Dr. Bombaugh joins consortium at Betsy Lehman Center; Proposed changes to Medicare Fee Schedule

News and announcements

Maryanne Bombaugh, MD, filmed a promotional video at the Betsy Lehman Center for a forthcoming article in their newsletter, Patient Safety Beat.

MMS President Dr. Maryanne Bombaugh attends consortium at Betsy Lehman Center

On Monday, July 29, Dr. Maryanne Bombaugh participated in the kickoff meeting of the Massachusetts Healthcare Safety and Quality Consortium in Boston. Convened by the Betsy Lehman Center for Patient Safety, an independent entity within the Center for Health Information and Analysis, the new consortium brought together The Massachusetts Medical Society, The Office of the Attorney General, The Massachusetts Health and Hospital Association, and 17 other groups to create a "Roadmap to Patient Safety."  In addition, attendees reviewed the consortium's charter, mission, and responsibilities, and discussed the foundational pillars for its roadmap, which included transparency, leadership and culture, learning health systems, and support for patients and the health care workforce.

To watch a short update from Dr. Bombaugh about the meeting, please click the button below.

Proposed policy, payment, and quality provisions changes to the 2020 Medicare Physician Fee Schedule 

On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a draft rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2020.

The calendar year (CY) 2020 PFS proposed rule is one of several proposed rules that reflect a broader administration-wide strategy to create a healthcare system that results in better accessibility, quality, affordability, empowerment, and innovation.    

Public comments on the proposed rules are due by September 27, 2019.    

For a fact sheet on the CY 2020 Physician Fee Schedule proposed rule, please click the button below.

Changes to National Government Services local coverage determination process schedule 

In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), the Centers for Medicare & Medicaid Services (CMS) is updating the “Medicare Program Integrity Manual” with detailed changes to the Local Coverage Determination (LCD) process. These changes were communicated in CMS Transmittal 863, issued on 2/12/2019.    

Please ensure that your staff is aware of the LCD revisions and transition of all coding to related articles. There has been no change in coverage associated with this update.

• All coding information will be removed from the LCDs and placed in a related billing and coding article, including national coverage provisions and associated information (documentation requirements, utilization guidelines).
• The article name will begin with “Billing and Coding,” followed by the title of the associated LCD.
• Bill types, revenue codes, CPT/HCPCS codes, ICD-10 codes, as well as any coding guidance or mention of codes in the LCD will now be found in the associated billing and coding article.
• Several LCDs will be revised for 8/1/2019 publication. The remaining LCDs will be revised in the coming months, with all completed by 1/1/2020.
• Billing and coding articles will be listed on the Medical Policy Center page alongside the related LCD.

Related Content

• More details on this update are available in MLN Matters® Article MM10901.
• For a complete listing of all LCDs, visit our Medical Policy Center.

Join our AMA delegation

The MMS Committee on Nominations is seeking candidates for nomination to the Massachusetts AMA Delegation. Visit www.massmed.org/amanoms to learn more about the qualifications and submit your application. The application deadline is Friday, August 30. 

Interviews with the Committee on Nominations will be held at MMS Headquarters, Waltham, on Wednesday, October 2, 4:30 p.m. – 8:00 p.m. Applicants should plan to be available on this date. Questions? Please contact Linda Healy at (781) 434-7008 or lhealy@mms.org, or Karen Harrison at (781) 434-7463 or kharrison@mms.org.

MMS Individual Claims Consultation Days: Spaces are limited!

The Massachusetts Medical Society is hosting in-person Insurance Claims Consultation Days (ICC). 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 adjudication of troublesome claims.    

Now available in two locations:

• Waltham ICC Day August 15, 2019
• Lakeville ICC Day September 19, 2019

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, Fallonhealth, Harvard Pilgrim HealthCare, Health New England, MassHealth, Medicare, Tufts Health Plan, UnitedHealthcare, and Unicare.

Benefit buzz

Legal Advisory Plan - Why you should enroll

When you receive a Board of Registration in Medicine (Board) investigation or complaint, it is recommended that an attorney delivers a well-crafted response to the Board. If you have to attend an informal Board conference about your situation, it is advised that an attorney represents you in person.

Your malpractice insurance may not cover these legal activities or perhaps only a portion. Your out-of-pocket expenses could cost you thousands of dollars.

Take advantage of the MMS Legal Advisory Plan, a members-only affordable legal service, for a nominal fee of $70/year – a fraction of typical legal fees. Enroll or renew for coverage through July 2020 now. Additional discounts for groups of five or more. Questions? Email lap@massmed.org or call (781) 434-7311.

Member verdicts:

"The Plan is a bargain. Our practice has contacted the attorneys a few times and resolved the Board matters quickly."
"The LAP newsletters were very helpful in helping me be aware of situations to avoid that could impact my medical practice and license."

The PHYSICIAN PRACTICE RESOURCE CENTER (PPRC) serves individual physicians and group practices of all sizes by providing expert knowledge and resources, advocacy, timely and critical information, and ongoing practice support. Our goal is to ensure that you have the information and resources you need to maintain a thriving practice of any size. In today’s challenging environment, practicing medicine is complicated. We make it easier.

We provide physician practices a powerful support and resource network so that you can operate successfully and focus on what matters most.

Feel free to contact us today at PPRC (781) 434-7702 or email us at pprc@mms.org.

Educational programs and events

CME education programs & events  

Featured NEW online CME course

• NEW - Restoring the Art of Medicine: The Power of Physician Wellness – The 2019 Annual Education Program
• NEW – Future Care: A Call to Collaboration – The 2019 Shattuck Lecture

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.    

September 8-10: Schwartz Center’s Compassion in Action Healthcare Conference (Westin Boston Waterfront)
This unique conference brings together clinicians, health system leaders, and others who are committed to making compassion a priority in their organizations and communities. Through interactive experiential sessions with experts from diverse care settings and communities, this conference will provide cutting-edge programs, strategies, and tools to help health care professionals across all roles and disciplines create and sustain cultures of compassion.

Quote of the week

"With a blood test, we could potentially screen thousands of people a month...that means we can more efficiently enroll participants in clinical trials, which will help us find treatments faster, and could have an enormous impact on the cost of the disease as well as the human suffering that goes with it."

—  Dr. Randall Bateman, the Charles F. and Joanne Knight Distinguished Professor of Neurology at Washington University School of Medicine, on a newly developed blood test for Alzheimer's disease. (The Guardian)

Tweet of the week

@AmerAcadPeds
The American Academy of Pediatrics. Dedicated to the health of all children.

What’s new in health care

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These are the best hospitals in Massachusetts, according to the 2019-20 U.S. News & World Report (Masslive)

Healthcare providers in Massachusetts, take a bow. Hospitals in the Bay State were again ranked among the top in the nation in the 2019-20 U.S. News & World Report best hospitals rankings released Tuesday. U.S. News compared more than 4,500 medical centers nationwide on more than a dozen categories, including: cancer, cardiology & heart surgery and diabetes & endocrinology.

Massachusetts closing down several substance abuse programs (WCVB)

The state Department of Public Health has shut down three programs at the High Point Treatment Center, which has multiple campuses including programs in Brockton, New Bedford, Plymouth and Taunton, and a criminal investigation is underway involving an allegation of a sexual assault of a female patient by a male staff member.

Risk of potentially deadly EEE virus elevated to ‘high’ in several Massachusetts communities (Masslive)

Several Massachusetts communities are at “high risk” from the eastern equine encephalitis virus, the state Department of Public Health announced this week. Officials said the EEE virus has been found in 92 mosquito samples this year, and one-third of them are from species of mosquitoes capable of spreading the virus to people. Carver, Easton, Freetown, Lakeville, Middleborough, New Bedford and Raynham in Bristol and Plymouth counties are now considered at high risk from the virus.

Bottles of water tainted with PFAS chemicals still for sale in New England (WCVB)

Bottled water tainted with a chemical used in carpets and firefighting foam remains on the shelves at some New England stores because the company says the water is in full compliance with state and federal regulations. Massachusetts Department of Public Health officials announced on July 2 that Per- and Polyfluoroalkyl Substances, also known as PFAS, were detected in bottled water from Haverhill-based Spring Hill Water, also known as Spring Hill Farm Dairy Inc.