“Immunizations are among the 10 best
improvements in health in the 20th cen- tury. We need to promote good public health in Texas. We need a much stron- ger and useful immunization registry to do this,” Dr. Murphey, a member of the Texas Medical Association Committee on Infectious Diseases, told the committee. Dr. Murphey emphasized the need
to strengthen the public health role of a registry, including making sure it is well-populated and easy to use. He also discussed recent pertussis outbreaks and stressed the need to vaccinate pregnant women as a strategy to protect infants, who are at highest risk of contracting vaccine-preventable diseases. “We need to have a better understand- ing of where our community’s needs are greatest so that we can target necessary outreach and education,” he said. Dr. Murphey testified on the need for the following improvements for the im- munization registry:
• Maintain better, more complete data for children and adults who want ac- cess to their immunization history.
• Conserve vaccine resources by avoid- ing duplication of immunizations.
• Use reminder/recall functionality to achieve timely vaccinations to best protect families and minimize disease burden in the community.
• Streamline administrative processing of ImmTrac consent.
When discussing functionality of the
new immunization registry, Dr. Murphey said it can effectively serve as a way to track vaccination coverage, identify needs, and educate communities on vac- cine-preventable diseases. He added the Texas Department of State Health Ser- vices (DSHS) can use the new registry to improve information sharing among public health officials and physicians.
Apply for meaningful use exemption by July 1
Physicians who are not participating in the Medicare electronic health record (EHR) incentive program, also known
12 TEXAS MEDICINE June 2014
as meaningful use, will be penalized by Medicare beginning Jan. 1, 2015. To prevent the penalty, physicians must ei- ther attest to meaningful use by Oct. 1, 2014, or apply for a hardship exemption by July 1, 2014. For more about mean- ingful use, visit
http://www.texmed.org/ ehrincentive.
Physicians who meet the following criteria are automatically exempt from the program and do not need to file an exemption application:
Specialties If you’re classified in the Medicare Pro- vider Enrollment, Chain and Ownership System (PECOS) as one of these five specialties, you don’t need to file an ex- emption and will be exempt for payment year 2015:
• Diagnostic radiology, • Nuclear medicine, • Interventional radiology, • Anesthesiology, or • Pathology.
New to practice If you are in your first year of practice, you do not need to claim an exemption. Based on Medicare data in PECOS, the Centers for Medicare & Medicaid Ser- vices (CMS) says it will know you are new to practice and will automatically exempt you.
Hospital-based If you perform more than 90 percent of services using place-of-service codes 21 or 23 (hospital), then you will auto- matically be exempt from the Medicare penalty.
Other exemptions are available, but you must take the time to fill out the 14-page application,
http://go.cms .gov/1dgNJf5, and submit it to CMS by July 1, 2014.
If multiple physicians at one practice
are applying, be sure to include the mul- tiple NPI addendum, available at http://
go.cms.gov/1goDGVu. You may apply for a hardship exemp- tion if your circumstances fall under one of the following categories:
• Infrastructure: You must demon- strate that your practice is in an area without sufficient Internet access to comply with meaningful use and that you face insurmountable barriers to obtain such connectivity.
• Unforeseen circumstances: This ex- emption can be claimed in the case of a natural disaster, closing of a prac- tice, bankruptcy, or if the EHR vendor goes out of business.
• Lack of face-to-face patient interac- tions: If your specialty isn’t listed above as exempt and you lack face-to- face interactions with your patients, you can claim an exemption.
• 2014 EHR vendor issues: If your ven- dor was unable to obtain a 2014 cer- tification by July 1, 2014, you should file an application for exemption.
Exemptions must be renewed annu-
ally, and you may not claim an exemp- tion for more than five years. For more information, refer to TMA’s one-pager,
http://bit.ly/1dNQWIM. Contact TMA’s Health Information Technology Department with questions by calling (800) 880-5370 or emailing
HIT@texmed.org.
Aetna seeks to axe $120M Ingenix settlement
Late last year, Aetna Inc. announced a proposed class settlement of up to $120 million over its use of the flawed Ingenix database. The settlement covered physi- cians and health care professionals who delivered out-of-network services to Aet- na subscribers any time between June 3, 2003, and Aug. 30, 2013, and received less than the billed charge. The U.S. District Court in New Jersey planned to consider final approval of the settlement at a March 18 hearing. Less than one week before the hearing, Aetna notified the court it was invoking a pro- vision of the settlement that allowed it to terminate the agreement if settlement claims of health professionals and sub- scribers opting out exceed $20 million. Aetna told the court, “Based on the list of opt-outs provided by the settle-
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