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Issue #165 - January 19, 2011
AAPC EdgeBlast
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CMS Rescinds Coverage for Key Element in Annual Wellness Visit
An amendment issued Jan. 10 by the Centers for Medicare & Medicaid Services (CMS) rescinds the addition and definition of “voluntary advance care planning,” as a specified element of the Annual Wellness Visit (AWV).

The provision was initially added and finalized in the Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011 final rule, published in the Nov. 29, 2010 Federal Register.

CMS states in the amended regulation:

“It has since become apparent that we did not have an opportunity to consider prior to the issuance of the final rule the wide range of views on this subject held by a broad range of stakeholders (including members of Congress and those who were involved with this provision during the debate on the Affordable Care Act). Therefore, we are rescinding the provision of the final rule that includes voluntary advance care planning as a specified element of the annual wellness visits providing personalized prevention plan services, and returning to the policy that was proposed, which was limited to the elements specified in the Act.”

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EHR Incentive Payments Begin
Just two days after registration opened for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, Oklahoma and Kentucky issued incentive payments to health care providers for successfully demonstrating meaningful use of certified EHR requirements under the Medicaid EHR Incentive Program.

Two physicians, Dr. Melissa Gastorf and Dr. Jeffrey Gastorf, at the Gastorf Family Clinic of Durant, Okla. received an incentive of $21,250 each. “We are very elated to be among the first to be paid the EHR incentive,” Darrel Ledbetter, CPM, practice manager for Gastorf Family Clinic told AAPC.

According to Ledbetter, the clinic worked closely with Regional Extension Center (REC) Oklahoma Foundation for Medical Quality to prepare for meaningful EHR use.

“We wanted to be on the front lines of the Meaningful Use, so as soon as we found out that the new version of e-MDs Solution Series was certified, we contacted e-MDs to ask if we could be a Beta clinic for pushing out the new version,” Ledbetter said.

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UHC Releases 2011 Evaluations to Docs
UnitedHealthcare released its fifth installment of the UnitedHealth Premium physician designation program this month. The program evaluates physicians across 21 specialty areas using evidence-based, medical society and national industry standards to promote quality care and consumer awareness. This year’s release, the carrier says, is more robust and raises the bar for physicians to meet national quality standards.

Using statistical testing of clinical information from health care claims, the program evaluates quality and cost efficiency in physician practices associated with UnitedHealthcare. Physicians must first be designated for quality before they can be designated for cost efficiency.

Participating physicians will first receive a designation assessment letter in the mail. Physicians can then view a full suite of assessment reports on the UnitedHealthcare website after they register for the new Premium section. Instructions for how to register are included in the assessment letter.

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Meaningful Use: CMS Tweaks Stage 1, ONC Moves to Stage 2
The Health Information Technology Policy Committee (HITPC) is seeking comments on stage 2 meaningful use objectives while the Centers for Medicare & Medicaid Services (CMS) is still perfecting stage 1 meaningful use. The agency recently issued a correcting amendment to the Electronic Health Record Incentive Program Final Rule.

Stage 1: Corrections Made

In addition to some typographical corrections, the correction notice CMS published in the Dec. 29, 2010 Federal Register contains a few noteworthy changes to the EHR final rule.

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Coding Tips

CMS: Quarterly Update to HCPCS Level II Codes
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CMS: O2 Cluster Headache Treatment Not Covered
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UHC: Notification, Prior Authorization Code Changes
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Telehealth Originating Site Facility Fee Announced
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Medical News

Guideline Update: Managing A-Fib Patients in 2011
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Payers Covering Avastin Despite FDA Recommendation
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CMS Rescinds Coverage
EHR Incentives
UHC Release to Docs
Meaningful Use Tweaks
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