QPP Group Eligibility Status Now Available

The Centers for Medicare and Medicaid Services (CMS) has announced that physician practices/groups may now log into the CMS QPP website to check their 2018 eligibility for Medicare's Merit-based Incentive Payment System (MIPS).  After groups log in, they will be able to click into a details screen to see the eligibility status of every clinician in the group ( based on their National Provider Identifier or NPI) to find out whether they need to participate during the 2018 performance year for MIPS.  Unfortunately, CMS will not be sending out letters to advise physicians of their eligibility status this year so checking on the QPP participation status look-up tool is the only way to determine or verify eligibility status.  Eligibility rules in 2018 are different than in 2017 so status this year may be different than last.  Also as is indicated in the look-up tool, exempt individual clinicians still will need to report if their group is eligible and chooses to report as a group.  The look-up tool can be found by clicking here. 

Join HealthSYNC of Louisiana May 15 (Lake Charles) and May 16 (Covington) for the next two CME events. Dr. Laura McCrary will be presenting, Quality Matters: The New Data Dilemma.

Click here to register to attend this great learning opportunity. For more information on HealthSYNC of Louisiana, visit healthsyncla.com.

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We are pleased to announce that WJMC physician network joined the LSMS as a NEW 100% physician group in May 2018. This 64 physician provider group serves Marrerro and surrounding communities, specializing in a variety of services - OBGYN, Cardiology, Internal Medicine, Otolaryngology, Family Medicine, Urology, Hematology/Oncology.

Robert Chugden, MD, a long-standing LSMS member and WJMC CMO, led the model for this new partnership. We are proud to support their efforts and appreciate the opportunity to serve the group's membership needs.
If your group would like a custom benefits package, please contact LSMS Director of Member Services & Administration Terri Watson, terri@lsms.org or 225-763-2303. 

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Congratulations and best wishes with the next step of your career!

If you matched here in Louisiana, we hope you have enjoyed the services that the LSMS has provided you while you were a student and that you will continue to belong as a resident member.  Dues are discounted for the resident/fellow category of membership in an effort to assist you financially as you move toward your ideal professional goal.  Click here to view of list of benefits for resident & fellow members. We hope to have the opportunity to continue serving your membership needs. Please contact Terri Watson,terri@lsms.org, for your 2018-2019 resident dues invoice.

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Office Managment Solutions now available through LAMMICO

Practice Solutions is LAMMICO's one-stop on demand collection of resources and services to help reduce malpractice risk and other risks, and help make the business of medicine more manageable. It is a robust collection of risk mitigation tools to help with the daily challenges of managing compliance and safety in medical practices. Information included in each focus area of Practice Solutions is chosen for its timeliness in the healthcare industry, relevance to their insureds and risk reduction potential. Click here for more information or contact Natalie Cohen - ncohen@lammico.com. LAMMICO policyholders and their qualifying staff can also access these resources by logging into LAMMICO.com.

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LAMMICO CEO Thomas H. Grimstad, M.D. Announces Retirement

After more than 20 years with LAMMICO, Thomas H. Grimstad, M.D., has announced his retirement as LAMMICO President and CEO effective March 1, 2019. The Board of Directors has elected LAMMICO's current Board Chairman, J. Michael Conerly, M.D., to succeed Dr. Grimstad as President and CEO.

Dr. Grimstad received his bachelor's degree from the University of Wisconsin and his M.D. degree from the Tulane University School of Medicine. He is Board Certified in Internal Medicine and Pulmonary Disease and began practicing in the New Orleans metropolitan area in 1977. READ MORE

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What's New with Novitas' Novitasphere Part B Provider Portal

Novitas, the Medicare Administrative Contractor (MAC) for Jurisdictions H (and Jurisdiction L), is always looking for ways to improve our customers' Medicare experience. Novitasphere, a FREE, secure internet portal for providers, billing services, and clearinghouses, is one of the great ways we do just that. We are excited to announce a number of new features that were implemented in April 2018 as well as new features coming in June 2018. 
 
Exciting New Features:

• Immediate Recoupment Requests: The immediate recoupment process is for providers who have received an overpayment demand letter from Medicare. Providers may elect to have overpayment(s) repaid through the immediate recoupment process and avoid paying by check or waiting for the standard recoupment that begins 41 days from the date of the initial demand letter.
• Appeals Requests for Redeterminations: The Appeal Requests feature is available to submit Redetermination and Clerical Error Reopening requests for finalized claims.
• General Inquiry Requests: This feature is available to submit a general question to Medicare, such as questions related to coverage guidelines, policy issues, or how to bill Medicare. This form should not be used to submit claim-specific questions, questions that require PHI to research, or Novitasphere-related questions. 
• Medical Review Claims: The Medical Review Claims feature is available to perform a search of medically reviewed claims to obtain Additional Documentation Request (ADR) dates, ADR letter copies, review status, and education information.

We have also implemented some changes to make Novitasphere even better for our users. For example:

• Changes to the Part B Claims Status and Claim Correction required search criteria allow for easier searches. Specifically, the Patient Medicare Number, First Name Initial, and Last Name fields are no longer required to search for claims.  You may choose to narrow your search by using these fields, but they are no longer required fields.
• Features that request the Patient's Medicare Health Insurance Claim (HIC) Number will now allow the new Medicare Beneficiary Identifier (MBI) to be entered. 

Additionally, more changes are coming to Novitasphere this summer. To assist providers with the Medicare Beneficiary Identifier (MBI) transition, the MBI Lookup tool will only be available in Novitasphere beginning in June 2018. This will be your go-to resource to look up the beneficiary's MBI number if the beneficiary has not provided an updated card.  If you are not already enrolled for Novitasphere, we strongly encourage you to enroll now.  To see what customers are saying about Novitasphere, check out our customer testimonials:

• Customer testimonials - JH

To learn more about Novitasphere, we offer a monthly series of educational webinars to review the features within Novitasphere.  We encourage you to join us for our upcoming presentations for the Novitasphere Part B Overview, Novitasphere Enrollment Overview, Novitasphere Claim Submission Overview, Novitasphere Claim Correction Overview, or Novitasphere Hot Topics and Frequently Asked Questions.
 
Please visit the Educational Events page of our website to register for an upcoming event. 

• Educational Events - JH Part B 

You may also visit our website for more information about Novitasphere, including enrollment forms and instructions.

• JH Novitasphere Center

For questions regarding Novitasphere, please contact a Novitas EDI Analyst at 1-855-880-8424.

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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.

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Born addicted: Louisiana's rate of newborns dependent on opioids is rising, pregnant women lack treatment options

In 2015, at least 384 newborns in the state were diagnosed with the condition, according to hospital discharge data. The national Centers for Disease Control and Prevention has estimated that every 25 minutes, an infant is born with neonatal abstinence syndrome in the United States.

They only represent a sliver of infants who have been exposed to drugs and alcohol in Louisiana. At least 1,681 newborns last year had valid allegations of this exposure, according to the state Department of Children and Family Services. 

Compounding the problem, those who treat addiction say options for pregnant women trying to get clean in south Louisiana can be hard to come by. Some doctors fear the liability of treating an addict when birth defects could be involved, according to a former state medical examiner. READ MORE