Harris County Medical Society

HCMS held its third annual Disaster Preparedness meeting with the HCMS Council of Hospital Chiefs of Staff, HCMS Council of Specialty Societies, HCMS EMS Committee, and the Houston Emergency Medicine Society on April 21. Pictured from left are: Drs. Steven D. Brown, Herminia Palacio, George D. Santos, David E. Persse, Kelli A. Cohen, and CMOC representative Doug Havron.

"Red flags" rule date pushed to Aug. 1

Largely as a result of AMA advocacy, physician practices now have until Aug. 1 to comply with the Federal Trade Commission's (FTC) "red flags" rule, which requires physicians to institute policies to identify, detect and respond to potential risks of identity theft. The rule originally was to have taken effect May 1, but the FTC voted April 30 to delay the compliance date for three months. The AMA will use this time to convince the FTC and Congress that physicians are not "creditors" and therefore should not be subject to the rule. Click here for more information.

Source: AMA

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Free consults on getting paid

There is still time to schedule your free and private 30-minute reimbursement consultation with a Texas Medical Association (TMA) reimbursement expert at the Southeast location. Consultations are a benefit of membership.

Wednesday, May 20,
9 a.m. to 5 p.m.
Southeast Houston,
250 Blossom, 3rd Floor,
Webster, TX 77598

Call now to schedule your free appointment to learn how you can improve your practice. For more information, email Suzy Pero or call 713-524-4267.

Dr. Fleming installed as TMA President

Dr. William H. Fleming III, former HCMS president, was installed as the president of Texas Medical Association (TMA) at TMA’s annual meeting TexMed on May 2 in Austin. Dr. Fleming just completed a one-year term as TMA’s president-elect. Previously, the Houston neurologist served as speaker of TMA’s House of Delegates, vice speaker and as a member of TMA’s Board of Trustees. He also is a TMA alternate delegate to the American Medical Association’s House of Delegates.

Dr. Fleming is TMA’s first African-American president. Dr. Fleming is a clinical assistant professor of neurology at The University of Texas Medical School at Houston. He also serves on the boards of Memorial Hermann Healthnet Providers, the Gulf Coast Regional Blood Center, and the American Heart Association. Dr. Fleming is board certified by the American Board of Neuromuscular and Electrodiagnostic Medicine. He also recently served on the Joint Quality Review Committee of Houston’s Memorial Hermann Southwest Hospital, and on the Board of Regents of Texas Woman’s University at Denton.

Dr. Fleming also has served in several leadership roles in other state and national medical societies. He was president of the Federation of State Medical Boards of the United States and chair of the State Affairs Committee of the American Academy of Neurology. He has served as president of the Texas State Board of Medical Examiners and the Texas Neurologic Society.

He also has served on the board of directors and in several other roles of several medical organizations.

Other leaders
The TMA House of Delegates, TMA’s policy-making body, elected HCMS President Dr. Lewis E. Foxhall to the TMA Board of Trustees at TexMed in Austin. Also, former HCMS President Dr. Michael E. Speer was elected chair of the TMA Board of Trustees and former HCMS President Dr. Tom Garcia was elected to the TMA Board of Trustees Executive Committee. Dr. Arlo Weltge received the C. Frank Webber MD Award from the TMA’s Medical Student Section. Spencer Pruitt, third-year medical student from The University of Texas Medical School at Houston, was appointed to the TMA Board of Trustees.

Public Health Focus H1N1 (swine flu)

The U.S. Centers for Disease Control and Prevention (CDC) and state and local public health officials are investigating H1N1 (swine flu) cases in people in several U.S. states, including Texas. Texas Department of State Health Services (TDSHS) has established a toll-free swine flu hotline (877-623-6274) and Web site (www.texasflu.org) for physicians and providers with questions about assessing, evaluating and treating swine flu. Please report all suspected swine flu cases to your local health department epidemiologists. Check the HCMS Web site for recommendations on testing and updates. I

If you need testing kits, contact Catastrophic Medical Operations Center (CMOC) at 713-884-4408 or cmoc@cityhouston.net. CMOC is open 8 a.m. to 8 p.m. on Monday-Friday and 9 a.m. to 5 p.m. on Saturday and Sunday. Other resources include Houston Department of Health and Human Services at 713-794-9120 or Harris County Public Health & Environmental Services at 713-439-6000. Remind your patients and staff that the best way to avoid the flu is to have good health habits.
     1. Avoid close contact with sick people. When you are sick, keep your distance from
     others to protect them.
     2. Stay home when you are sick to help prevent others from catching your illness.
     3. Cover your mouth and nose with a tissue when coughing and sneezing.
     4. Wash your hands often.
     5. Avoid touching your eyes, nose or mouth.
     6. Get plenty of rest, exercise, manage your stress, drink plenty of fluids, and eat
     nutritious food.

Presented by the HCMS Community Health Improvement and Communications Committee

President's Page
Dr. Lewis E. Foxhall

President's Page
Dr. Lewis E. Foxhall

News you can use

Keeping abreast of the latest news that affects my practice and the field of medicine is important to me. Forewarned, I can be prepared to respond to particular issues and I can watch out for potential problems. The Harris County Medical Society (HCMS) and Texas Medical Association (TMA) make it easy to stay informed on specific topics, without being inundated with information.

By signing up for HCMS Direct e-mails, you receive e-mails from HCMS only on the topics that you choose. Currently, you can choose to receive by e-mail: HCMS newsletter, managed care and insurance information, public health alerts, medical legislative news, CME opportunities, information on HCMS services and products, and Texas Medical Center Newsletter. Sign up for HCMS Direct e-mails online. Then choose the subjects you would like e-mailed to you. It’s that easy.

In times of disaster, HCMS uses its HCMS Physician Alert System to get word out to physicians by fax or e-mail on recent public health disasters. This service has proved to be invaluable during recent hurricanes, such as Hurricanes Katrina and Ike, and for providing recent health notices on swine flu.

On the HCMS Web site, www.hcms.org, the front page is updated as needed, but at least weekly with new information. On the Web site, you can find information on the business of medicine, managed care and insurance, an updated health plan contact grid, CME opportunities in the area, HCMS and specialty society events on the calendar, legislative and ethics information, respond to meeting invitations online, read back issues of the HCMS newsletter, and much more.

Interested in the latest health information technology news? Subscribe to the TMA HIT Newsletter. In it you will find information on the federal stimulus package; how the success of healthcare IT adoption is tied to identifying the ideal system; how physicians can maximize Medicare bonuses, and more. To subscribe, go to www.texmed.org/ Template.aspx?id=5511.

Want free help with juggling the demands of your practice? Then sign up to receive TMA Practice E-Tips twice a month. This electronic newsletter offers brief, practical tips for managing a medical practice in Texas. Each edition provides hands-on, use-it-now advice on coding, billing, reimbursement, HIPAA compliance, office policies and procedures, practice marketing, and much more, along with useful links for additional information. Your office staff also can subscribe to TMA’s Practice e-Tips. To subscribe, go to www. texmed.org/Template.aspx?id=1492.

Need answers to nonclinical issues related to practice management, TMA membership, benefits and services, and TMA programs and services? Contact the TMA Knowledge Center. The Knowledge Center also provides an alert service that allows users to keep abreast of new articles by subject. The results of searches are e-mailed directly to the user, or can be accessed via RSS feed. The alerts are provided with citations and abstracts with some full-text articles on everything from alternative medicine to professional liability. To see all the topics offered, go to www.texmed.org/Forms/ Process.aspx?formid=4621. You also can visit the Frequently Asked Questions page and look up information on the TMA Web site. Go to www.texmed.org and click on “Knowledge Center” in the left margin or call the Knowledge Center directly at 800-880-7955.

Take advantage of these helpful member benefit resources to stay up-to-date with our rapidly changing practice environment. Information overload is a constant challenge, so don’t miss out on these targeted sources. Get on top of news you can use.

Business of Medicine

Networking between offices

Communicating effectively between multiple office locations can be a challenge. However, advances in communication technologies offer numerous solutions.

     • VoIP. Have you considered using your Internet connection for your phone line? That’s essentially the definition of Voice over Internet Protocol (VoIP). Likely, you already have a data connection between your offices for billing purposes. If so, you can communicate without a separate phone line. Instead, your Internet and phone connection will share the data line. Even though your satellite office is across town, all you will need to do is dial four-digit phone numbers to communicate with anyone associated with your practice. One nice aspect of this approach is an increased ability to bypass the front desk staff, which frees them up to concentrate on incoming and outgoing patients.

     • Conference calls. A conference call, where all parties dial in from their separate locations, can be a real time saver. It is especially effective for a practice with more than one satellite office. The cost per phone can be as low as $.04 per minute, so a 20-minute phone call with three offices involved can be less than $10.

     • Video conferencing. Think of video conferencing as the platinum level of VoIP, as it also is done through the Internet. Various vendors—including Skype, Microsoft, Google, and Yahoo—offer the ability for two sides to see and talk to separately located individuals. Teaching staff, sharing solutions to problems and offering visual responses to statements work well. It offers a better solution than requiring staff members from satellite locations to commute to the main office for meetings.

     • E-mail. Person-to-person communication is almost always preferable to e-mail, which can be easily misconstrued because you lose the sender’s tone-of-voice cues. And too often, e-mail is used to communicate with coworkers who are in close physical proximity – such as those who e-mail a nurse who is literally 10 feet away! However, there are proper, if judicious, uses for e-mail, such as quick communication with satellite offices. This works quite well, as e-mail cuts down on phone tag and off-task chatter, and it creates a written log of conversations.

     • EMR. Yes, even your EMR can assist you with satellite-office communication. Once set up on your network, you can easily transfer information from one office to the next, improving patient care and eliminating the security risk of physically transporting or shipping charts across town.

In no way can you—or should you—replace face-to-face communication. Human interaction always trumps technology. But for cost savings and a more efficient operation, consider using technology in the best way possible for the good of your practice and your patients.

Source: Physicians Practice
Presented by the HCMS Board on Socioeconomics

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Getting paid in 2009

The current economic environment brings a host of new challenges in revenue cycle management. More and more patients have a high-deductible health plan, and many are without insurance coverage. To help you with these challenges, the Texas Medical Association (TMA) has developed a three-part audio seminar series that focuses on proven ways to enhance your revenue cycle. The series will provide a precise and detailed roadmap for strategies related to the pre- and post-visit issues, along with management and metrics. With a focus on performance improvement, these action-oriented initiatives will be ones you can implement immediately!

Audio seminar topics:

Wednesday, June 10, 11 a.m. to Noon
Pre-Encounter
• Financial screening
• Pre-service financial arrangements
• Time-of-service collections
• Addressing financial hardship and charity care
• Insurance verification
• Eligibility deposits

Wednesday, June 17, 11 a.m. to Noon
Post-Encounter
• Insurance and patient collections
• Filing clean, timely claims
• Preventing and managing denials
• Successfully appealing claims
• Collections cycle
• Collections letters
• Managing statements, including paper and online, and working with a collection agency

Wednesday, June 24, 11 a.m. to Noon
Metrics and Measures
• Benchmarking and reporting
• Key performance indicators
• Common mistakes
• Performing an audit, giving you the insight you need

For more information on fees, registration and CME go to: www.texmed.org/ Template.aspx?id=7655, or contact the TMA Knowledge Center at 1-800-880-7955, or Gay Anderson at 1-800-880-1300, ext. 1421, or gay.anderson@ texmed.org.

Source: Texas Medical Association
Presented by the HCMS Board on Socioeconomics

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Medicare Corner

New Medicare enrollment rules

Starting April 1, 2009, the effective date of Medicare billing privileges for newly enrolled physicians is the later of the date of filing or the date they first began furnishing services at a new practice location. Note: The date of filing for Internet-based Provider Enrollment, Chain and Ownership System (PECOS) applications for physicians is the date that TrailBlazer Health received an electronic version of the enrollment application and a signed certification statement that were both processed to completion. Physicians may, however, retrospectively bill for services when:

     1. The supplier has met all program requirements, including state licensure requirements,
         and

     2. The services were provided at the enrolled practice location for up to—
          • 30 days prior to their effective date if circumstances precluded enrollment in
          advance of providing services to Medicare beneficiaries, or
          • 90 days prior to their effective date if a Presidentially-declared disaster under
          the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C.
          §§5121-5206 (Stafford Act) precluded enrollment in advance of providing services
          to Medicare beneficiaries.

For example: * Dr. Smith completed residency and joined a small practice. He began seeing Medicare patients on May 1. On May 25, he filed his Medicare enrollment application by mail. May 25 is his effective billing date. Although Dr. Smith’s Medicare enrollment application was not approved until six weeks later, he can bill Medicare retrospectively for the services he provided starting May 1 because they are within 30 days of his effective billing date.

* Dr. Jones, formerly a partner in a group practice, has been enrolled in Medicare for 10 years and has just opened a solo practice. She reported her change of status and location to Medicare via the online PECOS system on June 15, a week before she moved into her new office. On June 22, she opened her new practice and began seeing Medicare patients that same day. June 22 is her effective billing date. Three days later, she was notified that Medicare had approved her enrollment changes. Dr. Jones can bill Medicare for the services she provided in her new practice starting June 22.

Timeframes for reporting changes of information

Physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives, clinical social workers, clinical psychologists, registered dietitians, nutrition professionals and organizations (e.g., group practices) consisting of any of the categories of individuals identified in this paragraph; the following changes must be reported within 30 days:
     • A change of ownership;
     • A final adverse action;
       Final adverse action means one or more of the following actions:
       (i) A Medicare-imposed revocation of any Medicare billing privileges;
       (ii) Suspension or revocation of a license to provide health care by any State
       licensing authority;
       (iii) Revocation or suspension by an accreditation organization;
       (iv) A conviction of a federal or state felony offense (as defined in §424.535(a)(3)
       (i)) within the last 10 years preceding enrollment, revalidation, or re-enrollment; or
       (v) An exclusion or debarment from participation in a Federal or State health care
       program.
     • A change in practice location.

If a physician does not comply with the reporting requirements relating to, respectively, final adverse actions and practice location changes, the physician may be assessed an overpayment back to the date of the final adverse action or change in practice location.

For a more comprehensive explanation of the changes, go to www.cms.hhs.gov/ MLNMattersArticles/downloads/MM6310.pdf .

To download the Medicare Provider Enrollment Toolkit created by the AMA and MGMA, go to www.ama-assn.org/ama1/x-ama/upload/mm/399/medicare-enrollment-toolkit.pdf on the AMA Web site or MGMA Web site at www.mgma.com. These sites are “members only.”

Sources: TMA, AMA, CMS and TrailBlazer Health
Presented by the HCMS Board on Socioeconomics

JUNE CALENDAR
Visit the calendar online
To register for meetings online, please click here .

TUESDAY 9
Noon, Retired Physicians Organization (RPO), Houston Racquet Club
6:30 p.m., Houston Pediatric Society, TBA

THURSDAY 11
6:30 p.m., Texas Gulf Coast Gastroenterological Society, The Grove

FRIDAY 12
6:30 p.m., Houston Dermatological Society, Houston City Club

SATURDAY-WEDNESDAY 13-17
American Medical Association Annual Meeting, Chicago

THURSDAY 18
6:30 p.m., Houston Otolaryngology, TBA

WEDNESDAY 24
6:30 p.m., Houston Society of Clinical Pathologists, Polo’s

THURSDAY 25
6:30 p.m., Houston Society of Plastic Surgeons, Trevisio

Member Mentions

Dr. Donald R. Butts will be honored as the Distinguished Houston Surgeon for 2009 by the Houston Surgical Society on May 20.

Dr. R. Andrew Harper III, will receive the 2009 Texas Society of Psychiatric Physicians Excellence Award.

Need ethics CME?

Need an ethics CME? Attend the HCMS Southwest Branch meeting on Thursday, May 21. For more information, call HCMS at 713-524-4267, ext. 245 or make an online reservation.

Alief, Sharpstown, Bellaire & Southwest areas
Southwest Branch
6 p.m., Thursday, May 21
Braeburn Country Club
Effective Management of Challenging Patient Encounters
Kenneth G. Davis, MD
1 hour Ethics CME

Doctors needed for Boy Scout Physicals

Physicians are needed to volunteer to provide free physicals to inner-city boys in the Urban Scouting Division on Saturday, June 6, 9 a.m. to noon, at the Boy Scout office, 2225 North Loop West (TC Jester & Loop 610).

The Urban Scouting Division of the Boy Scouts of America was established in 1987 to encourage at-risk boys to become involved in scouting, providing them with leadership skills and challenges in nature. This is the 16th year the Harris County Medical Society will coordinate free physicals for inner-city Boy Scouts. This physical enables the boys, many of whom could not afford it otherwise, to attend summer camp. Summer camp offers opportunities for the boys to earn badges that are necessary for their advancement. Approxi-mately 80 to 100 scouts will benefit from this service.

Lunch will be provided. For more information, e-mail Stefanie Cunanan or call 713-524-4267.

‘HOT’ Member Benefit

Contact Grid for Health Plans in Houston Area

View the Health Plan Grid, for assistance with issues concerning eligibility, benefits, physician portals, lab, provider representatives, inpatient certifications, disease and case management, imaging, DME, home health, unresolved patient care matters, etc. The Harris County Medical Society, in collaboration with health plans, developed the Health Plan Grid with the contact information for many of the health plans in the Houston area to assist physicians. The grid is updated regularly.

Click here to download the grid.

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Filing claims for uninsured evacuees of Hurricanes Dolly & Ike

The State of Texas has received a special Social Services Block Grant from the U.S. Department of Health and Human Services that can be used, in part, to process claims related to 2008’s Hurricanes Ike and Dolly for uninsured evacuees. A Medicaid provider may be reimbursed for services rendered to a hurricane evacuee who is uninsured and is not eligible for Medicaid.

Hurricane Ike and Hurricane Dolly claims are exempt from prior authorization and 95-day filing deadline requirements.

Funds for uninsured evacuees of Hurricanes Dolly and Ike are limited. Claims will be paid only until the funds are exhausted. Physicians are encouraged to file claims as soon as possible.

Claims will be accepted in three stages:

     1. Hurricane Dolly Claims (Dates of service: July 22, 2008- Sept. 19, 2008)
     Hurricane Ike Claims (With FEMA number) (Dates of service: Sept. 7, 2008- Nov. 7,
     2008) Claim submission dates: May 1, 2009- June 30, 2009

     2. Hurricane Ike Claims (Without FEMA number) (Dates of service: Sept. 7, 2008-
     Oct. 5, 2008) Claim submission dates: July 1, 2009- July 31, 2009

     3. Hurricane Ike Claims (Without FEMA number) (Dates of service: Oct. 6, 2008-
     Nov. 7, 2008) Claim submission dates: Aug. 1, 2009- Aug. 31, 2009

For more information on how to file claims, go to www.hcms.org.

Source: TMHP
Presented by the HCMS Board on Socioeconomics

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In Memoriam

Dr. R. E. Hearn, an anesthesiologist, died April 21. He had been a member of HCMS for 45 years.

Dr. Ralph A. Rittenhouse, a family medicine practitioner, died April 26. He had been a member of HCMS for 28 years.

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AMA: Making sure prescribing data is in the hands of physician

The American Medical Association (AMA) has worked hard to ensure that physicians are the ones who decide how their prescribing data are used. The AMA’s Physician Data Restriction Program (PDRP) offers physicians the option to withhold their prescribing data from pharmaceutical sales representatives, while still making it available for medical research purposes. The program also allows physicians to register complaints against sales representatives or pharmaceutical companies who they believe are using their prescribing data inappropriately.

The PDRP is available to all physicians, both AMA members and nonmembers. The AMA became aware that some physicians had concerns regarding the inappropriate use of their prescribing data by pharmaceutical sales representatives. To enroll in the PDRP, visit www.ama-assn.org/go/prescribingdata or call the AMA at 800-621-8335.

Spring Business Expo – Missed it? Attend Fall Expo Nov. 7

The HCMS Spring 2009 Business Expo at Reliant Center was a great success despite the rain. Approximately 200 physicians attended the Expo and enjoyed complimentary CMEs on risk management, important financial ratios to track for their practice, and managed care contracts. More than 60 vendors shared with HCMS members information about their products and services that benefit physicians and their practices.

Many door prizes were given away. The lucky winners included: Belinda Yeh, MD, won a free Practice Listing in the 2010 HCMS/HAM Pictorial Roster; John Hyun, MD, won four passes to the Sam Houston Race Park; Pin Lam, MD, won a weekend at the Crown Plaza Houston Downtown; Roberto Montoya, MD, won a golf weekend at Hyatt Regency Lost Pines Resort & Spa; and Lida Dahm, MD, won a Magellan Roadmate 1212 GPS.

We thank all members and staff who came to the Expo. Please join HCMS on Nov. 7 for the HCMS Fall 2009 Business Expo. For Expo information and photographs, click here.

HCMS nominations due May 29

Nominations for elected positions in 2010 within the Harris County Medical Society (HCMS) are due at HCMS by Friday, May 29. Elections will be held in October. The nominating board will consider qualified candidates for the following elective positions:
     • one position as president elect (one-year term);
     • one position as vice president (one-year term);
     • one position as secretary/treasurer (one-year term);
     • one position as a member-at-large on the Executive Board (four-year term);
     • three positions on the Board of Ethics (three-year terms). Candidates should
       have experience in peer review;
     • three positions on the Board of Medical Legislation (four-year terms);
     • three positions on the Board on Socioeconomics (three-year terms); and
     • alternate delegates to the TMA (two-year terms)

If you are interested in serving or nominating someone to serve on a committee, write in all that apply.
     • Business Community
     • Bylaws
     • Community Health Improvement
     • Emergency Medical Services
     • Health Plan Liaison (formerly Managed Care)
     • Medicaid Forum
     • Membership
     • Mini Internships and Communications
     • Physicians Counseling
     • Public Grievance

To nominate a member online, click here or complete the form below and fax it to 713-942-7072, or mail it to: Harris County Medical Society, Attn: Nominations, 1515 Hermann Drive, Houston, TX 77004-7126. If you make more than one nomination, please photocopy the form. If possible, include letters in support of the candidate.

Source: HCMS Nominating Board

HCMS Nominating Form
(Please Print)

I wish to nominate:_________________________________________________________

For the position of:__________________________________________________________

Name of Nominator:_________________________________________________________

Fax to HCMS at 713-942-7072, by Friday, May 29, 2009

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