by: Joan M. Grzybowski, DO

We as physicians will always be faced with a new dragon to fight, be it a new disease, or a new government rule. Today, it is a proposed government (CMS) change to E/M payment. The change they are proposing is to create a single payment system for levels 2-5 E/M codes. CMS states this will decrease our documentation requirement.

Are you surprised that is not the case? The same level of documentation will still be needed to fulfill another government proposal, a no win for us and a no win for our patients. They (CMS) also propose a 50% reduction of payment for procedures performed during an E/M visit using a modifier 25. (50% reduction of the lesser of the 2 codes) OMT would be hit hard.

Our patients will be impacted because it could increase the number of visits that a patient would need to take care of issues that we previously could have covered in one visit and have been reimbursed appropriately. Potentially, for a physician to survive financially, our patient visits would need to be remodeled to allow for procedures to be done at a future visit to allow for a more equitable reimbursement.

So, for now you can help by voicing your concerns to CMS during this period of comment that is open until September 10th. Contact CMS via the following link to voice your comments.

• Submit Comments>>
• Submit Letters to Representative and Senators>>

The AOA and ACOFP have emailed members earlier this summer with a similar request. You can also use their websites to obtain a more detailed understanding if needed, for further direction or help with comments. This is one of those times that should cause each of you to take an action.

CMS will review our comments, and recommendations will go forward. Be a voice, and fight this fight.

by: Diana M. Ewert, MPA, CAE 

Change away... 

This time of year always meant football to me. I’m a Kansas City Chiefs fan through and through. One of the best memories I have is watching the Chiefs win Superbowl IV with my dad. My Chiefs, however, are taking a back seat this year to the implementation of the Pennsylvania Licensing System (PALS). PALS went live on June 15. Paper applications are no longer accepted and online submission is now required. You’ve been sharing your frustrations with the system, the length of time it has taken to receive a license. And just as these issues were coming under a semblance on control, SBOM opened PALS for licensure renewal. 

Your pain is our pain. Your issues are our issues. As your professional membership organization, we have an obligation to interface with the state, bring your concerns and experiences forward, and effect change. And we are. POMA has been working with Ian Harlow, Commissioner of the Bureau of Professional and Occupational Affairs to address your concerns about the application process, and now licensure renewal. Commissioner Harlow is receptive and willing to work with us to resolve your issues while maintaining the integrity and necessity of the on-line process. I received a communication from Commissioner Harlow today (9/7) in which he shares that processing time for general active and training licenses is now within 90 and 30 days of application, respectively. Further, the Governor’s office has approved 11 new positions which will help alleviate the processing delays you’ve been experiencing. 

Renewing your license is also presenting some challenges. There are system issues for those with active/retired status and those living out of state but maintaining a Pennsylvania license. This brings me to the importance of sharing your experiences with POMA. The board can only address issues they know about and these “glitches” must be brought to their attention. For example, we had an out-of-state member try to renew his license. He is not registered for the PDMP because he lives out of state. The system “requires” the individual renewing the license to be registered. The PDMP does not allow the individual to register since he is out of state. It becomes a vicious spinning circle. By identifying the issue, with specificity, we can assist the board to clarify programming. Sharing your user experiences is critical to ensure the long-term success of PALS. Help us help the state help you. Email the issues you encounter with as much detail as possible to [email protected] with the subject line "LICENSURE". 

The Chiefs opener is Sunday in Los Angeles as they take on the Chargers (who used to be in San Diego and are sharing a stadium with the LA Rams who used to be in St. Louis, but I digress). And though I’ll be watching the game… loudly as ever… I’ll be thinking about the coming week and what POMA can share with the SBOM to improve your game and help you care for your patients.

The Pennsylvania Osteopathic Medical Association Foundation (POMAF)  has reviewed its scholarship program and is pleased to announce several new scholarships now open for application. Pennsylvania students who are enrolled as an OMS II, OMS III or OMS IV AND residents are eligible to apply as long as they meet the criteria. The scholarships and applications are accessible online. Applications can also be downloaded and mailed to the POMA Foundation at the address contained in the application. Scholarship amounts will be determined by the Foundation board. The deadline for applications is January 14, 2019. The Foundation board will review all applications and awards will be made late February/early March 2019.

We would greatly appreciate your help in circulating this among your student and resident contacts. Feel free to share the information and link in social media, newsletters, etc. Make sure to use the hashtag #POMAF19 and tag us on Twitter, @POMA_DOs and Facebook, @POMADOs.

The District Dish 

A recap of recent District events

District 4

What are the best ways to manage lipids to help prevent a future cardiovascular event? What treatments are available and what are their side effects? On Wednesday, August 29th, District 4 met at Ruth's Chris Steak House in Wilkes-Barre, PA to discuss what they have been seeing in the practice.

Frank Romascavage, DO, began with an energetic lecture on the effects of using Pure EPA to combat cholesterol issues. The group discussed several case studies, trials, and specifically the inflammatory markers to keep an eye on. Side effects are a factor in any treatment plan, and it was emphasized that what works for one may not be right for another. 

The Pennsylvania State Board of Osteopathic Medicine convened on August 22, 2018 at 9:30 am. Renewals of Pennsylvania Osteopathic Medical Licenses will now be conducted through the “PALS” system. Login and Password information used in the old system will remain the same for the new one. The “PALS” system is now open for renewals.

The Board discussed license renewal fees for the next cycle (2018-2020) will be $350.

The telephone system for the Pennsylvania State Board of Osteopathic Medicine has been upgraded. Phone prompts, call que and a return call option are among the improvements. The telephone number remains the same, 717-783-4858.

Representatives from the Physicians' Health Program (PHP), a program of The Foundation of the Pennsylvania Medical Society, which provides support and advocacy to physicians and other eligible health care professionals struggling with addiction, mental illness or behavioral concerns that impact their ability to practice their chosen profession safely, presented information to the Board. Those affected are encouraged to contact PHP:

Monday-Thursday, 7:30 am – 5:00 pm 
Phone: (866) 747-2255 or (717) 558-7819 
(Friday only): (717) 558-7817 - emergencies
Fax: (717) 558-7818
Email: [email protected]

BPOA License Status Update

The state of Pennsylvania transitioned from paper applications to an online application process for all licensed professionals. The Pennsylvania Licensing System (PALS) became effective June 15, 2018. Since this time, POMA has received calls and emails from osteopathic physicians seeking support to obtain a license. The Osteopathic board is not the only professional board having issues with the PALS system. POMA has written to the Commissioner for Professional and Occupational Affairs detailing specific instances of delay, lack of response, and issues with both the online and phone system, along with less than desirable customer service.

This week, state staff provided an update on implementation and application processing times. They have indicated that the backlog of paper applications is nearing completion. In the past week, they have processed 84 OS applications, 22 training applications, and 15 PA supervising applications. This leaves 163 OS applications pending with the oldest dating back to May 1, 2018; 1 training application is pending dating back to August 28, 2018; and 50 PA supervising applications are pending with the oldest dating back to July 11, 2018. The processing time for an OS application is 90 days and 36 days for a PA supervising application.

POMA continues to work with the State Board and BPOA to address issues that arise. If you are experiencing difficulty obtaining a new license, you can reach out to POMA by email to [email protected]. Provide the date you applied, any outreach you’ve made to the board (email, phone calls, etc.) and if there are any extenuating circumstances leading to a hardship if the license is not received.  Check POMA’s newsletter and website for the most up-to-date information.

Physician CME Requirements 101

The State Board of Osteopathic Medicine requires physicians to participate in continuing medical education in order to renew their license.

Below are the CME requirements for an osteopathic license with an active license wishing to renew the license with an active status:

·   Complete at least 100 credit hours during the 2-year license period (Nov. 1, 2016 – Oct. 31, 2018)

·   As part of the 100 credit hours, physicians must complete:

o    At least 20 credit hours of Category 1-A AOA approved activities.

Activities must be formal, face-to-face educational programs sponsored by an AOA-accredited CME sponsor.

o    At least 12 credit hours of activities related to patient safety or risk management.

Approved topics include: improving medical records and record keeping, reducing medical errors, professional conduct and ethics, improving communications, preventive medicine, health care quality improvements. Activities may be Category 1 or 2.

o    At least 2 credit hours of education in child abuse recognition and reporting requirements.

Verification of education must be submitted to the state directly from the course provider. Activities may be Category 1 or 2.

o    At least 2 credit hours of education in pain management, identification of addiction or the practices of prescribing opioids.

Must be taken from a board-approved education provider. Activities may be Category 1 or 2.

o    All remaining credit hours can be completed in any other Category (AOA Category 1-A, 1-B or 2; AMA Category 1 or 2)

Clarifying points:

·   The child abuse recognition and reporting credits cannot be counted toward the hours of education for patient safety and risk management.

·   The pain management, identifying addiction and prescribing opioids credits cannot be counted toward the hours of education for patient safety and risk management.

·   The patient safety credits; child abuse recognition and reporting credits; and the pain management, identifying addiction and prescribing opioids credits can be counted toward the hours of Category 1-A credit or the bucket of remaining credit hours.

Physicians with an active/retired license must complete the continuing education requirements for 2 hours of child abuse recognitions and reporting requirements and 2 hours of pain management, identification of addiction or the practices of prescribing opioids. They are exempt from the remaining requirements.

Physicians who completed residency or fellowship training between November 1, 2016, and October 31, 2018, are exempt from the continuing education requirement. A letter containing the start and end dates of training should be obtained from the training program and kept in your personal records in case the board requests such information. 

Remember, the POMA team is here for you! As a service to active POMA members, you have access to POMA’s online CME module and we can help clarify where you stand for license renewal. It’s important to be proactive – email [email protected] if you have any questions. Haven’t renewed yet? Click here to pay now.

by: Bruce Hironimus, Legislative Consultant 

Two months remain before General Election Day. Vigorous campaigning continues in the Governor’s race, and state Senate and House of Representative seats. The state House has eight scheduled voting session days, the state Senate has nine voting days on the calendar. The POMA government affairs consultant will continue to closely monitor any consideration on priority legislation including the certified nurse practitioner scope of practice; SB 25 and HB 100.

POFPS CME Certificates

All CME certificates for POMA-sponsored CME programs held in 2017 and 2018 were electronically sent to attendees.  Please check your e-mail for these documents prior to calling POMA.

2018 POFPS Symposium CME Certificates
CME certificates are now available on POMA’s CME module.  All attendees who are active members of POMA were e-mailed instructions on how to access the certificate.  Non-members of POMA will receive an e-mail with their certificate by September 20th.  If you need immediate access to the CME module and conference CME statement, renew your membership today.

2018 POMA Clinical Assembly Certificates
CME certificates are available in POMA’s CME module.  Login to the POMA website and click “My CME” in the Quick Links menu to retrieve the certificate. Need help accessing your CME certificate?  Click here for instructions or view our CME Module video here for step-by-step instructions.

As a reminder, if you have not yet paid your 2018-2019 membership dues, you do not have access to POMA's online CME module. Any requests for a CME record or reprint of a POMA sponsored CME program certificate will result in a $75 fee per request. Click here to pay now to gain access to this valuable tool.

View the
newsletter online!

POMA Membership Status

If you have not yet paid your 2018-2019 membership dues to maintain your "Active" status, you will no longer have access to POMA’s online CME module effective August 25, 2018. Any requests for a CME record or a reprint of a POMA sponsored CME program certificate will result in a $75 fee per request.

Your current membership status is  for 2018-2019. 

Click here to pay now.

 In This Issue...

1. President's Perspective
2. Executive Opinion
3. POMAF Scholarships
4. POMA-ISMIE Affinity Program
5. The District Dish
6. SBOM Report
7. BPOA License Status Updates
8. Physician CME Requirements 101
9. Government Affairs
10. POFPS CME Certificates
11. POMA Membership Status
12. POFPS Survey Reminder
13. Upcoming PGYP Meetings
14. Upcoming District Events
15. Free CME Events
16. Car Seat Inspections
17. Applications for Membership
18. Classified Ads
19. POMPAC

Survey Reminder!

The POFPS 43rd Annual CME Symposium Outcomes Survey is now available!  Physicians who complete the 10-minute survey can earn up to 2 Category 1-A AOA CME credits. Click here to complete the survey online.  The deadline for completion is September 15, 2018.

Upcoming PGYP Meetings

CLASSIFIED ADVERTISEMENTS

Please address all correspondence for POMA Box Letters to: c/o POMA, 1330 Eisenhower Boulevard, Harrisburg, PA  17111-2395.

PHYSICIANS WANTED:

CORRECT CARE SOLUTIONS: HIRING MEDICAL DIRECTORS in these cities: Cambridge Springs, Mercer, Huntingdon, Somerset, Waymart. For details call Robert Cross at 717-216-2055 or 570-954-0479.

OPPORTUNITIES WITH FAMILY MEDICINE PHYSICIAN OPPORTUNITIES: The Philadelphia College of Osteopathic Medicine (PCOM) seeks qualified physicians for our primary care and urgent care practices located in Philadelphia, PA and Sullivan County, PA. There are full time and part time positions available within our Department of Family Medicine. Must have a D.O. degree and be residency trained. Must have experience in clinical primary care and teaching medical students. For more information, please go to our employment page and apply.

OPPORTUNITY — PHYSICIAN POSITIONS AVAILABLE: Media and Lancaster. Flexible hours, private practice, 3-4 hour shifts, no on-call, malpractice insurance needed. For more information, please contact us at [email protected] or call 610-566-8885

LOOKING FOR A PART TIME PHYSICIAN in Family Medicine or Internal Medicine in Philadelphia. Please contact me @ 215-669-4001.

CLASSIFIED AD
RATES
— Per insertion —

Member Ads*: $10 for the first 20 words, $.25 for each additional word. $2 each for special services: box letter, all caps or all bold type, boxing an ad in.

Non-member Ads: (Payment must be received in advance.) $50 for the first 20 words, .50 each additional word. $5 for each special service (listed above).

*Please Note: Member ad rate to be used only by POMA members and only for their medicine- or practice-related ads. Charges for other types of members’ ads will be calculated using the non-member ad rate.

POMA does not take a position of endorsing any organizations, individuals or services whose classified advertisements appear in this publication. The POMA Newsletter reserves the right to select and edit all advertisements submitted.

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IS 
The Collective Voice of the Osteopathic Profession

 Pennsylvania Osteopathic Medical Political Action Committee

Send your personal check today to POMPAC in care of the Central Office, 1330 Eisenhower Boulevard, Harrisburg, PA 17111-2395, or charge your contribution to your VISA or MasterCard! 
PAC contributions are not tax-deductible.

Pennsylvania Osteopathic Medical Association | 1330 Eisenhower Boulevard, Harrisburg, PA 17111  (717) 939-9318 | www.poma.org