News & Media
MSMS Board of Directors Meet, Discuss Prior Authorization, Legislative and Health Care Delivery Issues
During the October meeting of the Michigan State Medical Society (MSMS) Board of Directors, the Board discussed the latest information in regards to Health Can't Wait, a coalition of patients, physicians, and health care providers dedicated to putting Michigan patients first and ending delays in patients' access to health care, legislative and health care delivery issues. Below are some highlights from the week's meeting:
- Senate Bill 433 -- Legislation that would make Kratom a Schedule II Controlled Substance. The MSMS Board of Directors unanimously agreed to oppose SB433 and encourage changes that would classify Kratom as a Schedule I controlled substance.
- Board of Medicine -- The Health Care Delivery Committee learned more about the Board of Medicine’s role to make decisions regarding applicants and licensees; set educational and examination standards; investigate allegations and complaints; impose sanctions and reinstate licenses. MSMS will develop a new resource guide to explain the complaint and investigative process. MSMS encourages members to seek assistance with any questions or concerns regarding their medical license. As a reminder, license renewals are due January 31. For more information regarding license requirements, please refer to page 3 of the Fall 2019 edition of Education Update.
- Modifier 25 -- BCN implemented a clinical validation edit that led to the denials of claims where modifier 25 was appended to an E/M code. The edit would trigger a denial if an E/M service was billed within a specified time frame (approximately four months) prior to an E/M service with an office procedure. The intent was to validate whether the E/M service billed in conjunction with an office procedure was appropriate. MSMS provided recommendations of ways to accomplish the validation of appropriate modifier use without denying claims upon initial submission. MSMS will continue to monitor this issue and advocate for a less burdensome process.
- Carrier Advisor Committee -- Wisconsin Physician Services (WPS), the Medicare Advisory Contractor for Michigan, is looking for physicians to serve on their Carrier Advisory Committee (CAC). The purpose of the CAC is to provide a formal mechanism for physicians to be informed of and participate in the development of local coverage determinations (LCD) in an advisory capacity. In addition to at-large positions, WPS has the following several specialty slots available: allergy/immunology, anesthesia, gastroenterology, general surgery, gerontology, internal medicine, interventional pain medicine, medical oncology, neurosurgery, orthopedics, pediatrics, peripheral vascular surgery, plastic and reconstructive surgery, psychiatry, pulmonary medicine, radiology, and urology. To nominate yourself or a colleague, please send a CV to Rebecca Blake.
- Enrollment in Medicaid’s Community Health Automated Medicaid Processing System (CHAMPS) -- Effective October 1, 2019, providers who prescribe drugs to Medicaid beneficiaries must be enrolled in Michigan’s online Medicaid provider enrollment system. Claims for drugs prescribed by a provider who is not enrolled in CHAMPS will be denied. This applies to all providers who prescribe drugs, including medical residents. Enrolling in CHAMPS does not require you to take new Medicaid patients.