FPD1199

The Federation of Physicians & Dentists / Alliance of Healthcare & Professional Employees (FPD/AHPE) is a non-profit organization representing public and private-sector physicians, along with a variety of other types of healthcare employees and professionals, dedicated to improving the working conditions of its members.

FPD/AHPE provides experienced assistance to physicians in negotiating contracts and acts as an expert bargaining agent for members in recognized collective bargaining units.

FPD/AHPE recognizes the critical relationships between public and private-sector healthcare providers, their payers and the patient community: each has a profound effect and influence on the other and on the standards of quality and care within healthcare professions. Achieving professional standards of quality in and of itself is a fundamental tenet of FPD/AHPE’s mission and goal.

Since 1989, when FPD/AHPE was elected the representative for all state-employed physicians in the State of Florida, FPD/AHPE has grown remarkably as an agent for public and private-sector groups. It has also gained increased membership among physicians wanting expert assistance negotiating agreements with insurers and managed care organizations. FPD/AHPE continues its fight to overturn federal antitrust exemptions for the insurance industry, while lobbying for collective bargaining rights not only for its own private-sector physicians, but for healthcare providers industry-wide.

FPD/AHPE is affiliated with the National Union of Hospital & Healthcare Employees (NUHHCE) and with the American Federation of State, County & Municipal Employees (AFSCME)/AFL-CIO. As such, FPD/AHPE is part of the largest union organization in the world, an organization which has been working for over fifty years to better the lives of its members and to achieve the dignity which, as professionals, they deserve.

21.2% Medicare Pay Cut Has Been Delayed 2 Months

Hidden in a 2010 defense spending bill was a 2-month grace period before the 21.2% cut in Medicare payments to physicians can take effect.

Now approved by both the House and the Senate, the bill awaits the signature of President Obama, and it gives an already bogged down Congress a little more time to pass legislation that would seek a more permanent solution to Medicare’s method of setting physician reimbursement.

Right now, Medicare relies on the controversial Sustainable Growth rate (SGR) formula for determining what a physician is to get paid and for calculating reductions like the one planned for 2010. Organized medicine, by and large, has maintained that meaningful health care reform must include a new formula. Otherwise, more and more underpaid physicians are going to be forced to turn away more and more Medicare patients.

Physicians also do not want to keep repeating the pattern since 2002 of Congress enacting 1-year reprieves at the eleventh hour to postpones each year’s cuts, which only adds more and more to the next cut - this is why the cut scheduled for 2010 is up to a whopping 21.2%!

Several proposals have been on the table to find a more permanent fix but none were expected to be approved before January 1. So, a 2-month grace period tucked away in the defense spending bill has been enforced.

Continue to check back periodically for the most up-to-date progress on this issue.

Membership Structure

The Federation of Physicians & Dentists is organized into two sectors - the Public Sector physicians (state-employed and private-employed physicians in the State of Florida) and the Private Sector (private practice physician nationwide).

The one big difference between these two Divisions is that as employed physicians, the Public Sector has the inherent right to collective bargaining under the National Labor Relations Act, while the Private Sector physicians are considered independent contractors, and as such, although they have the right to organize, they do not YET have the right to collective bargaining. Obtaining this right for private practice physicians has been one of our biggest fights and we will continue this effort for as long as it takes.

Private Practice Physicians

If you are a private practice physician, please visit our Private Sector web pages by clicking here or on the link above -left.

Employed Physicians

If you are a state or private-employed physician, please visit our Public Sector web pages by clicking here or on your link above left.

The Federation Opposes CMS’ Decision to Eliminate Billing for Consultation Codes

The many voices that speak on behalf of physicians specialty-wide that had expressed strong concerns about the Centers for Medicare & Medicaid Services’ (CMS) proposal to eliminate billing for consultation codes went unheard, as CMS announced its final decision to stop paying for consultation services come January 1, 2010.

The Federation opposes all public AND private efforts to eliminate payments for inpatient and outpatient/office consultation codes and supports legislation to overturn CMS’ decision.

HOW IT WILL AFFECT YOU

First of all, medical practices will not be able to bill consultation codes to Medicare (for now, that is - private payers almost always seem to follow what Medicare does) past December 31, 2009. Instead, they will have to report either a new patient visit code (99201-99205) or established patient visit code (99211-99215) for outpatient services; or an initial hospital care visit (99221)-99223) or subsequent hospital care visit (99231-99233) for inpatient services.

Second, inasmuch as this change will affect most medical practices, some specialists such as Gastroenterologists, Neurologists, Endocronologists, and Oncologists, who code almost all of their new outpatient and initial inpatient work as consultations, could see substantial reductions in reimbursement. Even with Medicare’s 6% adjustment to the outpatient E&M work RVUs and 0.3% adjustment to the remaining inpatient E&M work RVUs, some practices could face significant loss of income. This on top of the still possible 21.2% cut to Medicare rates that’s still looming on the horizon.

Not only will this change cause revenue loss for some specialties, some specialists will have to change the entire way they’ve built their practice and their relationships with physicians who refer patients to them. Many fear the change will cause more problems than it will solve. The problem this is supposed to be solving, of course, is the years of confusion and improper use of the consultation codes, most of which could be attributed to the discrepancies between CMS rules and the AMA’s CPT Manual. But it had been discovered that CMS had made an estimated billion in overpayments to physicians for services billed as consultations, but which did not meet all of the CMS requirements.

So, a paradigm shift and loss of revenue is what you may face for 2010. The Federation will continue to monitor and work on this issue and will make information available as it becomes available to us. We of course want to hear from you if you start seeing these changes take effect and if you receive similar changes among the private payers with which you may be participating.

Any questions may be directed to lyndafpd@aol.com.

WHAT IS MEDICAL JUSTICE®?

Founded and run by a neurosurgeon, Medical Justice® is a nationally recognized organization offering a proven track record of protection, deterring frivolous lawsuits and holding parties accountable for their actions. Bottom line - members of Medical Justice® are litigated against at a significantly lower percentage (2%) than the national average of 12%.

Each year many groundless malpractice suits are initiated against health care providers, and malpractice premiums are soaring as a result. Despite this dangerous trend, the insurance and legal systems continue to exert pressure on physicians and their representatives to settle frivolous lawsuits in order to minimize their financial risk. This system forces innocent physicians to appear to admit guilt and thus forces them to pay for their misfortune through higher malpractice insurance premiums.

BUT, as a Medical Justice® member, you access a proactive process to prevent frivolous lawsuits. Medical Justice® provides a proven, cost-effective complement to traditional medical malpractice insurance through their patent-protected legal strategies. To learn more about those strategies, call Medical Justice® today at 1-877-633-5878, or visit them at www.medicaljustice.com.

Also, try these simple, easy-to-implement methods for reducing your chances of being sued:

WAYS TO KEEP ATTORNEYS AT BAY!

Return pages from your answering service with your cell phone. Plaintiffs frequently allege the doctor did not call them back in a timely fashion, or even at all. If you call from a land line, there is no record of the call being made. Call from a cell phone and a record is created. Won’t patients abuse the privilege and call you directly on your cell? Generally not.

Now that you’ve called the patient back, document what was said. It is too easy to give advice and ignore the paper trail. If you use an electronic medical record, log-in, and record. If you have access to call-in transcription service, use it. If not, create a separate voice mailbox on your office phone to be used for transcription of after-hours messages.

·	Charting: Speak ill of your patient at your peril. Resist the temptation to pepper the chart describing your patient as “hysterical,” “histrionic,” or “crazy.” If you are wrong, you will pay dearly. Even if you are right, you may pay dearly. Keep it professional.

Document what you did NOT do. Although is sounds counterintuitive, there are time it makes eminent sense to document what was NOT done. Sometimes, there is extensive literature explaining the merits of following a particular algorithm for a particular condition, but, for a variety of reasons, you might choose, in your judgment, to forego such treatments. The default assumption by a plaintiff’s attorney will be, “that if it was not documented, you were unaware of such standards fro treatment, and you didn’t even think about it.” But, if you document your reasoning for avoiding such an established treatment, because in your judgment, in this particular case, the risks outweighed the benefits, you will sidestep the allegation you breached a standard of care. It takes two minutes to document. If you address it upfront, it’s an explanation. If you address it after the fact, it’s an excuse.

Never, never, never alter the record. If you alter the record after you have been served with the lawsuit, your defense attorney will develop an ulcer. Resist the urge to clarify the record. As noted earlier, documentation before there is a problem is considered an explanation. Documentation addressed after there is a problem it is considered an excuse.

Don’t wait until a frivolous lawsuit threatens your livelihood.
Join the growing community of doctors proactively protecting
their practices and reputations.

For more information, call toll free 1-877-633-5878 or visit www.medicaljustice.com