Practice Manager Insider

Free Medicare Remittance Advice Software

If you are still using Standard Paper Remittance (SPR), the free Medicare Remit Easy Print (MREP) software offered by the Centers for Medicare & Medicaid Services (CMS) may save you time and money. The software will allow physicians to view and print Health Insurance Portability and Accountability Act (HIPAA) compliant Electronic Remittance Advice (ERA) files from their computers. MREP is designed to allow practice managers to:

•    Print the ERA in the SPR format
•    Print remittance information as soon as the HIPAA is available
•    Execute reports concerning denied, adjusted, and deductible applied claims
•    Find claims information easily using a customized search
•    Electronically store remittance advice records

CMS’s Provider Communications Group offers a Medicare Remit Easy Print (MREP) software brochure that can be used during provider outreach and training activities.

New Book: Cutting Costs in the Medical Practice, 2nd Edition, by Whiteman, Hermanson, and Palkon

With the 2006 Medicare physician reimbursement cuts and planned restructuring of off-label chemotherapy drug coverage looming, it’s crucial that oncology practice managers maximize cost efficiency in order to realize a profit. Cutting Costs in the Medical Practice, recently released by Greenbranch Publishing, provides “no-nonsense practical guidelines for approaching cost containment issues within the practice” to address these concerns.  Topics include:

• Identifying areas of financial concern
• Optimizing organizational structures
• Finding cost savings through participation with affiliated organizations
• Implementing evolving technologies, such as EMRs, to cut costs
• Recruiting and retaining practitioners

Alan S. Whiteman, PhD, FACMPE, has almost 30 years of experience managing and consulting with physician practices; Jerry Hermanson, MBA, CHE, has extensive experience in hospital and healthcare administration; and Dennis Palkon, PhD, MPH, MSW, is a full professor and past chairman of Health Administration at Florida Atlantic University in Boca Raton.

More Time to Enroll in Medicare Part D Drug Plan?

In response to confusion surrounding enrollment in the Medicare Part D Senior drug plan, Congressmen Pete Stark (D-Calif) and Jan Sharkowsky (D-Ill) have introduced legislation that would extend the application deadline from May 15, 2006, to December 31, 2006. Stark indicated that giving seniors an extra 6 months to choose plans would “provide beneficiaries extra protection during the first year of this complex new program so they won’t feel pressured into making a bad choice.” In addition, the bill would allow seniors to change plans within the first year and would prevent companies from canceling retiree health benefits for 1 year.

Codemistress Interviewed on 2006 HCPCS

The changes in the recently released 2006 Healthcare Common Procedure Coding System (HCPCS), which go into effect January 1, 2006, with no grace period, will have a significant effect on coding procedures for oncology practice managers. Practice Manager Insider interviewed editorial board member, Roberta “Bobbi” Buell, MBA, a private healthcare consultant and author of the coding newsletter, “Codemistress Comments” regarding the impact of these changes.

Listen to an audio recording of the interview here.

Medicare Part D Prescription Drug Plan’s E-Prescribing Program

Medicare beneficiaries are not the only ones confronted with important choices in the face of the January 1, 2006, start date of Medicare’s new prescription drug plan. Oncology practices will also face a decision as to whether their physicians will make use of Medicare Part D Prescription Drug Plan’s e-prescribing program. Participation by physicians and pharmacies is optional; however, if they choose to participate, they must comply with the Electronic Prescribing Standards, which were published by Centers for Medicare & Medicaid Services on November 7, 2005. “These standards will allow Medicare, physicians, hospitals, group practices, other health providers, and prescription drug plan sponsors and Medicare Advantage organizations to take advantage of e-prescribing technology, to improve medication prescribing for Medicare beneficiaries that participate in the new prescription drug program,” said Mike Leavitt, Secretary of Health and Human Services. All Medicare Part D Prescription Drug plan providers are required to support electronic prescribing, in an effort to encourage all physicians to eventually utilize this new and evolving technology.

Get Ready for Medicare Part D

Get ready for the whirlwind of confusion that will accompany the November 15, 2005 sign-up for the Medicare Part D Prescription Drug Plan (PDP). Medicare recipients, 65 years of age and older, will be attempting to decipher how to choose the PDP that best suits their needs. The Center for Medicare & Medicaid Services (CMS) has blanketed the market with a slew of services, including an online PDP plan chooser, a website to educate beneficiaries regarding Medicare Internet search techniques, and numerous television ads. Nonetheless, confusion already surrounds the complicated choices seniors face. In an ominously titled web article, Confusion Is Top Response at Sessions on RX Plan, William Q. Beard, a 73-year-old retired chemist from Wichita, Kansas, who takes eight prescription drugs including several heart medicines, commented, “I have a PhD and it’s too complicated to suit me. . . . I wonder how the vast majority of beneficiaries will handle this.” Similar sentiments have been echoed in national newspapers and television broadcasts this week. Mike Leavitt, Secretary of Health and Human Services, said that in addition to the CMS plan chooser, beneficiaries can get help sorting through their options by calling, toll-free: 1-800-633-4227. Patients can also be referred to local seminars. It’s time to consider what you can do to make this difficult and important choice easier for your patients.                                       
                                                   

Medicare Coverage Restricts Off-label Cancer Treatment

Oncology drugs are frequently used off-label, but reimbursement can be tricky. A recent study presented at the Association of Community Cancer Centers (ACCC) 2005 National Oncology Economics Conference showed that a noteworthy percentage of oncologists alter their cancer treatment plans as a result of coverage limitations placed on off-label drug use. These results challenge optimism regarding the Centers for Medicare & Medicaid Services (CMS) press release, Medicare Launches Effort to Improve Cancer Care, which proclaims the expansion of efforts to increase access to care through evidence-based coverage using clinical data. The study concludes that further research is needed to determine how Medicare reimbursement policies may impact access to off-label drug use in cancer care. Christian G. Downs, JD, MHA, executive director of ACCC, told Practice Manager Insider, “The most important aspect of off-label drug use, whether we are speaking about deemed compendia, or any Medicare proposal, is that oncologists have maximum choice in treating their patients.”

Voluntary Quality Reporting for Physicians

Center for Medicare and Medicaid Services (CMS) is establishing the Physician Voluntary Reporting Program to reduce the impact of planned Medicare payment cuts that will occur over the next 7 years. “Physicians are in the best position to know what can work best to improve their own practices and ultimately the quality of care available to all patients,” CMS administrator, Mark B. McClellan, MD, PhD, said. “Through these voluntary reports by physicians on evidence-based quality measures, we can take an important step together to help them improve care, and ultimately to help make sure that they are adequately compensated for that care.” During the first phase of the program, physicians will record clinical data through the use of dedicated HCPCS codes, which will be submitted along with the claims information they currently send to CMS. The ultimate goal is for CMS to receive the data through an electronic health records system, which they intend to develop in the coming years.