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SlitLamp provides illuminating e-news for Colorado ophthalmologists. It keeps you in the know on the evolving Colorado health care scene by detailing the latest legislative and regulatory happenings. It also spotlights the information and resources you need for your practice.

 

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Colorado EyeMDs Take to D.C.

Posted By Chet Seward, Friday, June 8, 2018


A contingent of Colorado ophthalmology leaders recently trekked to the nation's capitol to advocate for pressing priorities, while championing the importance of quality, safe eye care. The group met with members of the Colorado Congressional delegation as part of hill visits coordinated by the American Academy of Ophthalmology during the Mid-year Forum. 

CSEPS thanks the following physician leaders that took time away from their practices and their personal lives to make the trip and make a stand for Colorado ophthalmology: Drs. Rebecca Braverman, Robert Fante, David Johnson, Ron Pelton, Cullen Ryburn, Leonard Seibold, Erin Seick, Prem Subramanian and Michael Wildes. 

Check out  more photos  from the trip.

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Executive director's update: Showing up

Posted By Chet Seward, Friday, June 8, 2018

Chet Seward,
Executive director

Thanks for making it.

 

 

That one-liner isn’t just a cheeky nod of gratitude for reading through the entire newsletter to get to my article. It’s also about being a member of CSEPS – for making and maintaining the commitment to your profession in Colorado. 

 

 

It has been said that the first rule of leadership is showing up. That’s what you do every day in clinic or in the OR with your patients. And that is what we do at CSEPS on behalf of Colorado ophthalmology. We show up and live out the CSEPS mission to promote excellence in patient care through advocacy, education and fostering professional fellowship. CSEPS is the only organization in the state dedicated solely to the needs of ophthalmologists and the patients you serve. Your participation in CSEPS is critical.

 

Showing up is the first rule and the first step. I ask that you keep showing up and continue to make CSEPS a priority by attending our meetings, donating to EYEPACand our small donor committeeto fuel our advocacy efforts, and answering our calls to action. CSEPS is a leading organization because of you. 

I will end where I began. Thanks for showing up. Please keep doing it.

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Opioid prescription fill limit bill signed into law

Posted By Chet Seward, Friday, June 8, 2018
As an ophthalmologist odds are that you do not prescribe many opioids to patients for patient. Odds are high that you also are aware of the continuing crisis that Colorado is facing with the opioid epidemic. While recent reports show that Colorado opioid prescriptions are declining, other data indicate that illicit opioid deaths continue to increase. Peer reviewed literature clearly show that one of the leading causes of addiction is via prescription opioids. 

The Colorado legislature recently passed a suite of bills to help reverse the crisis, one of which (SB18-022) instituted prescription limits for acute pain. CSEPS supported this bill. The bill immediately became effective once Governor Hickenlooper signed it into law on May 21. That means that as a prescriber you need to know that, among other things, you must limit a patient’s initial opioid prescription for acute pain to a seven-day supply. There are other conditions and exceptions to the bill. Treating your patient’s pain appropriately is paramount and so is combatting this public health crisis. Be sure you are aware of the details surrounding this new law and help Colorado reverse the opioid epidemic.

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Codequest 2018 takeaways

Posted By Chet Seward, Friday, June 8, 2018
“We are going to be audited.” That is not a sentence you want to hear at your practice, but thanks to the practice management experts at the American Academy of Ophthalmology this year’s Codequest program in Denver on April 28 equipped over 60 attendees with the knowledge and tools they need to stay out of hot water with auditors while ensuring that Colorado ophthalmology practices get appropriately reimbursed what they are due. Topics covered included how to avoid costly mistakes that trigger audits in evolving health care markets, how to audit-proof ophthalmology documentation with new, payer-specific checklists for top surgical procedures and reviewing the latest requirements on modifiers. Codequest is the recognized, leading program on ophthalmic coding, and CSEPS offers a session each spring. Thanks to all those that attended this year.

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Thanks Dr. Carter

Posted By Chet Seward, Friday, June 8, 2018

CSEPS thanks AAO President Keith Carter, MD, for coming to Denver on May 21 to provide an update on the latest state of affairs nationally. Dr. Carter's presentation also detailed many of the priorities and projects currently underway at AAO. The value proposition of AAO membership and CSEPS membership is clear.

AAO President Keith Carter, MD, reviews Academy priorities

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Executive director's update: Time to turn it down or up?

Posted By Chet Seward, Friday, April 13, 2018
Is it just me or is it getting louder? While that question clearly fits recent interactions at home with my teenagers who seem to have developed a pre-existing condition known as “loud talker syndrome” given the earbuds that are glued to their ears, professionally it is definitely one to ponder. Perhaps a better way of phrasing it would be, is civic engagement becoming shrill? 

I don’t know if the answer to that question is yes or no. Maybe social media, or the 24-hour news cycle, or current political discourse is driving people apart. 

What I do know is that in a seemingly divided world, CSEPS is a unifying force. We bring Colorado ophthalmologists together to solve problems and improve care. Whether it is through upcoming events like the meeting with AAO President Keith Carter, MD, FACS, Codequest, our first legislative reception or our new practice management online community, CSEPS offers members like you the chance to connect and engage in a broader dialogue on issues and interests that are important to ophthalmologists and the patients you serve.

So here is to turning up you participation with CSEPS. Get plugged in and stay plugged into your organization, the only one in the state solely focused on your priorities. I will be right there with you – that is of course after I attempt to take the earbuds away from my kids. Wish me luck.

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Negotiating physician employment contracts seminar

Posted By Chet Seward, Friday, April 13, 2018
Kevin Perez, Esq.
Thanks to all of the CSEPS members that attended the March event focused on the dos and don’ts of employment contracts. The program featured Denver attorney Kevin Perez who routinely works with physicians across the state on these sometimes-thorny negotiations. His real-world examples, expert insights and practical recommendations were a hit for all those that attended. The fact that the program occurred just days before St. Patrick’s Day and it offered attendees a chance to hoist a pint in honor of the green (pun intended) probably didn’t hurt either. Let’s face it – you have worked incredibly hard to get where you are and ensuring that you are reimbursed for the value that you bring is critical. If you missed the program but are still interested in connecting with Kevin and obtaining some e xpert tips for your next employment contract negotiation, then send an email to Chet in the CSEPS offices.

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New CSEPS president-elect

Posted By Chet Seward, Friday, April 13, 2018
After a statewide nomination process and subsequent election, Christopher Thiagarajah, MD, FACS, has been chosen as president-elect of CSEPS. An actively practicing oculo-plastic surgeon in Denver, Dr. Thiagarajah will work closely with CSEPS President Leonard Seibold and the rest of the board of directors to guide the organization forward. He will assume the presidency in January 2019. Congratulations Dr. Thiagarajah!

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MIPS 2018: Are you in or out?

Posted By Chet Seward, Friday, April 13, 2018

If you’re still trying to figure out whether you have to report MIPS data for 2018, based upon recent changes by the federal government, then a new online tool can help your decision-making process. The Centers for Medicare & Medicaid Services (CMS) has released an online tool that enables clinicians to determine whether they must participate in the Merit-Based Incentive Payment Program (MIPS) this year. 

Fierce Healthcare reports that “the second year of MIPS quality reporting requirements started January 1, yet physicians were not sure if they were in or out of the program. In fact, given new threshold requirements for the MIPS program in 2018, CMS estimates more than 500,000 clinicians will be excluded from MIPS this year.

In its notice about the 2018 MIPS eligibility tool, CMS makes note of the changes to its low-volume threshold requirements. To reduce the burden on small practices, CMS changed the threshold to exclude clinicians and groups if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule; OR
  • Furnished covered professional services to 200 or fewer Medicare Part B-enrolled beneficiaries

In other words, to be included in MIPS in 2018, clinicians or groups need to have billed more than $90,000 in Medicare Part B allowed charged AND furnished services to more than 200 beneficiaries. (The threshold exempts even more physicians, since in 2017, clinicians had to participate in MIPS if they billed Medicare Part B more than $30,000 a year and saw more than 100 Medicare patients a year.)”

Determine your 2018 MIPS eligibility status today by using the MIPS Participation Lookup Tool.

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Medicare billing issue

Posted By Chet Seward, Friday, April 13, 2018

CSEPS encourages all our members to proactive in reviewing their own documentation to make sure it consistently meets the payer requirements. Members should be aware of a recent notice from the American Academy of Ophthalmology (AAO) regarding issues affecting physicians in four states.

AAO writes, “Ophthalmologists in North Carolina, South Carolina, Virginia and West Virginia, whose comparative billing report puts them in the 80th percentile, with greater than $10,000 of allowed charges and more than 30 beneficiaries undergoing an exam plus cataract or complex cataract surgery from January - December 2016, are asked by the Medicare administrative contractor Palmetto to provide the answers to specific questions. Depending upon the answer, the physician's documentation may be directed to target, probe and educate (TPE) review. They are given 1 week to respond to the following questions:

  1. Is there documentation present for all dates of service billed and or operative eye billed?
  2. Is patients own assessment of functional status causing him / her to seek medical attention?
  3. Is there evidence of a comprehensive eye examination and ocular examination and a single diagnostic a scan to determine the appropriate lens?
  4. Is there documentation indicating that the cataract is significantly contributing to the patient’s visual impairment in the presence of one or more concomitant ocular diseases?
  5. What are your self-auditing methods?”

While these TPE reviews are not  happening in Colorado, take this opportunity to be aware of trends in other states and then review the latest local coverage determinations by Novitas here. For more information, contact Sue Vicchrilli, COT, OCS, AAO Director, Coding & Reimbursement.

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