| |
|
|
| |
Medical Doctors whose last names begin with the letters M through Z are required to renew their licenses for the years 2009—2011. The Board of Medicine will not be mailing a paper renewal application to medical doctors who are renewing their licenses.
The online application or paper application must be completed BEFORE June 30, 2009, at 4:30 p.m., to avoid the automatic expiration of the physician’s West Virginia medical license.
As of May 14, 2009, licensees who meet the following criteria for online renewal were able to go to the Board’s website and complete the online renewal process.
The criteria for physicians to renew online are as follows:
1. Physicians who currently hold an ACTIVE medical license;
2. Physicians who currently hold an INACTIVE medical license and will renew in an INACTIVE status;
3. Physicians who have obtained the required continuing medical education;
4. Physicians who answer “no” to all questions (see “Renewal FAQ’s” currently on the Board’s website); and
5. Physicians who desire to pay via credit/debit card.
Please note that physicians may only renew online if they meet the criteria listed above.
In order to renew online, physicians will need their West Virginia medical license number, their social security number, and a credit/debit card. There is a small credit/debit card convenience fee for renewing online.
If a licensee is unable to use the online renewal service, he or she must request a paper renewal application to complete and return to the Board offices. A request form for a paper renewal application is available on the Board of Medicine website http://www.wvdhhr.org/WVBOM) (under the “FORMS” section).
Please note that the Board of Medicine will be unable to finalize the processing of any application that is not complete. Completion of the renewal application is the responsibility of the licensee.
Each physician application is computer-generated to include personalized information previously reported by the licensee. Physicians must review this information to ensure that it remains accurate. Each licensee must provide a telephone number. The Board anticipates that this method of renewal will reduce the time necessary for the physician to complete the application.
|
|
|
Top |
| |
|
|
| |
“An Evening with the RAC”
Medicare Recovery Audit Contractor Program
Thursday, July 16, 2009
at the
Charleston Marriott
5:30 pm to 8:30 pm
CMS officials will be joined by the Medical Director and other top officials from Connolly Consulting Inc., the RAC for Region C, whichincludes West Virginia, to offer an exclusive presentation for West Virginia physicians and their office staff. This is the only scheduled physician meeting with Connolly Consulting and CMS in West Virginia. Please plan to join the WVSMA for this special presentation.
Purpose:
The purpose of this program is to introduce providers to the new RAC contractor and to provide information about the RAC program. Following presentations by CMS and Connolly Consulting, an open Q&A session will be held, allowing physicians and other attendees to ask questions and express any concerns.
Registration will be limited to the first 150 registrants. Because of anticipated high demand for this program, we suggest that you reserve your spot soon!
The RAC:
As a means of review, the RACs are hired by the Centers for Medicare and Medicaid (CMS) to reduce improper payments by identifying and collecting overpayments, identifying underpayments, and implementing actions to prevent improper payments in the future. Section 302 of the Tax Relief and Health Care Act of 2006 made the RAC Program permanent and required the Secretary to expand the program to all 50 states by no later than 2010. On October 6, 2008, CMS announced awards for the four permanent RACs. Each RAC is responsible for identifying overpayment and underpayments in approximately ¼ of the country.
The RAC demonstration program has proven to be successful in returning dollars to the Medicare Trust Funds; however, they also identify monies that need to be returned to physicians and other providers. The RACs are paid on a contingency basis for their recovery efforts.
Program/ CME Information:
Registration and reception will open at 5:00 PM. Heavy hors d’oeuvres will be served. The program will convene at 5:30 PM and end at 8:30 PM. The CAMC Health Education and Research Institute designates this educational activity for a maximum of 3 AMA PRA Category I credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Lodging:
The WVSMA has secured a discounted block of rooms at the Marriott for program attendees at $126.00 per night. To book a room online, go to www.marriott.com., locate the Charleston Marriott and use the Group Code BBGC and the 7 digit code BBGBBGA. To book by telephone, dial 304-345-6500. Request event code BBGC or the WV State Medical Association Reception. Discounted rates apply only to those rooms reserved by July 2, 2009.
Cost:
WVSMA members may attend for $175.00 and non-members for $275.00. Special rates are offered to any staff person(s) attending with a physician at $50.00 per staff person. Registration forms are available at the WVSMA website, www.wvsma.com. If you have additional questions, please contact Barbara Good (304) 925-0342, ext. 11 or via email Barbara@wvsma.com or by reply to this message.
|
|
|
Top |
| |
|
|
| |
The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.
Medicare FFS providers, including physicians, non-physician practitioners, should be wary of this type of request. If you receive a request for information in the manner described above, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the address found in the download section of the CMS.gov website found at http://www.cms.hhs.gov/MLNGenInfo/ or http://www.cms.hhs.gov/MedicareProviderSupEnroll
|
|
|
Top |
| |
|
|
| |
West Virginia is reporting a case of measles in a two year old unvaccinated resident of Wood County, West Virginia. This is the first case of measles in West Virginia since 1994. Rash onset was June 6, 2009, making the infectious period June 2 – June 10, 2009. The second generation of cases, if any, is expected to have rash onset between June 9 and June 28, 2009. During the infectious period, the child visited four health care facilities in Wood and Kanawha Counties, West Virginia. Physicians at two of these facilities requested measles IgM, which was positive in two independent laboratories. Serum is being referred to the Centers for Disease Control and Prevention for confirmation. Health care providers and patients who were exposed to this case during the infectious period have been contacted and advised to watch for signs and symptoms.
Providers are advised to be on the alert for possible measles. Measles presents with 2-4 days of a prodrome characterized by fever which increases in a step-wise fashion, reaching as high 103° - 105°F. Subsequent signs include cough, coryza (runny nose) and conjunctivitis (‘the 3 C’s’). The measles rash is maculopapular and lasts about 5 days. It begins at the hairline, and then proceeds gradually downwards over about 3 days, eventually reaching the hands and feet, including the palms and soles. The maculopapular lesions are generally discrete, but may become confluent. Initially, lesions blanch with pressure. By 3-4 days, most lesions will not blanch. Fine desquamation may occur over more severely involved areas. The rash fades in the same order as its appearance. Measles is highly contagious by the airborne route. Patients with suspect measles should be isolated immediately using airborne precautions.
Complications of measles occur in 30% of individuals and may include diarrhea, otitis media, pneumonia, and acute encephalitis. Death occurs in 0.2% of individuals. Suspect and confirmed cases of measles should be reported immediately to the local health department. Infectious Disease Epidemiology, Bureau for Public Health (800-423-1271) can assist with obtaining confirmatory testing through the Centers for Disease Control and Prevention. (False positives sometimes occur through commercial labs.)
If exposure is recognized, disease may be prevented in healthy susceptible persons by administration of MMR vaccine within 3 days of the exposure. Immunocompromised persons or infants or susceptible pregnant women should be offered immune globulin within 6 days of exposure. Prompt reporting enables tracing exposed persons and intervening to prevent secondary cases.
Measles can be prevented with two doses of MMR vaccine, given one month apart on or after the first birthday. Health care facilities should assure that all health care personnel are immune to measles. For further questions about measles, contact your local health department or the WV Bureau for Public Health’s Division of Infectious Disease Epidemiology at (800) 423-1271.
|
|
|
Top |
| |
|
|
| |
BrickStreet has added a new feature to their phone service called “caller-elected callback.” This feature allows callers to leave a callback number instead of having to hold indefinitely for the next available customer service representative.
Persons who call BrickStreet will be given the option of leaving a number or continuing to hold. Even if a number is left and the caller hangs up, the system has the ability to treat the call as if that person were still on the line. The next available representative receives the message and will return the call. If the caller does not answer, they will be redialed after a specified period of time. It is important to note this feature is only available during regular business hours. After hours and on weekends, calls will be handled as in the past.
BrickStreet recently began utilizing First Script, a new Pharmacy Benefit Management (PBM) Program through Coventry. First Script is a preferred pharmacy program designed specifically for workers' compensation.
First Script has approximately 62,000 pharmacies in their network and 523 in West Virginia. The list of pharmacies has been posted on BrickStreet.com under the 'StreetSelect' page.
BrickStreet is also committed to fighting worker’s compensation fraud. The BrickStreet Special Investigations Unit team has documented impressive savings as a result of the investigations completed that resulted in some type of administrative action being taken in a claim. Since 2006, the total estimated savings is over $3.1 million.
Referrals for fraud investigation cases are received both internally and externally. Internally, referrals come from claims adjusters and underwriters. Externally, referrals are received anonymously from the BrickStreet Web site or the fraud hotline. To report workers' compensation fraud, please call 866.926.3469 or e-mail reportfraud@brickstreet.com.
|
|
|
Top |
| |
|
|
| |
Mountain State Blue Cross Blue Shield (MSBCBS) has made some changes to the MSBCBS reimbursement allowances and conversion factor updates which are effective July 1, 2009. The new fees are for services provided on or after this date. This year, MSBCBS has adopted the Centers for Medicare and Medicaid Services (CMS) RBRVS values and the West Virginia Geographic Practice Cost Index (GPCI) modifiers to create transparency with MSBCBS using the same RBRVS values as CMS.
CMS implemented changes to its RBRVS physician fee schedule on January 1, 2009. MSBCBS has adopted these same CMS Transitional RVU values and West Virginia GPCI modifiers to also be effective July 1, 2009. MSBCBS will use these values times the applicable conversion factor to determine the allowance for each HCPCS/CPT code.
A summary of MSBCBS’s Reimbursement Methods and Fees, which includes the new conversion factors, may be found on the Mountain State Blue Cross Blue Shield website, www.msbcbs.com.
|
|
|
Top |
| |
|
|
| |
A series of PEIA Provider Workshops were recently held throughout West Virginia. Information was given about new policies, as well as billing and utilization review changes. Much of the information may be found on the PEIA website, www.wvpeia.com.
One of the biggest changes that will occur as of July 1, 2009, is that members will have new ID cards. Your practice should ask for new ID cards for PEIA PPB members. The cards will be hard plastic. Physicians should no longer accept Carelink Plan B cards since that plan has been discontinued. Advantra Freedom members will receive their new cards at the end of December for January 2010.
Physicians and practices will want to be aware that there are some new outpatient precertifications required. A list of procedures requiring precertification may be found on the PEIA website.
A change in the CHIP eligibility will enable more children to receive medical care through CHIP. As of January 1, 2009, the eligibility expanded from 220% - 250% of the federal poverty level. The eligibility and monthly premium varies according to which of the plans is selected—the Gold, Blue or Premium. More information about CHIP may be found online at www.wvchip.org.
|
|
|
Top |
| |
|
|
| |
United HealthCare has recently announced that they have signed a new agreement with the Charleston Area Medical Center (CAMC). The new contract, which begins July 1, 2009, will give United Healthcare commercial health plan customers in the Charleston area increased access to local, quality healthcare.
UnitedHealthcare customers have access to a health care provider network of more than 2,500 physicians and 21 hospitals throughout West Virginia.
|
|
|
Top |
| |
|
|
| |
The American Recovery and Reinvestment Act was signed into law on February 17, 2009. The Act authorizes $787 billion in new spending and tax cuts, including approximately $19 billion for health information technology (HIT) over the next five (5) years. There will be two main financial incentive opportunities; incentives through Medicare and incentives through Medicaid. As of this date, many of the provisions still need to be defined, modified and finalized during the federal regulatory process.
While the exact start date for the EHR incentive program is still unclear, it will most likely begin in 2011. It is anticipated that the Department of Health and Human Services will provide an initial set of standards, implementation specifications, and certification criteria by December 31, 2009.
According to sources from CMS, the EHR incentives will apply to physicians who can prove use of a qualified and certified EHR, regardless of purchase date, with the exception of hospital based physicians who “furnish substantially all services in a hospital setting”, either inpatient or outpatient.
For more information about EHR incentives, visit the West Virginia Medical Foundation’s website at www.wvsma.com/foundation.
|
|
|
Top |
|
June 26, 2009
|
