Monday, December 18, 2017

OCMA Blog

The Doctors Company Risk Tip: Including Risk Management in Your Vacation Planning Allows You to Relax

Because liability never takes a holiday, your vacation plans should include medical coverage arrangements for your practice, particularly when you use locum tenens. The following tips will help reduce risks in your practice and promote the safety of your patients as you plan your vacation:

  • Review managed care contracts for relevant coverage requirements. Some managed care contracts contain very specific language on this topic and many contain indemnification clauses that could expose you to the liability of the covering physician (as well as breach of contract). 
  • Whenever possible, make secondary coverage arrangements. Confirm coverage arrangements via e-mail or fax with the locum tenens who are covering your practice in order to avoid misunderstandings, possible uncertainty of dates or time frame, and exposure to abandonment.
  • Ensure that the practice coverage arrangements include an understanding about patient billing practices in conjunction with any managed care contracts or plans. 
  • Choose covering physicians who share your medical specialty and have privileges at the same hospitals that you do. 
  • Determine if covering physicians carry professional liability coverage and the limits of such coverage. While asking these questions could be awkward, you may be required to ask under certain managed care plans, provider agreements, and hospital bylaws.
  • Before leaving on vacation, prepare a list of patients who are hospitalized or are in the midst of diagnostic work-up, or who have special medical problems or needs. Give this information to the covering physicians and document any specific advice you provide. 
  • Inform the attending physicians or hospitalists of any hospitalized patients you are following about your coverage arrangements, and document the hospital chart to reflect these conversations. 
  • Advise your patients of the coverage arrangements and give them the covering physicians’ names.
  • Make each hospital where you have on-call responsibilities aware of the dates of your unavailability and the identity and phone numbers of the covering physicians. Give similar notice to your answering service and office staff.
Upon returning from vacation, promptly confer with all covering physicians. Document what you were told by the covering physicians about any significant developments in patients’ clinical course or treatment while you were away. 

Consider implementing these fundamental loss prevention measures for even brief periods when you are unavailable, such as observance of religious holidays, attending medical conferences, personal illness, or a long weekend. Unfortunately, vulnerability to claims is not diminished on these occasions. 

Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.

COMING THIS NOVEMBER TO A BALLOT NEAR YOU: ANOTHER FLAWED GOVERNMENT-RUN DATABASE MANDATE WITH NEW THREATS TO PERSONAL PRIVACY

Experts Agree MICRA Measure Mandate “Won’t Work” While Opening Floodgates to Personal Prescription Drug Records of Millions of Californians with No Additional Security Safeguards 

SACRAMENTO – A coalition of business, medical, labor and civil liberties organizations have come together to fight a misguided, deceptive initiative that would increase health costs, reduce health access, and rely on a government-run computer system that isn’t close to fully functional – all while putting the prescription drug histories of millions of California patients at privacy risk with no additional security protections.

The initiative, which qualified for the November ballot on May 15, 2014, is written and funded by trial attorneys and their allies.  In addition to increasing the overall number of medical lawsuits and the cost of health care across the board, it contains a number of unrelated provisions designed to mislead and deceive voters – including a little-discussed mandate relying on a massive expansion of a government-run prescription drug database, which third-party analysts say cannot be implemented as written and will leave personal medical information vulnerable to privacy breach.   
 
“We always knew this flawed measure was bad for the pocketbooks of everyday Californians, but the more they read the fine print, the more they realize it’s equally bad for their personal privacy,” said Jim DeBoo, campaign manager for the broad-based coalition of Californians formed to oppose the initiative.  “If this measure passes, it will mandate a database that isn’t properly working and open the privacy floodgates to the sensitive personal medical data of millions of Californians with no increased security safeguards or funding.  It’s a hacker’s dream – and a privacy nightmare.”

The so-called MICRA (“Medical Injury Compensation Reform Act”) initiative requires health care practitioners and pharmacists to consult a government-run prescription drug database (known as CURES) prior to prescribing or dispensing Schedule II or III controlled substances to patients.

The mandate relies on the uploading of personal prescription drug records of millions of California patients onto the database – accessible by hundreds of thousands of users.  But the initiative fails to add new funding for its expedited expansion or require any additional security standards or safeguards to prevent hacking, theft or improper access by non-medical personnel.

What’s more, experts say the CURES mandate will not work as required by the measure, will not be operational by the law’s effective date and will put doctors in the impossible position of choosing between violating their oath as health providers or violating the law.

“The CURES mandate on physicians cannot be implemented as written.  CURES needs to be updated and modernized and nothing in the initiative does that.” said Tim Gage, former California Finance Director and Principal at Blue Sky Consulting.  “Therefore, the initiative will put health providers in the untenable position of either violating the new law or withholding necessary treatment from patients unless the law is suspended.”

“The consequences of mandating the use of a government-run website that experts say won’t work when required before physicians are allowed to prescribe needed medication is nothing less than a recipe for disaster,” said Dr. Richard Thorp, M.D., President of the California Medical Association.    
 
The CURES database mandate problem comes at a time of widespread reports of illegal hacking, much of it involving digital medical records. Studies show that public fears about personal privacy are at an all-time high.  Last month, it was reported the FBI had taken the extraordinary step of warning that the entire health sector was particularly vulnerable to “attacks by hackers searching for Americans’ personal medical records” (Reuters, April 23, 2014). 
 
Since 2009, the U.S. Department of Health and Human Services has reported 991 separate incidences of medical data breaches involving 500 people or more, affecting a total of 30 million patients.  While many states are moving to increase protections for online prescription drug data, this measure would have the opposite effect in California.

“The public and lawmakers are really starting to understand what kinds of threats to privacy come when you start centralizing great quantities of sensitive personal information in giant electronic databases,” said Nathan Wessler, an attorney with the American Civil Liberties Union, last week to the Wall Street Journal (May 7, 2014).

As proposed, the CURES database maintains an accessible online record of every dispensed prescription of a Schedule II or III controlled substance, including highly sensitive and potentially stigmatizing details about a person’s health.  This prescription information could include medicines used to treat anxiety, insomnia, obesity, narcolepsy, drug detoxification, pain, epilepsy, conditions related to cancer and AIDS, asthma, chronic infection, and other sensitive medical conditions.

The MICRA lawsuit measure which qualified today is formally opposed by (partial list):   

  • AFSCME California PEOPLE
  • International Brotherhood of Electrical Workers, Ninth District
  • International Brotherhood of Electrical Workers, Local 477
  • Service Employees International Union (SEIU) California
  • Union of American Physicians and Dentists (UAPD), AFSCME Local 206
  • California Medical Association
  • California Dental Association
  • California Hospital Association
  • California Pharmacists Association
  • American Congress of Obstetricians and Gynecologists
  • American College of Emergency Physicians, California Chapter
  • California Association of Physician Groups
  • California Association for Nurse Practitioners
  • Planned Parenthood Affiliates of California
  • Community Clinics Association of Los Angeles County
  • La Clínica de La Raza
  • California Association of Rural Health Clinics
  • Central Valley Health Network
  • California Chamber of Commerce
  • California Black Chamber of Commerce
  • California Hispanic Chamber of Commerce
  • City of Long Beach
  • American Civil Liberties Union of California 

To learn much more about the myriad hidden costs, consequences and flaws in the trial-lawyer-supported MICRA lawsuit initiative, visit the “Stop Higher Health Care Costs/Protect Access to Care” website at: www.StopHigherHealthCareCosts.com.

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Orange County Medical Association Selects Acentec, Inc. as Business Partner

National healthcare technology firm will extend special offers on HIPAA compliance to OCMA Physician Members

Irvine, Calif., May 20, 2014 - The Orange County Medical Association is pleased to announce another benefit of membership.  The OCMA has designated Acentec, Inc. as its Business Partner for physicians seeking cost effective and complete HIPAA compliance and IT management. 
 
Acentec has agreed to offer OCMA members discounts up to 20% for HIPAA compliance and IT management needs.
 
"We're pleased to offer OCMA members the security and protection of our  HIPAA compliance and healthcare IT services," said Jeff Mongelli, CEO of Acentec, Inc. "New HIPAA requirements and increased penalties make the proper care and handling of sensitive patient health information essential for every provider and medical organization. We share in the common goal of OCMA members of keeping private information secure so our community can benefit from the authorized access of those who need it."
 
The following Acentec services are included in our relationship with OCMA members: discounted HIPAA compliance services including annual risk assessments, documentation, and employee training; IT services including network and systems management and monitoring, HIPAA compliant remote back-up and hosting, secure email & messaging, business disaster recovery that eliminates or minimizes downtime and data loss, and 24/7 access to our support staff.
 
 Acentec's corporate offices are located in Irvine, CA and they have staff  located nationwide.
 
About Acentec, Inc.
Southern California-based Acentec, Inc. provides a full range of healthcare IT services to medical practices nationwide. Our services include medical billing, IT management and support, EMR software support, HIPAA compliance, and a certified patient portal. For more information, visit http://www.acentec.com.
 

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Physician Advocate Tip of the Month: Request your FREE Covered CA Contract Analysis

May Tip:

Request your FREE in-depth, paragraph-by-paragraph contract analysis of the four insurance payors participating in Covered California!

OCMA contracted with our business partner Tredway Lumsdaine & Doyle, LLP, to do an in-depth analysis of the contracts of the three insurance payors (Blue Cross, Blue Shield and Health Net) that are offering plans through Covered California. OCMA members can receive a FREE copy of this paragraph-by-paragraph analysis to help aid your understanding of these health plan contracts.
 
Contact Mitzi Young at:
888.236.0267
myoung@cmanet.org


2014 CalOptima Circle of Care Award: Requesting Nominations

About CalOptima and the Circle of Care Award
 
CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner.

The CalOptima Circle of Care Award recognizes health care professionals, community groups and individuals who demonstrate excellence in the delivery of accessible and high-quality health care services to CalOptima members. The award honors those who go above and beyond in serving their profession, patients or clients. Since the award’s inception in 2000, CalOptima has recognized more than 250 distinguished people or groups whose dedication to our members and community is extraordinary.   
 

Nomination Criteria and Deadline
 
Please join CalOptima in recognizing outstanding health care professionals, community groups and individuals who, in the past 12 months, went above and beyond to serve our members by submitting the attached Nomination Form. Award recipients will be selected based on:
•         The nominee’s service to CalOptima members
•         The nominee’s accomplishments during the past 12 months

Nominators, please note the following criteria:

  • A nominee may only be a Circle of Care Award recipient a total of five times.
  • Only one Nomination Form per nominee is needed.
  • Self-nominations are welcome.
  • Completed Nomination Forms must be submitted by Friday, June 20, 2014.

Click here for the Nomination Form

Mail, deliver, fax or email Nomination Forms to:         

CalOptima Provider Relations Department 
Attention: Maria Wahab
505 City Parkway West, Orange, CA 92868
Email: mwahab@caloptima.org 
Fax: 714-796-6679  

Award recipients will receive an invitation to attend the Circle of Care Awards luncheon on Friday, September 12, 2014.  
 
If you have any questions, please contact Maria Wahab at 714-796-6143. Please allow adequate time before the nomination deadline for CalOptima to respond to any inquiry.


Now Accepting Nominations for the 2015 Physicians of Excellence Awards!

Is your doctor the BEST in Orange County?

Nominate him or her for the 2015 Physicians of Excellence Awards!

OC Register Magazine in conjunction with the Orange County Medical Association (OCMA), will publish its annual list of Orange County Physicians of Excellence in the February 2, 2015 issue of OC Register Magazine, and is currently seeking nominations. The Physicians of Excellence program was designed to honor outstanding physicians practicing in Orange County. The selection criteria that will be used to determine physician excellence were developed by a multi-specialty collaboration of the OCMA. Anyone can nominate a physician to be considered for the Physicians of Excellence program. Physicians need to be nominated only once to be eligible to apply for selection as a Physician of Excellence. Multiple nominations for the same physician are discouraged. Self-nominations will not be accepted. Once nominated, an application packet will be mailed to the nominee with the details of the application process. Membership in the OCMA is not a requirement for selection.

Minimum criteria for Physicians of Excellence include:

  • Hold board certification within specialty of nomination.
  • Maintain a primary practice location in Orange County, California for the last 5 years.
  • Be in good standing with the Medical Board of California
  • Have been in practice within his/her specialty field for the last 5 years consecutively
Nominators are not required to certify that the physician they are nominating meets these criteria.


Nomination forms are located at: 
www.ocma.org/ForPhysicians/Programs/PhysiciansofExcellence.aspx

You may also download the form by simply clicking here.
 
Submit your nomination form to the Orange County Medical Association by July 10, 2014
 
Send to:
OCMA, 17322 Murphy Avenue, Irvine, CA 92614 or 
fax to (949) 398-8120. 
For questions call (949) 398-8100 ext 106 


The Doctors Company Alert: Windows XP Use May Trigger HIPAA Non-Compliance

Alert from The Doctors Company:

Now that Microsoft has stopped supporting the Windows XP operating system, physician practices using Windows XP face threats from viruses, Trojans, and other potential security breaches. All PC workstations and laptops using Windows XP that contain Protected Health Information (PHI) are no longer compliant with HIPAA and the HITECH Act. This includes devices used to access PHI via the Internet. HIPAA Security Rule section 164.308(a)(5)(ii)(B) states that practices must implement “procedures for guarding against, detecting, and reporting malicious software.” This is no longer possible with Windows XP.

If your practice system currently runs on Windows XP, follow these tips immediately to bring your practice into HIPAA compliance:

  • Identify all at-risk workstations and laptops.
  • Analyze the hardware in all at-risk computers to determine if they are capable of running a new operating system, such as Windows 7 or 8.
  • Upgrade all at-risk computers identified as capable of running a new operating system.
  • For computers that cannot be upgraded, either replace the hardware or purchase new computers.
  • Create a transition plan for upgrading or replacing computers.
Internet Explorer 8 is also no longer supported—if your practice is running Windows XP and using Internet Explorer 8, you may be exposed to additional threats.


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