May 5, 2018

Physician's Guide to Gainsharing Arrangements

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.  This week's article will first address the federal health care law implications of gainsharing arrangements and then examine the guidance provided by the OIG concerning such arrangements.
Click here to learn more.

If you have any questions or concerns regarding this topic, please contact Scott Keaty at

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. 

White Coat Wednesday 2018

THANK YOU to our LSMS members who joined us for White Coat Wednesday. This year, LSMS partnered with the Louisiana Academy of Family Physicians and the American Academy of Pediatrics Louisiana Chapter to promote advocacy in action to protect your profession.


Medicaid Point of Care Testing Cuts - Sign On Letter

Click here to read the letter to the Centers for Medicare and Medicaid Services Administrator, Honorable Seema Verma expressing serious concerns that Medicaid beneficiaries in a number of states are on the verge of losing access to clinical testing services.

CMS Changes Name of the EHR Incentive Program and Advancing Care Information Performance Category 

In late April, the Centers for Medicare and Medicaid Services (CMS) announced proposed rule changes directly aimed at empowering patients and reducing administrative burden for physicians. These changes are tied to CMS's ongoing commitment to interoperability, patient data access and system-wide health information exchange (HIE). The meaningful use EHR Incentive Programs will now be known as "Promoting Interoperability", and the Merit-based Incentive Payment Program (MIPS) Advancing Care Information performance category will be known as the "Promoting Interoperability performance category" to maintain alignment across both programs.  The goal is to put patients first so they may access high quality care, benefit from more choices and enjoy better outcomes. In addition, the proposed rule prioritizes price transparency and interoperability while also allowing hospitals greater flexibility. CMS is updating its guidelines to specifically require hospitals to post their standard charges. CMS is seeking comment from the public on what price transparency information would be most useful and how best to help hospitals create patient-friendly interfaces. The goal is to make it easier to access relevant health care data and to compare providers. As part of CMS' commitment to reducing burden, it is proposing the removal of unnecessary, redundant, and process-driven quality measures from a number of quality reporting and pay-for-performance programs. A significant number of the measures acute care hospitals are currently required to report would be eliminated, and duplicative measures across the five hospital quality and value-based purchasing programs would be removed. This would remove a total of 19 measures from the programs and de-duplicate another 21 measures. CMS is proposing other changes that reduce the number of hours providers spend on paperwork, so more time can be spent providing patient care. The elimination of 25 total measures across the 5 programs is estimated to reduce 2 million burden hours and save approximately $75 million. The proposed rule reiterates the requirement for providers to use the 2015 edition of certified electronic health record technology in 2019 as part of demonstrating meaningful use to qualify for incentive payments and to avoid reductions to Medicare payments. Under Promoting Interoperability, updates to EHR and related technology includes the use of application programming interfaces, or APIs for patients to collect their health information from multiple providers, and to potentially incorporate all of their data into a single portal, application, program, or other software. Just a reminder CMS reporting for the Quality Payment Programs can be simplified using the tools and resources of HealthSYNC of Louisiana.

For more information on HealthSYNC, contact Jeff Williams,

For a fact sheet on the proposed rule (CMS-1694-P), click here.

To comment on the proposed ruling, visit: no later than 5 p.m. on June 25, 2018. Follow the "Submit a comment instructions."


Legislative Update

  • Click here to view updated LSMS bill positions tracker.

Open Enrollment for Healthy Louisiana Plans

Louisiana Department of Health Informational Bulletin 18-3 April 26, 2018

This bulletin outlines the details and dates of the 2018 open enrollment period for existing Louisiana Medicaid Healthy Louisiana members. You may download the Open Enrollment Informational Flyer and display it in your office.

To read the full bulletin, click here.

Other State News & Information


What Lyft and Uber are really bringing to hospitals 

Transportation apps are making their presence felt in hospitals, in EHR workflows - and even in federal policy discussions - giving access to appropriate care its due as a key social determinant of health. Click here to read more from

HealthSYNC of Louisiana is off and Running!  Click here to read the inaugural issue of the bimonthly HealthSYNC eNews. Find out who is officially the first to join the physician-led health information exchange, read about how HealthSYNC is engaging the health care community around the state, and find out how you can connect your patients to the myLAHealtheRecords, the statewide online patient portal, eliminating the need for patients to manage multiple personal health records. Be sure to SIGN UP to receive future issues of HealthSYNC enews directly. For more information, visit


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