Medicare/Medicaid
Special Report on Medicare
MEDICARE IN CRISIS: KEEP YOUR OFFICE DOOR OPEN!
Dear Colleague:
Unless you take action, your Medicare payments will be cut 10.6% on July 1, 2008 and then an additional 5% cut in 2009. Many primary care physicians, including both of us, will not be able to keep their office doors open for Medicare recipients.
Are you tired of this ‘unfunded mandate' that primary care physicians absorb disproportionately in caring for our nation's poor and elderly? Have you reached the point of ‘doing something' about it?
Then join us in demanding that Congress: 1) Immediately stop the upcoming July 1, 2008 and January 1, 2009 cuts; 2) Declare an 18 month positive payment update and use that time to work on a replacement for the Sustainable Growth Rate which accurately and fairly reflects both the value of primary care medicine and our actual cost of doing business.
We have provided the necessary tools for you to join us in demanding these actions of our members of Congress. All you need to do is:
1) "Speak out". Talk to your patients about the problem and urge them to join you in speaking out.
2) Write letters to your members of Congress.
3) Submit an op-ed article to your local newspaper(s).
4) Urge your patients to sign a petition to Congress to stop the cuts.
5) Urge your patients to write Congress.
6) Place a poster in your office.
Help us stop the cuts so that we can keep your office door open for your patients.
Best regards,
Howard C. McMahan, MD, FAAFP Jacqueline W. Fincher, MD, FACP
GA Academy Family Physicians GA Chapter American College of Physicians
P.S. Names and addresses of Georgia's Congressional Delegation: http://capitol.aafp.org/
May 12, 2008
Academy Joins Forces with ACCESS Healthcare Coalition
GAFP has joined the ACCESS Coalition along with several other associations and community groups, including the Georgia Chamber of Commerce, Association of County Commissioners of Georgia, Georgia Hospital Association, American Academy of Pediatrics - Georgia Chapter, American College of Physicians - Georgia Chapter, Georgia Dental Association, Georgia Health Care Association, Georgia OB/GYN Society, Georgia Pharmacy Association and Georgia Coalition of Children’s Hospitals.
The Coalition focuses on how underpayment for Medicaid patients increases prices for everyone as family physicians and other medical groups look to make up for the money they lose on the state program. The Coalition will ask the state to increase its financial commitment to the Georgia Medicaid program.
So far, the program has hosted regular meetings with leaders from these organizations to define objectives for the collaboration. The Coalition has launched a media campaign that has included publishing an informational flier, Atlanta television coverage of a physician greatly affected by accepting Medicaid in his office and a legislative lunch with key representatives.
In addition, The Augusta Chronicle, The Florida Times-Union, the Savannah Morning News and other publications throughout the Southeast recently published an article recognizing the Georgia Academy of Family Physicians as part of the new ACCESS Healthcare Coalition.
The GAFP is encouraging family physicians to speak to the media on the need for increasing reimbursement for physicians.
February 26, 2008
Notice from Vaccines for Children
This article was recently emailed to all GAFP members on December 13, 2007.
As a result of a recent manufacturer-initiated precautionary vaccine recall, Vaccines for Children (VFC) providers are being asked to identify and follow instructions regarding the Merck vaccines listed below.
The lots that are being recalled are:
Product Description Lot # Expiration Date
PedvaxHIB® 0677U 11 January 2010
PedvaxHIB® 0820U 12 January 2010
PedvaxHIB® 0995U 16 January 2010
PedvaxHIB® 1164U 18 January 2010 DISTRIBUTED BY VFC
PedvaxHIB® 0259U 17 October 2009
PedvaxHIB® 0435U 18 October 2009 DISTRIBUTED BY VFC
PedvaxHIB® 0436U 19 October 2009
PedvaxHIB® 0437U 19 October 2009
PedvaxHIB® 0819U 09 January 2010
PedvaxHIB® 1167U 10 January 2010
COMVAX® 0376U 05 January 2010
COMVAX® 0377U 08 January 2010
All inventory matching this description needs to be removed from your refrigerator(s) immediately. There is no need to maintain the cold chain for the recalled lot numbers. Place the vaccine in a bag or box and clearly label “Do Not Use” and include a sheet of paper with the following information: VFC ID #, Inventory details (Lot Number(s), Expiration date, and number of doses). Include the word “RECALL” somewhere on the sheet. Immunization Program Consultants (IPC) will be arranging vaccine pick-ups of recalled vaccine. If you choose, you may also send vaccine back to the warehouse as you would other wasted vaccines.
The recall, initiated by the manufacturer, is precautionary. More information on the recall, including Q & A, is available at: http://www.cdc.gov/vaccines/recs/recalls/hib-recall-faqs-12-12-07.htm Please check this site regularly. Keep yourself and your staff informed so that questions from concerned parents are met with knowledge and compassion. You may also refer questions to the Georgia Immunization Program at (404) 657-3158.
February 11, 2008
Tamper-Resistant Prescription Pads will be required for Fee-For-Service Patients
The Georgia Medicaid Fee-For-Service Outpatient Pharmacy Program will require prescribers to use tamper-resistant prescription pads for any new prescriptions with fill dates on and after March 1, 2008. This requirement applies to hard copy prescription orders for any drug, device or product covered through the Medicaid FFS outpatient pharmacy program, whether legend or over-the-counter.
- Effective March 1, 2008, a prescription pad must contain at least one of the following three characteristics:
- Effective for dates of service on and after March 1, 2008, all prescription pads utilized for Medicaid FFS recipient prescriptions must comply with all three of these characteristics.
- Required tamper-resistant characteristics include one or more industry-recognized features designed to:
- Prevent unauthorized copying of a completed or blank prescription form.
- Prevent erasure or modification of information written on the prescription by the prescriber.
- Prevent the use of counterfeit prescription forms. Access To Care
Examples include but are not limited to:
- High security watermark on reverse side of blank;
- Thermochromic ink technology;
- Copied prescription blanks show the word copy, illegal or void.
- Tamper-resistant background ink shows erasures or attempts to change written information.
- Duplicate or triplicate blanks.
The intent of this program is to reduce forged and altered prescriptions and to deter drug abuse. It is not the intent of the program to inconvenience a person seeking to have a valid prescription filled. The provision of covered outpatient FFS pharmacy products written on a non-tamper-resistant prescription pad is allowed on an emergency basis (as defined by the dispensing pharmacist and in accordance with all applicable Medicaid policies, as well as state and federal laws). However, the dispensing pharmacist must obtain a verbal, faxed, electronic or compliant written prescription within 72 hours of the date the prescription was filled. Failure to secure this verification may result in recoupment of such claims. Note prescriptions filled on an emergency basis because they weren’t written or printed on a non-tamper-resistant prescription pad are not necessarily limited to a 72-hour supply. Exempt from the tamper-resistant requirement are Medicaid prescriptions that are:
- Paid by a Georgia Medicaid Care Management Organization (Amerigroup, WellCare, PeachState);
- Provided in nursing facilities or intermediate care facilities for the mentally retarded (ICF/MR) and the drug is reimbursed as part of a total service and is not reimbursed through the outpatient pharmacy program;
- Provided in any other institutional or clinical settings for which the drug is reimbursed as part of a total service and is not reimbursed through the outpatient pharmacy program;
- e-prescribed, faxed to the pharmacy from the prescriber’s office or telephoned to the pharmacy by the prescriber;
l Refills for which the original prescription was filled before March 1, 2008.
If you have any questions, contact the Division of Medical Assistance Pharmacy Services Unit at (404) 656-4044.
October 8, 2007
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