|
News from the Florida
Academy of Pain Medicine
u Vol V
No. 1 u
Jan, 2011
FAPM Home
Best viewed in Internet Explorer |
 Message
from the President
Raul A. Monzon, MD, FAPM President
As we enter the new fiscal year 2011, there is
still much work to be accomplished in the field of medicine. The Academy
will need to remain diligent in our efforts to protect our member’s ability
to practice pain medicine without further restrictions imposed by various
governmental agencies. We must have the freedom to treat our patients in a
professional manner based on our medical training. FAPM continues to monitor
all the legislative issues confronting the practice of pain medicine, and
will strive to keep our membership informed of progress.
Included in this newsletter is information regarding Legislative
Ratification of Rules, Pain Management Clinic Registration Requirements and
the Medicare and Medicaid Extenders Acts of 2010.
Our
annual FAPM Conference will be held August 19-21, 2011, at the Breakers
Hotel in West
Palm Beach. This will be an
important conference for our members and associates to attend to keep
abreast of the issues facing the practice of pain medicine. We have been
able to negotiate a reduced hotel fee by returning to the Breakers again
this year. You can register on-line, via email, regular mail or by phone at
727-581-4319.
The
new fiscal year brings us a new dues billing cycle for 2011. Member’s dues
are vital to FAPM providing the benefits you have become accustomed to. (A
list of benefits is listed on this website). However, with the many issues
facing our medical practices, your FAPM dues are more important than ever
before. Please take time to pay them now in whatever way works best for you.
Finally, we have had to greatly increase our
legal fees budget this year. Our legal counsel has represented us at
numerous state board meetings and legislative sessions. It has been
extremely important for FAPM to have legal representation at these meetings,
along with Board and Staff members to show our interest in issues affecting
the practice of pain medicine. Therefore, we ask for each member to make a
contribution to the FAPM Legal Defense Fund when you pay your 2011 dues.
Legislative Ratification of Rules
MEMORANDUM
TO: Agency Heads and General
Counsels
FROM: Scott Boyd, Executive Director & General Counsel
DATE: November 17, 2010
SUBJECT: CS/CS1HB 1565 (2010-279, L.O.F.)
—
Legislative Ratification of Rules
The Florida Legislature, during the special session of November 16,
2010, voted to override the Governor’s veto of HB
1565.
The bill substantially amends the
rulemaking procedures of ss. 120.54 and 120.541, F.S., with respect to
agencies’ preparation of a statement of estimated regulatory costs fbr
proposed rules and requires legislative ratification of certain rules.
By joint resolution, the Legislature voted to make HB 1565 effective on
November 17, 2010.
The new legislation provides that if
a proposed rule will have an adverse impact on small business, or if the
proposed rule is likely to directly or indirectly ipcrease regulatory
costs in excess of $200,000 within one year after implementation of the
rule, the agency shall prepare a statement of estimated regulatory
costs. See
120.54(3)(b)1.; 120.541(1)(b).
A statement of estimated regulatory
costs shall include an economic analysis showing whether the rule
directly or indirectly is likely to have an adverse impact on economic
growth, private- sector job creation or employment, or private-sector
investment in excess of$ 1 million within five years after
implementation; have an adverse impact on business competitiveness in
excess of $1 million within five years after implementation; or increase
regulatory costs in excess of$ 1 million within five years after
implementation. See
120.541(2)(a).
Section 120.541(3) provides that if
the adverse impact or regulatory costs of a rule exceed any of the
criteria established in s. 120.541 (2)(a), the rule shall not take
effect until it has been ratified by the Legislature in the next regular
legislative session.
Proposed agency rules that have not
been filed for adoption, and proposed rules that have been filed for
adoption but are not yet effective, as well as proposed niles noticed on
or after the effective date of 2010-279, L.O.F., appear to be subject to
the new legislation. See
Florida Public Service
Commission v. Florida Waterworks Association,
731 So. 2d 836 (Fla.
1st DCA
1999); Life Care Centers of
America, Inc. v. Sawgrass Care Center. Inc.. 683 So: 2d 609 (Fla.
1st DCA 1996).
Please review your agency’s proposed rules as described above and advise
the Committee and the Department of State whether or not the rules
require legislative ratification pursuant to s. 120.541(3). Also,
please be aware that a proposed rule may now require the preparation of
a statement of estimated regulatory costs to meet the requirements of
ss. 1 20.54(3)(b) 1. and 120.541(1 )(b). The statement must be
provided to the Committee at least 21 days before filing the rule for
adoption. See 120.54(3)(a)4. An existing statement of estimated
regulatory costs that isrevised to meet the requirements of ss.
120.54(3)(b)1. and 120.541(1)(b) must be provided to the Committee at
least 45 days before filing the rule for adoption. See
120.541(l)(d).
For your convenience, we have attached a copy of chapter 120 prepared by
the Committee staff that includes the new provisions of 2010-279, L.O.F.
Please note that this document is not the official version of the
Florida Statutes prepared by the Division of Statutory Revision and may
contain inadvertent errors.
Please do not hesitate to contact our office if you have questions
regarding the requirements of
2010-279, LO.F.
Scott Boyd, Executive
Director & General Counsel
Notice of
change concerning rule 64B-7.001 Pain-Management Clinic Registration
Requirements
Jeffrey A. Zipper, MD
Dear Colleagues,
The Department of Health has posted a notice of change
concerning rule 64B-7.001 Pain-Management Clinic Registration
Requirements. The most significant change concerns an exemption to
the pain clinic registration requirement for Pain interventionists,
“With regard to the surgical services exemption,
interventional pain procedures of the type routinely billed using
surgical codes are included in the term surgical services.”. Other
rule changes discuss the time requirements for the designated
physician to be within the facility and how to make arrangements for
coverage in the absence of the designated physician. Attached you
will find a copy of the rule change for your review.
While this is welcome news for all Pain Management
physicians who perform interventional procedures it leaves all
non-interventionists holding the bag concerning pain clinic
registration. I have heard through the grape vine that there may be
a challenge to this aspect of the rule change. While I am not in
favor of a challenge to this rule change, I believe we must all
remain steadfast to the concept of amending SB2272 to protect our
Constitutional rights as well as those of our patients. PLEASE
UNDERSTAND THAT NONE OF THE ISSUES THAT ARE BEING LEGALLY CHALLENGED
AT THIS TIME HAVE BEEN ADDRESSED OR AFFECTED BY THIIS RULE CHANGE.
In my opinion the real issue at hand is the dispensing
of medications whether within a physician’s office or pharmacy. The
FAPM is working on amendment language to SB 2272 which we are hoping
to present to several legislators shortly. The FAPM’s proposed
amendments to SB 2272 will directly address the issue of dispensing
services, whether you are a pain management physician, physiatrist,
neurologist etc., and will go a long way to rectifying this crisis
once and for all. I will share this amended language with everyone
once all the concerned parties have agreed upon it conceptually.
Chief Executive Officer
National Pain Institute
5365 W. Atlantic Ave
Delray Beach, FL. 33484
Corporate Office 561-241-9300 ext 1020
E-Fax 561-515-8894
Medicare physician payment legislation update
From: Susan Franz <SFranz@flmedical.org>
To: CMS Executives <CMS-EXEC@medone.org>; Specialty Society Execs
<specialtysocietyexecs@flmedical.org>
Cc: Linda McMullen <LMcMullen@flmedical.org>; Leslie Barber
<LBarber@flmedical.org>
Sent: Thu, Dec 9, 2010 8:59 am
Subject: Medicare physician payment legislation update
By unanimous consent late yesterday, the Senate passed H.R.
4994, the "Medicare and Medicaid Extenders Act of 2010." The
legislation would stabilize Medicare physician payments at
current rates for 12 months, through the end of 2011. Medicare
payments are scheduled to be cut by 25 percent on January 1,
2011.
In addition to providing an additional 12-month reprieve from
the Medicare physician payment cuts being produced by the
sustainable growth rate (SGR) formula, the bill extends a number
of other payment policies that were set to expire at the end of
this year. Of particular interest to physicians, the bill would
extend through 2011:
-
the "floor" on geographic adjustments made for the physician
work component of the Medicare payment schedule;
-
the 5 percent payment increase for certain Medicare mental
health services;
-
an exceptions process for the cap on Medicare outpatient therapy
services; and
-
payments for the technical component for certain pathology
services.
Also of benefit to physicians, the legislation includes funds to
enable Medicare contractors to reprocess claims for physician
services affected by provisions of the Patient Protection and
Affordable Care Act (PPACA) passed last spring with a
retroactive effective date of January 1, 2010. These include
revisions to the geographic payment adjustments, increased
payments for bone density tests, and other policies. Retroactive
payment changes resulting from corrections that were made in the
calculation of certain relative value units when the 2010
Medicare payment schedule was first issued could be implemented,
as well.
The approximately $19 billion cost of the legislation was offset
by an increase in repayments to be made by individuals and
families whose income grew significantly after they were deemed
eligible for subsidies to purchase health insurance under PPACA.
Under current law, such repayments are capped at $250 for an
individual and $400 for families; the bill would raise these
caps according to an income-related scale to as much as $1,750
for an individual and $3,500 for a family making between 450-500
percent of the federal poverty level.
Now the House of Representatives must pass H.R. 4994 before it
is sent to the White House for the President’s signature into
law. So, it is not a “done deal” as yet, but I know many of you
were asking us and we wanted to keep you all apprised on what is
happening. Please note, per above information, this bill will
also fund to pay claims that have not been reprocessed due to
increases made by the PPACA last year. First Coast was unable
to reprocess those claims until they received funding and
instructions from CMS. If this bill passes, they should be
receiving the funding and instructions on payment to those
offices that are affected.
The FMA will continue to send out notices once we have more
information. At least this is a step in the right direction.
If you have any questions, please let me know.
Susan Franz
Medical Economics Specialist
Office: (850) 224-6496
Fax: (850) 222-8827
sfranz@flmedical.org
AOA - GOAL Advocacy Alert
CMS and ONC Announce Registration Start Date for
Electronic Health Records Incentive Program
| Electronic health records incentives registration
starts Jan. 3, 2011 |
More Info
|
| CMS, ONC Outline Resources to Assist Eligible
Providers |
| |
|
The Centers for Medicare and Medicaid Services (CMS)
and the Office of the National Coordinator (ONC)
have announced that registration for the Medicare
electronic health record (EHR) incentive program
will open Monday, January 3, 2011.
All eligible professionals are required to register
in order to participate in the Medicare and Medicaid
EHR incentive programs. To prepare for
registration, physicians should familiarize
themselves with the incentive programs’ requirements
by visiting CMS'
official site for the Medicare and Medicaid EHR
Incentive Programs. This site provides general
and detailed information on the programs, including
tabs on the path to payment, eligibility, meaningful
use, certified EHR technology, and frequently asked
questions.
Under the Health Information Technology for Economic
and Clinical Health Act (HITECH), part of the
American Recovery and Reinvestment Act of 2009
(ARRA), Medicare and Medicaid incentive payments
will be available to eligible professionals when
they adopt certified EHR technology and successfully
demonstrate “meaningful use” of the technology in
ways that improve quality, safety, and effectiveness
of patient-centered care. Physicians who meet the
eligibility requirements for both the Medicare and
Medicaid EHR incentive programs must select which
program they wish to participate in when they
register. Physicians cannot participate in both
programs; however, after receiving payment, they may
change their program selection once before 2015.
Under the EHR incentive programs, eligible
professionals can receive as much as $44,000 over a
five-year period through Medicare. For Medicaid,
eligible professionals can receive as much as
$63,750 over six years.
CMS and ONC also announced that on January 3
registration for the Medicaid EHR Incentive Program
will be available in Alaska, Iowa, Kentucky,
Louisiana, Oklahoma, Michigan, Mississippi, North
Carolina, South Carolina, Tennessee, and Texas. In
February, registration for the Medicaid EHR
Incentive Program will open in California, Missouri,
and North Dakota. Other states likely will launch
their Medicaid EHR Incentive Programs during the
spring and summer of 2011. The AOA will provide
information on additional state programs as it
becomes available. Physicians who choose to
participate in the Medicaid incentive program must
initiate registration at CMS’ registration site and
they must complete eligibility verification with
their state Medicaid agency. Physicians
participating in the Medicaid incentive program are
encouraged to contact their state Medicaid agency
for additional details on registration.
The following are a list of key dates provided by
CMS and ONC:
- Jan. 3, 2011 – Registration for the Medicare EHR
incentive program begins.
- Jan. 3, 2011 –States that are ready may launch
their incentive programs for Medicaid providers.
- January 2011 – Some state agencies begin issuing
Medicaid EHR incentive payments.
- April 2011 – Attestation for the Medicare EHR
incentive program begins.
- May 2011 – Issuing of Medicare EHR incentive
payments expected to begin.
- July 3, 2011 – Last day for eligible hospitals
to begin their 90-day reporting period to
demonstrate meaningful use for the Medicare EHR
incentive program for federal FY 2011.
- Sept. 30, 2011 – Federal FY 2011 payment year
ends at midnight for eligible hospitals and critical
access hospitals (CAHs).
- Oct. 3, 2011 – Last day for eligible
professionals to begin their 90-day reporting period
for calendar year 2011 to demonstrate meaningful use
for the Medicare EHR incentive program.
- Nov. 30, 2011 – Last day for eligible hospitals
and CAHs to register and attest to receive an
incentive payment for federal fiscal year 2011.
- Dec. 31, 2011 – Calendar 2011 payment year ends
for eligible professionals.
|
Department Inspections Continue and Change in Effective Date for MD Rule
On Standards of Practice for MDs Practicing In Pain Management Clinics
Dear Pain Management Clinic Designated
Physician
SUBJECT: Department Inspections
Continue and Change in Effective Date for MD Rule
On Standards of Practice for MDs Practicing In Pain Management Clinics
The recent Special Legislative Session voted into law HB 1565, an act
regarding rulemaking. HB 1565 will impact the implementation of proposed
Rules 64B-9.0131 and 64B8-9.0132, Florida Administrative Code, the Board of
Medicine’s proposed rules on standards of practice for MD physicians
practicing in pain management clinics. The
Board of Osteopathic Medicine Rules
on standards of practice for DO
physicians practicing in pain management clinics, 64B15-14.0051
and 64B15-14.0052, Florida Administrative Code, are in effect now and are
not impacted by HB 1565.
The new pain clinic statutes went into effect on October 1, 2010 and are not
impacted by HB 1565. Department
inspections for compliance with the new pain clinic statutes began earlier
this month. All clinics will be
billed $1,500 at the time of inspection.
Although rules are being considered to provide an option for pain
clinics to be accredited by board-approved national organizations in lieu of
the annual inspection, this option is not available now.
All pain
management clinics are subject to this annual Department inspection.
In order to comply with HB 1565, it is expected that the Board of
Medicine will be asked to direct
completion of an amended statement of regulatory costs (SERC). If based on
the amended SERC the Board determines that the
rule will reach a certain level of economic impact the
proposed rule will then need to be presented to the legislature. The
legislature would have to ratify the rule before it can become effective.
The Board of Medicine will have an opportunity to further discuss this
matter at the December 3-4, 2010 Board
of Medicine meeting.
Please visit our website to review:
a memo from Scott Boyd, Executive Director of the Joint Administrative
Procedures Committee, which explains the legislative ratification of rules;
the new Board of Osteopathic Medicine Rules and
the new pain clinic statutes:
http://www.doh.state.fl.us/mqa/medical/me_pain.html
Larry McPherson, Executive Director,
Board of Medicine
Anthony Jusevitch, Executive
Director, Board of Osteopathic Medicine
|
