BREAKING NEWS FOR ALL
CMS PROPOSED FEE CHANGES NOW OPEN FOR
2007 PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI)
by Jeffrey Kaufman, M.D., FACS
PQRI is upon us. Although reporting efforts will ultimately be reimbursed, many have felt that the potential payment available was not worth the effort involved (at least 80% compliance with at least 3 different applicable criteria is eligible for a bonus payment up to a maximum of 1.5% of all Medicare allowable charges for the interval involved capped by a complicated formula related to the volume fo reported events). READ MORE...
WESTERN SECTION AUA SOCIOECONOMICS FORUM
by Jeffrey Kaufman, M.D., FACS
We hope that you and your partners are planning to join us at the Western Section meeting in Scottsdale this October. The socioeconomics forum already has an excellent program scheduled for Sunday, October 28.
Emphasizing economic issues, we will have an update on the P4P program and new coding tips. READ MORE...
CMS PROPOSED FEE CHANGES NOW OPEN FOR COMMENT
On July 2nd CMS made available for viewing on its website proposed regulations and commentary that would materially affect the manner in which urologists have historically exploited ancillary revenue opportunities. The new proposed regulations and commentary are expected to be published in the Federal Register on July 12. The proposed regulations and commentary cover 924 pages, and comments are being solicited by CMS until 5 p.m. August 31, 2007. The regulations and commentary most material to urology practices are summarized below:
We will provide you with additional guidance in the near
future to assist you in timely preparing and submitting comments to CMS
regarding the proposed regulations.
regulations certainly threaten many urology ancillary income opportunities
but, more importantly, raise serious concerns with patient care and
This update on the new proposed regulations was prepared and submitted by Greg L. Smith, a healthcare attorney practicing with Womble Carlyle Sandridge & Rice, PLLC, and specializing in urology-based ancillary revenue opportunities. Greg can be reached at email@example.com and 336-721-3665.
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PQRI is upon us. Although reporting efforts will
ultimately be reimbursed, many have felt that the potential payment
available was not worth the effort involved (at least 80% compliance with
at least 3 different applicable criteria is eligible for a bonus payment
up to a maximum of 1.5% of all Medicare allowable charges for the interval
involved capped by a complicated formula related to the volume of reported
events). Certainly this is
true if reporting takes significant work, thought, energy or
overhead. However, if the
process can be made streamlined and effortless by automating your
reporting, then the financial reward is an attractive addition to your
If reporting requires you
to search through your records, expend any mental energy considering which
code to use and when, or spend any time deciding how to enter the CPT II
information, then the financial rewards are insufficient to warrant your
participation. However, a
little planning up front should allow the process to become routine and
automatic and thus cost effective.
This shouldn't be a problem for those with EMR. However, even for paper based
offices like ours, we have developed a simplified system that will involve
a minimum of effort and allow us to participate with virtually no increase
in time, energy or overhead costs.
The goal is
to simplify reporting and minimize our workload.
To further simplify our
participation, we have elected to ignore all exclusionary modifiers for
the present (1P, 2P, 3P or 8P) since we virtually always have done the
work that the PQRI reporting addresses. In the future, these explanations for why the event was not
performed even though reported may become more appropriate.
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AUA SOCIOECONOMICS FORUM
Disclaimer: The "CUA 4.5 Frontline Briefing" e-bulletin is published by the California Urological Association as a service to CUA members. Your comments are welcomed. The California Urological Association, Inc. (CUA) believes the information in this newsletter is as authoritative and accurate as is reasonably possible and that the sources of information used in preparation are reliable, but no assurance or warranty of completeness or accuracy is intended or given, and all warranties of any kind are disclaimed. This newsletter is not intended as legal advice nor is the CUA engaged in rendering legal or other professional services.