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  • Bringing relevant issues to practice management professionals
    WINTER 2016

  • Make Time for Free ISMIE Webinars on MACRA: Register Now for Jan. 18 Session on Quality Payment Program Reporting

    webinarISMIE's free live and archived webinars keep you and your team up to date on the latest with the Medicare Access and CHIP Reauthorization Act of 2015, better known as MACRA:

    • On January 18, ISMIE and the Illinois State Medical Society will present Quality Payment Program Reporting: Using Qualified Clinical Data Registries to Maximize Success from noon to 1 p.m.  This one-hour webinar will feature two health care quality experts from the American Medical Association -- Kathy Blake, MD, MPH, Vice President of Health Care Quality; and Lance Mueller, Manager of Healthcare Quality.

    • And in case you missed it, our webinar MACRA Rules in 2017: What You Need to Do to Avoid a Penalty in 2019 is available for online viewing. This archived ISMIE/ISMS webinar focuses on overall practice readiness and avoiding potential problems.

    Register here for the January 18 webinar. 



  • Medicaid Moves 'EpiPen' Brand to Non-Preferred Status

    epipenRecently, the Illinois Department of Healthcare and Family Services (HFS) announced that the brand-name epinephrine auto-injector products "EpiPen" and "EpiPen Jr." have moved to non-preferred status.

    As of Dec. 15, HFS now requires prior authorization when either medication is prescribed. The two branded products are still reimbursable, but only if the prescriber can medically justify why the generic options are not appropriate.

    Generic options remain available without prior authorization. When prescribing, you must specifically indicate "Epinephrine 0.3mg Auto-Injector" or "Epinephrine 0.15mg Auto-Injector," as HFS does not allow pharmacies to automatically substitute the generic options under this policy shift.

    For questions, contact HFS's Bureau of Professional and Ancillary Services Pharmacy Billing Consultant at 877-782-5565.



  • Remind Your Physician Staff - Midnight, Dec. 31 is the Deadline to Complete Their ISMIE Managing Risk Coursework!

    calendarEveryone's busy at year-end, but now's the time to remind your physicians that finishing up all their Managing Risk coursework by midnight, December 31 may earn them up to 15% in premium savings!

    Encourage them to visit www.ismiemutual.comto check what coursework they still need to complete. If they have questions, the ISMIE Managing Risk support team is available Monday through Friday from 8:30 a.m. until 4:45 p.m. All after-hours messages will receive a prompt reply the next business day. 



  • Your Managing Risk 'Cheat Sheet'

    Our offices will be closed all day Monday, December 26 and Saturday, December 31. Live support will be available during regular business hours on December 30.

    Password/web assistance:

    Call 888-476-7776 or email onlinehelp@ismie.com. After business hours, self-administration of password or login assistance is available on ISMIE's website.

    Questions for our Managing Risk team?

    Call the Risk Management division at 800-782-4767 or email riskmanagement@ismie.com.



  • Quick Hits

    quickhitsOT Pay Regulations Now Stalled - But Stay Tuned
    In late November, a federal judge in Texas granted an emergency injunction against the U.S. Department of Labor's (DOL) nationwide  overtime regulations scheduled to take effect December 1. Keep in mind that if the DOL mounts a successful challenge, the final rule or some version of it could be implemented. In short, keep your switchover plans handy! For more information, consult the DOL website or contact us for a copy of the Illinois State Medical Society's Issue Brief, New Federal Overtime Rules.

    Tell the Patient NOW if You Doubt Medicare Will Cover:  If you or a physician staff member expect that Medicare is going to deny payment for a particular patient service, you must notify that patient in writing before that service is provided. Here's a link to the forms and instructions you'll need, and this videofrom National Government Services - Illinois' Medicare carrier - provides an overview.

    Does Your Team Have a Plan for Handling Subpoenas? Recently, ISMIE News published an update on handling validly issued subpoenas for protected health information (PHI) that includes handy resources you can use to update policies and procedures on subpoenas delivered to your professionals or practice site. Read issue




  • Risk Management Education - By the Numbers