HIPAA Compliant Texting

can now text patient data legally using a HIPAA-compliant mobile application, DocBookMD. Designed by physicians for physicians, the smartphone application has enhanced communication among doctors resulting in better and faster care for patients.

Thousands of patients are getting answers faster thanks to more collaboration among physicians who use DocBookMD to send text messages, X-rays, EKGs, lab results and images. Certainly teens know the power of the text, and now our physicians members can use DocBookMD, a mobile application.

A HIPAA compliant messaging application, DocBookMD solves the ban on texting patient information recently imposed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

Since July 2011, physicians who sent individually identifiable health information via a text were in violation of HIPAA regulations, a felony offense. Penalties include hefty fines of up to $50,000 or up to one year in jail or both.

“By enhancing the way we communicate, patient care improves significantly,” said Dr. Tim Gueramy, an orthopedic surgeon and co-founder of DocBookMD. “Doctors can get nearly instant access to colleagues for consultations and to collaborate on a myriad of patient concerns.”

Thanks to PMSLIC, DocBookMD is a free member benefit to physicians, it’s available for iPhone, iPad, iPod touch and Android phones.

http://docbookmd.com/register

To download the application, visit the App store on your smartphone and search for DocBookMD.  Contact the ACMS office at docbook@acms.org to request your membership number to activate your app.

Laptops should be cleared of all data and restored to factory settings.  They can be dropped off at the Allegheny County Medical Society Building, or your can call (412) 321-5030 and arrange for pick-up.

Physicians and their employees in private medical practices are required to wear ID badges as of December 10, 2011.

Interim regulations define the required elements of the ID badge:

• A photograph of the physician or employee taken within the last four years
• The employee’s full name
• The title in which the employee is licensed or certified
• The name of the health care facility or employment agency

Additional resources

• Pennsylvania Department of Health Interim Regulation
• Pennsylvania Medical Society ID badge information page
• PA Academy of Dermatology ID information page
• Sample badge formats
• AMNews Article – “New Pennsylvania law requires physicians to wear photo IDs” – 12/20/2011

Monday, February 20, 2012

Western Psychiatric Institute and Clinic
3811 O’Hara Street
Pittsburgh, PA 15213

5:30 pm – 6:30 pm        Council Meeting- Room 412
6:30 pm – 8:00 pm        Educational Presentation with light snack- Auditorium
8:00 pm        Adjournment
TO REGISTER     CLICK HERE

Learning Objectives
At the conclusion of this program, the participant should be able to:

•  Identify college mental health resources available in the local community.
•  Develop solutions to barriers of continuity of mental health care for college students.
•  Identify mental health treatment needed for college students as they enter and leave college treatment settings.  Implement steps to ensure proper continuity of mental health care for college students.

Faculty

John Carter Brooks, MD
Consulting Psychiatrist
Division of Student Affairs, Counseling and Psychological Services
Carnegie Mellon

Stuart Hirsch, MD
Psychiatrist
Affiliated with University of Pittsburgh Medical Center Presbyterian Shadyside

Cynthia Valley, PhD
Director, Division of Student Affairs, Counseling and Psychological Services
Carnegie Mellon

Join us for a panelist dialogue between community and campus mental health care providers about current processes, barriers, and solutions to providing better care for students transitioning into the local college setting.  How can we as a community help these students from falling through the cracks?

If you have any questions please call 866-659-8629 or email at pittpsych@pamedsoc.org. Registrations are due by Thursday, February 16, 2012.

Materia Medica……………………500
Interesting Issues in Pharmacology and
Therapeutics, Part 2
John Lech, PharmD
Legal Report ……………………….504
Where Do Doctors Stand in the
Insurance War?
Michael A. Cassidy, Esq
Practice Management …………..508
Managing Human Resources in a Medical
Practice
Donna J. Kell, BS, MPM
Feature ……………………………….510
Stress, Burnout and Maladaptive Coping
James G. Bittner IV, MD
Zarrish Kahn, MD
Maya Babu, MD
Osama Hamed, MD
Special Report …………………….. 516
PAMED House of Delegates 2011
James D. Ireland
Profile ………………………………..519
Dr. Richard Daffner: Once a Boy Scout,
Always a Boy Scout
Christina A. Morton

Access complete issue

ACMS has been concerned that the lack of a contract will create difficult decisions for patients and their physicians. Patients, depending upon their choice, or their employers’ choice of an insurer, may find many physicians and facilities “out of network” which could substantially increase out-of-pocket costs. This happens with all plans that have a limited listing of “in network” or “participating” providers. Patients may then seek new physicians who are “in network” through their insurance plan.

The benefit to patients of “in network” physicians and facilities is an agreement to accept a discounted payment for services provided, usually with specified co-payments and deductibles, and to physicians and facilities to receive prompt payment for the care provided to the patient. Most patients in this area have enjoyed relatively wide access to care with Highmark’s broad “provider” network, including UPMC’s system of hospitals and physicians. This is an unusual marketplace for both the financing and delivery of health care services. There are no other similar situations around the country where we can look to examine how this situation will affect patients.

Highmark’s proposed acquisition of the financially challenged West Penn Allegheny Health System (WPAHS) has added a new dimension to this contractual battle. UPMC believes that Highmark has moved to structure itself after the UPMC model which links hospitals, employed physicians and a health insurance plan, to create an Integrated Delivery and Finance System (IDFS). Highmark has positioned its proposed integration as a necessary move to preserve the much smaller WPAHS as an alternative IDFS network to the UPMC system.

UPMC has stated that they will not contract with Highmark; western Pennsylvania now faces a very different medical care environment. The market has already changed with UPMC’s contracts with four national carriers that they previously did not accept. While it is always possible that positions will change, if a contract is not reached, employers will be forced to make a decision on their options. This decision will be affected by premiums and access to care, not only to UPMC and WPAHS hospitals/physicians, but to all providers and all acute, rehabilitation, and long-term care hospitals and facilities in our region. Patient care is often complex requiring access to multiple facilities and doctors for a particular problem and optimum care. It is not clear how these other facilities and the smaller hospitals and hospital systems which currently participate in most, if not all, insurer programs will be impacted. Employers will need to consider these unknowns when contemplating options for their employees.

There are valid concerns for patients, employers and physicians that should be addressed. The Commonwealth of Pennsylvania should examine its authority under existing law to encourage the parties to negotiate in good faith in a timely manner that will allow employers to make informed decisions for their 2013 employee benefits contracts. The administration should make a decision on whether or not to invoke Pennsylvania law and extend the existing contract through December of 2012. This is critical for employers as most benefit plan years are on a calendar basis. This will allow them to maintain the benefit plans that employees have selected through the benefit plan year without necessitating filing for federal approval of changed plans. They may then make informed choices of insurers and providers in the spring of 2012 for the plan year 2013. The Department has previously invoked this authority at the last moment to maintain pressure on entities to reach an agreement, but this situation affects many more patients than previous situations.

Patients and employers deserve a clear accounting on what ‘out of network’ charges will be from all systems and networks. Those amounts should be readily available and made public. A study should be undertaken to determine what state actions are needed to impose competition in the healthcare insurance and delivery markets to promote quality and value. There are areas that the PA Legislature can evaluate and then govern through law. The Legislature can address and clarify the authority of the Insurance Department. The PA Insurance Department needs enabling legislation delineating their powers to allow them to meaningfully act on behalf of consumers. The Insurance Department has limited authority to review and approve premium rates and that should be strengthened.

There are certain ‘one of a kind’ services and facilities that are critical to the community, either through the unique services that they provide or geographic location. Perhaps these should be treated as essential services, subject to open access under rates set by a public authority, much as a utility.

The Legislature should also act to address the issue of individual policies or coverage. Most insurers in Pennsylvania do not write individual policies, a significant issue for individuals, the self-employed and small employers. Health insurers writing group insurance in Pennsylvania should be required to offer individual coverage at rates approved by the Insurance Department. In an era of greatly increased “transparency,” insurance contracts should be available publicly and subject to review by the Insurance Department. Parties should agree to a standard protocol for handling the transfer of medical records and information when patients change physicians, or when patients arrive at non-participating facilities for care. The insurers also need to clearly outline how patients who are midway through treatment will be covered, such as patients undergoing chemotherapy or radiation therapy, or who have been prepared and authorized for surgery at the time contracts end. Perhaps existing contracts should apply until treatment is concluded or an attending physician believes patients can be transferred. All providers and parties involved should be aware that the Pennsylvania Patient Safety Authority has documented an increase in medical errors with the transfer of patient care.

The Legislature should consider any willing provider legislation; this would allow physicians who agree to accept payment schedules and participate in all quality measurement programs to participate in an insurer’s network. This would allow physicians not employed by a system more freedom to care for patients in the practice setting of their choice.

The Legislature should also review the Pennsylvania statute on corporate practice of medicine to support physicians’ roles as patient advocates, not dictated by the bureaucracy of insurers or health care systems. We must maintain the principles of patient care first and foremost, while addressing the financial need to pay for that care.

With respect to WPAHS, regulators should move expeditiously to review and examine the proposed acquisition by Highmark. The community deserves a rapid decision on the future of this system. There are outstanding physicians, nurses and medical personnel working in the WPAHS and critical medical services that are provided by those facilities, just as there are at UPMC. Expeditious resolution of this matter will allow this market to move forward and should increase competition.

ACMS respects Highmark’s and UPMC’s differences of opinion and recognizes the importance of both to our community. ACMS continues to believe that reaching an agreement will be the least disruptive to the patient and their physician and the continuity of care. We hope for a compromise that will benefit our patients, physicians and institutions while at the same time protecting the interests and concerns for both Highmark and UPMC. However, we recognize that may not happen; and therefore, UPMC and Highmark should formalize an orderly transition plan to minimize disruption of care and costs.

Physicians believe that our region will be best served by a competitive market for insurers, hospital systems, and physicians alike that preserves consumer choice and provides access to efficient, quality-driven physicians and facilities. We should be able to accomplish this in a larger system that provides for professional competition that continues to serve patients in the collegial manner that is the heritage of the medical profession. The community expects these two non-profit organizations to act in good faith as responsible corporate citizens and act in the best interest and shared values of our community.

That is our challenge, and our goal, as physicians – to serve and care for patients, to be the patients’ advocates, and do our best to heal and help them.

Adopted December 6, 2011

DEPARTMENT OF HEALTH

Amendments to Charges for Medical Records

[41 Pa.B. 6453]
[Saturday, December 3, 2011]

Under 42 Pa.C.S. §§ 6152 and 6155 (relating to subpoena of records; and rights of patients), the Secretary of Health (Secretary) is directed to adjust annually the amounts which may be charged by a health care facility or health care provider upon receipt of a request or subpoena for production of medical charts or records. These charges apply to any request for a copy of a medical chart or record except as follows:

(1) Flat fees (as listed in this notice) apply to amounts that may be charged by a health care facility or health care provider when copying medical charges or records either: (a) for the purpose of supporting any claim or appeal under the Social Security Act or any Federal or State financial needs based program; or (b) for a district attorney.

(2) An insurer shall not be required to pay for copies of medical records required to validate medical services for which reimbursement is sought under an insurance contract, except as provided in: (a) the Worker’s Compensation Act (77 P. S. §§ 1—1041.1 and 2501—2506) and the regulations promulgated thereunder; (b) 75 Pa.C.S. Chapter 17 (relating to financial responsibility) and the regulations promulgated thereunder; or (c) a contract between an insurer and any other party.

The charges listed in this notice do not apply to an X-ray film or any other portion of a medical record which is not susceptible to photostatic reproduction.

Under 42 Pa.C.S. § 6152.1 (relating to limit on charges), the Secretary is directed to make a similar adjustment to the flat fee which may be charged by a health care facility or health care provider for the expense of reproducing medical charts or records when the request is: (1) for the purpose of supporting a claim or appeal under the Social Security Act or any Federal or State financial needs based benefit program; or (2) made by a district attorney.

The Secretary is directed to base these adjustments on the most recent changes in the Consumer Price Index reported annually by the Bureau of Labor Statistics of the United States Department of Labor. For the annual period of October 31, 2010, through October 31, 2011, the Consumer Price Index was 3.5%.

Accordingly, the Secretary provides notice that, effective January 1, 2012, the following fees may be charged by a health care facility or health care provider for production of records in response to subpoena or request:

In addition to the amounts listed previously, charges may also be assessed for the actual cost of postage, shipping and delivery of the requested records.

The Department is not authorized to enforce these charges.

Questions or inquiries concerning this notice should be sent to James T. Steele, Jr., Deputy Chief Counsel, Department of Health, Office of Legal Counsel, Room 825, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120, (717) 783-2500.

Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) should contact James T. Steele, Jr. at the address or phone number listed previously, or for speech and/or hearing impaired persons V/TT (717) 783-6514, or the Pennsylvania AT&T Relay Services at (800) 654-5984.

*Note: Federal regulations enacted under the Health Insurance Portability and Accountability Act at 45 CFR Parts 160—164 state that covered entities may charge a reasonable cost based fee that includes only the cost of copying, postage and summarizing the information (if the individual has agreed to receive a summary) when providing individuals access to their medical records. The United States Department of Health and Human Services has stated that the fees may not include costs associated with searching for and retrieving the requested information. For further clarification on this issue, inquiries should be directed to the Office of Civil Rights, United States Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201, (866) 627-7748, http://www. hhs.gov/ocr/hipaa.

ELI N. AVILA, MD, JD, MPH, FCLM,
Secretary

[Pa.B. Doc. No. 11-2062. Filed for public inspection December 2, 2011, 9:00 a.m.]

2012 medical record reproduction fee schedule

MEDICAL RECORD FEES FOR PEER REVIEW FOR 2012

Additional information and get involved

Patients need to do their homework before selecting a plan so that they are aware of all possible premiums, copays, coinsurance, and deductibles, and so they choose a plan that best meets their health care needs.

To save you time and help reinforce this message, the Pennsylvania Medical Society (PAMED) has created a one-page flyer you can print and distribute when you talk to your Medicare-eligible patients. It simply reminds them to find out about a plan before they enroll, and points them to assistance and resources.

Additional information available at the PAMED website.

Lobbying Percentage:
Pennsylvania Medical Society – 20%

Allegheny County Medical Society – .45%