Who uses P4P?

What's in it for providers?

Much research and trials must still be done on the program, which will evolve as key findings are revealed. One key finding thus far is that quality incentives are better than utilization incentives. The ways in which quality is measured could become problematic. If your practice is on the cutting edge of this wave of the future, we'd like to hear about it. Tell us how long your provider(s) has participated in the program and how it has impacted your practice. Send us your comments in 250-500 words and you can earn up to 3 CEUs if your comments are published in a future article of The Link. For more details, send us your questions in an email to info@pmiMD.com and put "Link Editor" in the subject line.

Medicare Seeks to Improve Customer Service by Drug Plans

Since January, Medicare has taken more than 1,000 compliance actions to improve prescription drug plan service to beneficiaries, and in most cases, these actions have resulted in timely responses by the drug plans. Cases when plans did not resolve issues promptly have resulted in further enforcement actions to achieve compliance, such as restricting plans' ability to enroll beneficiaries. One plan with recurrent service problems has been placed on a track that may result in termination.

"While most beneficiaries report satisfaction with their coverage, we want to make sure that beneficiary complaints are being addressed and resolved quickly," HHS Secretary Mike Leavitt said in a press release issued by CMS on June 29, 2006.

In the past month, CMS received approximately 2.2 complaints per 1,000 Medicare beneficiaries enrolled in prescription drug plans. Most of these involve complaints about enrollment or disenrollment in a plan (the most common type in recent months), complaints about difficulty in getting needed drugs, and complaints about the cost of the drugs or incorrect co-pays at the pharmacy counter.

Mark B. McClellan, M.D., Ph.D., Administrator of the Centers for Medicare & Medicaid Services (CMS) said "We are taking actions to find and fix any problems that beneficiaries may have with their drug plan delivering the level of service required by Medicare. We have tens of millions of beneficiaries with drug coverage, we are filling millions of prescriptions a day at a much lower cost than expected, and we will remain vigilant about quality service throughout the Medicare program."

Medicare's oversight actions begin with direct contacts with drug plans, which usually result in resolution of the problem. In cases where this action does not lead to timely resolution, Medicare follows up with a formal notice to the plan.

New Drug Payment Rates for 3rd quarter posted on CMS Web Site

CMS recently posted a file on its Website that contains revised payment amounts that will be used to pay for Part B covered drugs for the third quarter of 2006. To view the new rates, go to: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/02_aspfiles.asp#TopOfPage

2006 Medical Practice Coding and Compliance Summit
Set for Harrah's on the Las Vegas Strip on November 9-10

Join your colleagues in Las Vegas and take your practice to new heights when you attend top-notch training sessions focused on giving you the tools and skills you need to strengthen and grow your medical practice.

Practice Management Institute and The CMC Group are pleased to announce our second annual Medical Practice Coding and Compliance Summit, to be held in beautiful Las Vegas, Nevada on November 9 and 10, 2006. This two-day conference will focus on the key issues facing medical practices today: coding and billing, documentation, legal and regulatory compliance, financial stability, and much more.

Earn 12 CMEs or 12 CEUs for PMI and AAPC-certified professionals. For more information on this event, go to PMI's Web site: www.pmiMD.com and click on the conference link.

Part-Time Work and Job Sharing

Throughout the working life of any employee, different stages bring different responsibilities and demands at and outside of work. Child care or elder care arrangements may call for a more flexible schedule. Consider options such as part-time work and job sharing to create career flexibility and retain a trained, reliable staff.

For employees who have child care and/or elder care responsibilities, as well as those interested in phased retirement, job sharing and other part-time arrangements can be very attractive alternatives. They enable employees to continue their engagement with work, contribute to the family income, and progress in their careers. Your practice will benefit from retaining talented, experienced and loyal staff.

For more information on flexible career options, take a look at the "Part Time Employment and Job Sharing Guide" offered online by the U.S. Office of Personnel Management: Part-Time Employment and Job Sharing Guide