Home2018-12-19T19:55:43+00:00

COMPLIANCE CORNER: Physicians And Laboratories

By DUSTIN WACHLER-WACHLER & ASSOCIATES, P.C.
Physicians increasingly seek to provide comprehensive care and increase revenue by offering clinical laboratory services to their existing patients. While many laboratory arrangements are permissible, Michigan healthcare providers must be aware of federal and state authorities governing their ability to derive revenue from orders for clinical laboratory services.

Physician practices may provide testing for their own patients through a physician-office laboratory, or refer laboratory tests to an independent clinical laboratory. The federal Stark law prohibits a physician from referring Medicare or Medicaid patients for clinical laboratory services to an entity with which the physician or an immediate family member has a financial relationship. Michigan licensure laws applicable to physicians and other healthcare professionals incorporate the Stark law, and thus the Stark law’s prohibitions and exceptions apply to referrals of laboratory tests for all patients in Michigan.

Michigan healthcare providers structure physician-office laboratories to comply with the Stark law’s exception for in-office ancillary services. This exception permits a physician group practice to provide clinical laboratory services to the practice’s patients if the arrangement satisfies certain requirements related to the performance and supervision, location, and billing of the laboratory services. However, due to these requirements, physician groups generally cannot own and refer to […]

LEGAL LEANINGS: Healthcare Compliance Programs

By ROSE WILLIS-DICKINSON WRIGHT
The phrase “healthcare compliance program” is commonly used to describe those processes and procedures implemented by a healthcare provider to prevent submission of erroneous claims and combat fraudulent conduct. The expectation is that providers using internal controls will more efficiently monitor adherence to legal and regulatory requirements than providers without such controls in place. However, confusion remains over whether a healthcare compliance program is legally required for many healthcare providers, particularly those in clinical practice.

Some healthcare providers may believe a formal compliance program is not necessary until a clear, legal requirement is established involving detailed parameters and penalties. This perspective primarily comes from those who don’t have the time, energy or resources to implement a program unless they understand it as an enforced legal mandate tied to penalties. Understandably, the same perspective surrounded compliance with HIPAA until the 2009 HITECH Act issued a clear enforcement rule with sizeable penalties for noncompliance.

Unlike HIPAA, currently there exists no clear enforcement rule setting forth explicit penalties against all types of providers for failure to implement a formal healthcare compliance program. While Section 6401 of the Patient Protection and Affordable Care Act requires as a condition of participation, all healthcare providers participating in a federal […]

ON MEDICINE: Treating Chronic Lead Toxicity?

By GERALD NATZKE, JR. DO
President
Genesee County Medical Society

As we enter the holiday season and ponder how 2017 has quickly flown past, many of us wonder if there is anything more we could medically do to assist the Flint residents who drank leaded water. We could easily argue that more should have been done to prevent this disaster by those responsible for monitoring the quality of the city’s water. Fortunately, a lot of good, caring people in this world have stepped up to provide aid. Several foundations, as well as the state and the federal government have granted monies for services to improve education, research, epidemiological needs and water line repair. On the periphery, it would seem everything is being taken care of as much as it can be. The true situation is…not really. There is still more, possibly a lot more. The GCMS Community and Environmental Health Committee have been researching this subject since the end of 2015. As a result, it has thoroughly evaluated several potential treatments and may have some answers. It seems there is very little information in the literature on the effects of low-level chronic lead ingestion and accumulation within a population. The FDA had long approved both oral DMSA and […]

The Opioid Crisis: It Is Not Physicians

By ALLAN DOBZYNIAK, MD
Blaming physicians for the “opioid crisis” is so far off the mark as to be potentially harmful. Then throw in pharmaceutical companies, and politics has definitely been substituted for truth. On “Face the Nation” former New Jersey Gov. Chris Christi, chair of the president’s opioid commission, blamed overprescribing doctors. He said, “This crisis started not on a street corner somewhere. This crisis started in the doctors’ offices and hospitals of America.” In the following discussion I will not even mention the significant contribution to the crisis related to the obsession with pain management by JCAHO, Medicare, Medicaid and finally by private insurance companies. But remember it was these bodies that forced the definition of pain as the fourth vital sign.

Correlation does not mean causation, but there are some correlations that seem not only interesting, but important relative to opioid abuse. If you have a job, are married, older than age 50, female and black the scourge of opioid abuse is less, much less. Recent studies though have shown cocaine related deaths to be greater in the African-American community. Being unmarried, divorced, unemployed or a young adult correlates with greater risk. One can wonder if the increased geographic risk in West Virginia, New […]

LANSING LINES: State Seeks To Dump Dental Contract Suit

The state is asking a judge to dismiss a lawsuit claiming the Department of Technology, Management and Budget showed “blatant favoritism” in awarding a $657 million contract for the Healthy Kids Dental Program.

The state says MCNA Insurance Company’s suit filed in Ingham County should be dismissed “because disappointed bidders lack standing to challenge a public bid process,” according to court documents.

The state further alleges the court doesn’t have jurisdiction over MCNA’s appeal because DTMB’s award recommendation was not a final decision by a judicial agency.

“The state’s attempt to dismiss the case, on a technicality, sends a clear message: It believes DTMB’s procurement decisions are immune from judicial review and it can act with impunity no matter how flawed the process or how blatant a violation of the law has occurred,” said MCNA attorney Scott Eldridge, of Miller Canfield Paddock and Stone.

“Transparency and fiscal responsibility require judicial review of this flawed decision,” he added. “These tactics contradict Michigan’s stated commitment to fiscal responsibility and competitive bidding.”

MCNA Insurance Company asked an Ingham County judge to reverse the DTMB’s decision to award the Healthy Kids contract to Blue Cross Blue Shield. It filed a related suit in the Court of Claims in January regarding DTMB’s response to its […]

Medical Community Town Hall in Flint

The Genesee County Medical Society presents a Dinner Business Meeting and Medical Community Town Hall

Mindfulness: its Importance to the Medical Community and Patients
February 1, 2018
Flint Golf Club
3100 Lakewood Drive
Flint, MI 48507

Physicians, Practice Managers, and Health Care Professionals Welcome!
$40.00 – GCMS Members, Spouses, Practice Managers, & Staff
$40.00 – Genesee County Osteopathic Association Physician Members & Spouses
$25.00 – Residents & Students
$75.00 – All Non-Member Guests

Evening Schedule:
6 pm, Registration & Social Hour
6:30 pm, Dinner
7 pm, Meeting
7:15 pm, Presentations

Space is limited!
Please register by January 25, 2018
Please mail your reservation payment to:
Genesee County Medical Society
4438 Oak Bridge Drive, Suite B
Flint, MI 48532
Email Sherry at ssmith@gcms.org to register your attendance or call 810-733-9923 for more information.

Legionnaires’ Researcher Says Wells Repeatedly Blamed Hospitals

(FLINT) – A Wayne State University professor testified that Michigan’s chief medical executive consistently tried to blame Genesee County hospitals for the 2014 and 2015 Legionnaires’ disease outbreaks in Flint.

Shawn McElmurry, who led a team of researchers trying to identify the source of the outbreak that is attributed to 12 deaths, also testified Dec. 20 at the preliminary exam for Dr. Eden Wells that he told Gov. Rick Snyder that the team’s study “wasn’t going well” and he could use his help to carry out much-needed testing.

“It was made clear to me I don’t (report) directly to the governor,” McElmurry testified. ” . . . It was made clear to me I was to work with (Michigan Department of Health and Human Services Director) Nick Lyon.”

When Lyon wasn’t available, McElmurry said, he was to reach out to Rich Baird, a Snyder senior advisor.

Wells is charged with obstruction of justice and with lying to a peace officer by knowingly giving false statements to a water investigator.

The prosecution is expected to seek an involuntary manslaughter and misconduct charges at the conclusion of the preliminary exam, which continues Jan. 28 before Judge William Crawford III in downtown Flint. The manslaughter charge is in connection with the death of […]

Treat Pain And Opioid Addiction At The Same Time

By JOHN DALEY
Colorado Public Radio

Seven years ago, Robert Kerley, who makes his living as a truck driver, was loading drywall when a gust of wind knocked him off the trailer. Kerley fell 14 feet and hurt his back.

For pain, a series of doctors prescribed him a variety of opioids: Vicodin, Percocet and OxyContin.

In less than a year, the 45-year-old from Federal Heights, Colo., said he was hooked. “I spent most of my time high, laying on the couch, not doing nothing, falling asleep everywhere,” he said.

Kerley lost weight. He lost his job. His relationships with his wife and kids suffered. He remembers when he hit rock bottom: One night hanging out in a friend’s basement, he drank three beers, and the alcohol reacted with an opioid.

“I was taking so much morphine that I [experienced] respiratory arrest,” Kerley said. “I stopped breathing.”

An ambulance arrived, and EMTs administered the overdose reversal drug naloxone. Kerley was later hospitalized. As the father of a 12-year-old boy, he knew he needed to turn things around. That’s when he signed up for Kaiser Permanente‘s integrated pain service. (Kaiser Health News is not affiliated with Kaiser Permanente.)

“After seven years of being on narcotics and in a spiral downhill, the only thing that […]

Are EDs Inadvertently Taking Money From Primary Care?

By EWA MATUSZEWSKI
CEO MedNetOne Health Solutions

For years, there’s been a concerted effort by insurance companies to halt the number of unnecessary visits to the Emergency Department. (Note – it is no longer a room.) This was a wise move designed to contain overall health care costs and excessive—and often unmerited—testing. While numbers are still too high, there’s been a decrease in the number of visits over the past several years.

That’s good news, the education on not using the ED like a physician’s office is working! Yet the shift from the ED to urgent care clinics or primary care physicians, where patients’ nonemergent needs are best met, resulted in reduced fees to hospitals and health systems. Darn those unintended consequences! Coupled with the trends of decreasing hospital admissions and shortened hospital stays, something needed to be done, right? In response, the Agency for Healthcare Research and Quality (AHRQ) released a five-level emergency department triage algorithm that stratifies patients into five groups, from least to most urgent, based on patient acuity and resource needs; but left out of the reimbursement bonanza are PCPS rightfully doing the same work in their own office – which they pay for.

PCPs can’t charge an exorbitant facility fee, while hospitals and emergency […]

The Importance Of Maintaining Accurate Mailing Information

By SARAH HILLEGONDS
Wachler & Associates, P.C.

In today’s mobile society, it is important that physicians are reminded of the requirement to maintain current, accurate mailing information with the appropriate state and federal agencies for licensing and Medicare and/or Medicaid billing purposes. There are significant potential consequences if a physician has an inaccurate address on file, fails to regularly check the mailbox connected to the address on file, or does not timely report a change in mailing address or practice location.

For state licensing, under the Michigan Public Health Code, Act 368 of 1978, physicians have a duty to notify the Michigan Department of Licensing and Regulatory Affairs (“LARA”) of a change in mailing address within 30 days after the change occurs(1). Failure to report a change of mailing address is, by itself, a sanctionable offense under the Public Health Code. The disciplinary subcommittee may impose a fine or reprimand a physician who fails to timely report a change of address(2).

In addition, if LARA files an administrative complaint against a physician alleging any sanctionable offense, it may notify the physician by sending a copy of the administrative complaint through regular mail and certified mail, return receipt requested, to the provider’s last known mailing address(3). A physician has 30 […]

IN MY OPINION: The World Turned Upside Down

By PETER LEVINE, MPH

Recently, it was reported on CNN that a county in Great Britain has announced a controversial policy to “support patients whose health is at risk from smoking or being very overweight.” The plan for the local clinical commissioning group is to “delay access to routine or non-urgent surgery under the National Health Service until patients improve their health.” Criteria have been established for the time limits and percentage of weight loss required for those with a BMI of over 30 and over 40. For smokers to have elective surgeries would require a patient to go eight weeks or more without a cigarette. They would have to take a breath test to prove their claim of abstinence. The Royal College of Surgeons in the UK opposes this policy. These patients will eventually get surgery, even if they are unable to lose weight or stop smoking, but they will have to wait.

The CCG states that financial savings are not expected. These proposals were developed “with the best interest of the whole patient population of our area in mind!” Interestingly enough, surveys are reporting 85 percent public agreement with these policies. A 2016 report by the Royal College of Surgeons shows that one in three […]

VOICES: Medicine And Politics

By ALLAN DOBZYNIAK, MD

The practice of medicine was not a political exercise for centuries. Now it seems more political and proscribed than thoughtful, deliberative or even analytical. The educated experienced physician exercising judgment and guidance for a unique individual, his or her patient, has been increasingly replaced by rules, regulations, mandates, laws, schemes and perverse incentives. These have been mostly at the hands of non-professional administrators and bureaucrats. That medical professionals have been cajoled into participating in this evolution acknowledges physicians acceptance of such questionable transitions in rendering care.

Politics, laws, and the burgeoning onerous administrative state are not intrinsic to the medical profession. How this occurred, has been allowed to occur and continues to occur are questions one would think a profession populated by educated, talented individuals exercising critical insights and analysis might ponder.

At its very basis, it is hard to escape the evolution of a fundamental “misconception” that has become the accepted fallacy permitting government’s intrusion into the sanctity of the relationship between a physician and her patient: the political fallacy that medical care is a right. If medical care, which must include physicians’ services, is considered the “right” of the patient, the “right” should be properly protected by law. Here then is the […]

2017 Tax Reform And Its Effects On Health Care

By PETER DOMAS
Dickinson Wright

Over the past decade, the health care industry has been accustomed to being center stage in political debates, but while medical providers and facilities did not have a prominent role in the latest political drama, the far-reaching effects of the Tax Cuts and Jobs Act of 2017, will impact almost everyone delivering health care goods and services. In addition to the reduction of personal tax rates, the following provisions will likely be most applicable to health care providers:

1. Reduced Business Tax Rates

The tax rate for businesses taxed as corporations was reduced from 35 percent to 21 percent, and entities taxed as a partnership, S corporation, or sole proprietorship may now be entitled to a Pass-Through Entities Deduction of 20 percent of domestic “qualified business income.” The Pass-Through Entity Deduction, however, is complicated and has significant limitations. For example, select services entities, such as physician practices, have low upper limits for the availability of the deduction ($415,000 for married taxpayers and $207,500 for single taxpayers). As a result, this deduction may benefit only a limited number of health care providers.

Action Steps

There has been significant speculation as to whether there will be (or should be) a rush for S-Corps to revoke their designation, or […]

New Settlement Options Soon To Be Available To Medicare Audit Appellants

By KEVIN R. MISEREZ, ESQ.
Wachler & Associates, P.C.

The Department of Health and Human Services recently unveiled the next two steps in its ongoing efforts to reduce the significant volume of claims pending at the Administrative Law Judge (ALJ) level of the Medicare appeals process, each of which involve additional settlement options for providers to resolve their pending claim appeals.

The first new settlement option was announced by the Centers for Medicare & Medicaid Services (CMS), which CMS refers to as the “low volume appeals settlement option (LVA).” As the name suggests, the LVA will be limited to provider appellants with a low volume of claims pending at the ALJ and Medicare Appeals Council (MAC) levels of appeal. While CMS has only released limited details with respect to the LVA’s eligibility requirements at this time, CMS defined “low volume” as fewer than 500 Medicare Part A or Part B claim appeals pending at the ALJ and the MAC, combined, as of Nov. 3, 2017. Additionally, the billed value of each appeal must be $9,000 or less. According to CMS, for those eligible providers whose pending appeals meet these thresholds, and who also meet “certain other conditions,” CMS will offer to settle eligible appeals at 62 […]

LEGAL LEANINGS: Is Your Physician Organization Complying With Antitrust Law?

By JESSICA RUSSELL & PAHL ZINN

It is not uncommon for a physician organization to act as an intermediary between its physician participants and third-party payers to facilitate the negotiation and acceptance of reimbursement rates and other payer contract terms.

However, when facilitation becomes negotiation and a PO accepts contracts with third-party payers on behalf of physician participants, also known as “single-signature contracting,” a PO may be unintentionally engaging in illegal “price-fixing” in violation of antitrust law.

Under Section 1 of the Sherman Act, it is illegal to engage in horizontal price fixing arrangements. This includes circumstances where PO physician participants, who are otherwise competitors in the market, collectively agree or disagree to a third-party payer’s terms. As a result, if a PO negotiates and unilaterally accepts or rejects rates on behalf of all its physician participants, it must proceed with caution and comply with Section 8 of the Department of Justice and Federal Trade Commission in their Statements of Antitrust Enforcement Policy in Health Care.

SAFETY ZONES

Single-signature contracting is not always a violation of antitrust law. The DOJ and FTC (the “Agencies”) specifically outline “safety zones” by which such conduct is permitted, provided that there are no extraordinary or unusual circumstances involved with respect to the […]

Vaccination Choice Advocates Take Their Shots At DHHS

The Department of Health and Human Services would be barred from crafting future immunization-related rules, meaning any age- or dose-related updates would need legislative approval, under a pair of bills debated in committee Nov. 30.

HB 5162 and HB 5163 comes as parents with objections to child immunization told the House Oversight Committee how state and local health officials have been “overly zealous” in pursuing a pro-vaccination agenda by belittling those seeking a state exemption.

Joel Dorfman, of Michigan for Vaccine Choice, said DHHS has used the administrative rules process to “eviscerate” a state law that is neutral on child immunizations by treating citizens who don’t want to give their kids shots as “deviants who need coercion to mend their way.”

“(The bills) would send a message to DHHS that they can’t use the rules process to eviscerate the law,” Dorfman said.

Rep. Steve Johnson (R-Wayland Twp.) said HB 5162 and HB 5163 don’t change any current requirements. It only makes it clear that moving forward, DHHS can’t make any administrative rules regarding immunization. That includes alterations to vaccination schedules.

“This issue is so deeply personal that it should be made by a body that follows a Democratic process,” Johnson said.

Bob Swanson, DHHS’ program director of immunizations, walked the committee […]

Report Outlines ACA Repeal Affect On Hospitals

The American Hospital Association and the Federation of American Hospitals Dec. 6 released a report that details the impact a repeal of the Affordable Care Act would have on hospitals and health systems and the patients and communities they care for.

The report finds that, under the most recent repeal-without-replacement bill, H.R. 3762, hospitals across the nation would suffer losses amounting to hundreds of billions of dollars.

Rick Pollack, AHA present and CEO, and Chip Kahn, FAH president and CEO, observed that, “Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses. As you know, hospitals are often the largest employer in many communities, and more than half of a hospital’s budget is devoted to supporting the salaries and benefits of caregivers who provide 24/7 coverage, which cannot be replaced.”

In letters sent Dec. 6 to President-elect Trump and congressional leaders, Pollack and Kahn outlined the findings of the report and their concerns about the potential impact on patients and communities. They also expressed their commitment to working with the Trump administration and Congress as they begin reconsideration of the ACA and reiterated […]

Goodies Abound In 21st Century Cures Act

A sprawling health bill that passed the Senate Wednesday and is expected to become law before the end of the year is a grab bag for industries that spent plenty of money lobbying to make sure it happened that way.

Here are some of the winners and losers in the 21st Century Cures Act:

WINNERS

Pharmaceutical and Medical Device Companies. The bill will likely save drug and device companies billions of dollars bringing products to market by giving the Food and Drug Administration new authority and tools to demand fewer studies from those companies and speed up approvals.

The changes represent a massive lobbying effort by 58 pharmaceutical companies, 24 device companies and 26 “biotech products and research” companies, according to a Kaiser Health News analysis of lobbying data compiled by the Center for Responsive Politics. The groups reported more than $192 million in lobbying expenses on the Cures Act and other legislative priorities, the analysis shows.

Medical schools, hospitals and physicians. The bill provides $4.8 billion over 10 years in additional funding to National Institutes of Health, the federal government’s main biomedical research organization. (The funds are not guaranteed, however, and will be subject to annual appropriations.)

The money could help researchers at universities and medical centers get hundreds of millions more dollars in […]

Ascension Rebrands Michigan Facilities to Reflect Collaboration

As it works to integrate its national health system, Ascension facilities in Michigan and Wisconsin will be first to adopt the unified name of Ascension. The hospitals and other sites of care that are part of the current systems of Ascension Michigan – Borgess in the Kalamazoo region; Crittenton in suburban Detroit; Genesys serving the Flint/Grand Blanc area; St. John Providence in metro Detroit; St. Joseph in Tawas City; and St. Mary’s with services in Saginaw and Standish – will adopt the Ascension identity. Similarly, the hospitals and other care sites of the current systems of Ascension Wisconsin – Ministry Health Care, Columbia St. Mary’s and Wheaton Franciscan Healthcare, serving residents across the state – will now use the Ascension name.

The moves are intended to make it clearer and easier for patients to access care and to navigate their health through the Ascension system.

“We have an obligation to provide high-quality, affordable care, and quality outcomes, with an enhanced experience for our patients and our providers,” said Anthony R. Tersigni, EdD, President and Chief Executive Officer of Ascension. Adopting a unified Mission statement and creating a clear and consistent identity reflect our collaborative national system and move us in this direction.”

Collaboration among Ascension’s hospitals across the […]

Health Policy Reports Out Bill To License Advance Practice Nurses

The House Health Policy Committee Sept. 20 reported a bill to license and regulate nurses with a masters, post-masters or doctoral degree in a nursing specialty, called advance practice registered nurses (APRNs).

APRNs may be nurse-midwives, nurse practitioners or clinical nurse specialists. Currently, the Michigan Board of Nursing may grant specialty certification to a registered professional nurse who has training beyond the requirements of initial licensure.

The bill, HB 5400, would add a list of protected terms, restricted to be used only by individuals authorized to use them: “certified nurse midwife,” “CNM,” “advanced practice registered nurse,” “APRN,” “NP” “certified nurse practitioner,” “CNP,” “clinical nurse specialist,” “CNS,” “clinical nurse specialist-certified,” and “CNS-C.”

These nurses would have the ability to prescribe drugs and controlled substances, dispense complimentary starter doses of controlled substances and would allow APRNs to make house calls or go on rounds whose timing and frequency is unrestricted by a physician.

Bill sponsor Rep. Ken YONKER (R-Caledonia) has been working on this bill since his first term and this year worked with a variety of health care stakeholders to forge the draft reported last week. “It’s a very simple bill, but it’s been a very complex bill,” Yonker said.

The intent of the bill, Yonker said is to improve patient […]

Congressional Dems Drawing Battle Lines Over Flint Relief Funding

A number of Congressional Democrats—including every Democrat in the Michigan Congressional Delegation—announced they’re going to battle after emergency funding for Flint was removed from a government-funding bill.

The issue is swiftly becoming the pivotal matter on which a government shutdown may rest. If the impasse lingers, it will likely invite more national scrutiny to Flint’s water crisis, and with that, further squabbling over the allocation of blame.

Minority leadership in the U.S. Senate coalesced to block a vote on the bill that would keep the government funded for the next 10 weeks, due to the exclusion of funding for Flint as it still grapples with the water crisis. Republicans have accused the Democrats of political motivations underscoring the action.

The provision looks to provide $220 million in aid to the city and is fully funded.

Despite broad bipartisan support in the Senate, it has been stonewalled in the House, where leadership asserts the funding would be better placed in the Water Resources Development Act (WRDA).

When U.S. Rep. Dan KILDEE (D-Flint) reportedly attempted to introduce the funding to that legislation as an amendment in committee, it was rejected when Republicans split over whether it had proper jurisdiction there.

Party leadership has since become the point people for the showdown, but all […]

Legalized Pot Shops Bills Signed Into Law

For the first time since voters said “yes” to medical marijuana in 2008, the state will be legalized freestanding shops where the product can be sold, under legislation Gov. Rick SNYDER signed into law Sept. 21.

A five-tier regulatory structure will now co-exist with the current distribution model, in which a caregiver can grow plants for him or herself and five others.

The bills, HB 4209, HB 4210 and HB 4827, create a license structure for the growing, testing, processing and transporting of medical marijuana, as well as legalize medical marijuana in non-smokable forms.

Those with any of the five state licenses, however, will not be allowed to a license for any of the other four tiers. A grower can’t sell the marijuana to a customer, just as a transporter can’t test or process the product.

“This new law will help Michiganders of all ages and with varying medical conditions access safe products to relieve their suffering,” Snyder said in a statement. “We can finally implement a solid framework that gives patients a safe source from which to purchase and utilize medical marijuana.”

The bills, sponsored by Rep. Mike CALLTON (R-Nashville), Rep. Lisa LYONS (R-Alto) and Rep. Klint KESTO (R-Commerce Twp.), also allow “medibles,” oils, chocolates and other products that […]

U-M Health System, Meijer Pharmacies Partner On Hypertension Care

The University of Michigan Health System has established a new partnership with Meijer pharmacies to provide hypertension management services for adult patients.

U-M patients will be able to visit participating Meijer pharmacy locations to receive a blood pressure check and assessment. If the patient’s blood pressure is elevated, the clinically trained Meijer pharmacist will communicate directly with the patient’s U-M Health System provider. The patient will also receive appropriate follow-up and education about disease, clinical goals, medications and lifestyle.

In addition, documentation of the patient’s visit to their Meijer pharmacy will be recorded in their electronic medical record so the patient can easily discuss the reading and assessment with their U-M Health System provider at their next medical visit.

“This partnership is allowing us to provide our patients with clinical pharmacist services in the community,” says Hae Mi Choe, director and associate dean of pharmacy innovations and partnerships at U-M. “Our patients will have more access to an effective and safe hypertension treatment and monitoring program right in their neighborhood.”

The partnership is available at two participating Meijer locations in Ann Arbor: Meijer at 3825 Carpenter Road and Meijer at 3145 Ann Arbor-Saline Road.

Nearly 90 percent of Americans live within five miles of a pharmacy and a community pharmacist […]

CMS Set To Reduce Flexibility On ICD-10 Oct. 1

ICD-10, which contains more than 70,000 diagnostic codes, replaced the ICD-9 code set, which relied on just 11,000 codes.

The grace period had only applied to claims submitted to Medicare and Medicaid, and while many commercial insurers offered similar flexibility, the majority did not, according to a report in Healthcare IT News.
The lead-up to the ICD-10 had many healthcare providers worried that the exponential increase in diagnostic codes would lead to more errors in medical claims, and ultimately denials, due to the new specificity required. But the years of lead-up to the launch due to a handful Congressional delays gave healthcare providers more time to prepare. The years of training, and the extra time to staff-up coding departments paid off. Most studies show the rate of denials had gone practically unchanged since the roll-out.

Though the grace period will end on Oct. 1, CMS said providers will still be allowed to use unspecified codes when they are warranted.

“While you should report specific diagnosis codes when they are supported by the available medical record documentation and clinical knowledge of the patient’s health condition, in some instances signs/symptoms or unspecified codes are the best choice to accurately reflect the health care encounter. You should code each healthcare encounter to […]

Mental Health Group Awards WSU $3.2 Million For Research

Researchers in the Wayne State University School of Medicine’s Department of Psychiatry and Behavioral Neurosciences will use a new five-year, $3.2 million grant from the National Institute of Mental Health to explore the underlying mechanisms of impaired learning and memory in schizophrenia from the perspective of brain plasticity, function and network dynamics.

The NIMH defines schizophrenia as a chronic and disabling mental disorder that affects how a person thinks, feels and behaves, including loss of reality due to hallucinations, delusions, unusual or dysfunctional ways of thinking, and agitated body movements. People with the condition also have difficulty beginning or sustaining activities, focusing or paying attention, or remembering information immediately after learning it. About 1 percent of the United States population, or 2.2 million people, have schizophrenia, but the neurobiology of the illness remains poorly understood.

Principal Investigator and Associate Professor Jeffrey Stanley, PhD, and Co-Principal Investigator and Professor Vaibhav Diwadkar, PhD, lead the study “Advancing innovative brain imaging to detect altered glutamate modulation and network dynamics in schizophrenia,” which was funded on its first submission. The study is the first to combine functional MRI, or fMRI and complex analyses of brain imaging data with innovative measurement of the brain’s functional neurochemistry using functional magnetic resonance spectroscopy, or […]