HP-Update 6-29-2011

June 29, 2011

Dear Colleague:

We want you to know the highlights of the Academy's regulatory advocacy and the latest updates in business of medicine affecting the specialty and your patients. The Physician Payment Policy Workgroup (3P), led by Co-Chairs Richard Waguespack, MD and Michael Setzen, MD, along with your AAO-HNS Health Policy Team, are working hard on your behalf to advocate for you on socioeconomic and practice affairs issues. To provide you with an update on the most important health policy efforts and issues, we are sending the first of a series of quarterly health policy-specific e-newsletters. Read below for the latest socioeconomic and practice affairs news.


CMS Proposes New Exemption Categories under the Medicare E-Rx Program
As a result of the advocacy of the Academy and several specialty societies, the Centers for Medicare and Medicaid Services (CMS), on May 26, issued a proposed rule, which if finalized will add new exemption categories for physicians to avoid the 2012 Medicare E-Rx penalty. If you fall under any of these new exemptions, you must attest as such through an on-line web portal by October 1, 2011. If you do not fall under any exemption categories, you must still report on 10 unique electronic prescribing events (using the e-Rx measure G8553 on your Medicare claims) associated with office visits by June 30, 2011. More on the new exemption categories.

Academy Advocates for Expanded National Coverage of Cochlear Implants for Sensorineural Hearing Loss
On May 11, 2011, Academy members Jack Wazen MD, Debara Tucci MD, Craig Buchman MD, and staff attended a Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) meeting to provide data on the effectiveness of cochlear implants (CI) in patients and urged CMS to expand its coverage for the device. Although MEDCAC, which makes recommendations to CMS about its coverage for devices, concluded there was not enough evidence to expand Medicare coverage for CIs, it plans to continue engaging specialty societies and CI manufacturers so it can obtain more robust data on health outcomes.  More

New Policy Statement on Midline Glossectomy
We have posted a new policy statement: Midline Glossectomy for OSA. The Sleep Disorders committee diligently worked to develop this policy statement. We thank each member of the committee for investing their time and effort into this project.

Get Ready to Complete RUC Surveys this Summer
In July, the Academy will be surveying members on three otolaryngology-specific procedures—Diagnostic nasal endoscopy (31231); Removal of foreign body from ear canal (69200); and Tympanostomy with tube, local (69433) — to provide data to the AMA’s Specialty Society RVS Update Committee (RUC) at the RUC meeting taking place on September 22-25 in Chicago, IL. The RUC is a joint effort of the AMA and medical specialty societies that makes recommendations on revising and updating the resource-based relative value scale, which is utilized by Medicare and many private payers. If you receive a survey, please be sure to take the time to fill it out. Your work on this survey is critical in the Academy’s efforts to assure appropriate valuation. A high survey completion rate and thoughtful, well-informed survey responses greatly improve the probability that the Academy’s recommendations will be accepted by the RUC. Failure to fill out surveys may result in reimbursement delays for this service or a value set without otolaryngology input.

To obtain a comprehensive overview on the RUC process, view the RUC article in the May 2011 issue of the Bulletin and contact Tricia Bardon at TBardon@entnet.org.


View the Results of the 2011 Socioeconomic Survey at the 2011 Annual Meeting
The results of the Academy’s 2011 Socioeconomic Survey will be unveiled at this year’s annual meeting. The survey display will be located in the Esplanade Lobby of the Moscone Center. Don’t miss this opportunity to check important benchmarking tools for your practices’ productivity, revenue, and operations. View previous socioeconomic surveys.

Don’t Miss these Informative Sessions & Mini-seminars at the 2011 Annual Meeting & OTO EXPO
Health Policy staff and the Physician Payment Policy (3P) workgroup, the senior advisory body on issues related to socioeconomic advocacy, regulatory activity, coding or reimbursement, and practice management have organized and developed four sessions at this year’s Annual Meeting & OTO EXPO to help you better maneuver payment issues with Medicare and private payers, streamline your transition to ICD-10, and become a better advocate for your practice. The titles and dates for the sessions are listed below. More
• 9/11-10:30-11:50am 3P Mini-Seminar on Academy Advocacy for Physician Payment: New Strategies
• 9/12-2:30-4pm Understanding the RUC Process and Survey Instrument
• 9/12- 4-5:30pm Third Annual Medicare Contractor Advisory Committee (CAC) Session
• 9/14-10:30-11:50am ICD-9- Transition Hurdles to ICD-10 Diagnostic Coding Mini-Seminar

Pointers for Preparing for ICD-10 Transition
The mandatory transition to ICD-10 will occur on October 1, 2013. If you are looking for information on how to start preparing for this transition, please read this article from the April 2011 issue of the Bulletin.


J. Regan Thomas, MD

For more information, contact the AAO-HNS Health Policy Team at healthpolicy@entnet.org or visit http://www.entnet.org/Practice/CMS-News.cfm.


HP Update Issue Archive
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