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Sunday, May 29, 2016

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Providing news to the San Francisco Medical Community.


Medicare Quality Reporting Programs: What eligible professionals need to know for 2016

There is still one more performance year to go under the current Medicare quality reporting programs— the Physician Quality Reporting System (PQRS) and the Medicare Electronic Health Record Incentive Program (meaningful use). The 2016 reporting year, which affects the 2018 payment year, will be the last reporting year before these programs sunset on December 31, 2018.

To assist physicians, the California Medical Association (CMA) has prepared this tip sheet, which includes a summary of each program, critical deadlines ahead for this final year and helpful links to checklists that help practices successfully report.

Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System (PQRS) is a Centers for Medicare and Medicaid (CMS) quality improvement program that uses a combination of incentive payments and penalties to promote reporting of quality data. The program provides an incentive payment to eligible professionals (EPs) who satisfactorily report data on quality measures for covered physician services furnished to Medicare Part B fee-for-service beneficiaries. 

EPs who do not satisfactorily report quality measure data to meet PQRS requirements for the 2016 reporting year will be subject to a negative PQRS payment adjustment on all Medicare Part B Physician Fee Schedule services rendered in 2018, referred to as the payment adjustment year. 

View the 2015-2017 PQRS timeline to keep track of PQRS-related milestone dates and corresponding resources. 

  • For step-by step instructions on how to implement PQRS, view the How to Get Started page. In addition, learn more about PQRS and how to participate.
  • For information on quality measures including specification and selection, visit the Measures Codes page.
  • For information on payments, visit the Analysis and Payment page. Note that incentive payments were only authorized through 2014 program year reporting.
  • For information on negative payment adjustments, review the Payment Adjustment Information page.

If you have questions or need assistance with PQRS reporting, contact the QualityNet Help Desk. The Help Desk is available Monday – Friday; 7:00 a.m. – 7:00 p.m. Central Time (CT): 

Electronic Health Record Incentive Programs (Meaningful Use) 

Beginning in 2011, the Medicare Electronic Health Record (EHR) Incentive Program was established to encourage physicians and hospitals to adopt, implement, upgrade and demonstrate “meaningful use” of certified EHR technology.

  • EHR/Meaningful Use Objectives and Measures
  1. EPs are required to attest to a single set of objectives and measures. This replaces the core and menu structure of previous stages.
  2. For EPs, there are 10 objectives. Click here to view the 2016 measure specification sheets.
  3. In the 2016 reporting year, EPs must attest to objectives and measures using EHR technology certified to at least the 2014 Edition or the 2015 Edition or a combination of the two. 
  • EHR/Meaningful Use Reporting Period and Payment Adjustments
  1. For all returning participants, the EHR reporting period is a full calendar year, from January 1, 2016, through December 31, 2016. Returning participants who successfully demonstrate meaningful use for this period and satisfy all program requirements will avoid the payment adjustment in 2018.
  2. For participants that have not successfully demonstrated meaningful use in a prior year, the reporting period will be any continuous 90-day period during the 2016 calendar year. New participants who successfully demonstrate meaningful use for this period and satisfy all program requirements will avoid the payment adjustment in CY 2018.
  3. The 2016 attestation deadline is February 28, 2017. 
  4. For additional information click here.

The EHR Information Center is available to assist with registration and attestation system inquiries. Hours of operation are 7:30 a.m. – 6:30 p.m. (Central) Monday through Friday, except federal holidays:

  • Phone: (888) 734-6433 (press option 1)
  • TTY: (888)734-6563 

Click here to view the full Medicare Quality Reporting Programs Overview


SFMS Member, Dennis Song, MD, DDS, Attends National Security Forum

SFMS member, Dennis Song, MD, DDS received a personal invitation from the Secretary of the Air Force and attended the 63rd annual National Security Forum at the Air War College, Maxwell Air Force Base, Alabama. The purpose of NSF was to expose influential citizens to senior U.S. and international officers and civilian equivalents in order to engage each other’s ideas and perspectives on Air Force, national and international security issues. 

During the week of May 3-5, approximately 160 civilian leaders in business, education and government from all over the U.S. met with senior military leaders to explore current and future national security issues facing our nation. The NSF provided a great opportunity for an open and candid exchange of ideas among these guests, senior military and civilian leaders, and Air War College students. Dr. Song attended lectures, met in seminars for in-depth discussions and participated in social events.

Click here to read the full media release.


Anti-Tobacco Victories for California

Governor Jerry Brown signed five SFMS/CMA-supported tobacco control bills into law as part of the Governor’s special legislative session. "The Legislature's passage and Governor Brown's signing of these six laws represents Sacramento standing up against Big Tobacco for the first time in a long time and restoring California's leadership position in fighting Big Tobacco" said anti-tobacco leader Dr. Stan Glantz of UCSF. "Bringing e-cigarettes into the California's clean indoor air and tobacco licensing laws, closing loopholes in the state's clean indoor air law, raising in the age to 21, and ending the raid on California's anti-tobacco education and research activities to pay for enforcing tobacco license laws are all big steps forward."

The new tobacco control laws include:

  • AB 7 X2 (Stone) - Close loopholes in smoke-free workplace laws, including hotel lobbies, small businesses, and break rooms.
  • AB 9 X2 (Thurmond) - Require all schools to be tobacco-free.
  • AB 11 X2 (Nazarian) - Establish an annual Board of Equalization tobacco licensing fee program.
  • SB 5 X2 (Leno) - Add e-cigarettes to existing tobacco products definition.
  • SB 7 X2 (Hernandez) - Increase age of sale for tobacco products to 21.

In another major victory, the FDA has just made final sweeping new rules extending federal regulatory authority to e-cigarettes,nicotine delivery devices that have grown into a multibillion-dollar business with virtually no federal oversight or protections for American consumers. The SFMS succeeded in getting both the CMA and AMA to favor such rules five years ago, and the city of San Francisco already has such rules.

Click here for further information about the signed tobacco bills


Kristin Hudacek, MD: SFMS March 2016 Member of the Month

Dr. Kristin Hudacek has roots in the East Coast, but is now a full-fledged San Francisco Giants fan. She majored in Chemical Engineering at Princeton University, and then received her medical degree from the University of Pennsylvania. She completed her dermatology residency at Drexel University College of Medicine/Hahnemann University Hospital in Philadelphia, where she served as chief resident in her final year. 

Dr. Hudacek has worked as a board-certified dermatologist at the office of Richard G. Glogau, MD since 2014. She practices medical dermatology, with an interest in women's dermatologic needs and pediatric dermatology. She is also passionate about cosmetic dermatology, and enjoys individualizing her approach to improve the appearance of each patient with the use of botox, fillers, peels, lasers and sclerotherapy. She is accepting new patients. 

 In the Bay Area, Dr. Hudacek enjoys yoga, Spinning, and finding the perfect falafel. She recently got engaged, and she and her fiancé are having fun planning their wedding.

Click here to view Dr. Kristin Hudacek's practice information.


Why are you a SFMS member?

Since I am relatively new to San Francisco, I enjoy meeting people in the Bay Area. The SFMS allows me to connect with the local medical community and also keeps me updated on important health issues, such as the regulation of tobacco products and end-of-life care.

Which SFMS member resource is most helpful to you?

The events are my favorite part. I enjoy learning about advocacy issues and meeting other physicians at the SFMS mixers.

What do you like to do when you're not at work?

I like trying new restaurants and San Francisco is a foodie's paradise. Some of my most memorable dining experiences in the past year include visiting Lazy Bear and Al's Place. In the Bay Area, I also enjoy attending San Francisco Giants games and hiking scenic trails.

What is the most important thing you learned in medical school or residency?

To keep learning. My medical training taught me how to be comfortable reading medical literature, in particular the dermatological medical literature. Given that new treatments and guidelines are coming out constantly, it is important to stay current by reading medical journals. In the field of dermatology, it has been especially exciting to see new oncology treatments show promising results, even in advanced cases of melanoma.

What are some of the biggest opportunities or challenges you see in health care within the next five years?

Maintaining the affordability of pharmaceutical prices is a constant struggle. I dislike changing my prescribing habits in order to write for drugs that are more affordable, but I also know that prescribing medications with exorbitant prices is impractical. I provide patients with medication coupons whenever I can.

What do you love most about practicing dermatology?

Variety! I love that dermatology combines medical treatments, surgical procedures and cosmetic interventions. I'm also fortunate to treat everything from skin cancer to photoaging, and to see patients of all ages.

What is the best piece of advice you have been given throughout your career so far?

Care for the individual, not the disease. While I can read extensively about the treatment of any skin disease, my therapeutic plan will differ based on the age and habits of each particular patient. That is the art of medicine, and that is what keeps each patient visit unique and interesting.

Who’s your favorite music artist/band?

Led Zeppelin, Lady Gaga and Frank Sinatra.

What is your favorite restaurant in San Francisco?

Universal Cafe and La Ciccia

If you weren't a physician, which profession would you like to try?

Teacher. I enjoy educating others about dermatology, and have spoken to nursing students, urgent care health professionals, and mothers' groups about important dermatological conditions and skin care.


SFDPH Health Advisory: Request to Report Overdoses and Deaths due to Illicitly Obtained Fentanyl

At least 48 overdoses presenting in Sacramento County during March-April 2016, and several in other Northern California counties, including two in San Francisco, are believed to involve illicitly obtained fentanyl, an extremely potent opioid analgesic. The overdoses were caused by pills that the purchasers believed to be the opioid Norco® but actually contained fentanyl; several overdoses in 2015 involved both white powder and counterfeit Xanax® pills containing fentanyl in San Francisco. In response, the California Department of Public Health (CDPH) has instituted a surveillance effort based on hospital reporting to local public health departments. 

Actions Requested of San Francisco Hospitals and Medical Providers:

1. Report overdoses and deaths suspected or confirmed to be due to illicitly-obtained fentanyl to SFDPH. Obtain a Confidential Morbidity Report (www.sfcdcp.org/diseasereporting.html), complete the top half and fax it to SFDPH Communicable Disease Control at (415) 554-2848. 

2. Test for fentanyl when conducting drug screening, by adding it to the panel of substances tested. Positive fentanyl tests in the absence of overdose are not reportable, but can provide an opportunity for providers to educate patients regarding the potential for overdose due to fentanyl. 

3. Improve patient safety

a) Discourage patients from purchasing pills on the street. 

b) Refer patients with opioid use disorder to treatment. San Francisco has treatment-on-demand at BAART Turk Street and BAART Market Street methadone clinics close to Civic Center area. 

c) Ensure patients who may access opioids from the street have naloxone. Either direct patients to the DOPE Project or prescribe naloxone directly. 

Persons who may be exposed to opioids are encouraged to have access to naloxone, a short-acting opioid antagonist that is sprayed intranasally or injected to reverse an overdose. Naloxone is not a controlled substance, can be prescribed by any licensed provider, and can be administered by witnesses as a first aid measure. Naloxone is covered by Medi-Cal, Healthy SF, and most health plans, can be furnished by pharmacists without a prescription, and is available free from the DOPE Project, targeting drug users and their friends and family via syringe exchange sites.

Treatment Referrals

Click here for the SFDPH Health Advisory issued on May 3, 2016.


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