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October 2013


From the Governor

ACA Communication Directory Quick Guide

For your information the Family and Social Services Administration (FSSA) has developed the attached reference document entitled “The Affordable Care Act Communication Directory Quick Reference Guide”. This document was developed to ensure individuals who have questions about the implementation of the Affordable Care Act in Indiana, or other health coverage related questions, can be directed to the appropriate resource. It may not cover all situations that arise. Individual circumstances may vary. We thought you would find this to be a useful reference source.

J. Matthew Neal, MD, MBA, FACP
Governor, Indiana Chapter

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Congratulations to Our New ISMA President!

Dr. Azad

Congratulations to one of our Council members—Deepak Azad, MD, FACP—who has just assumed the role of President of the Indiana State Medical Association for the 2013-14 year. I am sure that Dr. Azad will provide tremendous leadership to the ISMA. Dr. Azad replaces Dr. Gordon Hughes, MD, FACP, another Indiana Chapter member.

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Registration is Still Open for the 2013 Indiana Chapter Meeting!

November 15-16, 2013
The Marten House Hotel & Lilly Conference Center
Indianapolis, IN

Visit our News & Meetings page to register!

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New, Free CME is available from Annals of Internal Medicine!

Introducing The Consult Guys! A unique and entertaining way to earn FREE CME from Annals of Internal Medicine!

The Consult Guys make learning a pleasure!

Hosted by Geno Merli & Howard Weitz, two, seasoned clinicians, educators, and comedians who answer questions from preoperative evaluations to clinical puzzlers. Each episode reviews topics essential for anyone practicing internal medicine or its subspecialties.

Enjoy, learn, and laugh while Geno and Howard entertain and teach you on their medical consult talk show:

  1. Watch the videos and then take the companion CME quizzes
  2. ACP Members and Annals subscribers can earn .5 CME credit per quiz. Nonmembers can purchase tokens for CME.
  3. 2 premier episodes are available now.

Episode 1: Cleared for Surgery? Perioperative Risk Assessment
Episode 2: Stumper: A 23 year old with a myocardial infarction - will you get the right diagnosis?

  1. Tune into a new episode each month.

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Indiana Chapter Seeking ACP Services Leadership!

The Indiana Chapter is seeking an individual for the position of ACP Services President. ACP Services is the advocacy (C-6) division committed to supporting efforts that improve the practice of internal medicine. Our mission is to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of internal medicine.

Dr. Bob Crook has served the Chapter admirably in this position for the last several years; however, Bob has relocated back to Ohio (where he was very involved in the Chapter there before) and we are seeking someone to fill his shoes.

A major responsibility of the ACP Services President position is to help coordinate and organize ACP’s annual Leadership Day. This event provides an opportunity for ACP and our members to increase our presence in Washington and bring visibility to issues of common concern. Participants receive a comprehensive orientation and briefing on ACP’s top legislative priorities and then have an opportunity to meet with legislators and the staff on Capitol Hill.

If you know of someone who has an interest in this position (or if you are interested yourself) please contact me or Donna Seawards.

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The Physician & Practice Timeline: Upcoming deadline, October 15, for PQRS & VBP

ACP’s new resource, the Physician & Practice Timeline, assists members in keeping track of various upcoming important dates related to a variety of regulatory, payment, educational, and delivery system changes and requirements. This tool outlines various important programs that physicians and their practices should be aware of.

An important upcoming date for the Physician Quality and Reporting System (PQRS) is October 15, 2013. This is the last day for physicians to register for 2013 PQRS group reporting and be on their way to avoid the 1.5% PQRS penalty and the 1% Value Based Payment (VBP) penalty in 2015. Group practice registering for the group practice reporting option (GPRO) for the 2013 PQRS reporting period must use the Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System to elect their reporting method. Group practices should use the PV-PQRS Registration system to select or change their PQRS group reporting mechanism for 2013 if they plan on using one of the following reporting mechanisms: GPRO-Web interface, registry reporting, or CMS-calculated administrative claims reporting mechanism. In addition, group practices should also use this system to elect quality tiering for the value based payment (VBP) program, if applicable, to calculate the VBP modifier. The VBP only applies to groups of 100 or more eligible professionals during this first year of implementation. Individual eligible professionals must also use this system to select the CMS-calculated administrative claims reporting mechanism in 2013 to avoid the PQRS payment adjustment in 2015.

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Join ACP’s Special Interest Groups!

ACP’s Special Interest Groups – an online forum for members only – provide members with a place to engage in discussions, share ideas, and support one another professionally and personally.

Participate by joining as many groups as you'd like, then connect with ACP members from all over the world with similar interests. Groups include:

African American Members | ACOs/New Practice Models | Caring for Adults with Developmental Disability | Clinical Problem-Solving | Clinical Research | Emerging Technologies | High Value Care | Hospital Medicine | LGBT Health | Maintenance of Certification | MKSAP | Physician Educators | Small Practices | Volunteerism | Women in Medicine | Work/Life Balance | Working Abroad

Join today.

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Items of Interest

Despite Government Shutdown, ACA Exchanges Open For Enrollment.

With health insurances exchanges set to begin taking applications from consumers on Tuesday, the Obama Administration on Monday stepped up its efforts to get Americans to sign up for coverage. The opening of the exchanges was covered by all three network news broadcasts last evening and is covered by several major print sources as well as two wire services and many local papers this morning. The coverage is notable in that it downplays the launch, occurring while the government enters a shutdown which is dominating the news cycle. In addition to that, many of the outlets acknowledge the glitches and confusion surrounding the marketplaces as they open.

ABC World News reported that amid the budget battle with Congress, “the President says he will not stop that other historic event about to take place tonight at midnight, Obamacare.” ABC noted that “50 million uninsured will be able to start shopping tomorrow.” The CBS Evening News also reported on the opening of the exchanges.

Reuters (10/1, Morgan, Begley) reports that the Obama Administration has stepped up its push to get Americans to sign up for health insurance under the ACA. Vice President Biden and HHS Secretary Sebelius encouraged uninsured Americans to ignore the congressional fight and focus on their families’ need for access to medical services.

The Los Angeles Times (10/1, Levey) reports that the Affordable Care Act is “full steam ahead,” despite “persistent anxiety over possible technical problems and intense opposition from Republican critics.

The New York Times (10/1, Kopicki, Subscription Publication) reports on several polls which have found “widespread misconceptions” about the Affordable Care Act, including the fact that “nearly two-thirds of those polled said they did not know that the health insurance exchanges were set to open on Oct. 1.” Moreover, nearly three-fourths of uninsured Americans are unaware of Tuesday’s significance.

The Wall Street Journal (10/1, Radnofsky, Subscription Publication) reports that the ACA looks very different than the bill the President signed 3 1/2 years ago. The Journal notes that the Federal government is running most of the new healthcare marketplaces instead of the states, as originally planned. In addition, key provisions of the bill, including the employer mandate, have been delayed.

Additional coverage of the exchange launch is offered by Bloomberg News (10/1, Wayne, Nussbaum), the Washington Post (10/1, Tumulty), Kaiser Health News (10/1, Galewitz), NBC News (10/1, Connor), Politico (10/1, Nather), Roll Call (10/1, Subscription Publication), The Hill (10/1, Hattem) “Regwatch” blog, the Chicago Sun-Times (10/1, Thomas), the Miami Herald (10/1, Chang), the Denver Post (10/1), CQ (10/1, Adams, Subscription Publication), The Hill (10/1, Garland) “Tube” blog, Politico (10/1, Kopan), The Hill (10/1, Viebeck) “Healthwatch” blog, and the Huffington Post (10/1, Blumenthal).

An Agency-By-Agency Rundown of Who Gets Furloughed

A government shutdown this week would interrupt some services and potentially jeopardize the paychecks of more than 800,000 federal workers. Find out where the cuts will fall. (WASHINGTON POST)

Insurers Fight Back Against Cost Of Covering Psychiatric Care Under ACA.

The New York Times (9/28, BU1, Abelson, Subscription Publication) reported on continuing battles patients fight to have mental healthcare covered by insurers, a situation the Times says is unlikely to get better until Federal regulators write the rules for parity under the Affordable Care Act. Until then, the effect of the law is “still unclear.” Despite the earlier Mental Health Parity and Addiction Equity Act of 2008, which is generally agreed to have “fallen short of its goal,” patients often owe thousands for treatment of serious mental illness. The Times says that’s partly because there’s little agreement or generally accepted standards of care for “how mental illness should be treated – and at what cost.”

Medical Device Tax Is A Main Target In ACA Repeal Attempts.

The Washington Post (9/29, Kliff) “Wonkblog” reported on how the 2.3 percent medical device sales tax came to play a central role in a threatened government shutdown. The tax, expected to generate $29 billion over 10 years, is designed to plow back money to help pay for the Affordable Care Act. The Post backgrounds why Republicans and some Democrats have backed its repeal, largely because of industry jobs in Massachusetts and Minnesota. Industry also has fought the tax hard, citing stifled innovation and job losses, but “the White House doesn’t buy it.” The Post concluded that “repeal of the medical device tax is a nonstarter.

Americans Ponder ACA With Range Of Health Issues, Questions.

The New York Times (9/29, BU1, Thomas, Abelson, Subscription Publication) examines the health and medical care of a series of Americans, showing what insurance they have – or don’t – now, and how they view the opening of the Affordable Care Act’s insurance exchanges. The Times says some “will need no persuading to sign up,” but “for others the decision will amount to a series of complicated calculations that would challenge an accounting whiz, let alone an ordinary human.” It provides the vignettes of the expected consumers, who range from the young and healthy and marginally employed to one over-50 couple already facing a medical bill of nearly $1 million for leukemia.

Bloomberg News (9/29, Nussbaum) provides a question-and-answer “primer” on the ACA and notes “it may be as late as April before it’s clear how many uninsured Americans sign up” for insurance on its exchanges. It also says that “building the exchanges has been a massive technical lift” and “glitches are inevitable; the question is how serious they may be and how long it takes to fix them.”

In a news analysis in the New York Times (9/29, Subscription Publication), healthcare reporter Elizabeth Rosenthal analyzes the Affordable Care Act. She says experts suggest that the question of whether the ACA is actually delivering affordable healthcare depends “on patients’ needs, where they live and – importantly – their preconceptions of what health insurance” should do.

Enforcement Of New Medicare Observation Rule Delayed.

In continuing coverage, the Kaiser Health News (9/27, Jaffe) “Capsules” blog reported that on Thursday, officials with Medicare made the announcement that “they will delay enforcement of controversial new rules that define when hospital patients should receive observation care, rather than being admitted, a distinction that makes beneficiaries ineligible for follow-up nursing home coverage.” While the new rules go into effect on Oct. 1, “officials said they will not be enforced until at least Jan. 1.” Under the new rules, hospitals will be required “to admit a patient who is expected to stay through at least two midnights.”

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Contact Information

Indiana Chapter Governor:
J. Matthew Neal, MD, MBA, CPE, FACP, FACE
Email: jneal6@iuhealth.org
(765) 747-4350; Fax (765) 751-1451

Donna Seawards
Executive Director
Email: donnaseawards@gmail.com
Ph: 224-356-6101

Chapter Address:
4319 West Clara Lane, PMB #288
Muncie, Indiana 47304