Louisiana Health Care Commission 

On Friday, September 6, LSMS Vice President of Legal Affairs Lauren Bailey, participated in a meeting of the Louisiana Health Care Commission where they received an update provided by the Office of Life, Health and Annuity regarding the hiring of an actuarial firm to provide an analysis of a new high risk pool under consideration in the event the affordable health care plan is no longer available.  

Ms. Ronnell Nolan of Heath Agents for America gave an update on what is going on at the federal level regarding surprise billing.  She indicated that the expectation is that the final bill will be a shell of what we see now and that it is highly doubtful that legislation will make it through the process year.   

There was then a presentation on Ready Responders, which is an EMT initiative to monitor patients with chronic disease in an effort to control costs and improve quality of care.   This was followed by an update from Dr. Gee, Secretary of LDH, on the progress being made relative to the Hepatitis Outbreak.

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Register for LAMMICO Webinar "QPP: Latest Updates and Q&A"
on Oct. 1

LAMMICO Practice Solutions will host a complimentary webinar, "QPP: Latest Updates and Q&A" on the Quality Payment Program (QPP) for LAMMICO insureds, physicians and their practice staff on Tuesday, October 1, 2019, from noon-1 p.m. CDT. The webinar will be presented by LAMMICO Practice Management Specialist, Natalie B. Cohen, MBA, MHA. Register here. After registering, you will receive a confirmation email containing information about how to join the webinar. 

October 3, 2019 begins the last 90-day period for reporting in the third performance year of the QPP, and the penalty for non-participation has increased to 7%. If your practice hasn't done anything yet, you can still avoid a Medicare penalty in 2021! If you are currently collecting data, you can still review and evaluate your QPP strategy.

Participation in the Quality Payment Program can also help you mitigate your malpractice risk through tracking and improving quality care (Quality Measures), increasing patient engagement and satisfaction (Improvement Activities) and improving communication using secure electronic transmissions between providers and with patients (Promoting Interoperability).

CME and CNE credits are available. No Risk Management Premium Discount Credits are available for this course.

Click here to register.

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P.H. Jones, MD, Scholarship Selection Criteria and Processes

Due to the growing number of people throughout the country who have been hospitalized with severe pulmonary disease associated with using e-cigarette products, the Louisiana Department of Health is asking physicians and other healthcare providers to report suspected cases to state health officials.

The Department is also advising physicians to ask all of their patients who report using e-cigarettes within the past 90 days about signs and symptoms of pulmonary illness.

9 cases reported in Louisiana

Since the beginning of the year, 215 possible cases of severe side effects linked with e-cigarettes have been reported in 25 states, and one person has died. 
 

In Louisiana, over the past two weeks, nine cases of pulmonary illness have been reported to health officials. These cases have been reported from throughout the state with the ages ranging from 20-33. There are no deaths in Louisiana associated with this illness.

In a statewide alert to healthcare providers, the Department of Health wrote: E-cigarettes typically contain nicotine, flavorings and other chemicals. Some may contain marijuana or other substances. The devices may be referred to as e-cigs, vapes, e-hookahs, vape pens, mods, tanks or electronic nicotine delivery systems.

E-cigarettes can contain harmful or potentially harmful substances, including nicotine, heavy metals (e.g., lead), volatile organic compounds and cancer-causing chemicals.

Those who do not currently use other tobacco products should not use e-cigarettes. While e-cigarettes containing nicotine have the potential to help some individual smokers reduce their tobacco use, the federal Food and Drug Administration has not approved e-cigarettes as a quit aid and no conclusive data exists on whether e-cigarettes are effective for quitting tobacco use.

Recommendations for the public

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Louisiana receives $4.9 million CDC grant to fund opioid data programs

Through a $4.9 million grant from the Centers for Disease Control and Prevention, the Louisiana Department of Health will fund opioid surveillance programs aimed at strengthening prevention strategies to tackle the opioid epidemic in Louisiana.

The Overdose Data to Action grant is part of the CDC's second wave of funding public health projects with the intention of creating surveillance and prevention strategies to use data to reduce opioid use.

The drug overdose rate in Louisiana was more than twice the national average between 2013 and 2017. This was fueled in part by the opioid prescription rate, which reached a high of 123 prescriptions per 100 people in 2013. As of 2018, that has fallen to 96 prescriptions per 100 people.

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Other State News & Information

• New $21M road expands access to Baton Rouge Health District, theadvocate.com

The Centers for Medicare and Medicaid Services (CMS) released a final rule with a comment period on Program Integrity Enhancements to the Providers Enrollment Process, which is intended to stop waste, fraud and abuse by requiring providers and suppliers to disclose certain affiliations. CMS Administrator Seema Verma emphasized that the agency now has the tools to "stop criminals before they can steal from taxpayers."
 
The final rule requires Medicare, Medicaid and Children's Health Insurance Program (CHIP) providers and suppliers to disclose current and previous affiliations with other providers and suppliers. Specifically, providers and suppliers will disclose any affiliation, direct or indirect that: has uncollected debt; has been or is subject to payment suspension under the program; has been or is excluded by the Office of Inspector General (OIG) from Medicare, Medicaid or CHIP; or has had its Medicare, Medicaid, or CHIP billing privileges denied or revoked.
 
The final rule also provides the agency the authority to deny or revoke a provider's or supplier's Medicare enrollment in specific situations, including situations in which a provider or supplier comes back into the program under a different name, submits bills from "non-compliant locations," or exhibits "a pattern or practice of abusive ordering or certifying of Medicare Part A or Part B items, services or drugs."
 
CMS also provides information regarding potential cost savings associated with the final rule, including that the new revocation authorities will lead to approximately 2,600 new revocations per year, with an estimated 10-year savings of $4.16 billion.
 
The authorities are effective November 4, 2019 and are intended to ensure "effective, proactive and risk-based tools designed to protect the integrity of these vitally important federal healthcare programs."  CMS is seeking public comment on provisions regarding Disclosure of Affiliations in Medicare and Medicaid.  The deadline for submitting comments is 5 p.m. on November 4, 2019.
 
We have attached below the final rule and the CMS press release, which includes a link to CMS initiatives to increase provider and supplier transparency.