April 7, 2017

Inside this issue
  State Activities  

The LAMPAC Board of Directors has endorsed Raymond Crews in the runoff for the House District 8 seat in Bossier Parish, which will be held April 29, 2017. The seat was recently vacated when Mike Johnson won the Congressional race to replace Dr. John Fleming.
Crews led the pack last Saturday night with 2,144 votes or 41 percent, and will face Robbie Gatti, younger brother of state Senator Ryan Gatti. Gatti, who was, and continues to be, heavily financed by the trial lawyers came in a close second with 1,947 votes or 37 percent.
Crews served 17 years in the U.S. Air Force, and flew in combat missions in Iraq and Afghanistan. After his service in the military, he flew for national airline companies and later started a small business in Bossier City.
To learn more about Crews and join LAMPAC, LABI, LMOGA, and many others in the business community in donating to his campaign, visit his website by clicking here.


Health and Human Services Subcommittee of the House Committee on Appropriations April 5, 2017.

LSMS Vice President of Governmental Affairs Jennifer Marusak, Vice Present of Legal Affairs Lauren Bailey and LSMS contract lobbyist Harris Deville Associate Ginny Martinez attended the Health and Human Services Subcommittee five and one-half hour budget presentation from the Louisiana Department of Health on Wednesday, April 5th. 

The Health and Human Services Subcommittee of the House Committee on Appropriations met this week to hear state testimony on the budget for the Louisiana Department of Health. Chris Keaton and Nancy Keaton with the Fiscal Division gave a presentation outlining the department's budget. LDH's budget totals $14.2 billion and is slated for a $2.4 billion increase, mostly from federal funds. The agency makes up 29.4 percent of state general fund spending, at $2.6 billion, which has been increasing 11 percent annually. However, this year, the need for SGF spending is decreasing due to increased federal funding for the Medicaid expansion, higher Federal Medical Assistance Percentage rates and cost savings. "If it continued to rise, the state couldn't afford it [SGF increase]," Chris Keaton said. Absent those federal funds and cost savings, LDH's SGF needs are growing faster than the SGF availability for the entire state. The state's annual growth rate in SGF Medicaid spending is 6.7 percent; the national average is seven percent.
The partner hospitals face a 6.2 percent ($84 million) reduction in the proposed budget for fiscal year 2017-18, and the cuts may not be applied across the board, due to differences in agreements. "We put a very minor cut on the partners [this year], and they put the full force of that cut on our universities," LDH Sec. Dr. Rebekah Gee said, noting the need to protect graduate medical education.
Medical vendor payments are increasing by $1.6 billion, mostly in federal dollars. Additionally, statutory dedications are increasing due to the provider fees for hospitals passed and implemented earlier. Essentially, the SGF need for the agency has been reduced due to means of finance swaps. With regard to the Upper Payment Limit, LDH Undersecretary Jeff Reynolds said local governments have "stepped up" where state support has decreased. LDH Sec. Gee wants to reduce state reliance on supplemental payments in the Medicaid program.
Dr. Gee said Medicaid takes up a large share of the state budget, 92 percent of the agency's budget, and inflation-adjusted costs since 2005 have been around five percent increases annually. Still, Louisiana spends $1 less per person than in 2005, despite covering an additional 600,000 people. The state spends $401 per capita on Medicaid expenditures annually; the national average is $408.

Other State News and Information



  Federal Activities  

House Majority Leader McCarthy Memo on ACA Repeal Progress

Below, please find a memorandum sent today by House Majority Leader Kevin McCarthy (R-CA) to House Republican Members announcing that the Rules Committee will meet later today to add an amendment to the American Health Care Act to create a $15 billion federal invisible risk sharing program. The program, which would begin in 2018, is intended to help states reduce premiums by reimbursing health insurers for high cost individuals. 

The Majority Leader informs Members that discussions will continue over the next two weeks on Affordable Care Act repeal and replacement, adding, "Should we be prepared to advance our bill through the House in the coming two weeks, we will advise Members immediately and give you sufficient time to return to Washington."

Click here to read the memo.

CMS Finalizes 2018 Payment and Policy Updates for Medicare Health and Drug Plans, and Releases a Request for Information

Rate Announcement supports benefit flexibility, efficiency, and innovation in Medicare Advantage and Part D

The Centers for Medicare & Medicaid Services (CMS) today released final updates to the Medicare Advantage and Part D Prescription Drug Programs for 2018. Through these changes, CMS seeks to support benefit flexibility and efficiency that allows Medicare enrollees to choose the care that best fits their health needs.

"Medicare is committed to strengthening Medicare Advantage and the Prescription Drug Program by supporting flexibility and efficiency," said CMS Administrator Seema Verma, MPH. "These programs have been successful in allowing innovative approaches that give Medicare enrollees options that best fit their individual health needs."

The final policies are similar to those proposed and discussed in the Advance Notice and draft Call Letter in February but incorporate several changes in response to feedback received during the public comment period. On average, plans can expect a revenue change of 0.45 percent, though individual experiences will vary. When accounting for the expected growth in coding acuity, plans can expect a total change of 2.95 percent in revenue. Plans that improve the quality of care they deliver to enrollees will see higher updates and can grow and enhance the benefits they offer to enrollees.

Chairman Hatch Urges CMS to Consider MA FFS Normalization Factor Changes

Below, please find a press release issued by Senate Finance Committee Chairman Orrin Hatch (R-UT) regarding the Centers for Medicare & Medicaid Services (CMS) 2018 Medicare Advantage (MA) Rate Announcement & Call Letter released yesterday.  Chairman Hatch "applauded a number of positive changes" made by CMS to "help ensure the program continues to offer high quality, affordable health care plan options for our seniors, including an overwhelming majority of Medicare beneficiaries in Puerto Rico that use MA plans."  He did not single out any specific policy.

Chairman Hatch also stated he is hopeful the agency will consider enhancing the transparency and predictability of Fee-for-Service Normalization Factor," noting he will continue to review MA final policies and work with CMS in the future to address other MA issues.  Chairman Hatch and other Senate Republicans previously wrote to CMS in support of additional MA policy changes, including those regarding the benchmark cap, risk adjustment, and guidance on quality-based adjustments to Medicare Physician Fee Schedule payments. The Chairman's earlier letter and press release are attached for reference, as is the CMS 2018 MA Rate Announcement & Call Letter.

Click here to read the full release

American Health Care Amendment Text re: Federal Invisible Risk Sharing Program

Below, please find the text of an amendment to the American Health Care Act that would create a $15 billion federal invisible risk sharing program.  According to a Memorandum from House Majority Leader Kevin McCarthy (R-CA) to House Republican Members, the program is intended to help states reduce premiums by reimbursing health insurers for high cost individuals.  The House Rules Committee will meet today regarding the amendment.  Leader McCarthy's memorandum is also attached. 

Click here to read the amendment



  Member News & Information  

Physician's Guide to Louisiana's Anti-Kickback Statutes and Stark Law

Authored by W. Scott Keaty and Joshua G. McDiarmid 
Kantrow, Spaht, Weaver & Blitzer (APLC)

The LSMS has partnered with the law firm of Kantrow, Spaht, Weaver and Blitzer, APLC, to feature guest articles concerning common legal issues facing the medical profession.  In this week's article we will discuss the Louisiana analogues to the federal statutes, and explain the meaningful distinctions between these state and federal laws. 
Click here to learn more. 

If you have any questions or concerns regarding Stark law, please contact Scott Keaty at scottk@kswb.com or Vice President of Legal Affairs, Lauren Bailey at lbailey@lsms.org. 

This information is provided for informational purposes only and with the express understanding that (1) no attorney-client relationship exists or is created hereby, and (2) neither the LSMS nor its attorneys are engaged in providing legal advice. 

The MIPS Navigator™ - The easy way to create a practice-specific MIPS action plan and gain a bonus rather than suffer a penalty

Every physician and other clinician who is subject to the new Medicare Incentive Payment System (MIPS), will receive a MIPS score reflecting that clinician's aggregate 2017 performance on Quality, EHR use and Practice Improvement. That MIPS score will, in turn, be translated into an individualized payment adjustment, up or down, to Medicare's Physician Fee Schedule as it is published two years after the MIPS performance year. For 2019, that payment adjustment ranges from a 4% penalty to a bonus which will depend in size on how many suffer the penalty. By 2022, the maximum penalty will have increased to 9% and your Medicare patients' costs will also be factored heavily into your score!
  • Don't settle for a cut, or even a Medicare fee freeze! Obviously, the stakes are high, and only getting higher. Unfortunately, the MIPS rules are profoundly complex, resulting in a mind-numbing set of possibilities that change for each practice. Few practices can decipher the requirements and make a plan for success, even after many hours of study and seminar attendance.
  • Louisiana State Medical Society's Powerful Solution - The MIPS Navigator™: There is a better/easier way. The MIPS Navigator™ is an online tool that makes it possible for individual clinicians or practice administrators to quickly and easily sort through the various MIPS alternatives and produces a practice specific "2017 MIPS Itinerary/Plan" for each of the 3 MIPS domains that will maximize their likely MIPS success.
  • By answering a few questions specific to your practice you receive:
  1. A step-by-step guide on how to maximize your score, avoid any penalty and get the largest possible bonus (upward adjustment to your fee schedule)!
  2. Continued access to the MIPS Navigator FAQs and list serve throughout 2017 with the ongoing ability to update your plan.
  3. The ability to model various MIPS payment adjustments and see what they will mean to your practice in 2019
  4. The information you need to know about Alternative Payment Models (APMs)


To access this exclusive member benefit and increase your potential MIPS bonus, email LSMS Education and Member Services Coordinator Jennifer Tewell jtewell@lsms.org to receive your access token today!

Stay connected for up-to-date information on news and events! 




  Educational and Research Foundation  

Get Involved! LSMS Educational and Research Foundation Seeks Board Members

The LSMS Education and Research Foundation (ERF) is seeking volunteers to serve as members on its Board of Directors. The LSMS ERF Board serves as the governing body for the 501(c)3 ERF  as well as the CME approval committee for all ERF CME activities. Additionally, the ERF Board oversees educational processes and activities such as its research symposium, the P.H. Jones Scholarship Fund, and other educational activities. The board meets quarterly via conference call and most work and communication is done electronically. To be considered, please forward your CV to Kayne@lsms.org. Current LSMS members who serve on the LSMS ERF are Dr. Mary Jo Fitz-Gerald, Dr. Richard Paddock, Dr. Geoffery Garrett and Dr. Myo Myint.  Once all positions have been filled, the LSMS president will designate a Chair.  
The ERF has been more active now than ever!  In the past year we have: 
  • Become an accredited CME provider 
  • Rolled out our online CME platform for members and non-members
  • Launched our physician leadership academy 
  • Coordinated 2016 and 2017 HOD including the research symposium and the MICROposium on physician payment models 
  • Continued to work with community partners to implement the community program Walk With A Doc.  
In order to ensure the success of the ERF, we need support and leadership from members like you! For more information or questions, please contact Kayne Daigle, ERF director,kayne@lsms.org.


LHA Presents: Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): Assessing MACRA Readiness and Strategies 

The Medicare Access and CHIP Reauthorization Act (MACRA) revolutionizes reimbursement to clinicians for Medicare beneficiaries. The focus will be more on quality of care and population health rather than fee-for-service. 

The MACRA Quality Payment Program reporting period for 2017 began on Jan. 1 and will close on Dec. 31, 2017. Depending on the MIPS track of the Quality Payment Program you choose and the data you submit by March 31, 2018, your 2019 Medicare payments will be adjusted up, down or not at all. If you have sufficient participation an Advanced APM in 2017, then you may earn a 5% incentive payment in 2019. 
  • Wednesday, April 12, 2017, 8 a.m. - noon
  • LHA Conference Center, 2334 Weymouth Drive, Baton Rouge, LA 70809 
  • LSMS member price: $125
For more information or to register, click here.


Science & Technology News



Focus On

National Autism Awareness Month - April

National Autism Awareness Month is an effort to promote autism awareness, inclusion, and self determination for all, and assure that each person with ASD is provided the opportunity to achieve the highest possible quality of life. 

Click here for more resources

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