Medical Record Summer 2012 by Hoffmann Publishing Group

Summer 2012

Medical Record o f

t h e

B e r k s

C o u n t y

M e d i c a l

S o c i e t y

ical Society

Pennsylvania Med

Berks County Medical Society

Why Berks Physicians Should Care About the Rest of PA.......................... 22 Social Media and Your Practice, Should Facebook Be A Part of Your Marketing Plan?............... 10 Alliance Updates: A Lesson In the Power of Perspective ...............12 BCMS News: Legislative Breakfast, Residentsâ&#x20AC;&#x2122; Day ........................21 Presorted Standard U.S. Postage PAID Permit #213 State College, PA

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Medical Record

of the Berks County Medical Society

A Quarterly Publication To provide news and opinion to support professional growth and personal connections within the Berks County Medical Society community.

The Berks County Medical Record

Lucy J. Cairns, MD, Editor Editorial Board

Margaret S. Atwell, MD Charles Barbera, MD Betsy Ostermiller Bruce Weidman Berks County Medical Society Officers

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William C. Finneran, III, MD, President Pamela Q. Taffera, DO, MBA, President-Elect Raymond C. Truex, Jr., MD, Chair, Executive Council Kristen Sandel, MD, Treasurer Christie L. Ganas, MD, Secretary Jerome I. Marcus, MD, Immediate Past President Bruce R. Weidman, Executive Director Publisher: Niemczyk Hoffmann Group, Inc. Reading, Pa | 610.685.0914 | nhgi.net For advertising information contact MedAds@nhgi.net or visit nhgi.net/media Berks County Medical Society, 1170 Berkshire Blvd., Ste. 100, Wyomissing, PA 19610 Phone: 610.375.6555 | Fax: 610.375.6535 | Email: info@berkscms.org

The opinions expressed in these pages are those of the individual authors and not necessarily those of the Berks County Medical Society. The ad material is for the information and consideration of the reader. It does not necessarily represent an endorsement or recommendation by the Berks County Medical Society. Manuscripts offered for publication and other correspondence should be sent to 1170 Berkshire Blvd., Ste. 100, Wyomissing, PA 19610. The editorial board reserves the right to reject and/or alter submitted material before publication. All manuscripts and letters should be typed double-spaced on standard 8 1/2"x11" stationery. The Berks County Medical Record (ISSN #0736-7333) is published four times a year in March, June, September, and December by the Berks County Medical Society, 1170 Berkshire Blvd., Ste. 100, Wyomissing, PA 19610. Subscription $50.00 per year. Periodicals postage paid at Reading, PA, and at additional mailing offices. POSTMASTER: Please send address changes to the Berks County Medical Record, 1170 Berkshire Blvd., Ste. 100, Wyomissing, PA 19610.

Summer 2012

Social Media and Your Practice Should Facebook Be A Part of Your Marketing Plan?

Alliance Updates A Lesson in the Power of Perspective

BCMS News Legislative Breakfast Residents’ Day

PAMED,

Berks County Medical Society

Why Berks County Physicians Should Care About the Rest of PA

Foundation Report A Report of the Foundation PAMED

Departments: Editor’s Comments ............................................................................................................................................................... 6 President’s Message ............................................................................................................................................................ 8 Legislative and Regulatory Updates..................................................................................................................................... 16 Calendar of Events.............................................................................................................................................................. 30 Notes From the Field: ICD-10 FAQs and Webinars............................................................................................................... 26 Members in the News......................................................................................................................................................... 28 New Members.................................................................................................................................................................... 30 Department of Family Medicine........................................................................................................................................... 30 MEDICAL RECORD | SPRING 2012 |

EDITOR’S COMMENTS

Lucy J. Cairns, MD, Editor

he Reading Eagle recently featured an article on how the health of Berks County residents compares to that of other Pennsylvania counties, and how our rankings have changed over the last year (“County’s health on the mend” April 4, 2012). Berks moved up a notch in health outcomes, but lost ground in the area of ‘health factors,’ which includes poverty, the teen birthrate, and access to medical care. As a physician, I was interested to learn

When I need a doctor, I don’t want to have to call office after office to find someone who is accepting new patients and who participates with my insurance. something about how the community I care for is doing. And, along with all other physicians who live in Berks County, I am part of that community – not sitting on the outside looking in. In addition, every physician is also a patient sooner or later, in need of care from the same Berks County providers and institutions available to other local residents. While it is undeniably true that timely access to medical care is only one factor affecting population health, such access makes all the difference for an individual in trouble. When I need a doctor, I don’t want to have to call office after office to find someone who is accepting new patients and who participates with my insurance. If I need a specialist, I would much prefer not to have to travel out of the area to get the care I need. For an urgent problem, I hope the doctor I need is able to see me without a long delay. And when I finally get in the exam room with the doctor, I am most likely to be satisfied with the encounter if that doctor has a practice environment in which he or she enjoys working, feels fairly compensated, and is able to focus on me instead of on the clock. Which leads me to the issue of the “health” of the Berks County physician community. A healthy physician community is

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one able to provide top-quality care in a way that maximizes patient satisfaction. As Dr. Michael Baxter pointed out in the Eagle article, Berks County’s ratio of population per primary care physician is significantly worse than the average for our state. In addition, the age distribution of Berks County physicians is skewed towards those over age 50, so our ability to recruit young doctors to Berks is likely to become increasingly important to even simply maintain current levels of access. In the fall edition of the Medical Record, we plan to publish a detailed examination of factors affecting the health of our physician community and the implications of recent trends for the future of that community and for Berks County as a whole.

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Among the more important factors affecting our practice environment are those resulting from legislation, regulation, and dealings with the public and private entities which pay for and regulate physician services. When decisions affecting medical practice are being made in Harrisburg, it is vital that physicians have a seat at the table (“if you are not at the table you will be on the table”). While legislators value input from physicians as individuals,

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PRESIDENT’S MESSAGE

Dr. William C. Finneran, III, President

Dr. William C. Finneran, III, President attended the “Leadership Forum” discussed below. Dr. Finneran would like to share the highlights presented by PAMED President, Marilyn J. Heine, MD. PAMED President’s Post: Special Edition, Highlights of the County Medical Society Leadership Forum

t the April 26, 2012 forum hosted by the Pennsylvania Medical Society (PAMED), county medical society (CMS) leaders networked, shared ideas about their activities, heard from a prominent Pennsylvania political pollster, and were updated about PAMED priority initiatives and resources to aid CMS leaders. Thank you to all the county medical society leaders who participated along with PAMED Executive Committee members and staff. As noted in the opening overview of the Pennsylvania physician practice environment, PAMED programs, and opportunities for physician leadership – with county medical society leaders at the local level and PAMED’s statewide voice – together we can make a difference.

PENNSYLVANIA’S POLITICS: Jim Lee, President of Susquehanna Polling and Research, Inc. provided insight about Pennsylvania’s primary and general elections. Although Steve Welch was the GOP-endorsed US Senate candidate, GOP voters selected Tom Smith to challenge incumbent Democratic Bob Casey. While Casey is favored to win the general election the race could tighten if Smith can effectively link Casey to President Obama – depending on the electorate’s sentiment in the presidential race. Pennsylvania is an anticipated battleground in the contest for the White House. CMS leaders discussed a variety of grassroots legislative events they have held that meet their needs – from breakfast to dinner, Harrisburg to local, social to issue-based, delegation to individual legislator. PAMED can help plan and guide an event. Forum attendees were shown how PAMPAC’s physician board members come from across the Commonwealth and help determine its operations, political education, and candidate support decisions.

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PAMED PRIORITY INITIATIVES: Medical Staffs of the Future A Task Force on Designing Ideal Governance for a Health System will seek to identify strengths and weaknesses of the organized medical staff, study alternative models, develop guidelines, and suggest an action plan for PAMED leaders to consider. Governance Task Force Overview Spearheaded by a PAMED Young Physicians Section resolution, a task force is studying the governance process and structure of the House of Delegates and Board of Trustees. This supports PAMED’s strategic plan to “move away from its traditional decision-making processes and strive to create a culture of agility and rapid response to issues and trends.” The task force surveyed recent PAMED trustees, delegates, council and commission members, and young physicians. Survey results and feedback from constituencies will form the basis of a report to the 2012 PAMED House of Delegates. Advocacy for Employed Physicians The Hospital and Healthsystem Association of Pennsylvania (HAP) has called two meetings of selected physician leaders in multiple hospitals and health systems in an effort to engage them in discussions to develop a strategy for HAP “to advocate for and represent physicians.” May 16 PAMED’s Board of Trustees will consider potential short and long term actions for engaging employed physician leaders. Forum participants agreed that PAMED must increase its efforts to prove value to the core physician leaders of hospitals and healthsystems, independent of any action taken by HAP, as these physicians will ultimately shape the future of healthcare in the Commonwealth.

IDEAS SHARED IN BREAKOUT GROUPS: On communications: Most counties have some form of newsletter, either print or electronic. All agree communications must be brief and interactive. Most counties have a web site or a listserv. A mix of communication vehicles may be required and should be “mobile-device friendly.” When possible, items should be sent by a person with whom the physicians will identify. Communications may go through the county presidents who could serve as a filter to determine what they forward to their members. On resources, advocacy, and services: Generally, participants are aware of PAMED resources. PAMED needs more resources that can immediately impact physicians, like the Patient Satisfaction Survey. PAMED should help physicians begin to easily gather practice data. PAMED should help quantify “return on investment” of programs and resources for members. On PAMED’s BluePrint initiative: Participants generally found the BluePrint to be too theoretical. Most leaders understand the main point of the BluePrint is about improving quality and value and helping physicians adapt to the changing environment, but they were not comfortable explaining the document to peers. RESOURCE GUIDE: Practice Economics & Payer Relations The practice management “hotline” staff responds to inquiries from physicians and practice administrators on topics including billing, coding, audits, information technology, incentive programs, medical policy, fraud and abuse, practice transitions, payer initiatives, contracting, medical records, HIPAA, and ICD-9 and 10. Staff is acquiring knowledge to assist members who are interested in moving into budget-based payment systems, such as global payments and accountable care organizations. Staff members represent physicians in discussions with payers, produce a monthly practice management newsletter Vital Lines, promote the physician’s perspective on HIT, and assist members with EHR questions. The research section studies Pennsylvania physician demographics and workforce, patient access to physician care, Medicaid issues, and impacts of health system reform. Unconventional Drilling PAMED is exploring ways to identify gaps in the epidemiological study of the health impacts from unconventional gas well drilling, and to address concerns that have been expressed regarding clarification of the confidentiality provisions contained in Act 13, Unconventional Drilling law. Legislative Update During budget-time in Harrisburg our goals this year are to maintain physicians’ medical assistance funding and help prevent legislators from raiding the approximately $130 million

Mcare balance to bolster possible increases in spending. The Supreme Court has yet to decide the fate of our Mcare litigation. Without a Supreme Court decision it is unlikely that the legislature will again take money from Mcare for budget purposes, however, if the court rules against us the Mcare surplus could be vulnerable. Work continues on multiple measures that include scope of practice bills, timely credentialing by health plans, and regulation of tanning facility use by minors. PAMED has worked very closely with the Department of Health and HAP to update Pennsylvania’s 30-year old hospital regulations while ensuring that physicians continue to direct clinical care provided in hospitals and control who can serve on a hospital’s medical staff. Capitol Insight and a weekly blog keep PAMED informed of developments. CME License Year Update In 2012, we are in the second year of a two-year licensing cycle for physicians in Pennsylvania. To renew their licenses, physicians must meet the state’s CME requirements by the end of the year. PAMED’s five CME publications offer more than enough CME to meet the state’s requirement of 12 patient safety/risk management credits. Additional CME is available in video and webinar formats on PAMED’s website. PAMED’s CME Tracker is available to all member physicians to help them log and organize their CME. PAMED Foundation Heather Wilson, the new Executive Director for the Foundation, outlined three key programs all supported by philanthropy: the scholarship and loan program at favorable interest rates for medical students and residents, the Physicians’ Health Program that confidentially supports physicians who are at risk or require help addressing health concerns including those that arise from addiction and substance abuse, and LifeGuard ® that offers unbiased clinical skills assessment and a personalized plan to assist those who have fallen behind in clinical skill or continuing education. The Foundation offers financial management services to many of the specialty societies and county offices. Grant writing services are now available for a fee through the Foundation. Please feel free to contact me anytime if you have any questions about PAMED programs or if we can be of any assistance. Best regards, Marilyn J. Heine, MD President, PAMED

MEDICAL RECORD

SPRING 2012

Social Media and Your Practice Should facebook be a part of your marketing plan?

ost people would agree that the best way to market anything is by word of mouth. Social media has become a sort of “virtual word of mouth” – where millions of people are constantly posting, tweeting, instant-messaging, and blogging about their daily life experiences. And millions of other people are reading, following, and using this information to influence their decisions and activities. So, it could be a good idea to take advantage of that “virtual word of mouth” environment to promote yourself and your services--if it is something that will fit into your marketing plan. However, beware the pitfalls if this strategy is not implemented correctly. Even though Facebook was initially created as a social study tool that was limited to users from a single college campus, it has turned into the leading social networking site – with more than 750 million users as of July, 2011. If you’ve never experienced Facebook in action, take a look at the Pennsylvania Medical Society’s page to get a better feel of how it functions (www. facebook.com/PAMedSoc). Facebook allows users to create a Profile and interact with other users (friends) through a variety of avenues such as Wall, Photos, News Feed, Messages, Groups, Events, Places, Notes, and Chat. Facebook also allows businesses to create a “profile,” called a Page, which is similar to a website because you can include everything that relates to your practice all in one place: Overview Website and contact information Press releases Videos Blogs Twitter updates News and status Customer interaction Facebook makes it easy to update your Page -- you just log in and you can add photos, edit text, post videos, etc. Conversely, making even small edits to your website usually requires a phone call to your web developer and may take days to finalize. 10 | MEDICAL RECORD

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After you’ve set up your Page, you will have to do some promoting of it so that patients and prospective patients will know you have a presence. Some ways to do this include posting a notice in your office for your patients to see; including a Facebook Page button on your website; tweeting about it through your Twitter account (if you have one); printing the link on your business cards and brochures; and sending an email notification. When users visit your Page, they can click a “Like” button (which is a default button on all Facebook Pages). Every time a user clicks the “Like” button, a message is posted on their personal Profile Wall that explains what Page they like, and allows their friends to “Like” that Page, also (through a link posted in that message). This type of “viral” marketing provides more exposure for your Page and directs more traffic to your Page. From an October, 2010 article by Amy Dawson, Senior Vice President, Healthcare Lead, for Fahlgren Mortine, called, “Physicians do an about face with social media,” here are some ways that medical practices are using Facebook: Monitor feedback about the practice Introduce new services or changes in existing ones Recognize their staff as well as community supporters Demonstrate involvement in their community Promote physicians appearing at public events and speaking engagements Communications about new patient care options, technology, procedures, and treatments Incorporate patient testimonials and photos (with consent) Promote patient referral programs and discounted services Provide reminders about seasonal health and wellness issues such as flu shots, back-to-school physicians, etc. Let people know that last-minute appointments are available Announce new physicians and practice members or to explain their roles Point people to relevant, valuable, and credible content on the Internet If creating a Facebook Page sounds like something you’d like to integrate into your marketing plan, there are some things to consider: Do you have the manpower to monitor your Page? Unlike other methods of marketing that are usually “once and done” (such as print advertising; website; television/radio ads), after you create a Facebook Page, someone should monitor it on a daily basis. Social marketing is an interactive environment and if users feel like no one is on the other end, they most likely will stop visiting your page. Do you have a policy in place about the boundaries of social media tools while at work? You don’t want your employees to become distracted with their own, personal social media outlets while they’re monitoring/updating the practice’s Page. You must also trust that they won’t post PHI (protected health information)

or try to offer personal medical advice in such a public forum. The American Medical Association has established guidelines on professionalism in the use of social media to help physicians who want to develop an online presence (http://www.ama-assn. org/ama/pub/meeting/professionalism-social-media.shtml). You can use these guidelines as a reference as you develop your own internal controls.

The AMA has established guidelines on professionalism in the use of social media to help physicians who want to develop an online presence. Are you prepared to receive negative feedback/comments? By joining a public forum such as Facebook, you are exposing yourself and your practice to public comment. You have to be prepared for negative feedback and decide how it should be handled. Your responses should be tactful and honest. If possible, you may also want to address the situation personally and privately. And keep in mind that not all negative feedback is

bad. If a person has a legitimate complaint, you can respond by thanking them for bringing the issue to your attention, offer an apology (if appropriate), and state what steps will be taken so the situation won’t happen again. It’s important to respond promptly and keep your comments positive; you don’t want to get into an online argument—not only will that create more negativity, but it is not professional. Many practices who create a Facebook Page find that it is a valuable tool; however, it’s not without its risks. Before moving forward, ensure that you have a well-planned strategy for use and monitoring. Take time to look at what other practices have done and note what you like and dislike. Talk to your peers who have taken the Facebook plunge to determine if it’s been a positive or a negative for their practice. Social media sites such as Facebook may be the only way we market in the future, but while it’s still new, take your time and decide if it’s the right fit for you. PMSCO Healthcare Consulting (PMSCO) is a subsidiary of the Pennsylvania Medical Society and provides a variety of practice management services for physicians and medical practices. For more information, visit their website at www.consultPMSCO.com or send an email to experts@ consultPMSCO.com.



port on Me eaningful U Use Notes from the Field: A Sttatus Rep By Sherry L. Mig gliore, MPA, FACMPE, FA FACH HE, Director oof Consulting

It’s been n about 10 months m since e the officiall start of thee Meaningfull Use incentive program. Much ha as happened d since early y 2011, and medical m pracctices are in various stattes of learnin ng what the requireme ents mean an nd how they y need to maake changess to their org ganizations to ents. Some physicians p arre just in thee process of purchasing and meet the requireme enting EHRs. And yes, many m are still debating w whether theyy are going tto get on board impleme at all!

Your choice for alternative health care. e EHR vendo ors are still catching c up. Some of th e vendors th hat have recceived Even the certification status have h not yett tested all of o the clinical quality mea asures, or C CQMs (Core e 10). For more m information about this, go to th he Certificatio on Commisssion for Health Measure Informa ation Techno ology (CCHIT T) website (w www.cchit.o org) and clickk on “Find Product” to se ee if your EH HR vendor orr one you are e considering has comp leted the tessting of thesse measuress. The CQM Ms have bee en a source of o confusion n for many p practices we’’ve worked w with -- and judging by the number of Frequ uently Asked d Questions ((FAQs) on th his topic on the Medicarre website, this is a na ational trend as well.

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w with pra actices that have either already atteested or are close to atte esting, it’s In our work apparen nt that they have spent a great deal of time worrking on thiss to make su ure they get it right. So ome of the practices p tha at have had an a EHR for a while are ffinding that they now ha ave to make e changes to o workflow and chart doccumentation n because when they we ere originallyy trained, Meaningful Use was no ot on the horrizon. So wh hile they werre trained iniitially to use their sysstems to effiiciently docu ument and manage m patieent care, the ey now have e to make su ure they’re also a using th he EHR in su uch a way ass to ensure tthat MU requ uirements are met.

Chiropractic Care Physical Therapy Massage Therapy Acupuncture Nutrition Counseling Weight Management An exam mple of this is i the list of current med dications.Hair Prrior toRemoval Meaniingful Use, itt was not Facials Laser

generallly thought to o be necessa ary or imporrtant to notee in the chartt that “the p patient does not have an ny active med dications.” However, H Co ore Measure 5 requires tthat 80% of all patients seen mu ust have an entry about the status of o current m medications. IIf the patien nt is not currently taking any y medication n, then this too must be documented d in the appropriate ed towards the t 80% thrreshold. Sim milarly, Core M Measure 3 location in the EHR to be counte ate problem list of curre ent and activve diagnosess or documentation that “no requiress an up-to-da problem ms are known n.”

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hallenges are being face ed by practicces in the pr ocess of transitioning to o an EHR Other ch system and at the same s time trrying to attesst as quicklyy as possible e. A word of advice for physicia ans in this sittuation -- do on’t rush into o attesting u until you havve at least 80 0% of your patientss in the EHR. Dr. Also, bePatrick su ure to read carefully cBorja the, details of ea ach rac measure e on the CMS S Chirop tor website. Each meassure descripttion includess a section caalled “additional informa ation” where e

3 9 3 3 Pe r k i o m e n Av e n u e , R e a d i n g , PA 1 9 6 0 6 • w w w. s p i n e a n d w e l l n e s s . o r g • ( 6 1 0 ) 7 7 9 - 4 5 8 8 MEDICAL RECORD

SPRING 2012

ALLIANCE UPDATE E mily B undy B C M S A P resident - E lect

Lesson in the Power of Perspective: Spring General Meeting

pproximately 20 Alliance members came out to the Spring General Meeting. Our speaker Chris Kaag, owner of Corps Fitness and Founder of the IMAble Foundation, shared his inspirational personal story of being diagnosed at the age of 21 with AMN (Adrenomyeloneuropathy), a degenerative nerve condition that affects his ability to walk. Instead of letting this condition control his life, he chose to view this obstacle as a stepping stone to motivate others to “redefine the way they view their personal challenges.” He demonstrates the power of perspective while motivating others around him to achieve their full potential. For example, Chris replaces the phrase “I can’t” with “I have the opportunity to…” climb a mountain, run a gym, help others achieve their goals. When you first meet Chris Kaag and you see he is in a wheel chair you may have some preconceived ideas about things he can and cannot accomplish. Yet when you hear his story you are forced to adjust your perspective. Chris’s story reminded me of another titled “Two Battleships” which is told by Frank Koch in Proceeding, the magazine of the Naval Institute. Below is the version as retold in Stephen Covey’s 1989 The Seven Habits of Highly Effective People. Think of this story next time your preconceived notions are challenged. Two battleships assigned to the training squadron had been at sea on maneuvers in heavy weather for several days. I was serving on the lead battleship and was on watch in the bridge as night fell. The visibility was poor with patchy fog, so the captain remained on the bridge keeping an eye on all activities. Shortly after dark, the lookout on the wing of the bridge reported, “Light, bearing on the starboard bow.” “Is it steady or moving astern?” the captain called out. Lookout replied, “Steady captain,” which meant we were on a dangerous collision course with that ship. The captain then called to the signalman, “Signal that ship: We are on a collision course, advise you to change course 20 degrees.” Back came a signal, “Advisable for you to change course 20 degrees.” The captain said, “Send: I’m captain, change course 20 degrees.”

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“I’m a seaman second class,” came the reply. “You had better change course 20 degrees.” By that time the captain was furious. He spat out, “Send: I’m a battleship. Change course 20 degrees.” Back came the flashing light, “I’m a lighthouse.” We changed course. Chris teaches people that you don’t know your limits until you Top: Chris Kaag hiking up to the Pinnacle in challenge them. Hamburg, PA using an adaptive mountain bike. We often short His Foundation raises funds for adaptive exercise change ourselves, equipment such as this to enable people with assuming what is disabilities to lead more active lifestyles. or is not possible Above: Dee Dee Burke, Kristin Feightner, Chris Kaag, Kelly O’Shea & Emily Bundy before attempting to achieve the goals we set for ourselves. As Alliance members we will keep this in mind as we approach our own organization-wide challenges such as increasing membership, expanding community support, and fundraising. Like Chris, we will try to push our limits in the upcoming year and achieve success in these areas. Thank you for challenging us to change our perspective when viewing obstacles like these, so that we get the opportunity to achieve more than we may have thought possible!

Health in Balance Series Thank you to Kalpa Solanki , her team, and our panel of speakers for producing a high quality program again this year. In total, over 50 people were in attendance. Over half (13 out of 19) of all school districts in Berks County were represented at the program (see chart & map). Additionally, representatives from Schuylkill , Lancaster, Northampton and Philadelphia Counties were present. The audience consisted of school nurses (both public and private), physical education teachers, preschool directors, parents of children with diabetes, Alliance members and members of the general public. Feedback from the surveys indicated that participants found the program enjoyable, informative and well executed. Topics suggested by attendees for consideration in next year’s program included asthma, autism spectrum disorders, ADHD, and mental health topics.

http://en.wikipedia.org/wiki/Berks_County,_Pennsylvania

Health Project Committee Members- Sue Russo, Lisa Banco, DeeDee Burke & Lisa Geyer Room View

Schools and School Districts Represented at the Program Wilson School District Kutztown School District Twin Valley School District Hamburg School District Conrad Weiser School District Wyomissing School District Exeter School District Fleetwood School District Schuykill Valley School District Muhlenberg School District Blue Mountain School District Jewish Federation of Reading & Preschool Lehigh Valley Academy Saint Ignatius Cocalico School District (Lancaster County) Brandywine School District Changing of the Board Thank you to the 2011-2012 board members for their time and dedication! A special thank you to this year’s Alliance President, DeeDee Burke for her great leadership and cheerful smile. May next year’s board strive to maintain the same high standards established this year and in years prior. The new board will be installed on May 8th at Off the Avenue Café.

Left to Right: DeeDee Burke (Alliance President), Karen Franey (Speaker), Gary Scheiner (Speaker), Kalpa Solanki (Health Project Chair)

Membership As always, if you are interested in joining or coming to a meeting contact Amy Impellizzeri at aimpell@gmail.com. Don’t forget to check out our website at www.berkscmsa.org and “like” us on Facebook! 

Panel of Speakers: Gary Scheiner, Karen Franey, Dr. Arti Patel & Ralph Cincinnati

FOUNDATION REPORT B y S usan L indt

A Report of the Foundation of the Pennsylvania Medical Society

Heather A. Wilson, MSW, CFRE

eather Wilson sees a bull’s-eye on your heart. In fact, she sees a bull’s-eye on everyone’s heart. And she admits she’s aiming right for it. “‘Heartshare’ – that’s my own term – it’s that part of your heart that belongs to an organization,” said Heather, who’s freshly installed as executive director of The Foundation of the Pennsylvania Medical Society, the charitable affiliate of the Pennsylvania Medical Society. “What you need to make philanthropy successful is a group of individuals with heartshare. No matter what the cause, the heartshare has to be there.” Anyone who has had a conversation with Heather surely has heard her signature term. A veteran of the battle for donor dollars, Heather long ago identified the crucial weapon in the war – your heart. And what makes your heart sing (i.e. what makes you reach into your pocket to make a donation)

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is as exacting to an individual as DNA. For an animal lover, a philanthropy waging war on puppy mills might grab that donation. For a hospital charity, a donor may be a former patient who experienced a great outcome. But it’s Foundation heartshare that’s on Heather’s mind these days as she switches gears from her last position as director of major gifts at Lancaster General Health Foundation, the hospital’s philanthropic affiliate. Programs at the Foundation of the Pennsylvania Medical Society benefit Pennsylvania’s physician community. The Physicians’ Health Programs intervene for doctors affected by addiction or mental illness. The LifeGuard® program helps physicians who want to switch specialties or need advocacy because the quality of their skills has been questioned. The Foundation also awards scholarships and low-interest loans to deserving medical students. So now Heather is formulating her plan to strengthen Foundation programs with an infusion of donor dollars. She has mapped her strategy. She’s on the move. And she has already logged countless miles getting acquainted with Foundation friends and friends-to-be. “I want to heighten the Foundation’s visibility and messaging across the state,” the Lancaster resident said. “I want to make new connections and deepen current relationships with hospitals, physicians and the larger medical communities. I want to share our relevance to the future of medicine in Pennsylvania and how it’s delivered here. I’m looking to heighten engagement at all levels.” If those are her long-term goals, just staying afloat is a daily concern of any charitable organization today. But Heather, 44, has witnessed the nonprofit animal from several vantage points over the years. After earning a Temple University bachelor’s in elementary education (followed by a master’s in social work, also from Temple), she landed as social services coordinator at Lancaster’s Salvation Army in the ‘90s. She managed emergency assistance for 50 families a week, oversaw the opening of a men’s

Heather Wilson sees a bull’s-eye on your heart. In fact, she sees a bull’s-eye on everyone’s heart. And she admits she’s aiming right for it. housing unit and helped create an HIV/AIDS program. When she left The Salvation Army for Lancaster General in 2000, she started in a series of positions with the health care system with a focus on raising funds to support programs advancing the health of the Lancaster community.

“ More important is remaining ... in the heartshare of donor partners because ... it’s easy to become the flavor of the day if you don’t have solidified relationships with donors.” Recent years have been the leanest in most fundraisers’ memories. And the hyper-connectivity of the new millennium means an appeal is only as good as the seconds it takes to skim and discard a tweet. “One of the most important issues for philanthropies now is riding out the uncertainties of the economy,” she said. “But more important is remaining at the front of the minds - in the heartshare of donor partners because our society is so information driven now that it’s easy to become the flavor of the day if you don’t have solidified relationships with donors. It’s so easy to fall off their radar.”

How she goes about spreading the Foundation’s mission to help educate future physicians and host programs encouraging physician wellness and excellence in practice is new territory. And it’s a smaller audience than she’s used to, but she’s banking on the richness of the cause to make her case with potential donors. “The challenge is having very definite people you impact: future doctors, physicians struggling with addiction, physicians redefining or revalidating their area of practice through the LifeGuard® program…those concepts are very narrow in scope as far as who you serve,” she said. “However, when you know someone in that constituency, there is no greater gift you can support than an organization that supports your colleagues.” With the March retirement of Heather’s predecessor, longtime Foundation Executive Director Virginia Henning, there has been a lot of talk about legacy. Heather said if she could choose what others will someday say about her impact on the Foundation, she’d like them to say her leadership was marked by true partnership with donors and program participants; a time not marked by drastic change, but by deepening relationships. “I’d like people to say that when I was here, people were treated with dignity and respect,” Heather said. “I’d like people to say that I delivered on what I promised and that their donation was used for programs that were full of integrity and had a meaningful impact. I’d like people to say that they felt like partners in the process and together we accomplished something great.” 

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LEGISLATIVE AND REGULATORY UPDATES From: J. Scot Chadwick, V i c e P r e s i d e n t, G o v e r n m e n t a l Aff a i r s ———————— Amy C. Green, Ass o c i a t e D i r e c t o r , G o v e r n m e n t a l Aff a i r s P e n n s y l va n i a M e d i c a l S o c i e t y

he General Assembly is now engaged in the last significant period of legislative activity in the 2011-2012 session. Much will be accomplished, including the enactment of the annual state budget, between now and June 30, when our Solons are scheduled to break for the summer. Little of controversy will be considered when they return briefly in the fall, as members will be focused on their reelection campaigns and the upcoming November general election. And, as the Senate leaders have already declared that there will be no “lame duck” session after the election, it is clear that anything meaningful must be done before the summer recess. Governor Corbett’s top priorities for his first term – tort reform, sale of the state liquor stores, and an on-time, no-taxincrease state budget – have met with mixed results. Corbett’s number one tort reform priority, reform of joint and several liability, was passed, and the House has passed PAMED’s apology legislation. Unfortunately the Senate has thus far shown little interest in further tort reforms, so progress on that issue going forward remains slow. Sale of the liquor stores still looks like a long shot, as does repeal of the state’s prevailing wage law. However, the 2011-2012 budget was completed on schedule, and the 2012-2013 budget may actually come in ahead of schedule. Unfortunately the coming year’s budget is likely to contain further painful spending cuts (more on that below), though legislative leaders want to restore some of Governor Corbett’s proposed reductions. And, there have been significant Mcare developments. Following is a status report on key legislative and regulatory activities in Harrisburg.

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LEGISLATIVE UPDATE 2011-2012 State Budget Pennsylvania faced a massive $4.2 billion shortfall as legislators began drafting the 2011-2012 annual state budget. Governor Corbett pledged to balance the budget without any tax increases, though a bill to allow local Marcellus shale impact fees did receiving serious consideration (it may still happen). With revenue enhancements out of the mix, cost cutting was the order of the day, and Corbett’s proposed budget left few unscathed. Grants and subsidies for Organ Donation Awareness were eliminated and Diabetes Programs saw a decrease from $190,000 to $100,000, or a 47.4% cut. Other decreases include Maternal and Child Health (-63.5%) and the Regional Poison Control Centers, reflecting a decrease of 27% from the 2010-11 level. One of the largest cost-containment reforms involved Medical Assistance. In 2011-12, the Medical Assistance program will provide health care and long-term care services to more than 2.2 million Pennsylvanians, a 4.5% increase over the prior year. Despite that increased pressure on the system, the budget cut hospital payments for Obstetric and Neonatal Services, Burn Centers, Critical Access Hospitals, Trauma Centers, and Uncompensated Care, reducing state funds by $12 million from the 2010-11 available funds. Funds for Mental Health Services

Despite that increased pressure on the system, the budget cut hospital payments for Obstetric and Neonatal Services, Burn Centers, Critical Access Hospitals, Trauma Centers, and Uncompensated Care, reducing state funds by $12 million. received a slight increase of 3.1%. The budget significantly cut numerous appropriations in DPW, and overall the Department saw a slight decrease of 0.5% in its total of all funds. One of the biggest changes for the Insurance Department was the expiration of adultBasic that forced approximately 42,000 people to either pay more for coverage, or become uninsured. The Children’s Health Insurance Administration will see the redirection of shared information technology contracts

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previously funded in the Adult Health insurance Administration appropriation. It is also projected that an average of 201,000 uninsured children will be served by the Children’s Health Insurance Program (CHIP) in 2011-12. Funding for CHIP remained at approximately $97 million. The budget showed a decrease of 34.4% to the Academic Medical Center’s payments that fund the medical schools at Temple, Penn State, and University of Pittsburgh, as opposed to the Governor’s earlier proposal to eliminate funding completely. The budget added $3 million in state funds for three additional academic medical centers: the Commonwealth Medical College in Scranton, Philadelphia College of Osteopathic Medicine, and Lake Erie College of Osteopathic Medicine. Cuts were at 50% from the 2010-11 level for physician practice plan payments that fund the medical schools at Drexel, Thomas Jefferson, and the University of Pennsylvania. Unfortunately, the budget situation has continued to deteriorate since the enactment of these painful cuts last June. The latest estimates show revenues coming in about $300 million below current year projections, not good but considerably better than the numbers looked a few months ago. Government leaders remain committed to balancing the budget without raising taxes, so yet another round of spending cuts is almost certainly in the works. Indeed, those cuts have already begun, as in early January Governor Corbett announced a spending “freeze” totaling $142 million. This “freeze” constitutes money that was actually appropriated in the 2011-2012 budget, but will not be spent.

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So in reality the “freeze” is additional spending cuts on top of the cuts outlined above. These new cuts touch all areas of state government, with Medical Assistance the primary area of healthrelated cuts. MA funds frozen include the following: Medical Assistance - Obstetrics and Neonatal Services $3,681 - 368 = $3,313 -10.0% MA - Hospital-Based Burn Centers 3,782-378=3,404-10.0% Medical Assistance - Critical Access Hospitals 3,576-358= 3,218 -10.0% Medical Assistance - Trauma Centers 8,656-866=7,790 -10.0% Expanded Medical Services for Women 4,794-240=4,554 -5.0% With Medical Assistance and education constituting the largest areas of the budget that contain “discretionary” (not mandated by law) spending, look for them to remain key items of discussion as the new budget is developed. In fact, education spending is becoming a major point of contention between Governor Corbett and the Senate.

Tort Reform The House has made good on its promise to enact broadbased tort reform in 2011-2012. The Republican-controlled chamber passed House Bill 495, PAMED’s apology legislation (171-27), and House Bill 1, the long-sought reform of joint and several liability (112-88). The House also passed House Bill

1907 (103-89), which would extend the existing cap on punitive damages against physicians to nursing home liability cases. Other proposals in the House queue include PAMED-requested reform of the certificate of merit requirement, liability protection for ER care and uncompensated care, and a number of pro-business reforms already obtained by physicians in Act 13 of 2002. As expected, the difficulty in enacting these reforms has been in getting the Republican controlled Senate to act. All tort reform bills in the Senate, whether Senate bills or House bills already passed by the lower chamber, are referred to the Senate Judiciary Committee, which is chaired by tort reform opponent Sen. Stewart Greenleaf (R-Montgomery).

As we enter “crunch time” in the 2011-2012 session, PAMED and its allies are continuing their push to enact comprehensive liability reform. PAMED is part of a large tort reform coalition which is comprised of organizations involved in health care, business, local government, and others. The coalition is actively engaged in a coordinated campaign to generate Senate action on these important initiatives. After a lengthy and aggressive push by the coalition Senator Greenleaf eventually released from his committee a watered down version of the joint and several liability bill, which the full Senate promptly amended to restore the stronger language. The House quickly ratified the Senate action, and shortly before the legislature recessed for the summer Governor Corbett signed the measure into law as Act 17 of 2011. As we enter “crunch time” in the 2011-2012 session, PAMED and its allies are continuing their push to enact comprehensive liability reform. Late last month the coalition sent a joint letter to the Senate urging action on the apology bill.

Mcare Pursuant to Act 13 of 2002, this spring Insurance Commissioner Michael Consedine examined the financial health of the state’s primary liability insurance carriers to determine their capacity to begin selling physicians and hospitals $750,000 in coverage, rather than today’s coverage level of $500,000. On July 29, 2011, Commissioner Consedine ruled that the primary insurance limits would NOT be increased for the next two years. A positive finding would have caused the primary

limits to rise to $750,000 next January, with a corresponding reduction in Mcare coverage from its current $500,000 level to $250,000. A negative finding would have kept primary and Mcare insurance at current levels for another two years, when the process would be repeated. An increase in the primary limits would have resulted in a significant rise in out-of-pocket liability insurance costs for physicians unless accompanied by transition relief. As it did the last three times the Commissioner has examined the private market (2005, 2007 and 2009), PAMED notified the Commissioner that it supports the phase-out of the Mcare Fund, but only in a manner that does not impose the cost of retiring the Fund’s $1.3 billion unfunded liability on the state’s physicians. Meanwhile, Senator John Rafferty (R-Montgomery) has expressed interest in advancing Senate Bill 811, his legislation to freeze the primary and Mcare limits at current levels for a number of years. PAMED has discussed the legislation with Senator Rafferty in some detail, and suggested improvements including a shorter freeze and a requirement that Mcare yearend surpluses be used to reduce the following year’s assessments. HAP is also advocating legislation to raise the primary limits by $100,000 to $600,000, using the current Mcare “surplus,” estimated at $130 million, to offset the increased out-of-pocket costs for providers. The HAP proposal would then freeze the limits at this new, higher level and use future surpluses to reduce the following year’s assessment. In the event that a single year surplus of $75 million or more is realized, the primary limits would be raised by another $100,000, with the large surplus again helping to offset increased out-of-pocket costs for physicians. PAMED is studying this proposal. The Insurance Department has retained Price Waterhouse to run numbers on what this proposal and other possible phase-out scenarios might look like, and Representative Glen Grell (R-Cumberland) is drafting legislation to move the proposal forward if stakeholders approve. PAMED is coordinating its examination of this issue with the Pennsylvania Orthopaedic Society and other stakeholders.

Community Based Health Clinic Funding On May 3, 2011, the Senate passed Senate Bill 5, legislation establishing a framework for funding community based health care clinics. As funds are appropriated, they would be distributed to various types of clinics around the state pursuant to a somewhat complex formula. As passed by the Senate, the bill contains no funding for the program. Further, the state budget for FY 2011-2012 does not contain funding for the program, and the Department of Health indicates that they do not have any funding available for the program either. Nevertheless, it is MEDICAL RECORD

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possible that funds could be appropriated as part of the coming year’s state budget negotiating process. The bill has been referred to the House Health Committee for its consideration. PAMED has a number of questions about the legislation and is working closely with the Committee to get answers to those questions. A number of House members share those questions, and the bill has not received further consideration as of this writing.

Prompt Credentialing On May 18, 2011, Representative Bryan Cutler (R-Lancaster) introduced House Bill 1551, PAMED’s prompt credentialing legislation. A similar bill, Senate Bill 1224, was introduced by Senator Gene Yaw (R-Lycoming) on October 18, 2011. These bills are intended to eliminate the unnecessary delays that frequently occur when physicians apply to be credentialed by various health insurers. Under the bills, insurers would have to notify applicants of the status of their application for credentialing within five business days after receipt, including their intention to continue the process and an itemization of any missing items. Insurers would have 60 days to act on a completed application, and physicians would be eligible for reimbursement within 15 calendar days from the postmarked date on the application. From that point until the credentialing process is complete, health insurers would reimburse physicians based on their fee schedule rates applicable to nonparticipating physicians. If the physician applicant is a member of a medical group practice currently contracted with the health insurer he or she will be reimbursed at the group’s contracted rate. A health insurer would be required to accept the CAQH’s Provider Credentialing Application when submitted by a physician for participation in the health insurer’s provider panel. On November 30, 2011, the House Insurance Committee held a public hearing on the bill, at which PAMED testified. PAMED is working aggressively to secure passage of this legislation, with support from the physician practices in our CEO Panel. Recently the panel prepared a document that rebuts inaccurate hearing testimony provided by several insurers who oppose the bill. That document will be sent to all committee members shortly. In addition to easing the burden on physicians, the legislation would also help ensure access to care for Pennsylvanians and reduce patients’ out-of-pocket expenses. Fair Contracting Once again PAMED is seeking enactment of legislation to level the playing field between physicians and payers. In an

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effort to break the longstanding deadlock over fair contracting, Representative Nick Miccarelli (R-Delaware), has introduced House Bill 1763, legislation intended to closely track expired court settlements known as the Love settlements. The bill was referred to the House Insurance Committee. HB 1763 addresses a long list of issues that have been problematic in physician/health insurer relations. Subjects dealt with in the bill include: Written fee schedules Precertification Written notice of policy and procedure changes Disclosure of claims payment practices Dispute resolution All products clauses Termination without cause Medical necessity Timelines for clean claims Automatic downcoding Gag clauses Most favored nation clauses Arbitration Overpayment recovery limitations On November 29, 2011, the House Insurance Committee held a public hearing on the bill, which, as expected, generated considerable opposition from the Blues. Nevertheless, while resolving these issues has been a long and difficult road, PAMED is committed to persevere, and looks forward to working with Representative Miccarelli on this important legislation.

REGULATORY UPDATE Internet Prescribing The Society has reviewed and commented on the draft regulation from the State Board of Medicine. The intent is to regulate the prescription of non-controlled substances and to require that a physician/patient relationship be established prior to prescribing. The goal of this regulation is intended to address internet prescribing, which has become a major concern for Pennsylvania. The three main drugs that it regulates are Carisoprodol, Butalbital, and Tramadol hydrochloride. The regulation was published in the PA Bulletin as proposed in February 2012. The Society collaborated with the PA Psychiatric Society and sent in a general letter of support of the proposed regulatory changes and viewed them as being good patient care and in the best interest of patient safety. 

News berks county medical society

Please Save the Date! Berks County Medical Society Fall Outing October 11, 2012 at Ledge Rock Golf Club More information to follow Legislative Breakfast The Berks County Medical Society held its Legislative Breakfast on Friday, May 21, 2012 at VIVA. Senator Judy Schwank, plus Representatives Gillen, Day, Caltagirone, Cox and MacKenzie were in attendance to share thoughts and answer questions from the 75 attendees. Residents’ Day Poster Contest winners QI Project-Weight Loss Project J. Diaz Fraga, MD TRHMC PHISH J.P. Lucke, DO SJMC Treat a Rash, Save a Life Marina Tilich, MD TRHMC Individual Relationships between Plasma- 25- Hydroxyvitamin D And C- Reactive Protein Sharon Vila-Wright, MD TRHMC

Residents’ day Memorial Lecture Following the poster presentations, Maria J. Baker, PhD., M.S. made a presentation to the group on “Hereditary Cancer Predisposition Syndromes.” Dr. Mike Baxter also remembered the following physicians who passed away within the last year: Raylene Devine, MD; Robert Greenberg, MD; John S. Hunter, MD; Benjamin Longenecker, MD; Robert Schweizer, MD; Ethan Trexler, MD; Russel Youngberg, MD.

Why berks county physicians should care about the rest of PA

Many members rely on PAMED’s free online CME to meet their physician licensing requirements. Nearly 15,000 free patient safety and risk management CME courses will be taken online for this two-year licensing cycle (www.pamedsoc. org/cme). Plus, more than 3,000 members record their CME activities with CME Tracker, an online credits tracking tool (www.pamedsoc.org/tracker). Many physicians are confused by licensing regulations and rules. Learn about them at www.pamedsoc.org/cmefaq. Information Flow

erks County is a pretty nice place to practice medicine, raise a family, and make a life. So why would a physician from Wyomissing or Fleetwood give a darn about the rest of Pennsylvania? And, to be exact, why spend hard earned money on Pennsylvania Medical Society (PAMED) membership? Physicians across Pennsylvania—including physicians from Berks County—have told us about their struggles and their vision of better health care and a better profession. “The Pennsylvania Medical Society has a lot to offer,” says Kristen Sandel, MD, an emergency physician at Reading Hospital and treasurer for the Berks County Medical Society. PAMED listens to our members and takes action

Through our physician leadership and our annual business meeting, our members voice their concerns and set our policy. As a result, we’re lobbying for issues vital to physicians, from medical liability reform to scope of practice legislation. Our lobbyists are monitoring more than 350 bills. We’re also speaking up for physicians who are having problems with insurers, and representing physicians with state regulatory agencies. We answer about 2,500 questions a year from members baffled by state regulations. Keeping Your Practice Strong, Viable

Busy physicians and managers contact us more than 7,800 times a year for reimbursement and compensation assistance. They get individualized attention on payment issues, coding, EHR incentives, and more. If you have questions, call us (800) 228-7823 or email stat@pamedsoc.org. Helping Physicians Who Are Employed

Among the services directly impacting employed physicians are a series of articles about productivity ratings and their impact on pay and quality of care (www.pamedsoc.org/productivity) and deeply discounted contract reviews conducted by experienced attorneys (www.pamedsoc.org/contracts). 22 | MEDICAL RECORD

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PAMED members have access to a broad base of information about medical practice, patient care, politics, and more. All members receive the monthly PAMED News while subscriptiononly newsletters are targeted at members interested in legislation and regulations (Capitol Insight) or practice management and reimbursement (Vital Lines). Online, more than 90,000 unique visitors use our website every year. In addition to CME, website visitors read about the latest breaking news and use our numerous online tools and tips. Of course, you can find us on Facebook, Twitter (@ pamedsociety), and LinkedIn feeds. Physician leadership in an age of change and reform

PAMED is calling on physicians to get involved and engaged, shaping how quality care will be provided in the future. We’re working with independent and employed physicians to help them take on leadership roles and influence the future of health care. A sizable discount on leadership training through the American College of Physician Executives (ACPE) is now available to PAMED members at www.pamedsoc.org/ leadershipacademy. This includes a discount on ACPE’s Certified Physician Leader course. We’ve also created the PAMED Better Health Network™ (www.BetterHealthPA.org) to share physician innovations, part of PAMED’s strategic vision to work with health care stakeholders to improve health care quality and value. You can find six CME credits on health care leadership at www.BetterHealthPA.org. Foundation of the Pennsylvania Medical Society and PMSCO

Our non-profit Foundation – chaired by Berks County’s Raymond Truex, MD – offers the Physicians Health Program to get impaired physicians practicing again and LifeGuard, which helps physicians who have raised quality concerns or fallen behind in clinical skills or education. PMSCO is PAMED’s consulting subsidiary, offering services in practice management, EHR implementation, surgical center start ups, and more.

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Medical liability reform

Even with reforms in 2002 and 2011, medical liability is still a major concern. Among PAMED’s current reform efforts are a bill that would keep apologies from being used against a physician, improved certificate of merit, and state-paid liability insurance for physician volunteers. Reasonable treatment in your dealings with insurers

Physicians tell us they spend too much time on red tape. PAMED has proposed legislation to streamline the physician credentialing process and standardize contracting between physicians and insurers and help ensure fair contracts. Scope of practice: A matter of quality and safety

PAMED is fighting bills that would expand scope of practice for CRNAs, optometrists, audiologists, acupuncturists, and other non-physician providers.

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Preparing for ICD-10 and HIPAA deadlines

Our members have access to valuable information and tools so they can better prepare for transitions to ICD-10 and the HIPAA 5010 standards. www.pamedsoc.org/ICD10. Legislative Victories

In the current two-year legislative session, PAMED has helped pass laws on: Concussions—Act 101 of 2011 establishes standards for managing concussions and head injuries in student athletes. Texting—Act 98 of 2011 bans reading, writing, or sending a message while driving. Joint and Several Liability—Act 17 of 2011 addresses the issue of proportional liability. HIV testing—Act 59 of 2011 makes HIV testing part of routine medical care; makes state law consistent with CDC recommendations. We’ve also made progress on these issues: A statewide controlled substances database while protecting physicians from liability. Protecting the role of physician medical staffs and keeping physicians in leadership in health care. Delaying Medicare cuts through the Sustainable Growth Rate payment formula while looking for a long-term solution Opposing the Women’s Right to Know bill because it would significantly jeopardize the open dialogue within the physician-patient relationship. So, as you look out for the health care of Berks County patients, PAMED works with the Berks County Medical Society to look out for you. Contact PAMED at (800) 228-7823 or stat@pamedsoc.org. If you’re not a member, join at www.pamedsoc.org/membership. And if you are a member, thank you for your support.  24 | MEDICAL RECORD

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Notes from the Field: ICD-10 FAQs and Webinars F r o m P AMED

additional time to improve clinical documentation practices in preparation for the more specific and granular codes associated with ICD-10. 4. Will ICD-10 replace CPT procedure coding? No, this change will not affect CPT coding for providers. 5. Why is ICD-9 being replaced? ICD-9 has become outdated and cannot accurately describe diagnoses with the level of detail needed for the reporting purposes of our health care system.

Find the latest information and resources at www.pamedsoc.org/ICD10

6. When will ICD-9 codes stop being accepted? ICD-9 codes will not be accepted for dates of service on or after the new deadline. ICD-10 codes on the other hand will not be accepted for services prior to the deadline.

any physicians and practice managers say

they’re concerned–and sometimes anxious–about ICD-10

7. Every year we experience diagnosis code changes, so why is the

and the number of codes increasing from about 15,000 to

transition to ICD-10 different from the annual code changes?

69,000. The Pennsylvania Medical Society (PAMED) has a

ICD-10 has a completely different structure than ICD-9.

variety of online resources, free to members, to help make

Some of the key differences are that ICD-10 is alpha-numeric

the transition smoother.

and contains three to seven characters. ICD-10 also is more robust and specific, allowing for coding of laterality, stages of pregnancy, episodes of care, etc.

ICD-10 FAQs

1. What is ICD-10? ICD-10 stands for the International Classification of Diseases,

8. Will there be a grace period for ICD-9 once ICD-10

10th Edition, and is a diagnostic coding system implemented

is implemented?

by the World Health Organization (WHO) in 1993 to replace

No, there is no indication that providers will be granted

ICD-9. ICD-10 is used in almost every country in the world

a grace period.

except the United States. 9. Will overly detailed medical record documentation be 2. What is the ICD-10 compliance date and will the

required for ICD-10?

date be postponed?

As with ICD-9, lCD-10 codes should be based on medical

The Centers for Medicare and Medicaid Services

record documentation. While documentation supporting

(CMS) recently proposed a one-year delay for ICD-10

accurate and specific codes will result in higher-quality

implementation to Oct. 1, 2014.

data, nonspecific codes are still available for use when documentation doesn’t support a higher level of specificity.

3. Should I continue to prepare for the transition or put everything on hold?

10. What are the benefits of ICD-10?

Practices should continue to prepare their remediation

There are a number of benefits such as: improving accuracy

programs. The delay will allow time for robust testing

of claims processing; higher quality data for measuring

and smoothing of costs and resources. It also provides

health care service quality, safety, and efficiency; better

26 | MEDICAL RECORD

SPRING 2012

tracking of patient outcomes; and possible increase in

the implementation date, including providers and payers

reimbursement.

who do not participate with Medicare.

11. How many diagnosis codes are there in ICD-10 compared

ICD-10 Webinars

to ICD-9?

ICD-10 Will Change Everything –

ICD-10 has approximately 69,000 codes compared to the

www.pamedsoc.org/ICD10webinar

15,000 codes in ICD-9. 12. What should providers be doing to prepare for the transitions to ICD-10? Providers can begin to prepare by talking with their billing service, clearinghouse, and practice management software vendors. Identify needs and resources, such as training. Start with PAMED’s webinars on ICD-10 available at www. pamedsoc.org/icdl0. An ICD-10 transition plan should take into account specific practice or organization needs, vendor readiness, staff knowledge, and training. 13. When should I begin training on the new ICD-10 code set? To ensure ICD-10 coding education is retained through the implementation date, it is recommended that practices wait until at least six to nine months prior to the deadline to begin comprehensive ICD-10 coding training. 14. Are there any guidelines to assist with the mapping between ICD-9 and ICD-10? Yes. The 2011 General Equivalence Mapping (GEM) documents are available on CMS’ website, www.cms.gov. The GEMs are forward and backward mappings, also called

In this webinar, Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, vice president of ICD10 education and training for the American Academy of Professional Coders, covers: Your compliance responsibilities The areas of impact on physician practices Coding and documentation transitions Key implementation hurdles and potential challenges Learn What You Need to Do to Prepare for ICD-10 Straight From a PA Health Plan – www.pamedsoc.org/ICD10webinar2 In this webinar, hear first-hand from a payer about its preparations plus tips on avoiding delays and claims denials. Lara Brooks, PAMED’s in-house expert on ICD-10, and payer representatives from Independence Blue Cross (IBC), discuss what health plans are doing to prepare for the switch, what the Blues plans need from you to keep reimbursement flowing at your practice, the impacts of being compliant (and noncompliant), and more. Even if you don’t participate with IBC, what you’ll hear in this webinar will be very similar to all Blues plans across the United States. 

crosswalks, between the ICD-9 and ICD-10 coding systems. 15. Where can I find the ICD-10 code sets? The ICD-10 code sets are available free of charge and can be found on the following websites: CMS: www.cms.gov/ICD10/12_2010_ICD_l0_CM.asp WHO: www.who.int/classifications/icd/en/ CDC: www.cdc.gov/nchs/icd/icd10cm.htm#10update 16. If I don’t participate with Medicare, will I have to transition to ICD-10? Everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must transition to ICD-10 on

MEDICAL RECORD

SPRING 2012

MEMBERS IN THE NEWS

On April 5, 2012 at the Crowne Plaza in Wyomissing, Berks VNA presented Mary Ann Glocker of the Children’s Health Center with its 2012 Nursing Champion Award and Dr. D. Michael Baxter of Reading Hospital with its 2012 Health Care Champion Award. Approximately 200 people attended the Breakfast. This event raised money for the agencies’ charity care programs.

Dr. D. Michael Baxter Accepts 2012 Health Care Champion Award

Dr. D. Michael Baxter 2012 Health Care Champion

Dr. Barry E. Graham was honored in an article written in The Reading Eagle by Jason Brudereck. Dr. Graham retired in March after a career in obstetrics and gynecology that covered more than 35 years. The article reflected the changes that he saw during his career, and praised him for the compassion shown to his patients. We wish Dr. Graham a wonderful retirement! Honoring BCMS Members Who Are Serving at the State Level Margaret S. Atwell, MD Vice Chair, PA Medical Society’s Board of Trustees Dan Kimball, MD PA Medical Society’s Board of Trustees representing Primary Care (Internal Medicine) Ben Schlechter, MD PAMPAC Board, District V Eve Kimball, MD Patient Advocacy Executive Council Raymond Truex, Jr., MD Chair, Board of Directors, PA Medical Society’s Foundation Richard Bell. MD KePro Board, AMA Alternate Delegate

Berks County Medical Society 28 | MEDICAL RECORD

SPRING 2012

Reach Some of the Best Prospects in Berks County

sprin g 2011

Barrister Th e Be rk s

FOR SERIOUS AND NOT SO SERIOUS FITNESS ENTHUSIAST IN AND SPRING ARO UND BERK S COU NTY | SPRI NG 12

FITNESS

Remembering Judge Golden

sue 3 Volume i | is

Appalachian Adventure

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Neko Mulally: Fastest 18 Year Old In the States |

ChuRChes ConfeRenCe of Reading BeRks

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Presorted standard U.s. Postage PaId Permit #213 state College, Pa

Book review: sCOr piOns by an ation noah FeldmHydr

On the Go

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Spring 2012

Healthy Choices

M e d i C a l

wedding planner

 The Berks Barrister - The official magazine of the Berks County Bar Association delivered to attorneys’ homes and their practice reception area.  Fitness Berks - A new quarterly magazine promoting fitness and health activities for fitness and outdoor enthusiasts throughout Greater Reading.  One - The official magazine of the Reading Berks Conference of Churches reaching 60,000 readers quarterly.  Medical Record - The official magazine of the Berks County Medical Society delivered to doctors’ homes and their practice waiting rooms.  Greater Reading Wedding Planner - A comprehensive annual planning guide full of helpful advice, tips and vendor resources for all activities and events leading to the wedding day.

s o C i e t y

Greater Reading

Beating the Winter Blues Hope & Help for Families of those Incarcerated

Non-Profit Org. U.S. POSTAGE PAID Reading, PA Permit No. 731

Put Your Advertising Dollars to Work

For advertising opportunities and additional information visit

nhgi.net/Media

2012

2921 Windmill Road, Suite 4, Reading, PA 19608 610.685.0914

Social Media and Your Practi

ce, Avoiding Damage and Misuse .................. ...................................... Page 8 Access to Care, Who Cares? .....

New members medical society of pennsylvania

TRHMC Department of Family Medicine F A L L 2 0 1 2 lecture series

David Martinez Category: Student/Exempt 17 Chaser Court Shillington, PA 19607-9717

Steven M. Evans, DO Category: Active/Full Amount The Reading Neck & Spine Center 1270 Broadcasting Road Wyomissing, PA 19610-3203 Phone: (610) 469-1289

Kirk A. McMurtry, MD Category: Active/Full Amount Bornemann Health Corporation 2494 Bernville Road, Suite 207 Reading, PA 19605-9468

SUMMER CALENDAR Thursday, June 7 6:30 pm Monday, June 25 noon Friday, June 29 7 am

Executive Council Meeting Retired Physicians Luncheon Administrative Committee

Friday, July 27

7 am

Administrative Committee

Friday, August 31 7 am

Administrative Committee

Thursday, Sept 6 Friday, Sept 28

Executive Council Meeting Administrative Committee

6:30 pm 7 am

September 14 – Physician Burnout Jodie Eckleberry-Hunt, PhD Conference Center Rooms 1 & 2 8:00a.m.

September 28 – Weight Management Federico Ceppa, MD Conference Center Rooms 1 & 2 8:00a.m.

Timeless Timepieces

HEALTH TALK Tune in to Health Talk Live on WEEU radio to hear live community conversations about health topics with members and guests of the Berks County Medical Society!

Join the discussion every Wednesday evening from 6 to 7pm when the Berks County Medical Society presents “Health Talk”. It’s your chance to call and chat with many of the region’s leading health care practitioners! Take a look at the Berks County Medical Society’s website, BerksCMS.org, for more information.

FOr Live call in: (610) 374-8800 or 1-800-323-8800 to participate. Wednesday June 6th “Current Women’s Health Issues” Host: Chuck Barbera Guests: Dr. Jean Payer and Dr. Christie Ganas Wednesday June 13th “Update on AIDS–Is it Still the Terrible Disease it Once Was?” Host: Dr. Pam Taffera Guests: Carolyn Basik, Executive Director of the Berks Aids Network and Debra Powell, MD

30 | MEDICAL RECORD

Wednesday June 20th “Diverticilitis” Host: Bill Finneran Wednesday June 27th “Open Forum” Host: Margaret Wilkins

Broadcasting Square Shopping Center Wyomissing • 610-374-9330 • VanScoy.com |

SPRING 2012

get baCk

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MEDICAL RECORD

SPRING 2012

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999 Berkshire Blvd  Suite 160  PO Box 6243  Wyomissing, PA 19610 P 610.685.1790  T 866.685.1790  F 610.685.1791 32 | MEDICAL RECORD

SPRING 2012

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