Feb. 19, 2018
CMS Physician Leadership Skills Series 2018: "Persuasion and the Art of the Elevator Speech" - March 10 
When: March 10, 2018 - 8 a.m. - Noon
Where: Colorado Medical Society offices, Denver, CO
 
Odds are that as a physician you face situations daily where you must persuade others to act. Whether it is with your patients, your practice team, physician colleagues, business partners and even your family, getting your messaging just right to coax change is an art that can be learned and constantly refined.
 
Plan on attending the next installment of the CMS Physician Leadership Skills Series on Saturday, March 10 in Denver to get the expert tips and interactive practice you need to hone your persuasion skills.
 
At the end of this session, participants will be able to:
  1. Craft a brief statement to secure the attention of another person in less than a minute, using the 27-9-3 Rule.
  2. Craft an effective appeal so that your audience is more likely to listen. 
The program will feature Janna West-Kowlaski and Kathy Kennedy, DrPh.
 
Don't miss this opportunity! Registration for this program is free for CMS members thanks to a grant from the Physicians Foundation and support from CMS. Register now.

And watch for more information on the 2018 series as it is available!
Anthem responds to CMS letter opposing pay cut for same-day services, prompts continued CMS opposition

The Colorado Medical Society, American Medical Association and other state medical societies have been actively advocating against a plan by Anthem Blue Cross Blue Shield to reduce payment for significant, separately identifiable evaluation and management (E/M) services that are provided on the same day a procedure is performed or a wellness exam is conducted.
 
The company announced in December that it would reduce the size of its planned pay cut from 50 percent to 25 percent and move the implementation date to March 1, 2018. CMS President M. Robert Yakely, MD, sent a letter on behalf of CMS on Dec. 15, 2017, to Elizabeth Kraft, MD, medical director of Anthem BCBS in Colorado, expressing the society's opposition to the cut.
 
In her Jan. 29 response, Kraft defended the pay cut citing duplication of the fixed/indirect practice expense when performing a minor surgery and E/M service on the same day by the same provider. "To redress the duplicative payment, Anthem's Policy reduces the office visit reimbursement by 25 percent and, thereby, reduces the double payment for fixed/indirect practice expenses."
 
Yakely responded on Feb. 12 that there is no overlap of indirect practice expense and that "by providing two separate and distinct services during the same visit the physician can be more efficient, streamline care for the patient and facilitate a prompt diagnosis, potentially avoiding additional out-of-pocked expense for the patient" -- particularly for patients in rural areas or those seeking certain types of specialty care that have long wait times for non-emergency appointments. He continued to back up his point that codes are already adjusted by the Relative Value Scale Update Committee (RUC), making further reductions inappropriate.
 
CMS stands by its original request that Anthem retract the new modifier 25 policy without delay. Watch for more information as this issue develops.
California to investigate Aetna following admission by former medical director that he never looked at patient records when deciding whether to approve or deny care; Colorado DOI to inquire further

California's insurance commissioner has launched an investigation into Aetna after learning a former Southern California medical director for the insurer admitted under oath he never looked at patients' records when deciding whether to approve or deny care, according to a Feb. 11 CNN story

The deposition of Jay Ken Iinuma, MD, came as part of a lawsuit filed by one of Aetna's insureds who was denied coverage for a medical procedure.

Colorado Interim Insurance Commissioner Michael Conway responded, saying that the Colorado Division of Insurance will work to ensure that Colorado consumers' appeal rights are offered in compliance with Colorado law.

"We take this information seriously," said Commissioner Conway. "This is a story out of California, but Aetna is a national company with a footprint in many states, including Colorado. Our office will be contacting Aetna to inquire further."

Colorado law states that in appeals to an insurance company, the physician conducting the review must be familiar with the standards of care for Colorado, must evaluate the appeal, must consult with other specialists if the case is outside of the physician's area of expertise, and must sign a written determination. If the appeal involves what was a request for a pre-authorization of a service, the physician evaluating the appeal must be different than the one who reviewed the initial pre-authorization request.

Board of Health seeks representative for tobacco grant review committee

The Colorado Board of Health is seeking a representative from a statewide association representing physicians to serve on the statutorily mandated Tobacco Education, Prevention and Cessation Grant Program Review Committee (based at the Colorado Department of Public Health and Environment). Application deadline: Feb. 28.

Those interested in serving on the committee must submit a 1) signed application form, 2) current resume/CV, 3) statement of interest and 4) letter of support/recommendation from the representing organization. Persons who reside outside of the Denver Metro area and particularly in rural areas of the state are strongly encouraged to apply. Find the application and full criteria here.

More information about the committee and the grants program can be found on the   Tobacco Review Committee webpage
HHS launches new opioid website

The U.S. Department of Health and Human Services has launched a new website offering resources and links to services to address the opioid epidemic. The website, www.hhs.gov/opioids, provides information on prevention, treatment, recovery and information about the epidemic. Approximately 116 people a day die from opioid-related drug overdoses and nearly 80 percent of heroin users report using opioids prior to turning to heroin. The website highlights the National Helpline, 1-800-622-4357, for 24/7, 365-days-a-year confidential assistance and a link to over 14,000 substance abuse centers.
Now available: 2018 Medicare Participation Physicians/Suppliers Directory (MEDPARD)

The 2018 Medicare Participation Physicians/Suppliers Directory (MEDPARD) was made available on the Novartis website on Jan. 30, 2018. Find the 2018 Medicare Participation Enrollment information on the tool bar on the left-hand side of the website. As in the past, there will be no hardcopy distributions. Beneficiaries can use the internet or contact 1-800-MEDICARE for assistance in locating a participating physician/supplier near their home.
Primary care physicians: Take advantage of a  new leadership training opportunity in Colorado

Ready to make a difference in Colorado health care? Not sure where to start, or if you have the abilities?

Primary Care Movers and Changers (PCMAC) is a new leadership program offered by the Regional Institute for Health and Environmental Leadership (RIHEL). Spend four transformative weekends with fellow primary care providers, learning how to lead and advocate for change in Colorado.  This leadership program is advocacy focused, and offers participants a wealth of resources including collaborative training, personal leadership assessments, a peer coach, media training, hands-on advocacy practice and much more.

The program is open to a wide range of primary care providers, including physicians, nurses, physician assistants, behavioral health specialists and dental providers. Participants must practice in underserved metropolitan communities, or themselves come from an underserved community or background.

The training is provided free of change, and includes stipends to help providers with travel and related expenses.  Ready to advocate for the changes you believe in? Click here for more information and to apply.
Upcoming events
The Weinstein Effect: What is happening and what practices should do to protect their employees, their physicians and the practice: March 7
The Arapahoe-Douglas-Elbert Medical Society, Aurora-Adams County Medical Society and Denver Medical Society, in collaboration with COPIC, present their next event in their quarterly practice management series on March 7 in Greenwood Village. Speakers will discuss why allegations of sexual harassment in the workplace are becoming more prevalent and what practices should do in response. 1 COPIC point is available per practice. To RSVP, email ADEMSstaff@gmail.com. Questions? Contact Andrea at 303-761-2887.
Colorado Pain Society Annual CME Conference - Chronic Pain Management: April 6-8
The Colorado Pain Society will host its third annual Pain Conference designed to meet the educational needs of providers involved in the care of patients dealing with chronic pain.  Find more information and register here.
Basics of Chronic Pain Management: A Pre-Conference Seminar at the CAFP Annual Summit - April 12
The Center for Personalized Education for Physicians (CPEP) and the Colorado Academy of Family Physicians will host a one-day seminar in Colorado Springs that will help you treat the growing population of chronic pain patients with safety and confidence. This seminar is designed for clinicians who manage or encounter patients with chronic pain. It is not intended for pain management specialists. To register for this seminar, click here. Once you reach the registration page, be sure to select the "Pain Management Pre-Conference Course" option.
Medical Spanish and Cultural Competency Class: April 20-23
To enhance physician communication capabilities with Spanish-speaking patients, Denver Medical Society is offering a four-day intensive, total-immersion learning experience in conversational and medical Spanish for physicians, nurses, PAs, NPs and other medical staff. Find more information here.
Physician Burnout: Integrated Strategies for Diverse Stakeholders: May 10-11
This two-day conference in Avon, Colo., will focus on the root of physician burnout and provide tools and resources for mitigating burnout and achieving a holistic approach to physician wellness. Speakers from all over the country will share their research and experience on this important subject at this innovative and exciting event. Register here.
Sponsors
Get covered with COPIC

COPIC Insurance Company is Colorado's leading medical liability insurance provider. Three out of four physicians choose COPIC for this critically important coverage. CMS members receive a 10 percent premium discount from COPIC.

For more information, call (720) 858-6000 or visit www.callcopic.com.


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To comment on something you read in ASAP or to update your contact information, send an e-mail to enews_editor@cms.org. Visit us online at www.cms.org.
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