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GOVERNOR'S NEWSLETTERApril 2015
In this Issue:
- Hunton to receive ACP Legacy Award
- New Governor-Elect to the Wyoming Chapter of the ACP
- Wyoming Medicaid launches PCMH Case management Fee Program
- WYhealth…Get Plugged In!
- WYhealth Diabetes Incentive Program
- WYhealth Weight Management Programs
From the Governor
James F. Bush, MD, FACP, ACP Governor
Hunton to receive ACP Legacy Award
Cheyenne - Very few awards in this world are truly given out once-in-a-lifetime, but Dr. Don Hunton will receive one of them next month in Boston. Dr. Hunton will receive the ACP's Chapter Centennial Legacy Award for his work in Wyoming with the ACP over 30 years of practicing in Cheyenne.
Wyoming members of the ACP will honor Dr. Hunton on Thursday, April 30 at 8 p.m. at the Legal Harborside, 270 Northern Avenue in Boston. For more information, contact Dr. Jim Bush at 307-777-7245.
The Legacy Award celebrates ACP's centennial by recognizing one seminal chapter member whose service to the chapter had a significant impact on the chapter's viability. This individual should exemplify ACP's core values including leadership, excellence, respect, compassion, professionalism, and responsibility.
"I am greatly honored to receive this award," Hunton said. "I worked hard when I was in practice with the ACP. It was a major focus of my extra curricular activities.
"Belonging to the American College of Physicians and becoming a fellow established you as a good internist," he continued. "We all very much respected any physician who was in the American College and was a Fellow."
Hunton is a Wheatland (Wyo.) native who graduated from the University of Wyoming in 1950 before moving to Rochester (NY) for medical school, as well as an internship. A two-year stint in the Air Force brought him back to Cheyenne before he spent his residency in two different Rochesters (New York and Minn.) before he returned to Cheyenne.
In July of 1961, Hunton said he joined Dr. David Flint and they formed the Internal Medicine Group, where he practiced until he retired on Dec. 1, 1992.
"I liked that we were our own bosses," Hunton said about his time in practice. "We lived in the golden age of medicine when we didn't have government or anyone else telling us how to practice medicine. I liked being able to take good care of our patients and we did do that. It was a great pleasure of taking care of patients."
In nominating him for the award, Dr. Bindschadler emphasized that Dr. Hunton was critical to the formation of the Wyoming chapter of the ACP. "If not for him we would have withered away as a minute part of the Colorado Chapter. Make no mistake, the WY chapter as a stand alone (chapter)… is largely due to his early efforts. "
In addition to his time practicing, Hunton was also very active in Wyoming medicine, serving as the President of the Wyoming Medical Society in 1975, before spending eight years on the State Board of Medicine and then another 12 years on the State Board of Pharmacy, after being appointed by Gov. Mike Sullivan in 1993.
New Governor-Elect to the Wyoming Chapter of the ACP
Congratulations to Dr. Mike Tracy, who is the new Governor- Elect Designee of the Wyoming Chapter of the American College of Physicians. At IM 2015 he will become Governor Elect, and then at IM 2016 he will replace Dr. Jim Bush as Governor through 2020.
Wyoming Medicaid Launches PCMH Case Management Fee Program
Wyoming Medicaid is very pleased to announce the beginning of an exciting new program that will allow Medicaid providers to enroll and receive Case Management Fees in addition to your usual Fee for Service to Medicaid Clients. For 2015 payment will be $3 pmpm, in future years there will be higher and lower rates depending upon clinical quality as reported in your Clinical Quality Measures. Requirements for participation include:
- Ability to function as a Patient Centered Medical Home (PCMH)
- Reporting Clinical Quality Measures (CQM's) into the State Level Registry (SLR)
- Utilizing the Continuity of Care Document viewer
There is no cost to you participation is voluntary. Here are the details and instructions. The link is on the left hand side, titled Patient Centered Medical Home.
WYhealth…Get Plugged In!
Wyoming internists have some great resources available for their complex cases involving diabetics and smokers that they can use at no cost to them or their patients. WYhealth partners with Wyoming Medicaid to provide both behavioral and medical case management to patients with chronic illness and other health related needs across the state. Wyoming providers refer complex Medicaid patients to WYhealth knowing their patients will receive support on following through with the doctor's directions and further understanding of the patient's diagnoses.
For each referral the provider makes to WYhealth, the provider can receive a $50 reimbursement from Medicaid. This reimbursement is part of the Pay 4 Participation (P4P) program. This program includes reimbursement to providers for referrals to WYhealth, diabetes education and reduction of risk counseling. For more information on this program please visit our website.
|S0315||$50.00||Disease Management Program Referral; initial assess-ment and initiation into the program. Must refer patient to the WYhealth Get Plugged In program for disease management. Maximum of one referral per provider per diagnosed disease per new visit.|
|S0316||$25.00||Disease Management Program; follow-up assessment (by physician, PA, NP or PHN). Must reinforce WYhealth Get Plugged In program for established illness.|
SCREENING AND EDUCATION
|99401||$34.97||Preventative medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes. Services may be provided by a physician or nurse practitioner.|
|99406||$13.53||Smoking and tobacco cessation counseling visit; Intermediate, greater than 3 minutes up to 10 minutes, which may include prescription.|
|99407||$25.95||Smoking and tobacco cessation counseling visit; Intensive, greater than 10 minutes.|
|D1206||$35.00||Topical fluoride varnish; therapeutic application for moderate to high risk caries patients. Age approved patients 0-14.|
|G0108||$21.81||Diabetes outpatient self-management training services; Individual session. 1 unit = 30 minutes, maximum of 2 units. Services may be provided by physician, nurse practitioner, and/or designated staff. Must bill under the physician, nurse practitioner or hospital's provider number. Do not bill a separate office visit on the same date of service.|
|G0109||$11.65||Diabetes outpatient self-management training services; Group session (2 or more). 1 unit = 30 minutes, maximum of 5 units per individual per training session. Services may be provided by physician, nurse practitioner, and/or designated staff. Must bill under the physician, nurse practitioner or hospital's provider number. Do not bill a separate office visit on the same date of service.|
|S9446||$21.48||Diabetes patient education, not otherwise classified; non-physician provider; Group (2 or more) per session. 1 unit = 30 minutes. Services may be provided by hospital, nurse practitioner, and/or designated staff. Must bill under the nurse practitioner or hospital's provider number.|
WYhealth Diabetes Incentive Program
WYhealth and the Wyoming Department of Health have teamed up to offer Wyoming Medicaid clients an opportunity to enroll in a diabetes incentive program called "Choice Rewards". This year- long educational program is for Medicaid clients 18 years or older diagnosed with diabetes.
The goal for this program is for those Wyoming Medicaid clients with diabetes to learn and use self-management techniques and live a healthy lifestyle. WYhealth aims to achieve this goal through telephonic coaching utilizing our WYhealth care managers. WYhealth currently has a Certified Diabetes Educator on staff to support the patients in the Choice Rewards program. The care manager will provide education and guidance to the participants. This program is not intended to compete with other educational diabetes programs. It was created to compliment and reinforce the self-care behaviors learned in face to face recognized diabetes programs.
Those that complete the required criteria each quarter in the program, with the assistance of their WYhealth care manager, will receive a $25 incentive card from the Wyoming Department of Health.
With the obvious challenges of diabetes self-management, it is the hope that with the addition of the Choice Reward program, those with diabetes and their families will experience greater success in their diabetes management and minimal long-term complications leading to healthier, happier, and longer lives.
To learn more visit or call WYhealth at 888-545-1710.
WYhealth Weight Management Programs
WYhealth is offering a free, sophisticated weight-management program for your adult Medicaid patients. The program, developed by National Jewish Health, is called FitLogix. WYhealth is accepting self or physician referrals now.
FitLogix is a comprehensive program aimed at those Medicaid clients needing to lose 100 pounds or more, increase physical activity, and inspiration to make healthy lifestyle choices. It provides one-on-one coaching and encouragement toward sustaining these behavioral changes. Participants that complete coaching sessions 3, 6, and 9 will earn a $15 incentive card (up to $75).
The FitLogix program runs 52 weeks. It is composed of self-paced learning modules and also includes one-on-one coaching calls. In addition, the program provides free of charge to the patient a wireless digital scale and activity meter. FitLogix clients also have access to an online interactive program which is tailored to each person's needs and offers online chat support.
In addition to FitLogix, the Wyoming Department of Health is offering QuitFit for those that want to quit smoking and lose or maintain their weight. This is a six month long program provided free of charge, using the Wyoming Quit Tobacco Program and a modified FitLogix program to help patients quit smoking and lose weight.
A third option for weight management is 12 Healthy Habits. This program is for clients to learn the skills for a healthy lifestyle at their own pace. The 12 Healthy Habits is for youth and adults.
Here is more information on these programs.
WYhealth's team is experienced in care management and supporting the Wyoming Medicaid patient achieves their health goals. For more information, call 888-545-1710 or download referral forms and fax to (888) 245-1928.