HMSA Payment Transformation Rates Explanation of each member’s rates to be implemented 10/1/18 were distributed last week. If you would like a one-to-one session in your office to review your rates with HMSA, please contact Joyce at jvitales@ehiipa.com or 808-797-3113. Contract agreements will be distributed soon and must be signed no later than September 1, 2018. East Hawaii IPA is continuing to negotiate separately with HMSA for additional funding to supplement the global PMPM compensation and quality performance dollars for PCPs.
New CMS Rule Proposes Significant Changes to Medicare Billing and Documentation Requirements As of last Friday, July 27th, the Centers for Medicare & Medicaid Services (CMS) began accepting public comments on its proposed rule updating payment policies and quality provisions for Medicare’s physician fee schedule and Quality Payment Program (aka MIPS). While CMS officials maintain the rule is an attempt to “put patients over paperwork,” the proposal, which includes a single new rate for evaluation and management (E/M) services, provisions to incentivize EHR interoperability and telehealth services, and much more, have met with a mixed reception from the health care community. The AAFP link (attached) highlights the proposed changes.
SBIRT 50 providers and staff met on 7/31/18 to review SBIRT program progress to date. Offices with questions on billing for screens & interventions, please refer to the attached reimbursement guide. Please email Jane if you have any questions at jbontuyan@ehiipa.com or call 808-797-3113.
Beacon Behavioral Health Presentation On July 20, Beacon Health Options came to talk about ways to collaborate with EHI IPA. Beacon Health is interested in supporting East Hawaii providers and wants to know what they can do to help. Attached is the PPT from the meeting. Also provided are handouts for their case management (attached) and consult services (attached).
UnitedHealthcare Request for Refund Billing Issue UnitedHealthcare (UHC) has been rejecting claims for billings sent over 90 days from the date of service under their DSNP contracts. Providers have 365 days to submit claims. There was a “glitch” in their system which is being corrected. Raul Castro of AkamaiMD informed us of this issue. Please contact him at raul@akamaimd.com or 808-238-0947 if you have any questions. He is willing to share a template letter for providers to send to UHC to stop the billing rejections.
COREO Release Notes Deadline for completion of Review of Chronic Conditions measure has been extended from September 30 to December 21, 2018. Attached are the Coreo Release Notes regarding the EPSDT Engagement measure, member search functionality, and health center selection when adding an HMO.
Symposium Complimentary Luncheon Invitation – Saturday, August 18, 2018, 12:30-1:30 PM – Fairmont Orchid Hotel EHI IPA Providers/Staff are invited to attend a complimentary luncheon presentation on Non-Tuberculous Mycobacteria (NTM) and Inflammation, Cardiovascular Health and the CANTOS Study. Complimentary sit-down lunch at the Fairmont Orchid is being hosted by Insmed Incorporated. First come, first served for clinicians who are Symposium participants. Drawing for a newly released iPad after the presentation. Attached is the registration form.
Membership Dues Reminder Invoices were mailed to members the first week in July. Members have the option to pay $600 for 2018 (July 1-December 31) or pay $100 monthly. Please contact Joyce at jvitales@ehiipa.com if you have not received your invoice.
SAVE THE DATE! 2018 Hawaii Health Workforce Summit “Form Burnout to Balance” – Saturday, September 8, 2018 – Hawai‘i’s doctors attend and fly for free! Flyer attached.
Announcements:
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The Doctor Is In! Scott Kronlund, MD started as East Hawaii IPA’s first full-time Chief Medical Director on Monday, July 23. Dr. Kronlund will be “rounding” to meet everyone. In the meantime, please feel free to reach out to him at 808-895-0714 or skronlund@ehiipa.com.
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Advance Health Care Directive Fill-out at ADRC – New dates attached.
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Hilo Medical Center CME Activity: “Opioid Alternatives: A Fresh Approach to Old Therapies in a Time of Heroin’s Comeback and Drug Shortages” – Friday, August 3, 12:15-1:15 PM, Ground Conference Room B/C. Flyer attached.
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Hilo Medical Center Diabetes Support Group – “Carbs You Can Count On” – August 7, 4:00-5:00 PM. Flyers attached here and here. Will continue every first Tuesday of the month for the rest of 2018.
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Hilo Medical Center CME Activity: “Tuberculosis in Hawaii” – Friday, August 10, 12:15-1:15 PM, Ground Conference Room B/C. Flyer attached.
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22nd Annual East Hawaii IPA Healthcare Symposium – August 17-19, 2018 – Deadline: August 3, 2018 – This year’s theme is “Advancing Wellness for Patients, Providers and Organizations.” Please see attached for the latest schedule of events, topics & speakers. EHI IPA members receive a discounted rate of $75 which includes AAFP CMEs, all sessions, trade show attendance, pau hana event and two breakfasts. Flyer attached.
