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COS Advocating For You & Patients
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2020 State Legislative Session
February 5, 2020
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AAOS Prior Authorization Legislative Alert
How much time does your office spend completing prior authorizations? Orthopaedic surgeons across the country are voicing concern over the growing burden of prior authorization requests and the dangerous delays in care that they create for patients. Prior authorization reform is needed now.
Bi-partisan legislation was recently introduced in the U.S. House of Representatives that aims to protect patients from the burden of prior authorizations. The Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107) would reduce unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, and providing both oversight and transparency for health insurance. Please join AAOS in urging your Representative to cosponsor this bill.
Congress is likely to vote on prior authorization reforms this spring, so now is the time to make your voice heard.
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COS Priorities for Upcoming Legislative Session
The COS has been working diligently on key priorities of the orthopaedic community and their patients. Prior to the start of the 2020 session, Board members met with key legislative leaders including Attorney General Tong and his office, to discuss the need for insurance reforms for patients and physician practices.
The proactive, patient centered advocacy we will be working toward this legislative session includes reforms to the High Deductible Health Plans to ensure that the collection of payment is done by the insurer and does not interfere with Physician Patient Relationship and prohibiting any drug formulary changes mid policy contract. In addition, we will seek to collaborate and augment the legislative work of our State and Specialty colleagues.
The COS is committed to advocating for meaningful legislative change to benefit patients and the practice of medicine.
Our actions will be expertly guided by COS Lobbyists, Bill, Jim and Ross however we need the collective voice of Connecticut's orthopaedic community to help deliver strong messages to the Legislature. Throughout the session, we will be reaching out to the membership with grassroots alerts. Please answer the call to action and add your voice to debate.
If you have not already, please renew your 2020 membership TODAY! Visit www.ctortho.org to renew and pay online. The COS is the only statewide orthopaedic organization that represents you, the profession and your patients.
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Medicare Updates/Changes -Please Note
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The Medicare Carrier Advisory, National Government Services, recently conducted a review of current Medicare topics, 2020 changes, and operational updates and discussed the initial changes to Evaluation and Management billing which are planned for 2021.
A detailed PowerPoint presentation is attached for your information. Please share with your billing and coding staff as well. Important to note that if you and/or your staff have any questions or need clarification on any matter covered in the
PowerPoint
or
MLN
documents, NGS will take your questions via email to Katherine Dunphy at
Katherine.dunphy@anthem.com
. Please feel free to submit your comments to
Susan
at COS as well.
Takeaways from Conference Call
- Major Change – Appropriate Use Criteria for Advanced Imaging (including MRI). This year will be Educational (through 12/2020), full implementation is expected 1/2021. When ordering advanced imaging for Medicare patient, physician will be required to consult a qualified Clinical Decision Support Mechanism (CDSM) which will provide the physician with a determination of whether the order adheres to the AUC. – Please see complete details outlined in MLN document (click here).
- All Claims Must Use the New MBI number on Medicare Beneficiary Card
- Evaluation & Management Codes will change from 5 levels to 4 levels- Emphasized the importance of documentation of medical decision making and recording of time spent with patients. Changes are planned for 2021.
- Physician Assistants – In the absence of any state rules for physician supervision of PA services, CMS is finalizing a revision to the current supervision requirement to clarify that physician supervision is a process in which a PA has a working relationship with one or more physicians to supervise the delivery of their health care services.
- Cap on Amount of Therapy (PT and OT) per calendar year; $2080/each therapy mode. Once reached cap, care can continue as long as patient is progressing in goals outlined by referring MD. New OT and PT Modifiers.
- Location of all LCD data is now housed on CMS Medicare Coverage Database Site.
- LCD Reconsideration Process Revised (see slide 35 for process). All reconsideration requests must include the LCD# referencing; reason for reconsideration request; studies /evidence to support the reconsideration. Email requests to ngs.lcd.reconsideration@anthem.com.
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CSMS Physician's Day @ Capitol
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Your Invited to Attend
CSMS Physicians’ Advocacy Day at the Capitol
Thursday, March 5, 2020
8:00 am - 10:00 am
Legislative Office Building, Hartford,CT
Join your colleagues at the Capitol for Physicians’ Advocacy Day on March 5th.
The day begins at 8:30 a.m. with a Meet-and-Greet Breakfast.
Invited speakers will be joining us to share their thoughts about the ongoing session.
Invite your legislator too – ask them to the breakfast to speak with you.
Or make an appointment to meet with your legislator.
Need help making those arrangements? Let us know – we’re happy to help! Please RSVP to Denise Tyrell:
dtyrell@csms.org or
call: 203.8650587 x111 . Registration online at www.csms.org.
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The COS is pleased to offer the 2020 Power Coding Workshop presented by Karen Zupko and Associate's power presenter, Dr. Michael Marks, MBA.
The Power of Coding
&
Changes to Office E/M
What Every Practice Needs to Know
Thursday, April 2, 2020
9:00 a.m. – 3:00 p.m.
Marriott Farmington
15 Farm Springs Road
Farmington, CT
Register Today!
Space is Limited.
Attendees will receive CEU/ AAPC credits, workbook, breakfast and lunch all for the low registration fee of $295.00 per attendee.*
*All 2020 Dues Paid COS Members and their office staff register at the reduced rate of $295.00 per attendee. Non-members register at the $495.00 per attendee rate.
Deadline to register is March 23, 2020.
Please note: Registration fee is nonrefundable however you can transfer to another person in your office.
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Annual Meeting
Friday, May 8th
8 a.m. - 2:30 p.m.
Farmington Marriott
Farmington, CT
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You won’t want to miss this year’s Annual Meeting with relevant CME accredited clinical information for your practice, Uconn and Yale Resident Paper Presentations, Special Award Presentations and more.
Whether you attend for the informative presentations from experts in orthopaedics, networking with your colleagues, or to learn more about the latest products and services for your practice, the 2020 Annual Meeting offers something for all and there is no fee to attend if you’re a 2020 member.
Register Today!
2020 Paid MD and PA Affiliate Members
No Fee to Register
Simply email RSVP to ctorthoexec@gmail.com
NOT SURE IF YOU RENEWED FOR 2020?
Special thanks to Michael Kaplan, MD, Program Chair and COS Board member, for arranging the speakers and developing a relevant and diverse program. The COS is grateful for his leadership and commitment to the education of our members.
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COS Signs Onto AAOS Collective Comments to CMS Concerning Scope Expansion
The COS was pleased to support the American Association of Orthopaedic Surgeons (AAOS) and all those represented by the orthopaedic state and specialty societies in response to the CMS request for comments concerning the President's Executive Order to expand the scope of practice for PAs and APRNs.
READ MORE HERE.
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