Friday December 17, 2010President’s Message
Melanie K. Kuechle, MD
Dear WSDA Colleagues:
Season’s Greetings. As 2010 comes to an end, I want to take this moment to reflect on the activities of the WSDA and promote upcoming events. The annual Pacific Northwest Dermatological meeting held in Vancouver Washington was a great success, with over 100 attendees. The syllabus and lectures are available on-line, and many members commented on the convenience of this feature. Remember to mark your calendars for the 2011 meeting which will be held at the Fairmont Hotel Vancouver in Vancouver, British Columbia, July 21-24, 2011.
Our website has been redesigned and now includes many new functional features. We are currently working on populating the site with our Society members’ information. We would like to position the website as a prime source of information about quality dermatologists in the state. All dermatologists who are members of the Society will be able to have their profiles listed on the website. We will soon be able to offer job postings for both professional and ancillary staff. Dermatology resident’s are offered membership to the society dues free (!), and may find the job postings section particularly relevant.
Ever notice how that especially hard to diagnose or treat patient can’t quite seem to make it to the biannual WSDA meeting? Ever wonder why the EMR in your particular office is so hard to use and think to yourself: “Surely there is a better way?” One feature of our web site we are working on is a member’s only discussion board; an internal “face-book” site for dermatologists where questions and photos can be posted and suggestions reviewed. Even if you just want to vent about the #$&# EMR!
The WSDA Board of Directors met in November to outline upcoming priorities. Indoor tanning use, especially by adolescents, remains a concern. Legislation to limit access and require parental consent for minors was introduced in 2010, but did not pass. We will be introducing new legislation during the 2011 session that will seek to regulate the indoor tanning industry and limit access for minors. To kick off the 2011 legislative session, the WSDA will be offering a free skin cancer screening in Olympia on January 13th. This is a good opportunity to meet the faces behind those that have impact on our practices. While tanning may be at the top of the discussion board this session, other issues continue to rise.
Other issues on our radar include 1.) Truth in Advertising and 2.) Anatomic Pathology billing. Remember the aesthetician injecting mislabeled substances into client’s faces? Some of my patients asked me about that, and I had to explain that this person was not a board certified physician, much less a board certified dermatologist. Other states have introduced legislation that ensures patients are clearly informed of the training and qualifications of their health care practitioner. WSDA is considering introducing similar legislation. Regarding Anatomic Pathology Billing: it is the position of the AAD as well as the WSDA that Dermatologists, based on their education and training, should be able to interpret skin pathology specimens and be paid fairly for their work. When dermatologists choose to send pathology specimens out for interpretation, they should be able to choose
the Dermatopathologist they deem best for their patients. The WSDA will continue to monitor this legislation and keep you up-to-date during the 2011 legislative session. If you have any questions or concerns, please don’t hesitate to contact me or the WSDA office at smc@wsma.org.
To a happy, healthy, and productive 2011.
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Obama Signs 'Doc Fix' Bill
The annual Washington craziness is back again for the holiday season, after President Obama signed a bill that delays a dreaded 25% pay cut for physicians who treat Medicare and military patients. Medical groups said the decision was sorely needed to maintain access to quality care for seniors, as they do each year, in an effort to force Congress to end-run one of its own laws. Ho-hum. Implementation of the formula, which is based on the economy and how much Medicare spends, has been delayed consistently since 2002, and in that time the percentage of pay cut has steadily grown. Each time, physician groups and others who demanded a permanent fix criticized Congress for "kicking this can down the road one more time" rather than permanently repealing it.
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Bill Exempts Doctors from FTC's Red Flag Rule on ID Theft
The Senate and House have each passed a bill that changes the Red Flags Rule's definition of "creditor" and relieves doctors of complying with the Federal Trade Commission's identity theft prevention law.
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Know Your Options Re: Medicare
From mid-November through December 31, physicians will have their annual opportunity to review and perhaps change their Medicare participation status. Given the severe Medicare payment disruptions and uncertainty going forward the WSMA encourages you to review your options carefully.
To help you choose the direction that is right for your practice, the AMA has developed the “Know your options: Medicare participation guide.” This kit contains a detailed explanation of the three available options:
- participation (PAR),
- non-participation (non-PAR), and
- private contracting.
It also includes a helpful revenue calculator and various sample materials to help physicians share information with current, new, and prospective patients. The Medicare options kit is accessible at www.ama-assn.org/go/medicareoptions.
Also, please continue to urge your patients to get involved by directing them to our online petition www.wsma.org/melt-down.cfm.
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Interpreter Services Payment Cut Delayed
The Washington Medicaid program has delayed until March 1, 2011 its proposed elimination of coverage for interpreter services. As part of the state’s budget crisis, the cut was scheduled to take effect on January 1.
The WSMA, in cooperation with Physicians Insurance A Mutual Company, has prepared updated guidance on interpreters’ services, available on www.wsma.org (Practice Resource Center, Practice Management Operations).
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Governor Rolls Out Change Proposals for Pensions and Health Care
Saturday’s special legislative session went quickly and quietly as this latest round of budget cuts, necessary to get through the remainder of the fiscal year, were approved and sent to the governor. Cuts included $27.7 million to be gained by reducing enrollment in the Basic Health Plan; the majority of these savings will come from not filling slots as they come open.
On Monday the Governor rolled out further changes, announcing proposals to change the state's health care and pension systems to reduce costs. Her office reports that if enacted, the pension system reforms could save more than $400 million during the 2011-2013 biennium; the health care reforms could save the state several billion dollars over the next ten years.
Pension reforms include ending the automatic annual pay increases now provided for some pensioners, and early retirement incentives, plus an end to the current practice of retire-rehire exemptions. For more information, go to www.governor.wa.gov
(Transforming Washington’s Budget, scroll down to ‘Policy Briefs’ then ‘Reforming Pensions’), or download a 3-page pdf.
The governor's health care proposals are intended to limit the overall increase in health care costs in Washington state to no more than five percent a year by 2014 (the state currently pays for health care for 1.2 million low-income children and adults and 335,000 public employees, retirees and their families). If the plan meets its goal, Gregoire expects all Washingtonians to save a combined $26 billion on health care over the next 10 years.
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Electronic Health Records and "Meaningful Use"
The third quarter 2010 issue of the WSMA Preceptor (www.wsma.org, News & Events) provided guidance on the “meaningful use” standards in the Final Rule issued by the Centers for Medicare and Medicaid Services (CMS). Practices without EHRs should watch for further developments on the temporary and final certification of EHRs as they select their own system. Practices with EHRs should ask their vendors how their systems will be brought into alignment with the new requirements and if the practice would incur additional costs as a result. If their current systems cannot be upgraded, practices may need to switch to different models. Useful resources include these Fact Sheets:
- CMS guidance on the Final Rule: www.cms.gov/EHRIncentivePrograms
- EHRs standards and certification criteria: http://healthit.hhs.gov/standardsandcertification
Practices also should review the materials available from the Washington & Idaho Regional Extension Center (WIREC), offered through Qualis Health: www.wirecqh.org.
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