FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2054733419> ?p ?o ?g. }

• W2054733419 endingPage "13" @default.
• W2054733419 startingPage "1" @default.
• W2054733419 abstract "Kathleen M. Wilson, PhD, is director of government affairs for AMDA. LONG BEACH, CALIF. — Drug Enforcement Administration actions and Medicare payment policies continue to challenge long-term care professionals, AMDA Public Policy Chair Eric Tangalos, MD, CMD, reported at the AMDA annual symposium. For the past year, AMDA has received many phone calls and e-mails from state chapters and physicians complaining about the DEA's new interpretation of its policy that nurses can't be agents of providers prescribing scheduled drugs in long-term care settings. As a result, physicians are being required to directly confirm to pharmacies medication orders for controlled substances previously given to nurses. “AMDA physicians were like deep sea beacons looking for a tsunami,” said Dr. Tangalos of the Mayo Clinic, Rochester, Minn. Before anyone else was aware of the implications of the DEA's policy enforcement, AMDA members were alerting their state networks and national officers to a crisis that was leaving some residents in nursing homes without pain palliation. Dr. Tangalos described how, in June 2009, AMDA leveraged its membership in the American Medical Association's House of Delegates to pass an AMA resolution urging the DEA to amend its regulations so nursing staff could be recognized as agents of prescribers in long-term care facilities. At the time of the AMA meeting, physician organizations other than AMDA didn't yet understand the issue, said Dr. Tangalos, who serves as AMDA's delegate to the AMA house. “It was amazing how quickly we identified problems and locked on to come up with solutions.” Passage of the resolution put the AMA's weight behind AMDA's effort for a solution to the prescribing problem. “It is not AMDA's fight alone…. It is now the fight of the AMA,” said Dr. Tangalos. But “the fight is not over yet,” he cautioned. In December, AMDA Past President Jonathan Musher, MD, CMD, took Senate committee staff on a tour of a nursing facility. Dr. Musher walked the group through the process of obtaining schedule II medications for patients in this setting, and he explained why requiring a physician and then a nurse to call before a pharmacist will release a controlled drug is far more burdensome than the process in hospitals. In January of this year, AMDA partnered with the AMA to convene a meeting of the two groups' leaders with representatives of the American Academy of Hospice and Palliative Medicine, the American Academy of Family Physicians, the American Geriatrics Society, and the American Osteopathic Association. The agenda was to identify potential solutions to controlled substance– dispensing delays that could then be discussed with the DEA and the Senate Special Committee on Aging. Dr. Tangalos added that AMDA would provide testimony at a hearing of the Senate panel (see page 19). Next, AMDA Public Policy Committee Vice Chair Charles Crecelius, MD, PhD, CMD, reported better news for nursing facilities and long-term care practitioners. Medicare's Jan. 1, 2010, elimination of payments for consultation codes had a favorable effect on nursing facility codes, he said. When the Centers for Medicare and Medicaid Services deleted the consultation codes, it also increased the physician work values for office, initial hospital, and nursing facility visits. “As a result, our physicians will see a relative increase in payments,” said Dr. Crecelius of Associated Medical Consultants in St. Louis. However, as part of the work-values change, the CMS issued revised policy stating, “In the inpatient hospital setting and nursing facility setting, any physician and qualified [nurse practitioners] who perform an initial evaluation may bill an initial hospital care visit code …or nursing facility care visit code …where appropriate.” Dr. Crecelius said that AMDA spotted the language and found it “conflicting and confusing to people because it failed to distinguish between the SNF and NF setting.” Specifically, the policy failed to clarify that only a physician may perform the initial visit in a skilled nursing facility. AMDA asked the CMS to reaffirm in writing the agency's policies on physician delegation of authority for nursing home visits. The agency responded with a clarification, titled, “Questions and Answers on Reporting Physician Consultation Services” (www.cms.hhs.gov/MLNMattersArticles/downloads/SE1010.pdf). The article clarifies that only a physician can perform the initial visit in a skilled nursing facility. AMDA also convinced the CMS to reverse changes it had made to descriptors for time spent performing services under nursing facility codes. “This is a fine point and an important one,” said Dr. Crecelius. In 2009, the CMS changed the descriptors to read, “Physicians typically spend xx minutes with the patient and/or family or caregiver,” which is wording typical of office-based codes. At AMDA's request, on Jan. 1, 2010, the CMS reverted to its earlier descriptors for nursing facility codes: “Physicians typically spend xx minutes at the bedside and on the patient's floor or unit.” Nursing facility visits are more like hospital visits than office visits, said Dr. Crecelius, so physicians should be paid for the time they are on a nursing home floor and unit. Because of the revision, the CMS is now paying for the entire time a physician spends working on a unit. Other AMDA actions over the past year also had tremendous fiscal impacts, Dr. Crecelius reported. AMDA was first to spotlight an error in the final physician fee schedule. Physician work values for the initial nursing facility codes had been decreased between the time the proposed and final rules were published. AMDA wrote to the CMS requesting that the data be reviewed. The agency's correction of the error will result in approximately $10 million in physician reimbursements in 2010 for the codes 99304, 99305, and 99306 that otherwise would have been lost. What's next for policy initiatives? Dr. Crecelius said that AMDA has asked the CMS to put the nursing facility discharge codes, 99315 and 99316, in the fourth Five Year Review. The same compelling arguments for increasing reimbursements for initial and subsequent visit codes, which were reviewed in 2006, hold true for the discharge codes, he said: increased medical complexity among nursing home residents, requiring ever-increasing physician time." @default.
• W2054733419 created "2016-06-24" @default.
• W2054733419 creator A5071123414 @default.
• W2054733419 date "2010-04-01" @default.
• W2054733419 modified "2023-10-18" @default.
• W2054733419 title "AMDA Is Watching Prescription, Pay Policies" @default.
• W2054733419 doi "https://doi.org/10.1016/s1526-4114(10)60085-6" @default.
• W2054733419 hasPublicationYear "2010" @default.
• W2054733419 type Work @default.
• W2054733419 sameAs 2054733419 @default.
• W2054733419 citedByCount "0" @default.
• W2054733419 crossrefType "journal-article" @default.
• W2054733419 hasAuthorship W2054733419A5071123414 @default.
• W2054733419 hasConcept C138885662 @default.
• W2054733419 hasConcept C159110408 @default.
• W2054733419 hasConcept C2426938 @default.
• W2054733419 hasConcept C2778137410 @default.
• W2054733419 hasConcept C41895202 @default.
• W2054733419 hasConcept C512399662 @default.
• W2054733419 hasConcept C71924100 @default.
• W2054733419 hasConceptScore W2054733419C138885662 @default.
• W2054733419 hasConceptScore W2054733419C159110408 @default.
• W2054733419 hasConceptScore W2054733419C2426938 @default.
• W2054733419 hasConceptScore W2054733419C2778137410 @default.
• W2054733419 hasConceptScore W2054733419C41895202 @default.
• W2054733419 hasConceptScore W2054733419C512399662 @default.
• W2054733419 hasConceptScore W2054733419C71924100 @default.
• W2054733419 hasIssue "4" @default.
• W2054733419 hasLocation W20547334191 @default.
• W2054733419 hasOpenAccess W2054733419 @default.
• W2054733419 hasPrimaryLocation W20547334191 @default.
• W2054733419 hasRelatedWork W1542936630 @default.
• W2054733419 hasRelatedWork W1984922927 @default.
• W2054733419 hasRelatedWork W2030093865 @default.
• W2054733419 hasRelatedWork W2072136885 @default.
• W2054733419 hasRelatedWork W2077900558 @default.
• W2054733419 hasRelatedWork W2402748888 @default.
• W2054733419 hasRelatedWork W2511806764 @default.
• W2054733419 hasRelatedWork W2896422724 @default.
• W2054733419 hasRelatedWork W3104784792 @default.
• W2054733419 hasRelatedWork W4312194851 @default.
• W2054733419 hasVolume "11" @default.
• W2054733419 isParatext "false" @default.
• W2054733419 isRetracted "false" @default.
• W2054733419 magId "2054733419" @default.
• W2054733419 workType "article" @default.