Important message about upcoming federal legislation; BORIM revisions regarding physician licensure

News and announcements

Hello, friends and members of the Massachusetts Medical Society. I hope your summer has been enjoyable and restful.

I’m speaking with you today to provide both an update and a very important ask.

Because Congress is on August recess, the weeks ahead present an opportune moment to share the narratives of our patients, and our profession, with our elected leaders on three critical healthcare issues—issues that Congress will address during the fall session:

• Preventing firearm violence
• Increasing access to affordable drugs
• Ending surprise bills

So, what is your call to action? I’m asking you to please contact your congressional representatives, whether by email, letter, or town hall meeting.

Tell them, as a physician and a member of the Massachusetts Medical Society, that you are committed to passing a federal law this year that will reduce firearm violence; tell them that your patients need legislation permitting more access to affordable medication; tell them that surprise billing, which prevents physicians and insurers from negotiating on equal terms and reduces access to in-network care, demands immediate reevaluation and correction.

Thank you for your help to get this done!

For more information on any of these issues, and how to contact your Massachusetts Senators and Congresspersons, go to www.massmed.org/2019federal.

- Dr. Maryanne Bombaugh

Click the thumbnail below to watch Dr. Bombaugh's full call to action.

BORIM revisions concerning physician licensure 

Last week, the Board of Registration in Medicine (BORIM) approved revisions to the regulations governing physician licensure and the practice of medicine. The MMS realizes there is confusion concerning the meaning of the revisions, how the changes were made, and where members may find guidance about implementation.

Because of this, the society circulated an email to all members clarifying the regulations and the Board’s updated guidance. Please check your inbox!

The society will continue to provide updates about this issue. If you have not received the email, please contact MMS Government Relations Advisor Casey Rojas at crojas@mms.org.

Click the video below to watch Dr. Bombaugh explain the BORIM revisions in more detail.

Dr. Bombaugh meets with HRSA to address food insecurity and social determinants of health

(Left-right) Veronica Roa, HRSA Office of Regional Operations Public Health Analyst, Dr. Maryanne Bombaugh, MMS President, and Jeffrey Beard, HRSA R1 Regional Administrator, Office of Regional Operations.

Last Tuesday, MMS President Dr. Maryanne Bombaugh met with Jeffrey Beard and Veronica Roa of the Health Resources and Services Administration (HRSA) to discuss the relationship between food insecurity and social determinants of health as well as potential outlets for collaboration. HRSA is an agency of the U.S. Department of Health and Human Services (HHS) that provides health care to people who are geographically isolated, and/or economically or medically vulnerable.

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 health care 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.

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.

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.
 

Payer watch

HICN to MBI Transition Period Ends 12/31/19

Physicians/Providers/Suppliers have 20 weeks until all claims must be submitted with MBIs only

If a beneficiary has not yet received his/her new Medicare card, he/she must contact 1-800-Medicare to update their home address to ensure another card can be mailed to the correct address.

As you are aware, the Medicare Beneficiary Identifier will replace the SSN-based Health Insurance Claim Number (HICN) for all Medicare Beneficiaries. New Medicare cards have been issued and we are reminding Medicare patients to bring the new card with them to all physician and provider medical/hospital visits. The transition period will end on 12/31/2019 and all claims and transactions MUST use the MBI as of January 1, 2020. It is imperative that providers begin to use the MBI as soon as possible as we do not want them to have any issues once the transition period ends. Here are a few ways members can obtain the new MBI:

• Ask your Medicare patients during patient intake/registration:
  • At time of service, ask your patients for their new Medicare card. For those patients that are not able to give their card during their visit, please offer them this flyer created by CMS as a reminder to bring the card to you the next time they visit, or send to you in an alternate way: Get Your New Medicare Card
  • If they don’t have their card with them at the time of service, remind them that they can use MyMedicare.gov to get their new Medicare number 
  • Offer patients who do not have their card the CMS-approved flyer Get Your New Medicare Card
• Use the NGSConnex secure MBI look-up tool - Registered users of NGSConnex can access the MBI Lookup Tool to get their patients’ MBIs. The user must enter the patient’s first and last name, their date of birth, and their SSN (not their HICN), and the provider’s NPI.
  • If the provider does not have access to NGSConnex, go to NGSConnex to register for a free account
• Check the remittance advice (formerly Explanation of Medicare Benefits)

Throughout the transition period, when a claim is submitted with a valid HICN, the MBI will be returned on the remittance. The returned MBI on the remittance is not a verification of Medicare entitlement. Please ensure you go through normal eligibility verification steps once you have the MBI. For all your payer update, contact us today at PPRC (781) 434-7702 or email us at pprc@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.

Available:

• 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.

Educational programs and events

CME education programs & events  

Featured NEW online CME course

• NEJM Knowledge+ Pain Management and Opioids - NEW
• New Opioid Prescribing Guidelines in Pratice
• Legal Advisor: Identifying Drug Dependence
• Massachusetts Prescription Awareness Tool (MassPAT)

Upcoming events and trainings

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

"I just attended another funeral for someone who was a victim to that epidemic. Under the status quo, people will continue to die. We need to be bold to take on an epidemic."

—  Somerville mayor Joe Curtatone on his plan to open a supervised consumption site in his city (WBUR)

Tweet of the week

@BetsyLehmanCtr

The Betsy Lehman Center is a non-regulatory state agency that uses communications, research, and data to improve the safety of health care in Massachusetts.

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.

New rule could affect hundreds of Cape immigrants (Cape Cod Times)

Dr. Maryanne C. Bombaugh, a Mashpee doctor who is president of the Massachusetts Medical Society, said the physicians organization also will challenge the rule. "The Massachusetts Medical Society asserts that health care is a basic human right," Bombaugh said in a statement. "It is disheartening to see that notion challenged and health jeopardized anywhere in the world, let alone in Massachusetts and in the United States." In a CBSN videotape Monday, Ken Cuccinelli, acting director of U.S. Citizenship and Immigration Services, said the rule "encourages and ensures self-reliance and self-sufficiency for those seeking to come to or to stay in the United States."

Harvard Pilgrim Health Care and Tufts Health Plan agree to merge (MassLive)
Harvard Pilgrim Health Care and Tufts Health Plan on Wednesday signed an agreement to merge, a deal that would bring together the state's second and third largest insurers, creating a powerhouse to rival Blue Cross Blue Shield of Massachusetts. Tom Croswell, president and CEO of Tufts Health Plan, will serve as CEO of the new organization. Michael Carson, president and CEO of Harvard Pilgrim, will serve as president, overseeing "the organization's diverse business lines and subsidiaries," according to a release. "

Data show flood of opioids before OD surge (Lowell Sun)

For Maryanne Bombaugh, president of the Massachusetts Medical Society, the database, shows where we were and what we should change — from education to prescribing practices. "We have data to look at," she said. "We can see where we were, what was going on. Getting a better idea of how serious, significant and widespread prescriptions for opioids happened to be occurring. And because of that data, it facilitates us to be able to make changes." Her organization was supportive of the new opioid prescribing guidelines passed by the Board of Registration in Medicine in 2015. From the first quarter of 2015 to the first quarter of 2019, the number of Massachusetts residents with prescriptions for Schedule II substances decreased 39 percent, according to the Massachusetts Department of Public Health.

Study finds Mass. to be one of the best states to have a baby (MassLive)

Massachusetts is the second-best place to have a baby in terms of health care, family friendliness and first in lowest infant mortality, according to a survey conducted by WalletHub. The cost of having a child can be a worry for most parents but one thing they don't have to be concerned about is healthcare costs, according to the online financial website.