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Photos top: KMA 4th District Trustee David Zoeller, MD, and others from Hardin County met with legislators.

middle: Nancy C. Swikert, MD (r) talked with Health and Welfare Committee Chairs, Sen Julie Denton (R, Louisville) and Rep Tom Burch (D, Louisville).

bottom: Lexington physicians Thomas K. Slabaugh, MD, and Rodney M. Mann, MD, talked at the Capitol with KMA President J. Gregory Cooper, MD

KMA’s 2005 Physicians Day at the Capitol, held February 17, drew almost 200 participants. Several dozen physicians and medical students began the day with visits to legislators. KMA President J. Gregory Cooper, MD, noted that “this was a great opportunity for physicians to present medicine’s message in a ‘one-on-one’ venue.” Attendees at the Legislative Seminar, held in the afternoon at the Kentucky History Center, heard from the top leaders in state government. Governor Ernie Fletcher, MD, in discussing his Tax Modernization Plan, received a standing ovation when he said, “it’s time to raise the cigarette tax to reasonable rates.” To effect tort reform, the Governor said, “Physicians must show up, speak up and put stress on their legislators.”

State Representative Bob DeWeese, MD, (R, Louisville), commended attendees, saying, “It’s very important that you are here to demonstrate to the General Assembly, the press and the public that you are concerned about the things that are happening to interfere with your ability to take care of patients.” Medicaid modernization was the focus of Medicaid Commissioner Shannon Turner’s message. She reported on some of the recent changes in the Department, including disease management, a call center and the future addition of Medicaid provider relations representatives.

William Hacker, MD, Commissioner of Public Health, reviewed some of the legislative initiatives being addressed by the 2005 General Assembly. Over 90 bills have been introduced specific to public health issues, including expanded newborn screening, obesity in children, organ donor registry, breast cancer research, cancer drug repository, Hepatitis C education, lead testing and trauma services. House Speaker Jody Richards (D, Bowling Green) and Senate President David Williams (R, Burkesville) brought the latest information to the group on upcoming votes in the House and Senate on the state budget, medical liability reform and e-Health. Both leaders stressed the high priority given by the Legislature to the delivery of health care in the Commonwealth. An evening reception provided a final opportunity for physicians and legislators to discuss KMA’s health care agenda.

Lexington physicians - Bruce M. Belin, MD, and Katrina M. Hood, MD - were two of only 16 young physicians nationally to receive the 2005 AMA Leadership Award. The awards, presented annually to medical students, residents/fellows, young physicians and international medical graduates, recognize individuals who show strong non-clinical leadership skills in advocacy, community service and/or education. Dr Belin, a surgeon with Bluegrass Surgical Group, is current chair of the Lexington Medical Society Administrative Council and serves

on the LMS Executive Committee. He is also a KMA delegate. Dr Hood is a pediatrician with Pediatrics & Adolescent Associates in Lexington and is a 1994 UL graduate. The awards will be presented in March in Washington, DC, preceding the 2005 AMA National Advocacy Conference.

One of AMA’s top priorities for 2005 is to prevent Medicare cuts forecasted beginning in 2006 and replace the current Medicare payment formula with a new system that appropriately reflects increases in practice costs. To that end, AMA is surveying physicians to determine how they would respond to a 5% cut in Medicare rates for 2006 and a long-term cut of 31% (from 2006-2013). Sign up to receive the survey on the AMA Web site. If you have already received a copy of the survey, please complete and return it to AMA as soon as possible. Kentucky physicians, over this eight-year period, would realize a cut in Medicare payments of $1.71 billion, averaging $24,000 per year per physician.*

Because of continued complaints regarding claims issues with AdminaStar, KMA is collecting information from its members on the scope of the problem. A survey was faxed to all member offices on March 1 asking about the dollar amount of outstanding claims and which claims have caused problems. Completed surveys need to be faxed to KMA no later than March 7. If you did not receive the survey on March 1 and wish to participate, contact Becky Romines.

Physicians are invited to attend a special program on March 16 to demonstrate Enhanced KASPER, Kentucky's new web-enabled Prescription Monitoring Program. Enhanced KASPER features real-time access with online review capabilities. This first public view will take place from 10:30 - 11:30 am at the Transportation Cabinet Auditorium, 200 Mero St., Frankfort. The program is presented by the Office of the Inspector General, Division of Fraud, Waste and Abuse/Identification and Prevention. Register for the program by e-mail to no later than March 9, 2005.

The 2004 KMA House of Delegates adopted Resolution 29 allowing the KMA Board or Executive Committee to amend the amount of the voluntary assessment for the Legal Trust Fund with the 2006 dues billing. The House once again strongly urged all active members of KMA to contribute to the Fund. Since its formation in 1973, the Fund has supported the legal efforts of physicians on issues “which adversely affect the practice of medicine.” The Fund has been used extensively in recent years to help underwrite KMA’s efforts to amend Kentucky’s Constitution on tort reform, as well as successfully challenging the provider tax, recovery of Medicaid payment cuts and defense of Kentucky’s Any Willing Provider Law. In spite of these increased efforts, only 34% of Active members have contributed this year. Physicians can send contributions to the fund directly to KMA.

The KMA Cancer Committee wants to draw attention to Colorectal Cancer Awareness and screening and treatment recommendations for major forms of cancer through its new Cancer Web site. The new site lists proper detection steps for all major forms of the disease, along with helpful information for physicians on referral sources, literacy and scientific references. The material includes consensus-developed statements on risk factors, screening intervals and preferred screening methods. Other information helpful to physicians is available from the American Cancer Society on such issues as frequent concerns expressed by patients, “higher” risk groups, cultural barriers to screening and responses to general questions.

“Selecting and Implementing the Right Electronic Medical Record” is the focus of a day-long Technology Summit to be held September 15, 2005, in conjunction with the KMA Annual Meeting. Faculty for the program, which will be held at the Kentucky International Convention Center in Louisville, includes representatives from the Coker Group, national heathcare consultants, and the American Medical Association. The goal of the program, which will carry 5.5 hours of CME, is to bring physicians and practice administrators up to speed on the plethora of EMR systems and to provide guidance for making informed and cost effective decisions. A variety of EMR vendors will be available onsite during the session which will run from 7:15 am to 4:15 pm. Registration information will be mailed to all KMA members and will be available on the Web site in the coming months.

Since AdminaStar Federal’s conversion to a new standard claims processing system in December 2004, many medical practices have encountered substantial delays in payments. After meeting with AdminaStar officials, KMA President J. Gregory Cooper, MD, and Jefferson County Medical Society President Fred Williams, MD, sent a joint letter in January to AdminaStar outlining problems members are having since the conversion. At the behest of KMA, the Centers for Medicare & Medicaid Services also met with AdminaStar to outline specific actions needed.

On February 17 th, AdminaStar officials met with the KMA Medical Business Advocacy Committee and reported on the current status of the actions they are taking to address payment delays. AdminaStar conceded that problems continue to plague the system, although many have been resolved. They also stressed that its customer service representatives should NOT be communicating to practices that only a few issues may be addressed per call. If KMA members continue to receive that response, they should contact KMA with the name of the customer service representative. KMA has encouraged AdminaStar to continually update the log of issues available on its Web site, which contains the approximate date the issue was or will be resolved.

Governor Ernie Fletcher announced implementation of emergency regulations that will bring changes to the state Medicaid program, including a limit on the number of brand-name drugs a Medicaid recipient may be prescribed. Medicaid members are currently allowed to receive an unlimited number of brand-name drugs. Under the proposal, physicians will be required to justify additional brand-name prescriptions after three have been prescribed in one month. There will be no limit on generic drugs. Other changes include no longer reimbursing long-term care facilities for certain items; decreasing reimbursement rates for prescription drugs; and allowing Medicaid recipients to receive a 90-day supply of maintenance drugs when they suffer from chronic medical conditions. KMA continues to review the new requirement regarding brand name drugs and raised several issues with the Medicaid Department regarding the practicalities of the new policy.

Medical providers must be in compliance with the HIPAA Security Regulation by April 2005. The Illinois State Medical Society and the ISMIE Mutual Insurance Company drafted a set of sample policies and procedures for physician offices to assist in compliance with the HIPAA Security Regulation. This material was provided to KMA for distribution to its members and slight modifications were made to conform to Kentucky state requirements. The material contains sample policies, checklists and other helpful resources, and is available on the KMA Web site.

The 2004 KMA House of Delegates passed Resolution 2004-09 regarding the issue of third party payers sharing their physician networks with other third party payers. This situation is sometimes referred to as a “Silent PPO.” KMA has prepared a short paper on silent PPO’s which is available to KMA members on the KMA Web site.

Effective January 1, 2005, Medicare significantly increased the RBRVS values for administering injectable vaccines by recognizing the physician work involved in administering vaccines. Such recognition exemplifies the work of the AMA advocacy efforts as well as Medicare’s commitment to increase immunization rates by more appropriately reflecting the cost of performing this service. The geographically adjusted Medicare payment amounts for 2004 and 2005 in Kentucky are as follows:

A new tax law may affect physicians who receive deferred compensation, including deferred compensation when leaving a practice. The new law could impose an additional 20% tax on physicians in such situations. For more information, visit the KMA Web site.

The Kentucky Medical Group Management Spring conference, “No Frills Practice Management,” will be held May 19-20 at Holiday Inn North in Lexington. Approximately 110 medical office managers and administrators are expected to attend.

Your opinion is valuable and KMA wants to hear from you! Please respond to our new member poll on the KMA Web site