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Issue Briefs

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    The ISMS Division of Health Policy Research and Advocacy assists members by decoding the myriad rules and regulations that apply to the medical profession.

    Our Issue Briefs aim to equip member physicians with practical information and resources to help them run their practices.


  • 2021
    • Telemedicine in Illinois: Emergency Measures Made Permanent
      August 2021 - On July 21, 2021, Governor Pritzker signed a new law (Public Act 102-0104) that expands access to telemedicine services for patients throughout Illinois. The new law makes permanent many of the emergency telemedicine rules that were authorized during COVID-19.
    • New Federal Rule on Information Blocking and the Release of Electronic Health Information
      March 2021 - In 2016, the 21st Century Cures Act was signed into law. The Cures Act includes provisions to promote interoperability of electronic health records (EHR) and prevent entities, including physicians, from "information locking," a practice that impedes access to and the exchange of relevant information contained in an individual’s electronic health record.
    • Medicare Quality Payment Program For 2021
      March 2021 - This year marks the fifth year of the Centers for Medicare and Medicaid Services’ (CMS’) implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA ushered in a new Medicare payment system, the Quality Payment Program (QPP), which was intended to promote high-value care that yielded lower costs and improved patient outcomes.
  • 2020
    • Changes Ahead for Office-Based and Other Outpatient Evaluation and Management Codes
      December 2020 - In late 2019, the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel issued new coding guidance for office and other outpatient evaluation and management (E/M) services. The changes are included in the CPT 2021 code set, and are among the most significant changes made to E/M coding guidance in a quarter century.
    • An Illinois Focus on Physician Wellbeing
      October 2020 - Even in the best of times, being a physician can be stressful. The very nature of the profession means that doctors feel a deep sense of responsibility and commitment to their patients, a privilege that often provides a sense of joy and satisfaction, but occasionally brings feelings of despair and helplessness when compassion is the only instrument left in the medicine bag.
    • Combating Prescription Drug Misuse and Abuse: Physician and Patient Roles and Responsibilities for Disposal of Unused Medications
      ISMS-unlock September 2020 - As the country grapples with an opioid epidemic, a frontline of this battle is preventing unused medications from getting into the hands of those who might misuse them. Appropriate disposal of unused medications is paramount for success in this area; however, it is also important to dispose of these medications without harming the environment or others.
    • Overview of Federal COVID-19 Regulatory Changes Impacting Credentialing and Scope of Practice
      April 2020 - As part of its effort to combat the coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) has relaxed rules related to credentialing and scope of practice in order to expand the medical workforce. These are changes in Federal rules, thus waiver authority only applies to Federal requirements and the waivers do not apply to Illinois statutory or regulatory requirements for licensure or scope of practice.
    • Medicare Quality Payment Program (includes COVID-19 update)
      March 2020 - This year marks the fourth year of the Centers for Medicare and Medicaid Services’ (CMS’) implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA ushered in a new Medicare payment system, the Quality Payment Program (QPP), which was intended to promote high-value care that yielded lower costs and improved patient outcomes. 
  • 2019
    • On the Horizon: An Expedited System for Multi-State Practice
      October 2019 - In July of 2015, Illinois became the eleventh state to join the Interstate Medical Licensure Compact. Two years after establishing the system, the Illinois application process came online in September 2017. This initiative, spearheaded by the Federation of State Medical Boards (FSMB) and supported by the Illinois State Medical Society (ISMS), now provides an expedited process for eligible physicians to obtain medical licenses in other states participating in the Compact.
    • Helping Patients Understand The Cost Of Medical Services
      June 2019 - This resource is designed to help health professionals walk patients through a complete understanding of how health insurance works; what their particular plan covers, and how its cost-sharing provisions are structured; how to find cost estimates for specific treatments and bundles of care; and how to bring all this knowledge together to make informed decisions about their care.
    • Dense Breast Notification: New Responsibilities for Physicians in Illinois
      May 2019 - Illinois Public Act 100-0749 was signed into law in 2018 and requires health professionals to notify individuals via a summary of the mammography report if the mammogram indicates the individual has dense breast tissue. The law requires notification only, and does not establish any other obligations for a physician or the healthcare team.
  • 2018
    • Federation of State Medical Boards Guidelines for the Chronic Use of Opioid Analgesics
      September 2018 - Illinois Governor Rauner issued an Executive Order in August 2017 directing the Illinois Department of Financial and Professional Regulation (IDFPR) to establish opioid prescribing guidelines for physicians. Later that year, IDFPR proposed to incorporate the Guidelines for the Chronic Use of Opioid Analgesics issued by the Federation of State Medical Boards (FSMB) by reference into its medical disciplinary proceedings rules.
    • The Illinois Prescription Monitoring Program
      March 2018 - The PMP is an electronic database that collects information on Schedule II, III, IV, and V controlled substance prescriptions. This prescription data is reported to the PMP database on a daily basis by retail pharmacies dispensing in Illinois.
    • Modifier -25: Billing separately identifiable E/M services at the same encounter as a minor procedure
      March 2018 - The purpose of this Issue Brief is to provide information to assist physicians in understanding how to properly code and document evaluation and management (E/M) services provided on the same day as a procedure.
    • Privacy Protection in the Digital Age: The Threat Posed by Ransomware
      March 2018 - The modern privacy era in health care began with the passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996. During the past two decades, HIPAA has changed significantly through legislative and rule-making processes, with the bulk of those efforts focused on protection of patient’s personal information. Physicians, health centers and hospitals are often on the front lines of those efforts, spending significant time, resources and money to comply with procedures required by the Department of Health and Human Services’ (HHS) Office of Civil Rights (OCR).
    • 'Incident To' Explained
      January 2018 - "Incident to" refers to professional services that are provided by a non-physician (e.g. advanced practice registered nurses, physician assistants, or psychologists), but are billed by a physician supervising the services as if the physician provided the service in its entirety – in other words, the services were provided incident to the physician’s own provision of care.
    • Telemedicine Principles
      January 2018 - Various telemedicine technologies have been available for over 40 years, but interest in and demand for telemedicine services are increasing. Telemedicine is growing in popularity because of its potential to increase access to care, lower costs, and make certain types of medical visits more convenient for patients.
  • 2017
  • 2016
    • New Federal Overtime Rules: Understanding the Change and Successful Compliance
      July 2016 - On May 18, 2016, the United States Department of Labor (DOL) announced new federal rules governing overtime. The new regulations will have a significant impact on the number of individuals receiving overtime pay. The impact of the new rule on the health care industry is expected to be substantial, and ISMS has developed this Issue Brief to help physicians prepare their practices.
    • The SGR is History: What Physicians Need to Know
      Updated March 2016 - The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, Public Law 114-10), which finally repealed the sustainable growth rate formula (SGR), includes provisions that will significantly affect the way physicians practice and get paid for caring for Medicare patients.
  • 2015
    • IMPACT: Illinois Medicaid Program Advanced Cloud Technology
      July 2015 - The State of Illinois is revamping its current Medicaid management information system (MMIS) by moving to a web-based process called IMPACT. This general overview of the initiative will address who is affected by this transition, why the transition is occurring and what it means for physicians.
  • 2014
    • Why am I Being Charged for Services That Were Part of My Annual Visit or Preventive Care?
      ISMS-unlockAugust 2014 - The Affordable Care Act expanded coverage for preventive care and screening services. It eliminated the assessment of co-pays, co-insurance amounts, and deductibles for preventive, well care, annual exams and certain preventive screenings when it is determined that these services are being provided to prevent illness and detect first signs of disease.
    • Medicare Advantage Plans: The Basics for Physicians and Patients
      ISMS-unlock June 2014 - Medicare Advantage (MA) plans – also known as Medicare Part C or Medicare replacement plans – were born out of the Balanced Budget Act of 1997. MA plans are similar to commercial managed care insurance plans in that patients enroll in a managed care plan where services are sought from a network of participating physicians and health systems.

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