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New laws help protect your patients, streamline reimbursements, remove penalties
e-Reports, June 27, 2011
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When the Indiana legislature meets, the ISMA’s Government Relations staff works on your behalf at the Statehouse, watching bills that impact your patients and medical practice. Their efforts are guided by grass-roots members like you who submit resolutions to the House of Delegates and are prioritized by the Commission on Legislation.

During the last legislative session, more than 1,000 bills were introduced but only 230 were signed into law. Many of them will take effect July 1.

Here is a review of some significant new laws that will benefit your patients and your medical practice.

Governor Daniels sign concussion bill
Sen. Travis Holdman, R-Markle, (left) author of SEA 93, and Joseph O’Neil, M.D., (right) a supporter of the measure, look on as Gov. Mitch Daniels signs the bill into law.

SEA 366 – Death Registry
Last year, the ISMA received calls about problems with the state’s electronic death registry system. Among them were concerns about the stiff class B misdemeanor penalty for non-compliance.

The ISMA worked to remove the criminal penalty. This new law states that a physician in violation of death registry regulations may be fined up to $1,000 but not reported to the National Practitioner Data Bank. The law also institutes a grace period until Jan. 1, 2012, before a physician is found in non compliance. This gives physicians an opportunity to become more familiar with the system.

“I think the new law shows good common sense,” noted Ripley County Health Officer David Welsh, M.D. “There are still some issues to work out with the system, but I’m glad they took out the criminal component, which was not fair. This is a good example of the positive work the association does for physicians.”

Meanwhile, if you or a colleague encounter trouble with the death registry process, please contact both the ISMA and the Indiana State Department of Health. Read more in the Jan. 24, 2011, ISMA Reports at www.ismanet.org/news/article246.aspx.

Find an online tutorial and register to use the system on the IDRS website.

HEA 1171 – Diagnostic codes and forms for Medicaid

To help streamline reimbursements, Medicaid must establish a single verification system, operated by the state, beginning Jan. 1, 2012.

“It is imperative that a single accurate enrollment system be up and running at the beginning of every year,” explained Bernard Emkes, M.D., a member of ISMA’s Physician Medicaid Task Force. “Providers have to have accurate enrollment data to serve thousands of Medicaid members.”

Also, the Office of Medicaid Policy and Planning (OMPP) is required to use the most current forms for claims within 90 days after the effective date of any new form.

“Any rule that brings consistency to payer systems is an advantage to physicians and hospitals that update their systems in a timely fashion,” added Dr. Emkes.

SEA 331 – FSSA (Family and Social Services Administration) matters
The OMPP or a managed care organization (MCO) must notify you 30 days in advance of any changes to prior authorization, claims processing, payment rates, medical policies and claims issues.

If OMPP or the MCO fails to abide by the policy, the notice or bulletin is void. A claim may not be denied because it does not comply with the void notice or bulletin, and the bulletin may not be reissued for 30 days.

“In order to be reimbursed for any services provided and avoid denials of claims, a certain lead time is required” said Dr. Emkes. “Publicizing changes in advance will certainly help the prior authorization process, but physicians also can help the process by reviewing internal procedures and educating staff.”

SEA 93 – Concussions and head injuries in student athletes
To protect the health of student athletes, players cannot return to play after sustaining a head or neck injury without first being cleared by a licensed health care provider.

Supported by ISMA policy, the statute also requires parents or guardians to sign a form educating them and the student about the dangers of concussions and brain injuries that may occur during athletic participation.

“Before this law, parents and coaches were making decisions about further play. Now, a licensed health care professional with concussion management training and experience must make that decision, which is in the athlete’s best long-term interest,” explained Stephen Simons, M.D., chair of the ISMA Commission on Sports Medicine and director of Sports Medicine at St. Joseph Regional Medical Center in South Bend. “Often, athletes downplay or fail to disclose the severity of an injury to avoid being pulled out of the line-up for upcoming games or events. It behooves physicians to be aware of this behavior.”

ISMA members may log in to find a list of all new laws affecting medical practice in the May 16 Legislative News on the ISMA website.

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