Happy birthday to Practice Matters, which is one year old with this issue!

-RSL Matters-

Physician Extenders and "Incident to" Billing
Physician extenders (nurse practitioners and physician assistants) are playing a bigger role in the healthcare system and with that comes increased scrutiny of the "incident to" billing requirements. There are many factors involved with "incident to" billing. First, not all insurance companies, including Medicaid, follow the Medicare "incident to" rules. Therefore, patients might still need to be seen by the physician. Second, depending on the insurance company, a new patient cannot be billed under "incident to" and only established patients can be seen. Third, some insurance companies might not allow procedures, such as skin testing, to be billed under "incident to." Strong consideration should be given to having physician extenders credentialed under all insurance plans that the practice accepts so if needed, a claim can be filed under the physician extender's NPI number.

• Check this quick reference guide for licensure and regulatory requirements, as well as practice environment details, for all 50 states and the U.S. Territories.
• Read a Q&A on "incident to" billing.
• Is "incident to" billing worth it for medical practices?
• Read more on the ins and outs of "incident to" reimbursement.

Coding - Who's Responsible?
As physician employment arrangements evolve, questions continue to arise as to who is responsible for billing and coding. This answer may be complicated depending upon the relationship that exists between the physician and his/her employer. The article below is an interesting anecdote about one physician's experience. We encourage all A/I physicians to understand their responsibilities related to patient visit coding.

• Read more in the article, "Is Your Employer Making You Liable for False Claims?"

Epinephrine Legislation Signed into Law in Texas
On May 28, the governor of Texas signed into law Senate Bill 66. This legislation encourages schools to stock epinephrine auto-injectors on public school campuses and at events off-campus.

• Read more.
  

-Advocacy Matters-

Specialty Secures Significant Win in Medicare ACO Final Rule
Earlier this year, the AAAAI submitted comments to proposed Centers for Medicare and Medicaid Services (CMS) revisions to Accountable Care Organization (ACO) regulations addressing concerns for allergist/immunologists affiliated with an ACO, as well as for the specialist whose practice may be affected by ACOs. Per the AAAAI's request, CMS finalized that the specialty would be excluded from step 2 of the beneficiary assignment process, which means AAAAI members will not be forced into exclusivity with one Medicare ACO. This is a significant win.

• View a summary prepared by Hart Health Strategies of the major final actions described in the CMS Medicare Shared Savings Program ACO final rule. (Note: member log-in required to view.)

AAAAI Responds to FDA Draft Regulations on Mixing, Diluting or Repackaging Biological Products
At the 2015 Annual Meeting, the AAAAI Immunotherapy, Allergen Standardization and Allergy Diagnostics Committee discussed draft regulations from the Food and Drug Administration (FDA) on mixing, diluting or repackaging biological products. AAAAI leadership invited the committee to draft comments for consideration on behalf of the AAAAI. Michael Nelson, MD, PhD, FAAAAI, led the effort to present the draft comments to the AAAAI Executive Committee for input and final approval.

• View the final comments that were submitted.

AAAAI Weighs in on Health IT Certification Criteria and Meaningful Use Stage 3
Members of the AAAAI Health Informatics, Technology & Education Committee worked with staff from the AAAAI and Hart Health Strategies to respond to two recent areas of proposed regulation which are of interest to the A/I specialty. In response to the 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications, comments were submitted to address appropriate documentation of medication allergies and pharmacogenetic variants. Comments submitted regarding Stage 3 of the Medicare and Medicaid EHR Incentive Program and associated Meaningful Use criteria addressed a number of issues and challenges A/I physicians face in participating in Meaningful Use.

• View the AAAAI comments on Health IT Certification Criteria.
• View the AAAAI comments on Meaningful Use Stage 3.

SGR Fix Passed but Work Continues
Now that the Medicare Access and CHIP Reauthorization Act, more commonly referred to as the SGR fix, has been signed into law, the AAAAI joined the American Medical Assocation (AMA) and other specialties to encourage CMS to work with these societies and other established experts to develop quality measures needed by physicians to participate in new payment models and programs. The AAAAI will continue to update our members as this important work moves forward.

• Read the letter.
  

AAAAI Expresses Support for Bill Clarifying Sunshine Act
The AAAAI also joined the AMA and various other physician organizations to express support for H.R. 293. This bill would clarify that certain applicable manufacturer transfers of value to support independent medical educational programs and materials are exempt from reporting under the Physician Payments Sunshine Act.

• Read the letter of support that was sent to the Honorable Michael Burgess, MD.

-Practice & Policy Matters-

Top 10 Reasons to Attend the 2015 Practice Management Workshop
Have you registered for the 2015 Practice Management Workshop in Denver, July 17-19?

• Read the top 10 reasons you should attend.
• View the course brochure and register by July 13. Members and their office staff can use coupon code SAVE100 to take $100 off the registration fee.

Consensus Communication on Early Peanut Introduction and Prevention of Allergy in High-Risk Infants Published in JACI
While an update to the National Institute of Allergy and Infectious Diseases (NIAID) food allergy guidelines is due to begin this summer, a "Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-Risk Infants" has been published by The Journal of Allergy and Clinical Immunology.

• Read the consensus communication.
• Read the results of the Learning Early About Peanut (LEAP) study, which provided new evidence to support early, rather than delayed, peanut introduction during the period complementary foods are first given to infants.
• Read the AAAAI's media alert announcing the consensus communication.

AMA Launches STEPS Forward™ Initiative
The AMA has introduced STEPS Forward™, a new practice-based initiative. Its goal is to provide proven strategies that can improve practice efficiency and help you reach the Quadruple Aim — better patient experience, better population health and lower overall costs with improved professional satisfaction.

• Find out more.

Looking for past issues of Practice Matters? An archive is available at: aaaai.org/practicematters