February 2016
Vol. 2, Issue: 9

-Advocacy Matters-

2016 AAAAI Annual Meeting to Feature Special Panel Discussion on USP's Proposed Compounding Changes
Immediately following the Monday Plenary session at the 2016 AAAAI Annual Meeting, the AAAAI will hold a special panel discussion on USP's proposed changes to the sterile compounding rules, its potential implications on the allergy/immunology specialty, and what the AAAAI has done about the issue. The panel will take place Monday, March 7 from 9:45 to 10:45 am in the Los Angeles Convention Center, Level One, South Exhibit Hall G. AAAAI President Robert F. Lemanske, Jr., MD, FAAAAI, will serve as moderator. Watch your email for further details to be announced, including who will be participating on the panel. The panel will be filmed and made available to all AAAAI members after the Annual Meeting.

Also being presented on Monday at the 2016 Annual Meeting is a session that will discuss how the Affordable Care Act will impact clinical practice reimbursement. The session will also cover process measures, outcomes measures and evidence based guidelines, as well as how using the AAAAI Allergy, Asthma and Immunology Quality Clinical Data Registry may benefit your practice. Find more information here.

Future of Healthcare Payments Webinar Now Available Online
The Medicare Access and CHIP Reauthorization Act (MACRA), the replacement for the Sustainable Growth Rate, incorporates Merit-Based Incentive Payment Systems (MIPS) and Alternative Payment Models (APMs) as new mechanisms through which physicians will be paid by Medicare. What we know about MIPS and APMs, how these are related to the current requirements of reporting for the Physician Quality Reporting System (PQRS), Meaningful Use, and the Value Based Modifier (VBM), and what you can be doing now to prepare for the changes that lie ahead, are covered in a webinar now available online exclusively to AAAAI members. You may have heard the announcement that Meaningful Use will be ending, but this is a part of these larger changes.

Senate Committee Passes Health IT Bill, Telemedicine Bill Introduced in Congress
The Senate Committee on Health, Education, Labor and Pensions (HELP) unanimously passed the bipartisan Improving Health Information Technology Act (S. 2511). It includes several provisions that will advance electronic health records (EHR), prioritizing interoperability, provider directories and patient matching. The bill also includes the previously introduced TRUST IT Act (S. 2141), which promotes greater transparency of EHR capabilities through a public rating system to assist purchasers in making more informed decisions and prohibits information blocking. The final version of this legislation was released on February 7 and introduced in the Senate on February 8.

In other Congressional news, a bill to advance the practice of telemedicine was introduced in both the U.S. House of Representatives and the Senate. Called the CONNECT for HEALTH Act (S. 2484/HR. 4442), the bill would remove outdated statutory restrictions on Medicare coverage of telemedicine that limit beneficiary access to these services, including for physician participants in alternative payment models and the new Merit-based Incentive Payment System (MIPS). The legislation would also accelerate the adoption of healthcare delivery models that promote coordinated and patient-centered care.

-Practice & Policy Matters-

Nearly 1,000 Coding Questions Answered in 2015, Learn More about Modifier 25
In addition to Practice Matters, the AAAAI Office of Practice Management oversees a variety of AAAAI services including advocacy, payer relations, practice management resources, and answering coding questions submitted by members. The AAAAI received and responded to nearly 1,000 coding related inquiries alone from AAAAI members during 2015.


Practice Changers

We have partnered with the editors of JACI: In Practice to bring you monthly "Practice Changers" from recently published journal articles.

Highlighting cutting-edge information keeps you current and assists you in educating patients and physicians who rely on the expertise of our specialty!

The Effect of Tiotropium in Symptomatic Asthma Despite Low- to Medium-Dose Inhaled Corticosteroids: A Randomized Controlled Trial. By Pierluigi Paggiaro et al.

Tiotropium, a once-daily long-acting anticholinergic bronchodilator, has demonstrated efficacy in patients with asthma who were symptomatic despite treatment with at least medium- to high-dose inhaled corticosteroids (ICS). In this study, once-daily tiotropium Respimat (2.5 or 5 μg) add-on to low- to medium-dose ICS maintenance therapy was effective in adult patients with mild to moderate asthma, in improving peak post-dose FEV1 by 159 and 128 mL, respectively, as well as trough FEV1 by 110 and 122 mL respectively, vs placebo. Its safety and tolerability were comparable to placebo at 12 weeks. These data provide further evidence for tiotropium Respimat as an efficacious alternative bronchodilator therapy when added on to ICS in inadequately controlled asthma.

Click here to read the abstract.

Hypertension and Asthma: A Comorbid Relationship. By Sandra C. Christiansen et al.

Prior epidemiologic studies suggest that asthmatic subjects are more likely to manifest arterial hypertension than nonasthmatic subjects. Using a case-control design and fully adjusted model, we found that comorbid hypertension was associated with increased established measures of adult asthma severity. Angiotensin converting enzyme inhibitor use was associated with a significantly increased risk for all measures of asthma severity, while beta-blocker use was associated with a reduced risk for β-agonist dispensing. Physicians treating these 2 common conditions should be aware of this association, which may have broader implications for systemic diseases involving endothelial and smooth muscle cellular differentiation, regulation, and remodeling.

Click here to read the abstract.


Comment on SLIT Practice Parameter Draft by March 15
At the request of the Joint Task Force on Practice Parameters, you are invited to review the draft practice parameter titled, "Sublingual Immunotherapy: A focused allergen immunotherapy practice parameter update." This is the first parameter on sublingual immunotherapy (SLIT). The Joint Task Force will be taking comments until March 15.

2016 Practice Management Workshop Kicks Off with "Governmental Policy and Allergy Practice: What You Need to Know"
Registration opens March 1 for the 2016 Practice Management Workshop, July 22-24 in Washington, DC. This unique AAAAI annual event focuses on the day to day issues that all A/I physicians face—whether in solo private practice, a multi-specialty group or the academic setting. The weekend will start at 2:00 pm on Friday with a special session on "Governmental Policy and Allergy Practice: What You Need to Know," presented by William Rogers, MD, ICD-10 Ombudsman and Director of the Physician Regulatory Issues Team at the Centers for Medicare and Medicaid Services (CMS), alongside Emily Graham, RHIA, Vice President-Regulatory Affairs at Hart Health Strategies. You will not want to miss this Washington insider presentation.

Avoid Meaningful Use Penalties: Apply for Exemption by March 15
Physicians have until March 15 to apply for a hardship exemption from the electronic health record (EHR) Meaningful Use financial penalties for the 2015 program year. Those who do not apply could face up to a 3% cut in their Medicare payments in 2017 since Meaningful Use operates on a two-year look-back period. New for this year is that individuals can apply on behalf of a group of physicians.

All physicians, even those who believe they met the requirements of the Meaningful Use program in 2015, should apply because CMS will broadly grant hardship exemptions as a result of the delayed publication of the Stage 2 meaningful use modifications rule, which left physicians with insufficient time to report under the modified program requirements issued in late 2015. This inclusive approach to hardship exemptions is a result of the Patient Access and Medicare Protection Act, which the AAAAI and other physician organizations successfully advocated for. Submitting an application for a hardship exemption will not prevent those who qualify from receiving an incentive payment.

Learn about the Future of Public Reporting on Physician Compare, How It Will Affect You
The Centers for Medicare & Medicaid Services (CMS) will host a series of webinars covering recent updates to the Physician Compare website and future plans for public reporting on Physician Compare, including a publicly reported benchmark and star ratings. Each webinar will offer an opportunity to ask questions about public reporting and quality measures on Physician Compare. All webinars will present the same information, but multiple times are being offered: Tuesday, February 23 at 12:00 pm ET/ 9:00 am PT; Wednesday, February 24 at 4:00 pm ET/ 1:00 pm PT; and Thursday, February 25 at 11:00 am ET/ 8:00 am PT.

AHRQ Study: EHR Drug Allergy Safety Warnings Need Urgent Improvement
According to a study from the Agency for Healthcare Research and Quality (AHRQ), there is an urgent need to improve the accuracy and relevance of drug allergy safety alerts issued through computerized provider order entry systems. The improvements are needed to reduce the rate of alert overrides by clinicians who may be subject to "alert fatigue," or becoming desensitized to safety alerts by either ignoring or failing to respond appropriately to them. Based on more than 611,000 drug allergy alert records from 2004 to 2013 at two large Boston academic hospitals, the study found that alerts for two serious reactions were overridden about three-quarters of the time.

-RSL Matters-

Get Ready to Tweet in Los Angeles Using #AAAAI16
The 2016 Annual Meeting is almost upon us and A/I physicians attending the Los Angeles meeting will once again be tweeting updates on the latest advances in the specialty. Follow #AAAAI16 on Twitter to get all the latest information from the 2016 Annual Meeting and participate in onsite conversations. Don't forget to re-tweet #AAAAI16 tweets to your followers so others can become more informed about the advances in A/I.

Explore the Life Spectrum of Asthma, July 29-31 in Chicago
You are invited to attend a unique AAAAI educational program that will provide you with a comprehensive understanding of the clinical spectrum of asthma throughout life. An initiative of AAAAI President Robert F. Lemanske, Jr., MD, FAAAAI, the Life Spectrum of Asthma course takes place July 29-31 in Chicago and is built around four themes: asthma inception and progression; reducing and/or eliminating asthma exacerbations; preventing and treating severe asthma; and Asthma and COPD Overlap Syndrome (ACOS).

2016 RSLAAIS Assembly Forum to Focus on the Future of Allergy Practice
Allergy/immunology thought leaders will speak about the future of allergy/immunology practice at the AAAAI RSLAAIS Assembly Forum and Business Meeting during the 2016 AAAAI Annual Meeting, Friday, March 4 from 4:45 to 6:30 pm. This year's forum will focus on several areas of practice including the future application of technology, healthcare payment systems strategies, quality measures, future practice frameworks and the role of academic allergy in community practice. This session is open to all AAAAI members.

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