password protected materials, practice management professionals of ISMS members may request a username and password by contacting us.

  • Medicare Payment Overhaul: It's a MACRA World Now


    Well that flawed sustainable growth rate (SGR) formula finally met its much deserved demise when it was eliminated by the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015.

    MACRA creates a new Medicare payment system with incentives, which kicked off with an annual base payment increase of 0.5 percent through 2019. A two-track payment system follows next.  

    See our infographic: Key Payment Provisions under MACRA

    Recently, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule for MACRA. 

    ISMS sent out a request for medical practice feedback regarding the proposed rule. Thanks for your help! Numerous practices responded, which greatly assisted us in communicating our concerns to CMS.  

    Learn more about MACRA with these resources:

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

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

  • Remind Me - What's the Current Fee to Copy Medical Records?

    Does it seems like once you learn how to handle a request for medical records, new regs come along and change everything? Here we go again with new guidancefrom the U.S. Department of Health and Human Services (HHS). 

    To better understand the guidance in the context of Illinois law, access ISMS' medical legal guideline Individual and Third-Party Access to Medical Records. The guideline includes medical record copying and delivering fees, individual access to protected health information and timeliness requirements for fulfilling medical record requests.

    Questions? Call 800-782-4767 or send an email.

    This medical legal guideline is password protected. If you wish to view this resource, you'll need a username and password as a practice management professional of an ISMS member. Please contact us.

  • New Overtime Rules Will Impact Medical Practices

    In less than five months, many medical offices will need to comply with new federal regulations concerning overtime pay. The U.S. Department of Labor (DOL) recently issued a final rule to update overtime regulations, which will take effect Dec. 1, 2016.

    Once implemented, more workers will automatically become eligible for overtime pay when they work more than 40 hours a week. What's more, the DOL has predicted that health care workers will make up the bulk of those affected.

    Learn more.

    Questions? Call the ISMS Division of Member Advocacy at 800-782-4767 ext. 1470 or send an email.

  • 'Ask ISMS' and Get Your Questions Answered!


    Our 'Ask ISMS' feature in Off the Charts is 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.

    Q  Can a physician grant me permission to check the Prescription Monitoring Program (PMP)? 

    A Physicians can authorize a designee to consult the PMP on their behalf. Designees must be employed by the physician, or be employed in or under contract with the same practice as the physician. It is your designating physician's responsibility to make sure you are trained to use the PMP. It is also important to keep in mind that the information contained in the PMP is protected by HIPAA, so access to the database is limited to authorized designees for authorized purposes only. The physician remains responsible for any breach of confidentiality.


    On-demand course: The Illinois Prescription Monitoring Program and Your Practice.

    Case study: ISMS Members Making it Work: Illinois Prescription Monitoring Program.

    Q I hear we are now required to provide medical records to patients immediately. Is that true? 

    A Covered entities, such as physicians, should provide access to protected health information (PHI) within 30 calendar days of receiving the individual's request. The Department of Health and Human Services has stated that this is an outer limit and covered entities should respond to access requests as soon as possible. Indeed, many practices use electronic systems that allow nearly instantaneous access.

    If a covered entity is unable to fulfil the request within 30 days, they must 1) inform the individual in writing of the reason for the delay and 2) provide the date by which they can provide access. This written notice must be provided to the individual within the original 30-day time period. Covered entities are allowed only one 30-day extension per request.

    To learn more, access ISMS' Individual and Third-Party Access to Medical Records.

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

  • Getting Ready to Order Flu Vaccines? Don't Order the Nasal Spray, Says the CDC


    This just in: The Centers for Disease Control and Prevention (CDC) is advising to discontinue the use of live attenuated influenza vaccines (LAIVs), also known as the "nasal spray," for the upcoming 2016-2017 season. 

    Going forward, the CDC recommends to continue the use of inactivated influenza vaccine (IIV) or the recombinant influenza vaccine (RIV). These vaccines are given by injection and approved for all patients older than 6 months. 

    New data assessed from the past three influenza seasons shows that only IIV and RIV provide protection against the flu. The nasal spray, or LAIV, which is approved only for healthy patients ages 2 through 49 years, was deemed not effective enough. 

    For general flu info, access ISMS' Seasonal Influenza Information for Patients.

  • Help Educate High-Risk Patients on Hepatitis C Screening
    Only 25 percent of those infected with Hep C know they have it.

    Here are ISMS resources to help you get the word out about the importance of Hepatitis C screening:

  • What's Going on in Springfield that Affects Medicine?


    From the summer of 2015 to this summer, Illinois was locked in a brutal budget stalemate making it unusually difficult for legislation to pass this session in Springfield. In recent weeks state officials agreed to send the troops home until November and passed legislation to "keep the lights on" in Illinois through year-end. 

    Despite the difficult legislative climate, ISMS worked to support several legislative proposals favorable to Illinois physicians and patients. 

    Learn more about ISMS' advocacy by accessing our 2016 Update on ISMS Legislative Activity.

    Your medical scoop on the "stopgap" budget 

    Hours before the start of fiscal year 2017, lawmakers finally reached a compromise on June 30 for a spending proposal: a stopgap budget deal.

    But this spending plan primarily addresses social services, K-12 schools, road construction, capital projects and public universities. The vast majority of items in Medicaid and other human services agencies will continue to be paid pursuant to court orders. 

    Further, funding for the Illinois State Employee Group Insurance Program (SEGIP) was not included in this agreement. The governor and legislative leaders believe that funding for this program will be secured when a resolution to the remaining fiscal year 2017 budget impasse is resolved. The debt currently owed to physicians and their practices, as well as hospitals, is approximately $3 billion. The governor's office has acknowledged that it will be necessary to refinance this outstanding debt to pay physicians and hospitals what they are owed for providing care to those enrolled in SEGIP.   

    Improvements arrive for medical cannabis program

    A new law makes changes to Illinois' Medical Cannabis Pilot Program, which includes provisions initiated by ISMS. 

    Due to our advocacy, the program will be much less burdensome for doctors in that they will no longer be responsible for "recommending" medical cannabis. ISMS also advocated to create a communication system between the Illinois Department of Public Health and the state's Prescription Monitoring Program to allow physicians to see whether their patients have been certified for medical cannabis.

    For the latest updates, stay tuned to ISMS' Legislative Action Hub.

  • Here's How to Save with 'Card Carrying' Patients


    As a practice management professional, you know all too well that patients expect to use their credit or debit cards for payment. But did you know customizing these payment processing needs will save your medical office time and money? 

    Get started with TransFirst, an ISMS Benefit Partner, offering a complimentary analysis of your credit card payment costs. With no set-up (lease/purchase equipment) or early termination fee, there's nothing to lose.

    Contact TransFirst today and consolidate your payment procedures immediately.

    Learn more about our many ISMS Benefit Partners.

  • Attention Medical Practices Serving Children: Unvaccinated Students Will Need Doctor to Confirm Religious Exemption

    Your busy season for school physicals is ramping up, bringing your office the enormous influx of school physical forms. Here's what's new for the upcoming school year 2016-2017 concerning religious exemptions.  

    Parents and guardians must complete this Certificate of Religious Exemption form if they wish to exempt their children from required school immunizations on religious grounds.

    The certificate must be signed by a physician, stating that the student's doctor counseled the family about the benefits of the vaccines and the dangers of opting out. The form also confirms that the family understands the student's school exclusion policy should a vaccine-preventable disease break out.

    The form is required for children entering kindergarten, sixth grade and ninth grade for both public and private schools.

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