The California Medical Association (CMA), the American Medical Association and dozens of other state and specialty medical associations have asked the Centers for Medicare & Medicaid Services (CMS) to delay for one year new Medicare rules that would allow multi-hospital systems to establish system-wide medical staffs.
CMA commented extensively on this and prior iterations of this rulemaking expressing serious concerns about the proposed amendments to the CoPs and their impact on medical staff self-governance. CMA believes that medical staff self-governance is a vital part of a carefully crafted system designed to ensure the delivery of quality patient care.
The letter says that the organizations have written “to express our extreme disappointment with the CMS final rule…..that makes unprecedented changes to the Medicare Hospital Conditions of Participation (CoPs) that will dramatically alter the make-up and efficacy of hospital medical staffs nationwide.”
The letter asks CMS to delay the effective date of the rule from July 11, 2014, to give medical staffs sufficient time to develop the policies and procedures necessary to comply with the rule.
Major provisions of the final rule related to medical staffs are:
Multi-hospital systems may have the option of having a single unified and integrated medical staff, but a majority of each medical staff must affirmatively vote to accept a unified and integrated medical staff structure or to opt out of such a structure and to maintain a separate and distinct medical staff for their respective hospitals.
The final rule does not require members of the medical staff to serve as representatives on the hospital governing body. However, hospital governing bodies must periodically throughout the year consult directly with each medical staff within the multi-hospital system.
CMA will continue to look for advocacy opportunities to advance physician leadership in hospital and other settings.
Click here to read the letter.
Contact: Yvonne Choong, (800) 786-4262 or email@example.com.
Beginning January 1, 2015, Medicare physicians who have not successfully attested to meaningful use of a certified electronic health record (EHR) system may incur payment penalties, as mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. These payment adjustments will be 1-2 percent of total Medicare charges in 2015, to 2 percent in 2016 and 3-5 percent in 2017 and beyond.
The 2015 penalties are based on 2013 reporting data. Physicians who failed to successfully demonstrate meaningful use in 2013 can apply for a hardship exception to avoid the upcoming Medicare payment adjustment for 2015. Hardship exception applications must include supporting documentation that proves that demonstrating meaningful use would be a significant hardship for the physician. The deadline to submit a hardship exception application for 2015 is midnight Eastern time on July 1, 2014.
The Centers for Medicare Services (CMS) will review applications to determine whether or not you will be granted a hardship exception. If approved, the exception is valid for one year.
Eligible professionals can apply for hardship exceptions in the following categories:
Lack of face-to-face or telemedicine interaction with patient
Lack of follow-up need with patients
CMS has posted hardship exception applications on the EHR website at www.cms.gov/ehrincentiveprograms. CMS has also published a hardship exception tip sheet for physicians.
For more information on the federal EHR incentive program and meaningful use, see CMA On-Call documents #4301 "Electronic Health Records: Federal Incentive Program," #4302 "Meaningful Use of EHRs: Stage 1," and #4305 "Meaningful Use of EHRs: Stage 2."
In a 238-181 vote, the U.S. House of Representatives today passed HR 4015, a bill to repeal the Medicare sustainable growth rate (SGR) and put in place a replacement payment system with an amendment offered by House Republican leaders that would pay for the repeal through a five-year delay of the Affordable Care act's individual mandate penalty.
Though cheered by House Republicans, the legislation is viewed as "dead on arrival" by policy analysts and health care providers, as its defeat in the U.S. Senate is a near certainty. The move is seen as purely a political move that is not likely to go anywhere beyond the House floor.
Although there is bipartisan, bicameral support for the SGR repeal, there is no consensus on how to pay for it. House Democrats, meanwhile, attempted amendments in the Rules Committee to add unspent military funds from Iraq and Afghanistan as the funding source, but those motions were defeated. If the funding proposals are not settled soon, Congress may adopt another temporary nine month patch to stop the 24 percent SGR cuts.
The California Medical Association (CMA) continues to urge Congress to go back to the negotiating table and find bipartisan funding sources. CMA is opposing another nine month patch. CMA is calling upon Congress to FIX MEDICARE NOW!
On Wednesday, the Senate Leader, Harry Reid, filed a motion to consider the Senate’s identical version of the Medicare legislation, S. 2000 after they return from recess. Like the House bill, the Senate legislation does not include a bipartisan way to pay for the legislation.
The House and Senate have decided to take a one week recess next week and will not be returning to Washington, D.C. until Monday, March 24. We are at a crucial juncture in the process, and encourage all physicians to call, email and meet with their representatives while they are in the state to let them know that a bipartisan payment solution for the bill needs to be negotiated.
CMA continues to fight to get the bipartisan, bicameral Medicare SGR legislation with the California locality update across the goal line before March 31. CMA and the American Medical Association (AMA) have sent letters to House and Senate leadership letting them know that a nine-month patch is unacceptable.
To overcome the opposition, Congress needs to hear from a large volume of physicians. Tell congress to pass a Medicare SGR bill with a bipartisan funding source and to oppose anther one-year patch.
Please make as many calls and send as many emails as possible. Everyone makes a difference! We are asking physicians to call/email the following individuals:
To contact members of Congress:
Call AMA’s Grassroots Hotline, (888) 434-6200, to be connected with your members of Congress in Washington. You will be asked to enter your zip code and select your representative. You are also encouraged to call your representatives in their local district offices.
You may also email your federal legislators via the AMA's "Fix Medicare Now" grassroots website. Physicians can use the sample letter provided on the page, it takes no more than two minutes.
Physicians can ask their patients to take a "Fix Medicare Now" flyer and call their representatives, too.
Visit the CMA’s grassroots action center for more information, including talking points and legislator contact information.