Thursday, March 26, 2015

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Providing news to the San Francisco Medical Community.


San Francisco Medical Society Hails U.S. House Passage of Medicare Access Bill; Urges U.S. Senate to Act Swiftly

Today, the U.S. House of Representatives passed H.R. 2, the “Medicare Access and CHIP Reauthorization Act,” by a substantial bipartisan margin—392 to 37.

SFMS congratulates representatives for working together to develop a bill that implements meaningful reforms to the Medicare program, and urgently asks their colleagues in the Senate to do the same before spring recess.

H.R. 2 will reform the broken Medicare sustainable growth rate (SGR) physician payment system and extend the expiring Children’s Health Insurance Program (CHIP). Both of these important reforms will help to improve access to doctors in California for five million seniors on Medicare, one million military families on TriCare and the nearly one million uninsured children currently covered by CHIP.

SFMS members are urged to contact Senators Feinstein and Boxer to ask them to vote YES on H.R. 2 before adjourning for the April recess.

  • Sen. Dianne Feinstein district office - Phone: (415) 393-0707
  • Sen. Barbara Boxer district office - (510) 286-8537

You can also use AMA’s toll-free Grassroots Hotline (800) 833-6354 to call or go to http://FixMedicareNow.org to send an urgent message by email or social media.


SGR Update: HR 2 Replaces HR 1470

Today, the Medicare physician payment reform legislation was modified to include budget offsets, policy extenders, and other provisions and reintroduced by Rep. Michael Burgess, MD (R-TX) as HR 2, the “Medicare and CHIP Reauthorization Act” (MACRA).

Click here for a section-by-section analysis prepared by staff of the House committees of jurisdiction.

HR 2 replaces HR 1470, and builds on the bipartisan, bicameral SGR replacement policy negotiated last year. Additional provisions of interest include the following:

  • The work GPCI (Geographic Practice Cost Index) floor was extended through 2017.
  • The therapy caps exceptions process was extended through 2017.
  • The Qualifying Individual (QI) program that provides Part B premium support for low-income Medicare beneficiaries was extended permanently, as was the Transitional Medical Assistance (TMA) program that allows Medicaid recipients to maintain coverage for a year as they transition from welfare to work.
  • Funds for Community Health Centers and the National Health Service Corps and the Teaching Health Center GME Payment Program were all extended through 2017.
  • The Children’s Health Insurance Program (CHIP) was extended through 2017.
  • For new enrollees beginning in 2020, Medigap plan coverage will be limited to costs above the amount of the Part B deductible.
  • Income-related premiums for Medicare Part B and D under current law have been readjusted; those with incomes between $133,501 and $160,000 will increase from 50% to 65%, those with incomes at $160,001 and above will increase from 65% to 80%.
  • The decision by the Centers for Medicare and Medicaid Services (CMS) to eliminate bundled payments for 10-day and 90-day global surgical services has been reversed; instead, CMS will collect data on these services beginning in 2017 to determine the accuracy of payment rates.

The bill is scheduled for consideration by the House Rules Committee on March 25. Floor debate is expected to occur on March 26, with a vote taking place early afternoon.

Also on March 26, The Senate will be voting on amendments to the FY 2015 budget resolution, which cannot be interrupted for other business. The budget votes are expected to continue well into the night, after which some action could occur regarding HR 2.


SFMS Applauds Leader Pelosi for HR 1470 - Bipartisan SGR Repeal Package

Lawmakers yesterday unveiled a bipartisan bill to eliminate the Medicare sustainable growth rate (SGR) formula. The bill, HR 1470 (no number has been assigned yet to the Senate version), is an updated version of the policies set forth in last year’s bipartisan, bicameral Medicare payment reform bill.

House Speaker John Boehner and House Minority Leader Nancy Pelosi have now largely agreed to a $213 billion deal to fund the permanent SGR replacement, along with a two-year extension of Children’s Health Insurance Program (CHIP) funding. The newly introduced legislation would block a 21% cut in physicians’ Medicare fees that otherwise takes effect April 1. It would also offset about $70 billion of the projected costs.

The House is expected to vote on the entire proposal on March 24.

SFMS and the California Medical Association fully support the SGR bill, the funding framework, and CHIP extension. SFMS leaders have contacted Leader Pelosi’s office to thank her for her work on this bill and for her tireless efforts to improve access to care in San Francisco and California.

Key provisions of HR 1470

HR 1470 calls for:

  • Immediate repeal of SGR.
  • Positive annual payment updates of 0.5% would be provided for four-and-a-half years, beginning July 1.
  • Current Medicare quality reporting programs would be replaced with a simplified and consolidated merit-based incentive payment system (MIPS).
  • 5% incentive payment for physicians is provided for physicians who participate in alternative payment models and meet certain thresholds.
  • Provisions similar to the Standards of Care Protection Act are included.

Click here to view the proposed bill. 

Physicians’ Call to Action

SFMS and physician organizations across the country are urging physicians nationwide to participate in a National Call to Action day. Contact your senators and representatives on Tuesday, March 24, and urge them to support HR 1470 in any of the following ways:

  • Use AMA's toll-free Physicians Grassroots Hotline at (800) 833-6354.
  • Send an urgent email to your lawmakers reinforcing the need for SGR repeal now.
  • Contact legislators directly through their own social media channels, and share your message with your own Facebook friends and Twitter followers. #FixMedicareNow

SFMS Member Benefit: Medical Practice Marketing

As the collective voice for medicine and all specialties, SFMS strives to enhance the professional development and quality of life for its members.

For $3/day, SFMS members receive more than $6,000 in savings and benefits per year. Click here for the comprehensive list of member benefits. 

SFMS provides medical practice marketing assistance to our members, including:

  • Online and Phone Patient Referral Service through SFMS’ phone referral line and online physician finder tool.
  • Exclusive member-only networking events to connect with local physicians and expand referral base. Join us for March 25 networking mixer at Pa’ina by clicking here
  • Personal Physician Webpage housed on the SFMS website is provided to all SFMS physician members. Personalized physician page include with office hours, practice website, and additional information to highlight their practice.
  • Inclusion in SFMS Membership Desk Reference, the only comprehensive pictorial directory of San Francisco physicians and used by many health care professionals on a daily basis for physician referrals. Click here to update your practice information.

SFMS Member Benefit: ICD-10 Training Seminars

For $3/day, SFMS members receive more than $6,000 in savings and benefits per year. Click here for the comprehensive list of member benefits. 

The newest savings for SFMS members is access to discounted ICD-10 training through the American Academy of Professional Coders (AAPC).

The California Medical Association (CMA), in partnership with SFMS, will offer statewide, two-day ICD-10 code set seminars in Summer 2015. CMA/SFMS has negotiated a reduced price of $399 for CMA/SFMS members; AAPC typically charges non-members $799 for this course.

The training is designed specifically for coding staff and intended to give attendees a comprehensive understanding of guidelines and conventions of ICD-10, as well as fundamental knowledge of how to decipher, understand and accurately apply codes in ICD-10.

Training is provided onsite in a classroom format and would be conducted over two days, including 16 hours of intensive general ICD-10 code set training along with hands-on coding exercises. Each attendee receives the AAPC ICD-10-CM Work Book and recently published 2015 ICD-10-CM codebook. The onsite training course is approved for 16 continuing education units (CEU) through AAPC. Following the onsite training, attendees will be given an ICD-10 proficiency assessment to ensure understanding of ICD-10 concepts and guidelines.

A list of seminar dates and locations will be posted to the SFMS website as they become available.


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