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November 2014
In this Issue
  • Top ISMS Headlines November 21, 2014


    State Lawmakers Take Action on Medical Practice Act, Anatomic Pathology Billing

    The 98th General Assembly convened earlier this week for the fall veto session. At press time, here's the latest news of importance to Illinois physicians.

    >>  Read more


    Planning to Change Your Medicare Participation Status for 2015?

    Toward the end of each year, physicians can decide if they want to change their Medicare participation status for the following year.

    However, the Medicare Physician Fee Schedule is not finalized yet due to inaction on Medicare's sustainable growth rate (SGR) formula. Unless Congress acts to either repeal the SGR or provide yet another "payment patch," a 21.2 percent Medicare payment cut will automatically go into effect on April 1, 2015.

    With payment issues in question, having to decide in 2014 whether to participate in Medicare in 2015 lands doctors in a timing dilemma.

    So here's what to do.

    >> Read more

    Be Aware of Molina's Update for Prior Authorization

    Molina Healthcare of Illinois, one of Medicaid's new care coordination entities, issued an updated version of its Prior Authorization/Pre-Service Review Guide last month, which applies to all of Molina's Medicaid and Dual Options Medicare-Medicaid members.

    For more info about the modifications to the guide, call Molina staff at 855-866-5462.

    Also check out ISMS' Issue Brief, Medicaid Mandatory Managed Care, for members only.

    HFS Updates:
    More Latitude for Preventive Visits; Policy Changes, Payment Increases for Family Planning

    As a result of ISMS advocacy, the Illinois Department of Health and Family Services (HFS) amended its policy on time limits for preventive services, such as school physicals.

    ISMS brought to HFS examples of situations in which more frequent billing of these preventive services was appropriate. HFS agreed, and physicians may now re-bill HFS for any denied preventive visit claims (Error Code X11) incurred between Nov. 1, 2012, and Sept. 15, 2014. Here's how.

    HFS also issued a notice this month detailing family planning policy changes and payment increases pertaining to contraceptive education and services. These latest updates are now available online.


    medmarijuanaGet "Up to Snuff" on Medical Cannabis

    Are you getting patient inquires related to the Compassionate Use of Medical Cannabis Pilot Program?

    Stay ahead of the curve on how to navigate this trial program by accessing these resources:

    Questions? Please call 800-782-4767 ext. 6485 or send an email.

    Ebola Expert "Hits the Mark" on How Docs Should Prepare

    At the recent 2014 AMA Interim Meeting in Dallas, an expert from the Centers for Disease Control and Prevention and captain in the U.S. Public Health Service, Arjun Srinivasan, MD, specified how physicians can prepare for Ebola patients in hospital and ambulatory care settings.

    Watch the archived video of Dr. Srinivasan's presentation.

    turkeyTake a Bite out of Obesity this Holiday Season

    A new report out this week by McKinsey Global Institute states that nearly 30 percent of the global population is overweight or obese. That's more than 2.1 billion people!

    With the holidays upon us along with the temptation to overindulge, it's a good time to be reminded of healthy eating habits and the importance of exercise as a daily routine. Check out ISMS' webpage for tips, tools and links to more info on healthy lifestyle choices.


    Digitize Your Practice Data - At a Discount

    Secure, store and retrieve your practice data with athenahealth, an ISMS Benefit Partner that helps medical offices "go digital." You'll achieve faster online billing, reduced dependency on paper and easy-to-search electronic health records.

    Practices with 100 percent ISMS membership are eligible for a 6 percent discount on athenaCollector®, a physician billing and practice management software.

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