Nueces County Medical Society NCMS NOTES - PHYSICIAN NEWSLETTER First Tuesday’s at the Capitol March Group

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2023 NCMS/TMA Dues Drop Date: March 6th There is still time to renew and reinstate your membership

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Renewing your dues is fast and easy using any of the options below: For a duplicate dues invoice contact NCMS at 361-884-5442 or [email protected] Renew your membership online at www.texmed.org/renew

Additionally, NCMS offers automatic membership renewals. By joining the automatic renewal program, you will ensure your membership never lapses and you will not miss out on any benefits. For questions, call NCMS at 361-884-5442.

Together we are stronger!

TMA to Congress: Tie Medicare Physician Payment to Inflation As part of a broader push for Medicare payment reform, the Texas Medical Association, along with the American Medical Association and 133 national specialty and state medical associations, recently called on Congress to index Medicare physician payments to inflation. Congress has a real opportunity to relieve the financial strain on Medicare physicians and strengthen access to care for current and future generations of Medicare beneficiaries,” they wrote in a March 15 letter to House and Senate leaders. “We urge you to answer that call.” Specifically, TMA and the other signatories asked Congress to pass legislation implementing an annual, inflation -based payment update based on the full Medicare Economic Index (MEI), a measure of physician practice cost inflation. Their request comes on the heels of a similar recommendation from the Medicare Payment Advisory Commission (MedPAC), a key congressional advisory panel, which voted in January to support increasing Medicare physician payments for the first time in several years. But MedPAC notably only recommended raising payments by 50% of the projected increase in the MEI.

“We commend MedPAC for taking this significant step,” TMA and the others wrote. “However, we feel strongly that implementing an inflation-based update based on only half of the full MEI growth rate would be a missed opportunity to meaningfully address this perennial issue of Medicare physician underpayment that threatens stable access for millions of Medicare beneficiaries.” Zeke Silva, MD, a radiologist in San Antonio and a member of TMA’s Council on Legislation, says it’s critical Medicare physician payment is tied to the MEI. He also chairs the AMA’s Relative Value Scale Update Committee, which makes payment recommendations to Medicare. “Physicians are paying more for supplies, equipment and staff,” he recently told Texas Medicine. “Accommodating these increased costs requires, by definition, increased payment.” Read more. Source: TMT

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NEW NCMS PHYSICIAN NETWORK Coastal Bend Medicine With a listing in the NCMS Physician Network, you can stay connected to your colleagues day in and day out. This feature is designed to help our members with referrals and consultations. The information is featured in all issues of the NCMS Coastal Bend Medicine and is accessible on the NCMS website, available to all physician members and to the community. Beginning in March - get your information to NCMS now.

Triple

A standard block — 2” x 3 “ is $800 for 4 issues . A double-block listing, spaced vertically, is $1,100 for 4 issues. A triple-block listing, spaced vertically, is $1,600 for 4 issues. There are no one- or two-time rates for these professional listings

Contact NCMS at: [email protected]

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Top Stories

New Cigna Policy Requires More Documentation for Same-Day Procedures Despite medicine’s pushback, Cigna plans to move forward with burdensome billing policy requiring additional documentation for routine, minor procedure claims starting in June.* Evaluation and management (E/M) services provided on the same day as a minor procedure (such as those with a zero or 10-day post operation period) typically have been included as part of the service. Starting June 11, however, Cigna will start requiring separate supporting documentation every time a physician bills for that minor procedure using modifier 25. That includes supplying medical records and “a cover sheet indicating the office notes support the use of modifier 25 appended to the E/M code,” according to Cigna’s first announcement of the policy last year. The claim will be denied if a physician fails to show a significant and separately identifiable service was performed.

Medicine won a delay of the policy that was supposed to start Aug. 13, 2022, after the American Medical Association (AMA) and the California Medical Association (CMA) voiced several concerns https://www.cmadocs.org/ Portals/CMA/files/public/CMA Letter to Cigna Re Modifier 25 Policy (061622).pdf including a likely increase in administrative burden and cost for practices due to duplicate requests and a lack of clarity on which Cigna health plans would be impacted. Medicine also expressed these challenges would not only harm patients’ experience, but also disincentivize physicians from providing unscheduled services.

As most practices use modifier 25 throughout the day, the additional documentation requirement could force practices to send several medical records daily, potentially contributing to physician burnout, says Odessa allergist Vivek Rao, MD. “So many specialties use 25 modifiers on a frequent basis, and this update is only going to delay processing claims,” he said. “My fear is that this is going to create a backlog where practices must wait to get paid for providing care to patients. Then, physicians are going to have to make some difficult business decisions, like not accepting new patients.” Read more. Source: Texas Medicine Today

Physician Practice Issues Healthcare Executives Looking For Technology Solutions That Address Clinician And Staff Burnout, Help Health Systems Weather Potential Recession, Survey Finds HealthLeaders Media (3/23, Wicklund) reports, “Healthcare executives looking to make technology deals at next week’s ViVE conference are looking for solutions that address clinician and staff burnout or help the health system weather a potential recession, a... survey” finds. This “survey of some 300 decision-makers in healthcare, conducted by Intelligent Medical Objects, also puts data storage and analysis tools at the top of the shopping list, while AI tools aren’t yet worth all the flashy marketing.” The survey found that “94% say they plan to invest in technology that either addresses workforce issues or prepares the health system for a recession.” Source: Medical News Roundup

TMA RESOURCES

Get Help With Billing and Coding TMA's billing, coding, and payment page offers resources for physician practices, from one end of the continuum to the other. Educate yourself with our articles and tools, or get help with more complex questions. Visit now.

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Health Research

Walking 8,000 Steps Several Days Per Week Tied To Lower Mortality Risk, Study Suggests MedPage Today (3/28, Monaco) reports, “Walking at least 8,000 steps even just a couple days per week was linked with a lower risk of death, a cohort study of U.S. adults suggested.” The “risk was even lower among those who hit 8,000 steps or more 3 to 7 days per week...noted” researchers. The findings were published in JAMA Network Open.

Healio (3/28, Rhoades) also reports.

Researchers Identify Potential Connection Between Common Viruses And Rare Hepatitis Cases In Children The New York Times (3/30, Anthes) reports, “A small new study of American children adds to the evidence that” a recent string of hepatitis cases in children, “which remained extremely rare, may have been caused by a simultaneous infection with multiple common viruses, including one known as adeno-associated virus type 2, or AAV2.” While “AAV2 is not typically associated with disease, and it requires a second ‘helper’ virus in order to replicate,” research shows that “many of the children with unexplained hepatitis, or liver inflammation, were infected with multiple helper viruses, the researchers found.” The findings were published in Nature.

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Source: Medical News Roundup

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Public Health

Federal Judge Blocks ACA Preventive Care Mandate Reuters (3/30, Pierson) reports that US District Judge Reed O’Connor in Fort Worth, Texas blocked the Affordable Care Act’s “mandate that health insurance plans cover preventive care, including pre-exposure prophylaxis against HIV (PrEP) and screenings for cancer, diabetes and depression at no cost to patients.” O’Connor “previously found that the PrEP mandate violated a federal religious freedom law and that other preventive care mandates were based on recommendations by an illegally appointed task force,” and “has now blocked the federal government from enforcing the mandates, a victory for conservative businesses and individuals that sued to challenge them in 2020.” Also reporting are the AP (3/30, Weber), the Washington Post (3/30, Goldstein), and The Hill (3/30, Weixel).

Most Patients Not Given Sufficient Hospital Discharge Information, Study Suggests Healio (3/22, Rhoades) reports new research suggests that “upon hospital discharge, most patients were not informed about ‘red-flag’ signs and symptoms,” and among “patients who received new or changed medications, 28% were not told the name or function of the new medications.” The findings were published in JAMA Internal Medicine.

Source: TMT

TEXAS MEDICINE TODAY March 28

U.S. Main Residency Match Posts Another Year of Record-High Positions Strong data from the National Resident Matching Program show that the 2023 Main Residency Match went well for many specialties. Among other records, this Match delivered an all-time high in the number of primary care positions offered. Read more.

Lege Poised to Boost GME Funding; TMA Urges Rural Workforce Investment Draft House and Senate budgets spell good news for graduate medical education (GME) funding. But rural loan repayment and training programs, and the Texas Medical Board, still need a boost to keep pace with Texas’ growing population and access to care needs. Read more.

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Friends of Medicine

Platinum Level

Gold Level

Silver Level

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Thank you 2023 Pictorial Directory Advertisers American Bank Coastal Bend Cancer Center Coastal Bend Eye Center CHRISTUS Spohn Coastal Orthopedics Corpus Christi Medical Center C.C. File Pro Corpus Christi Pain Medicine Driscoll Children’s Hospital Eye Institute of Corpus Christi Hanger Clinics Humpal Physical Therapy Kidney Specialists of South Texas Mission of Mercy Nurses on Wheels

OBGYN Associates Physicians PremiER Premier Bio Waste Solutions Radiology Associates South Texas Brain & Spine Southside Specialty Surgical Center SPAR County Medical Society Surgical Associates Texas Medical Association Insurance Trust Texas Vein & Vascular VasCare Vein Care Coastal Bend WellMed WoundCentrics

The Most Widely used book in the Coastal Bend Medical Community!

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IN CASE YOU MISSED IT:

TMA-Backed Bills Would Increase Access to Women’s Reproductive, Early Childhood Health Care Twelve-month postpartum coverage and a boost to certain Medicaid payments top a list of measures Texas lawmakers are moving on that would bolster women’s health care services in line with TMA’s priorities for this session. TMA physicians were busy testifying on the bills this month.

TMA Director of Public Affairs Caitlin Flanders says the bills and budget additions would enhance health care access among new mothers and their babies in the wake of the June 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization regarding abortion. The decision triggered additional restrictions under state law and is expected to lead to an increase in pregnancies and young children. On the Medicaid front, House Bill 12 by Rep. Toni Rose (D-Dallas) would extend continuous coverage for postpartum women to 12 months and has already garnered bipartisan support.

Athens family physician Doug Curran, MD, testified in support of HB 12 during a March 16 hearing of the House Select Committee on Health Care Reform on behalf of TMA and half a dozen other medical specialty organizations. “Pregnancy-related complications all too often do not manifest themselves until months following delivery, making a full year of postpartum coverage essential,” he said, citing state health data showing nearly a third of maternal deaths occur between two months and one year after delivery. Read more.

DEA Permanently Lists Opioid Brorphine as a Schedule I Controlled Substance Given the high risk of harm and no agreed-upon medical use, DEA has classified the synthetic opioid brorphine with other dangerous drugs such as heroin and LSD. Illicit brorphine has been tied to at least 21 U.S. deaths. The move comes after brorphine was linked to at least 21 deaths in the United States between August 2019 and June 2021, DEA says. Brorphine is more potent than fentanyl, which is currently the leading cause of deadly overdoses in Texas and the U.S. DEA’s action makes permanent a March 2021 decision to list brorphine as a Schedule I drug temporarily. Brorphine was first synthesized in 2018 in an effort to build a better opioid – one that would treat pain without the dangerous side effects opioids are known for, such as arrested breathing, says Mesquite pain specialist C.M. Schade, MD, a member of the Texas Medical Association’s Subcommittee on Behavioral Health. “Chemists are trying to create an opioid-like medication that would give pain relief but not euphoria,” he said. The legal development of brorphine stopped quickly when experiments on animals showed that it caused typical opioid side effects, according to a March 2022 article in the Journal of Analytical Toxicology. However, brorphine became a street drug by 2019. Read more.

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Join Us for TexMed! Save the date: May 19-20

Coastal Bend Medicine Jan/Feb/March issue

Come by the NCMS office to pick up your copy or view it online at https://www.nuecesmedsociety.org/tmaimis/

Donations Needed! Local non-profit clinics are in need of medical supplies. Items needed: needle holders, small

scissors, bandage scissors, forceps of different sizes and ear irrigation equipment and any other medical equipment that you would like to donate. Any items would be greatly appreciated.

Help us to help the less fortunate. Email: [email protected] Or call the NCMS Office 361-884-5442

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From the Desk of Dr. Mark Geneser, Editorial Board Member, Coastal Bend Medicine

A Call For Cases I am certain that most, if not all physicians that appreciate these “Standout Cases” have tens, if not hundreds of similar cases experienced through their training or practice that have been instrumental in forming their clinical base of knowledge. We on the editorial board would like to extend an invitation to local physicians to summarize and share these cases that have been uniquely instructional to them and might be of interest to others. Please submit articles to: Sandra Montemayor at: [email protected] Do you have an article you’d like to submit for publication? Submit your entry to the NCMS for review, NCMS wants to hear from you. Who Can submit an article? Physicians, and medical professionals. Submit to [email protected]

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NCMS EXECUTIVE BOARD At its March 13th meeting, the Executive Board took the following action:. Membership Committee – 749 members, membership a decrease at this time, non renewasl at this time are 92 and the board was assigned physicians to call and encourage/remind to renew. Executive Director’s Report – NCMS membership numbers have decreased to 749 due to non-renewals, 92 physicians have been dropped. The board was asked to help with renewal calls and emails to those who have not yet renewed. Weekly TMA legislative update calls and county CMS meetings continue with TMA. Non-dues income continues to generate substantial income for society, Friends of Medicine and the directory continue on an upward trend. The Coastal Bend Medicine advertising continues to increase and has generated enough to cover cost of printing and mailing. Participation in First Tuesdays at the Capitol is off to a great start with physicians and alliance members traveling to the Capitol New Business: • The board approved bid from Leal Parking Lot for repair of parking lot • The board approved power washing the building • The Board approved meeting with the Nueces County Judge to inquire on the status of the Opioid Task force and take an active part in combating this growing crisis. • NCMS Rewards brochure has been created and will print next month

April 2023 April 4 ,

First Tuesdays @ the Capitol, Austin, TX

April 6,

NCMS Employee Relations Meeting, 6:00 p.m., NCMS office

April 8,

NCMS Walk With A Doc, 9:00 a.m., Water’s Edge Park , WellMed will be presenting the Health Topic

April 10.

Executive Board Meeting, 6:00 p.m., NCMS Office

April 12,

Membership Mixer, 6:00 p.m., Brewster Southside, sponsored by PlainsCapital Bank (Family Night)

April 18,

Lunch and Learn, 12:00 - 1:00 p.m., NCMS Office, Sponsored by Morgan Stanley, The Volpe Group. Developing a Strategy for the Retirement You Envision.

April 19,

Board of Censors Meeting, 6:00 p.m., NCMS Office

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