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News and announcements
Eric J. Rubin, MD, PhD, named Editor-in-Chief of the New England Journal of Medicine and NEJM Group
The Massachusetts Medical Society, publisher of the New England Journal of Medicine, today named Eric J. Rubin, MD, PhD, the new editor-in-chief of the Journal and NEJM Group. Dr. Rubin is chair of the Harvard T.H. Chan School of Public Health Department of Immunology and Infectious
Diseases and the Irene Heinz Given Professor of Immunology and Infectious Diseases. The selection of Dr. Rubin was made after a worldwide search conducted by an international search committee. He plans to start in September.
An author of 147 scientific articles, Dr. Rubin has been an Associate Editor of the New England Journal of Medicine since 2012. He also has served as an editor or editorial board member of the journals Tuberculosis, Current Opinion in Microbiology, PLoS Pathogens, and mBio.
Dr. Rubin succeeds Jeffrey M. Drazen, MD, who has been the editor-in-chief of the New England Journal of Medicine since 2000.
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Massachusetts Medical Society Testifies on ROE Act
Live broadcast: Dr. Carole Allen, MMS Vice President, spoke before the Joint Committee on the Judiciary.
The Massachusetts Medical Society provided written and oral testimony at a hearing before the state legislative Joint Committee on the Judiciary on Monday, June 17 in support of select provisions within H.3320 and S.1209, known collectively as the ROE Act. This testimony affirmed the
Medical Society’s support of (1) eliminating the requirement of parental or judicial consent for minors seeking abortion, (2) the updating of medical terminology in our legal code, and (3) the codification of safety net coverage for abortion. To read our entire written testimony,
click here.
The Massachusetts Medical Society’s House of Delegates in May adopted organizational policy pertaining to the provisions addressed in the aforementioned testimony.
At that meeting, the Medical Society also considered provisions that would support policies permitting abortions after 24 weeks of pregnancy in instances of lethal fetal anomalies, and policy to remove other barriers to abortion. After careful and thorough discussion, these matters were
referred for further study and resolution, with input from a cross-section of physician-led medical society leaders and committees. The Medical Society stands firmly behind the thoughtful, deliberative process that its members have undertaken to establish its current policy
position and the resulting testimony relative to the ROE Act.
Application for MassHealth Provider Access Improvement Grant Program
Earlier this month, MassHealth released the application for the Provider Access Improvement Grant Program, which aims to increase access to health care and improve health outcomes among MassHealth members with disabilities or for whom English is not a primary language, and is one of the
Delivery System Reform Incentive Payment (DSRIP) Statewide Investments.
The Grant Program will provide funding to selected MassHealth providers to purchase medical diagnostic equipment and other resources that help them better serve these populations. Grant awards of up to $25,000 will be made to selected MassHealth providers, totaling up to $2.07 million for
this grant cycle ending December 31, 2019. Applicants must be actively enrolled MassHealth physicians, dentists, or other health care providers working in a medical setting that is not a hospital or owned by a hospital.
For more information about the program, please
click here . Proposals are due no later than July 26, 2019. Please direct all questions to the
"Contact Us" page on the website.
An informational webinar is scheduled for June 25, 2019, at 12:00 pm EST. Please
click here to register for the webinar.
DPH e-prescribing requirement
The Department of Public Health (DPH) proposed regulations to implement an electronic prescribing requirement. This mandate, opposed by the MMS, was part of Governor Baker’s omnibus CARE Act—legislation passed last summer aimed to curb the opioid epidemic. These regulations mandate
federally-compliant, secure electronic prescribing of drugs and devices by January 1, 2020.
The proposed regulations list exceptions for when written or oral prescriptions may be allowed and outline a waiver process for prescribers and organizations who believe they are unable to comply with this mandate. The proposed regulations and details for the submission
of comments can be
found here . A public hearing will be held on June 27, and DPH will be receiving comments until July 2, 2019. MMS will be offering extensive testimony on these proposed regulations.
MMS individual claims consultation days
The Massachusetts Medical Society is hosting in-person Insurance Claims Consultation (ICC) days. ICC days are designed to allow MMS member physicians and/or their practice staff to schedule 30-minute appointments with health plans to focus on
the adjudication of troublesome claims. Available in three locations, representatives from health plans will be on-site to review claims with you to facilitate claims processing.
Schedule your appointment at
massmed.org/ICC2019.
The following health plans are participating: Allways Health Partners, Blue Cross Blue Shield of Massachusetts, Fallon Health, Harvard Pilgrim HealthCare, Health New England, MassHealth, Medicare, Tufts Health Plan, UnitedHealthcare, and Unicare.
Benefit buzz
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Closing a medical practice, transitioning to a new practice setting, or having a colleague leave a practice are all examples of major changes that may require advanced notice and proper planning. Advanced planning is
essential to meeting professional and ethical obligations and minimizing financial as well as other types of risk in the future.
If you are in the transitioning process, PPRC can help you address issues in less time with less stress and with better outcomes. Feel free to contact us today at PPRC (781) 434-7702 or email us at
pprc@mms.org.
Payer watch
Medicare Part B Claims Update
Common Reasons for Returned Claims
Claims submitted with missing or invalid information (e.g. invalid diagnosis or procedure codes, invalid benefit plan number, place of service, etc.) will not be processed.
Medicare Part B has identified some common reasons for returned claims:
Item 1a Insured ID Number – blank or not valid format
Item 21 Diagnosis – No diagnosis code report
Item 24b Place of Service – No place of service reported
Item 32 Service Facility location – Blank
Item 33a Missing NPI – missing or invalid format reported
How to avoid having claims returned:
Item 1a – Insured ID Number
Verify the patient’s Medicare HICN or MBI (Medicare Beneficiary Identifier). The new term “Medicare number” and “Medicare ID” as it appears on the patient’s red, white, and blue Medicare card for all Medicare claim submissions (primary or secondary). The MBI is 11 characters in length
and made up only of numbers and letters (no special characters).
Please note: Effective 1/1/2020, all Medicare providers will be required to use the MBI on all Medicare transactions. If a claim received on and after 1/1/2020 is submitted with the SSN-based Medicare number, it will be returned to the provider.
Item 21 – Diagnosis
Verify the patient's diagnosis/condition It is recommended that you bill the ICD-10-CM code(s) that you are treating at the time of the visit. All other conditions should be noted in the medical record.
Additional ICD-10 Reference:
Medicare ICD-10 Coding
Item 24b – Place of Service
Verify the appropriate two-position POS code to identify the location where the Item is used, or the service is performed.
You may refer to CMS website for
Place of Service Codes for Professional Claims
Item 32 – Service Facility Location
Verify the location where the service was rendered.
Item 33a – NPI number of the billing provider
Verify the NPI of the billing provider, group, clinic or organization.
For more information about claim filing instructions, please refer to
General Information or visit
NGSMedicare.com.
Legal Advisory Plan: Why you should enroll now
Did you know that your professional liability insurance may not cover Board of Registration in Medicine investigations, or that the policy may be limited? And your premium may subsequently go up? Take advantage of the Legal Advisory Plan, an MMS members-only benefit, as your first line of
defense. Enroll or renew for July 2019 – July 2020 coverage now for a nominal fee of $70 - a fraction of the cost of hiring an attorney. You must be enrolled at the initiation of an investigation to use plan services. Questions? Email
lap@massmed.org or call (781) 434-7311.
Learn more
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Educational programs and events
CME education programs & events
Featured NEW online CME course
More online CME
Upcoming events and trainings
July 9: You Can Do It: Buprenorphine Prescribing in Primary Care (MMS Headquarters)
This program aims to allow physicians in the primary care setting who have successfully made opioid use disorder (OUD) care a part of their daily practice to share their experiences, resources they have used along the
way, and empower attendees to start prescribing lifesaving buprenorphine therapy more regularly in their practices.
September
7-8: Enhanced Recovery After Surgery: Providing Evidence-Based Care in
the Multidisciplinary Setting Course and Workshops (MMS Headquarters)
Dedicated to addressing topics related to understanding all components of ERAS, including preoperative, intraoperative, and postoperative Phases, the course and workshops consider evidence-based best practices for each component according to the various levels of care across
different medical specialties. Participants will learn the value and implications of ERAS as a relatively new holistic approach to patient care.
Quote of the week
"For many patients, it is hard to make sense of what is happening. If access to their note provides them with knowledge and assurance, then that is important to provide."
— Dr. Neda Frayha, an internist at Ascension Medical Group in Baltimore
(Kaiser Health News)
Tweet of the week
@MA_FIMC
Building a health care system that truly recognizes the critical relationship between food and health. Co-led by
@HarvardCHLPI and
@communityserv
What’s new in health care
Check out the most clicked-on stories from this week's MMS Media Watch.
Sign up for daily Massachusetts media roundups by email. Some publications are fully accessible only to their subscribers.
Lawmakers express discomfort over abortions without parental consent (Boston Globe)
Even before it faces its first hearing on Beacon Hill Monday, an ambitious legislative effort to expand abortion
access in Massachusetts has run into opposition from lawmakers who consider it to be an overreach. Most concerning to legislators is the proposed elimination of an age restriction that requires anyone under 18 to have a parent's consent or a judge's order to get an abortion. The notion that a girl as
young as 12 could get an abortion without telling her parents is proving to be a tough proposition, even in liberal Massachusetts, where most lawmakers consider themselves supporters of abortion rights.
Brigham and Women's Faulkner plans $250M expansion (BBJ)
Brigham and Women's Faulkner Hospital is planning to build a
$250 million addition, one that will add a new 98,000-square-foot, five-story inpatient building to the Jamaica Plain campus. The hospital, which is under the Partners HealthCare umbrella, announced on Friday that it had filed a letter of intent with city officials to construct the space, which would
add 78 new, single room inpatient beds as well as clinical support and ambulatory services.
'Food is Medicine' report outlines menu of options (WBUR)
The Food is Medicine State Plan, a joint effort of the Center for Health Law and Policy Innovation of Harvard Law School and service provider Community Servings, focused on nutrition's link to chronic diseases like diabetes or cardiovascular disease, and the notion that food can act as
medicine when meals are tailored to meet the specific needs of people living with or at risk for certain serious health conditions. The report was released Tuesday at an event featuring Sen. Julian Cyr and Rep. Denise Garlick. About one in 10 households in Massachusetts struggles
with food insecurity, or not having consistent access to enough food for a healthy and active lifestyle, leading to $1.9 billion in annual health care costs that could be avoided,
the report said.
Massachusetts will release $8 million for family planning clinics (MassLive)
Massachusetts is preparing to
release $8 million to reimburse family planning clinics that will lose money under new rule implemented by President Donald Trump's administration that becomes effective after a Thursday court ruling. The new federal rule tightens abortion-related restrictions on the use of money from Title X, a
federal program that funds family planning clinics. Federal money could never be used to pay for abortion. But the Trump administration's new rules ban federally funded health clinics from providing referrals to abortion clinics and require a physical separation between a clinic that
gets federal funding and one that performs abortion.
