• For a one-year period starting Oct. 1, Medicare claims will not be denied solely on the specificity of the ICD- 10 diagnosis codes provided, as long as the physician submitted an ICD- 10 code from an appropriate family of codes. And Medicare claims will not be audited based on the specific- ity of the diagnosis codes as long as they are from the appropriate family of codes. This policy will be followed byMedicare administrative contrac- tors and recovery audit contractors.


• To avoid potential problems with mid-year coding changes in CMS quality programs for the 2015 report- ing year, physicians using the appro- priate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores. CMS will continue to monitor implementation and adjust the duration if needed.


• CMS will establish an ICD-10 om- budsman to help receive and triage physician and health professional problems that need to be resolved during the transition.


• CMS will authorize advance pay- ments if Medicare contractors are unable to process claims within es- tablished time limits due to problems with ICD-10 implementation.


Texas physicians at the AMA meet-


ing spoke out about the dangers they foresee, especially for primary care practices. E. Linda Villarreal, MD, TMA


trustee and an internist in the Rio Grande Valley, said she is concerned about the ramifications for access to care in South Texas, many parts of which already face a dire shortage of physicians. “I’ve taken three courses in ICD-10, and I still don’t get it,” Dr. Villarreal said. ButWashingtonwatchers say Con-


gress has no stomach for delaying the implementation date one more time. “The ICD-10 Coalition has done a bet- ter job than [medicine has] over the past four years,” one delegate said. That leaves organized medicine in


a tough spot, said Fort Worth pedia- trician Gary Floyd, MD, a member of the TMA Board of Trustees. Groups like AMA and TMA must continue to protect their members from the likely upheaval that will come with ICD-10, he explained. The Oct. 1 deadline for implemen-


tation of the ICD-10 code set is fast ap- proaching, and time is running out for physician practices to complete their preparation. TMA has a number of resources to help physicians prepare for the transition at www.texmed.org/ ICD-10.


MOC TRANSPARENCY While numerous physicians at the meeting expressed their extreme dis- satisfaction with the MOC process and the specialty boards that run it, others said that anger should not in- terfere with physicians’ dedication to lifelong learning. The house reaffirmed existing


AMA policy that MOC should not be a requirement for physician licensure, credentialing, payment, network par- ticipation, or employment. Delegates asked the American


Board of Medical Specialties (ABMS) to develop “fiduciary standards” for its member boards, including “full transparency” on the costs of pre- paring and administering the exams. They also said the standards should


“ensure that MOC and certifying/re- certifying examinations do not result in significant financial gain to the ABMS specialty boards.” Much of the ire appeared to be fo-


cused on the Cognitive Expertise (Part III) MOC exam. The house directed AMA to work with ABMS to reduce or eliminate the burden of this high- stakes exam. “Lifelong learning should be sepa-


rated from the exam because physi- cians are being tested every day,” said San Antonio hyperbaric medicine spe- cialist Jayesh Shah, MD. In addition, the house adopted


policy to:


Texans win AMA leadership posts


At the June meeting of the American Medi- cal Association House of Delegates, former TMA President Sue Bailey, MD, was elected speaker of the AMA house. New and returning AMA leaders from Texas include:


• Dallas internist Lynne Kirk, MD, reelected to the AMA Council on Medical Education;


• Theresa Phan of Texas Tech University Health Sciences Center in Lubbock, the new vice speaker of the AMA Medical Student Sec- tion (MSS);


• Former Texas medical student Ben Karfunkle, MD, of Louisiana, chair of the AMA Resident and Fellow Section (RFS) Region 3;


• Rie Sharky, MD, of Dal- las, vice chair of AMA RFS Region 3;


• San Antonio medical student Jennifer Nord- hauser, chair of AMA MSS Region 3; and


• Jerome Jeevarajan, a student at The Universi- ty of Texas Southwest- ern Medical Center, elected legislative chair of AMA MSS Region 3.


August 2015 TEXAS MEDICINE 15


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76