Contribute to IMPAC Today!
2024 will be an especially important election cycle for IMA and the State of Idaho. IMA has an opportunity to play a major role through IMPAC, our political action committee. IMPAC makes contributions to candidates from both parties in the Primary and General elections who are willing to govern and have a track record of supporting Idaho physicians – our friends of medicine.
Contributing to IMPAC is easy. You can do so by clicking HERE or by texting the word “IMPAC” to 208-996-8776.
Thank you for your support!
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In this Issue...
- IMA on Public TV discussing women's healthcare workforce challenges
- Resources available to answer questions about the Change Healthcare data breach
- Is your practice missing out on revenue?
- Webinar: What physicians need to know about the new Federal Corporate Transparency Act
- AMA Webinar: What we need to do now to address the maternal health crisis
- Hospital E/M Coding and Split/Shared Updates - IMA Education Webinar
- Physician Vitality Program
- IMA Membership reminder
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IMA Takes Women’s Healthcare Workforce Challenges to Public Television
IMA District Three Trustee Dr. Megan Kasper and St. Luke’s Chief Physician Executive Dr. Jim Souza joined IMA CEO Susie Keller on Idaho Public Television’s weekly news show, “Idaho Reports” to discuss ongoing Idaho women’s healthcare workforce challenges and their impact on patient access to care.
The IMA, the Idaho Coalition for Safe Healthcare and the Idaho Hospital Association had planned on presenting important information to a joint hearing by the House and Senate Health and Welfare Committees, but the March 26 hearing was abruptly canceled. You can read more about that decision here and here.
During the panel discussion with host Melissa Davlin, Keller highlighted the alarming decline in OB/GYN providers in Idaho since state’s abortion ban took effect in August 2022.. She said the IMA and its partner organizations had hoped to get a maternal health exception approved this session. She said many legislators she spoke with supported the idea, but “political dynamics are part of the legislative process and all we can do is keep telling our story and highlighting the pressures for physicians and the impacts on patients.”
Dr. Souza said Idaho’s laws have complicated physician recruitment and retention. “Positions that we used to fill in a matter of weeks now are open for months or they just go unfilled. And worse than that, we keep digging the hole deeper, so to speak. And probably the group of women's health care providers that have been hit the hardest by the fear and lack of clarity in the law have been the maternal-fetal medicine specialists.”
“What is starting to keep me up at night is the evolving maternity care desert in my own community where I work and practice,” said Dr. Kasper, who practices in Canyon County. “We need more help. We need more help to take care of Idaho moms.”
You can view the latest episode of “Idaho Report” here.
For the latest on the 2024 Idaho Legislative Session, visit the IMA’s Legislative Update.
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Resources Available to Answer Questions about the Change Healthcare Data Breach
The Department of Health and Human Services (HHS) has made available these resources to assist physicians, pharmacists, and hospitals, in the aftermath of the Change Healthcare cybersecurity attacks.
The American Medical Association (AMA) told HHS on a number of occasions that physicians were having difficulty securing information from health insurers about the availability of assistance with payments, flexibilities from administrative requirements, and additional contact information for troubleshooting due to the Change Healthcare cybersecurity attacks. Other interested parties raised similar issues. HHS responded by assembling the linked resources from health insurers. Please note the HHS’ cover letter points out that the resource document contains a national contact person for each plan, though HHS urges physicians, pharmacists, and hospitals, to reach out first to their health insurer’s regional contact. If these contacts do not respond to inquiries, please contact HHScyber@hhs.gov.
The AMA will continue to raise physician concerns to the Biden administration and payers. For more information, please visit the AMA webpage dedicated to this topic.
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CMS Underutilized Services - Is Your Practice Missing Out on Revenue?
By Jana Weis, Gill Compliance Solutions
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Back in 2022, the National Institutes of Health (NIH), conducted a study with Duke University analyzing CMS coordination and preventive services utilization within a cross-section of patients. The results were surprising and revealed that many providers were not billing for services they were likely performing. A small excerpt of this study was shared within the 2023 Physician Fee Schedule Final Rule. Quoting from the study:
Depending on the code, 8.8% to 100% of older adults, or approximately 67 to 762 patients per individual PCP panel, were eligible for specific preventive services, and physicians already provided services represented by those codes to 5.0% to 60.6% of eligible patients annually. However, a much smaller fraction of eligible patients was billed for having received the service, ranging from less than 1% for alcohol misuse counseling or obesity counseling to 35.8% for wellness visits, with most below 10%.
If a PCP provided and billed for all coordination services in half of all eligible patients, the PCP could receive, as an upper bound, $86,082 in additional revenue per year.
Although this is not an exhaustive list of preventive/coordination services, the chart below is an illustration, in billions, comparing an array of services to evaluation and management visits. Many of these services can be billed in addition to E/M services if supported by documentation.
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The IMA March webinar focused on many of these services, reimbursement for Idaho, and practice examples of potential missed opportunities. If you are interested in obtaining a paid copy of the presentation, please contact Rebecca at the IMA. If you would like to discuss strategic direction and applicability of these services as part of IMA membership, you can request to talk to Jana Weis through an email or call to the IMA.
Below is a short list (and short definition) of common services mentioned in the study to show payment, adjusted to Idaho, for your reference. We are encouraging providers to talk with their billing staff to determine if some of these services are appropriate for your practice and patient population.
99495 – Transitional care management (moderate complexity) - $190.47
99496 – Transitional care management (high complexity) - $257.65
99491 – Chronic care management (MD or QHP) - $78.57
99490 - Chronic care management (Clinical staff) - $57.88
99487 – Complex chronic care management (Clinical staff) - $123.52
99424 - Principal care management (MD or QHP) - $76.49
99426 - Principal care management (Clinical staff) - $57.14
99497 – Advanced care planning - $76.20
G0402 – IPPE (Welcome to Medicare) - $153.41
G0438 – AWV (Annual wellness visit) - $153.11
G0136 – Social determinates of health assessment (new) - $17.34
99406 – Smoking cessation counseling; 3-10 minutes - $13.51
99407 - Smoking cessation counseling; greater than 10 minutes - $25.30
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What we need to do - now - to address the maternal health crisis | |
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With the U.S. having the highest maternal mortality and morbidity rates among developed countries, the AMA continues to sound the alarm to policymakers that a multi-faceted approach is needed, one which includes addressing the leading causes of preventable maternal deaths and investing in the physician workforce to improve access to maternity care. During Black Maternal Health Week, April 11-17, it is particularly important to raise not only awareness of this issue, as it disproportionately affects Black and Native American/Alaska Native pregnant and postpartum individuals, but also to advocate for solutions.
Register for this Advocacy Insights webinar on April 15 at 11:00 a.m. Central time to learn about the AMA’s newly released recommendations on maternal health and what
approaches are needed.
Moderator:
- Willie Underwood III, MD, MSc, MPH, Chair, American Medical Association Board of Trustees
Speakers:
- Maryanne C. Bombaugh, MD, MBA, Mc, Member, Council on Legislation, American Medical Association
- Michael Rakotz, MD, Vice President, Health Outcomes, American Medical Association
- Jennifer Brown, JD, Health Equity Director, Advocacy, American Medical Association
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Physician Vitality Program
The Physician Vitality Program (PVP) offers confidential, affordable, and easily accessible mental health support tailored for Idaho's physicians. It is now available to all medical licensed professionals (physicians, PAs, NPs) who are members of the IMA wherever they practice. PVP was created by Ada County Medical Society in 2016 to address the growing needs of those facing the epidemic of physician burnout, as well as other occupational and personal stressors.
The program provides five confidential appointments at no cost, with a strong emphasis on maintaining the privacy of individuals seeking help. While many clinicians have access to Employee Assistance Programs (EAPs) through their insurance plans, they often hesitate to use them due to genuine or perceived confidentiality concerns. ACMS created its own panel of clinically licensed mental health professionals available throughout Idaho and via telehealth and chose those with a reputation for serving medical clinicians. It is suitable for those seeking help for depression, grief, relationship and work challenges, imposter syndrome, and other issues commonly faced by those who practice medicine.
To determine if you are eligible for services, you may verify your IMA membership at https://www.idmed.org/idaho/Idaho_Public/Physician_Finder/Idaho_Public/Physician_Finder/Search.aspx.
To find out more about this program and access appointments, visit the site by clicking the button below.
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Don't Miss Out!
Memberships not renewed by March 31 are no longer active.
If you would like to reactivate your membership, contact our Membership Department at membership@idmed.org or call our office at (208) 334-7888.
The Idaho Medical Association (IMA) is the leading organization representing physicians in all specialties, practice settings, and geographic locations in our state, and is recognized as the voice of medicine in Idaho. IMA’s mission is to unify and advocate for all Idaho physicians, promote the art and science of medicine, and remain dedicated to improving the health and well-being of all Idahoans.
The IMA has over 4,000 members, all Idaho medical professionals who meet the Association's stringent membership requirements. Predominant membership is comprised of over 2,000 actively practicing physicians, including residents, with the balance of members comprised of retired physicians, physician assistants, nurse practitioners, and medical students.
* Don't forget: If you pay your AMA dues through IMA, IMA benefits.
Visit www.idmed.org or contact us at (208) 334-7888 for more information.
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Don't Miss Out! Ensure Our Emails Reach You
It has come to our attention that some of our important emails may be getting lost in your junk folder. We understand that automated filters can sometimes be a bit overzealous, and we wouldn't want you to miss out on crucial updates from us.
To ensure that you receive our communications directly to your inbox, please consider adding the following email addresses to your safe senders list:
By applying this simple step, you can be confident that you won't overlook any essential information or announcements from the IMA.
Your continued engagement and participation are vital to our community, and we want to make sure you stay connected. Thank you for your attention to this matter.
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