RheumWATCH Archives

”RheumWatch

Read the RheumWATCH archives on topics such as rheumatology advocacy, policy updates, insurance advocacy, and practice management.

05

ACR RheumWATCH: November 5, 2015

Limited Edition ICD-10 Cheat Sheet at the RheumPAC Booth!

While you’re at the ACR/ARHP Annual Meeting in San Francisco, stop by the Discovery Center in the Exhibit Hall to make your RheumPAC donation for 2015. Not only will you help to Advance Rheumatology! on Capitol Hill, but RheumPAC donors will also receive a special edition laminated ICD-10 cheat sheet. The cheat sheet will have common codes for rheumatologic diagnosis along with a key including laterality and anatomical site references.

The cheat sheet will be great to keep at your desk or post in your nursing station.

RheumPAC and the ACR advocacy team previously achieved a one-year delay for ICD-10 and a safe harbor period for implementation. We hope the cheat sheet will help your practice in adjusting to the new coding system, while also supporting our future advocacy efforts in Washington.

File Your 2014 PQRS, Value Modifier Informal Review

Based on potential calculation issues with 2014 measures for the Physician Quality Reporting System (PQRS) and Value Modifier, the ACR strongly encourages physician practices to file a PQRS and Value Modifier informal review and download their Quality and Resource Use Reports (QRUR). The 2016 PQRS and Value Modifier payment adjustments are based on 2014 reporting.

For groups with 10 or more PQRS-eligible professionals who are subject to the 2016 Value Modifier, the QRUR shows how the Value Modifier will affect Medicare’s 2016 payments to physicians. Value Modifier cost and quality scores also will be provided in the QRURs for practices that are not yet subject to the Value Modifier. If physicians or group practices think an incentive payment or penalty was performed in error, they must file an informal review via the Quality Reporting Communication Support Page by November 9.

The ACR and rheumatology’s partners continue to advocate for changes to the PQRS and Value Modifier programs, and we are encouraging the Centers for Medicare & Medicaid Services (CMS) to extend the informal review deadline to allow practices more time to view and download their QRURs and file an informal review.

In order to access the portal to review reports and/or file an informal review, an Enterprise Identity Management System (EIDM) account is required.

CMS transitioned the portal from the Individual Access to CMS Computer Services (IACS) to this new system on July 13. The IACS system is now retired, but current PQRS and Value Modifier IACS users and their data and roles have moved to EIDM. This system is accessible from the CMS Enterprise Portal at http://portal.cms.gov. The EIDM system provides a way for business partners to apply for, obtain approval for, and receive a single user ID for accessing multiple CMS applications.

Cast Your Vote for the ACR!

We need all members of the AMA to cast their specialty ballot for the American College of Rheumatology. It’s fast and important! See the ballot >

Casting your vote for the ACR allows us to keep and grow rheumatology’s voice in the AMA House of Delegates. Rheumatologists leverage our advocacy efforts and dollars by using the significant resources the AMA brings to bear. We can Advance Rheumatology! more forcefully and serve you and our patients better by having a larger voice at the AMA. Thank you for taking the time to cast this quick vote.

Message from the Lupus Initiative Consortium Chair

Sam LimIt is with great excitement that I announce to my colleagues that the CDC has awarded the American College of Rheumatology’s The Lupus Initiative (TLI) with a five-year grant to support the development of a national, grassroots program targeting primary care providers, persons with undiagnosed Lupus, and rheumatology health care providers. The program will have three components, including opportunities for you to get involved:

  • Immediate dissemination of educational and training materials currently available on Lupus to state and local organizations throughout the country;
  • Development of a general awareness campaign to help the public identify signs and symptoms of Lupus and seek medical care; and
  • Development of community-tailored activities that will be piloted in select communities during the first year of the initiative.

We know that not only is Lupus often misdiagnosed, but patients commonly see at least three providers before diagnosis. Many of these providers are primary and emergency care providers who haven’t received significant training in diagnosing Lupus. These providers may have received an average of 90 minutes of training on Lupus in the first and second years of medical school combined. This often contributes to delays in timely and accurate diagnosis, both of which are critical to helping patients manage and live with this condition. We are hoping to change that by educating both the public and providers on what to look for and the best steps to take when they suspect Lupus.

The first phase of the program is scheduled to start this month and will focus on the national dissemination of TLI’s existing evidence-based education materials and programming. Foundational work for the next phases, community activities to pilot and an awareness campaign, are slated to begin in early 2016. The ACR plans to collaborate with the Lupus Foundation of America—who was also awarded grant funding—on the development of the awareness campaign. We know that persons with Lupus experience better outcomes when they are quickly treated by knowledgeable providers and taught self-management skills that allow them to be active participants in their own care. Our goal is to ensure they not only have these tools, but proper access to physicians who can help them.

For providers, existing materials include a variety of continuing medical education (CME) platforms, a free maintenance of certification (MOC) module worth 10 MOC credits, traditional and interactive case studies, a video library and PowerPoint presentations. For persons with Lupus, their families and caregivers, educational resources include patient-centric videos, a lupus-specific mobile application to track symptoms and medications, infographics, fact sheets on various aspects of lupus management, and more. The resources are available at The Lupus Initiative.

These resources were developed by a diverse body of experts in rheumatology, dermatology, nephrology and health disparities, and they have undergone rigorous expert review and evaluation by the target audiences they are designed for. We have made great strides in the many communities that are already utilizing these materials to educate their providers and community, so we’re happy to now have the resources to expand this program nationally—particularly to those areas that currently have a shortage of rheumatologists trained to treat lupus.

Twenty-five rheumatology state societies, multiple Area Health Education Centers, Arthritis Foundation chapters and the National Association of Chronic Disease Directors have already committed to participate in the immediate effort to implement Lupus education in their local communities and provider networks.

Established in 2009, TLI has received multiple awards from the U.S. Department of Health and Human Services to develop educational resources for medical providers and for persons with lupus and their families and caregivers to assist them in the recognition, diagnosis, treatment, and management of lupus. Most recently, in addition to the CDC funding, the ACR was awarded a grant by the Office of Minority Health (OMH) to expand its educational resources for providers. The ACR also played an active role in the development of the CDC’s National Public Health Agenda for Lupus.

I hope you will take a look at how you can join the network of providers, patient organizations and community health organizations dedicated to increasing Lupus education and awareness. Please contact The Lupus Initiative at info@thelupusinitiative.org.

S. Sam Lim, MD, MPH
The Lupus Initiative Consortium Chair
Associate Professor of Medicine and Epidemiology at Emory University