Practice Management

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Covid-19

  • 1.  Covid-19

    Posted 03-19-2020 10:16
    Let's keep this "infield chatter" coming on the reduction in volumes.  This is very good data to share with policymakers as we work to find a soft landing for our radiology business industry.  These drops in volume will tell a story and, perhaps, negate things like the upcoming revenue reductions for radiology in 2021 regarding EM coding.  Keep posting and we will share!

    ------------------------------
    Robert Still FRBMA
    Executive Director
    Radiology Business Management Association (RBMA)
    Fairfax VA
    (703) 621-3363
    ------------------------------


  • 2.  RE: Covid-19

    Posted 03-19-2020 10:33

    We are outpatient only, seeing an overall approximately 30% reduction in volume

     






  • 3.  RE: Covid-19

    Posted 03-19-2020 11:02
      |   view attached
    I wonder what a 30% to 40% reduction in volume would do to MedPACS's assessment of costs and RVUs.  Just a thought.  I'm sure much smarter people than me have started to think about that, but as the government is handing out money, perhaps keeping radiology afloat wouldn't be a bad idea.

    Trusted to provide 
    expert and caring radiology services for over 60 years

    Wayne Baldwin
    CEO
    (805) 879-7577

    CONFIDENTIALITY NOTICE: This electronic mail  may contain information that is confidential, privileged, proprietary, or otherwise legally exempt from disclosure. If you are not the intended recipient, you are hereby notified that you are not authorized to read, print, retain, copy or disseminate this message, any part of it, or any attachments. If you have received this message in error, please delete this message and any attachments from your system without reading the content and notify the sender immediately of the inadvertent transmission. There is no intent on the part of the sender to waive any privilege that may attach to this communication. Thank you for your cooperation.




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  • 4.  RE: Covid-19

    Posted 03-19-2020 11:05

    Yes, I have asked our representatives to please take a look at the legislation that is being introduced in New Jersey as most of us realize it will not kick in unless there is physical damage.  As a small breast center we will be hit very hard.

     

    Phyllis Fulk

    Administrator,

    Imaging For Women

    630 NW Englewood Road

    Kansas City, MO  64118

    Phone: 816-453-2700

    Fax:  816-453-9943

    Direct Line:  816-268-3309

    image001.png@01D18F32.7E281D70

     

    CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited.  If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

     






  • 5.  RE: Covid-19

    Posted 03-19-2020 12:46

    That is an excellent thought. And realistic too. I wonder what Dr. Silva's views are on the emergency powers CMS could rely on to rapidly expedite amendment to the MPFS rule.

     

    Altering the PE values across the Medicare PFS could provide relief to all physician practices.

     

     






  • 6.  RE: Covid-19

    Posted 03-19-2020 11:18
    We are seeing our reduction in volumes increase daily.  We're currently at a 31%.



    ------------------------------
    Steve Mims, Administrator
    Tahoe Carson Radiology, Inc.
    2874 N. Carson Street, Suite 300
    Carson City, NV 89706
    (775) 745-1194 Cell
    (775) 888-1195 Fax
    mims@tcrad.com

    ------------------------------



  • 7.  RE: Covid-19

    Posted 03-19-2020 12:50

    Our estimate is about 35% in the hospital. 

     

    We have taken a pretty conservative stance in regard to outpatient business.  We stopped any imaging that was not urgent or medically critical.  We don't want people coming out of their homes to get a shoulder MRI, for example.  Mammography is stopped.  With people over 65 being urged to shelter in place, I see no sense in bringing them out for an exam that could be postponed.  However, we want to be available for oncology patients, for example, as going into the hospital for imaging would be more risky for them.  There is a lot of effort being put into managing risk of exposure vs. medical necessity for the results.  This is resulting in a drop of 50-60% for us in the outpatient setting.  That is going to be an enormous cash flow problem for us.  But, we think it is the right thing to do.

     

    Question:  How aggressively are you managing the outpatient setting to prevent community spread and protect your staff from exposure?

     

    Rick Padelford, Executive VP

    San Diego Imaging

     






  • 8.  RE: Covid-19

    Posted 03-19-2020 13:54
      |   view attached
    So far, I haven't seen anyone who has stayed even or increased volume.  Can the ACR/RMBA use this data to get changes in policy/reimbursement?

    Trusted to provide 
    expert and caring radiology services for over 60 years

    Wayne Baldwin
    CEO
    (805) 879-7577

    CONFIDENTIALITY NOTICE: This electronic mail  may contain information that is confidential, privileged, proprietary, or otherwise legally exempt from disclosure. If you are not the intended recipient, you are hereby notified that you are not authorized to read, print, retain, copy or disseminate this message, any part of it, or any attachments. If you have received this message in error, please delete this message and any attachments from your system without reading the content and notify the sender immediately of the inadvertent transmission. There is no intent on the part of the sender to waive any privilege that may attach to this communication. Thank you for your cooperation.




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  • 9.  RE: Covid-19

    Posted 03-22-2020 12:27

    Has there been any easing of the direct supervision rules for contrast studies during the COVID-19 crisis? 

     

     






  • 10.  RE: Covid-19

    Posted 03-23-2020 10:04

    None that I am aware, Larry, but perhaps those who more closely track ACR activity might weigh in.

     

     

    Tim Barrett, CPA

    Chief Executive Officer

    8230 Summa Ave.,| Suite C | Baton Rouge, LA  70809-3421

    office  (225) 757-0552 | fax  (225) 763-9997

    tbarrett@lakeradiology.com

    image002.jpg@01D45A47.DF8C03A0   image003.jpg@01D45A47.DF8C03A0   image004.jpg@01D45A47.DF8C03A0  Description: youTube            

     

     






  • 11.  RE: Covid-19

    Posted 03-23-2020 10:42

    For a comprehensive listing, suggest you follow this page that links to Sec. 1135 waivers granted since President Trump declared an national emergency on March 13. I have seen no waivers of the physician supervision requirements for diagnostic tests.

     

    https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page

    Thomas W. Greeson
    703.641.4242
    tgreeson@reedsmith.com

    Reed Smith LLP
    7900 Tysons One Place, Suite 500

    McLean, VA 22102
    703.641.4200
    703.641-4340 Fax
    www.ThomasGreeson.com

     

    Follow us on Twitter @ReedSmithHealth

     

     

     






  • 12.  RE: Covid-19

    Posted 04-01-2020 15:47

    With the COVID-19 push to move to teleradiology, has there been any consideration of waivers for the supervision regulations related to imaging?

    Thank you,

    Kathy

     






  • 13.  RE: Covid-19

    Posted 04-01-2020 19:15

    I brought this issue to Ted Burnes's attention at RADPAC on 3/23.  He said he would follow up.  But, I suspect it is difficult to get a hearing in Washington these days.

     

    Rick

     






  • 14.  RE: Covid-19

    Posted 04-02-2020 08:11
      |   view attached

    There has been some relaxation of supervision levels.  Please see the section labeled "Workforce" under the attachment.

     

    Have a great day and stay safe!

     

    Lori

     

    Lori M. Shore, CPC, RCC, RCCIR, FRBMA

    Vice President, Coding Education and Compliance

    MBMS, LLC



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  • 15.  RE: Covid-19

    Posted 04-02-2020 09:02

    The Interim Final Rule scheduled to be published on 4/6 modifies supervision rules for diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests. CMS has done this for tests performed in physician offices and IDTFs and in hospital outpatient settings.

     

    On p. 58 of the IFR on regulatory flexibilities, CMS states:

     

    For the reasons discussed above, on an interim basis for the duration of the PHE for the COVID-19 pandemic, we are altering the definition of direct supervision at § 410.32(b)(3)(ii), to state that necessary presence of the physician for direct supervision includes virtual presence through audio/video real-time communications technology when use of such technology is indicated to reduce exposure risks for the beneficiary or health care provider. We are revising § 410.32(b)(3)(ii) to include, during a PHE, as defined in § 400.200 of this chapter, the presence of the physician includes virtual presence through audio/video real-time communications technology when use of such technology is indicated to reduce exposure risks for the beneficiary or health care provider.

     

    10. Section 410.32 is amended by revising paragraph (b)(3)(ii) to read as follows:

    § 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    * * * * *

    (b) * * *

    (3) * * *

    (ii) Direct supervision in the office setting means the physician must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean that the physician must be present in the room when the procedure is performed. During a PHE, as defined in § 400.200 of this chapter, the presence of the physician includes virtual presence through audio/video real-time communications technology when use of such technology is indicated to reduce exposure risks for the beneficiary or health care provider.

     

    On p. 61 of the IFR on regulatory flexibilities, CMS states:

     

    For all of the same reasons described above, we are adopting similar changes in the regulations at § 410.28(e)(1) with respect to the supervision of diagnostic services furnished directly or under arrangement in the hospital or in an on-campus or off-campus outpatient department of the hospital, as defined in § 413.65.

     

    9. Section 410.28 is amended by revising paragraph (e)(1) to read as follows:

     

    § 410.28 Hospital or CAH diagnostic services furnished to outpatients: Conditions.

     

    * * * * *

    (e) * * *

    (1) For services furnished directly or under arrangement in the hospital or in an on campus or off-campus outpatient department of the hospital, as defined in § 413.65 of this chapter, "direct supervision" means that the physician must be immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean that the

    physician must be present in the room where the procedure is performed. During a Public Health Emergency, as defined in § 400.200 of this chapter, the presence of the physician includes virtual presence through audio/video real-time communications technology when use of such technology is indicated to reduce exposure risks for the beneficiary or health care provider.

     

     






  • 16.  RE: Covid-19

    Posted 04-02-2020 12:53

    Do we know if ACR is allowing this flexibility as well with accreditation requirements?

     






  • 17.  RE: Covid-19

    Posted 04-02-2020 12:56

    This impacts only direct supervision. The rules re medical director/general supervision are unchanged. 


    Thomas W Greeson
    Reed Smith LLP
    (703) 517-0495
    tgreeson@reedsmith.com





  • 18.  RE: Covid-19

    Posted 04-02-2020 13:27

    Thank you so much!