March 2008

Somerset Physician PRO-Forum Managerial Model
The Somerset Health Care Team has developed a managerial model unique to the industry. The model has four suites that record and compare performance against industry benchmarks in the areas of financial profit/loss, revenue cycle effectiveness and physician coding norms. The fourth suite is a fee analyzer that supports a fee schedule based on payer reimbursement, geography and increased revenue versus increased contractual allowance realization. The revolutionary aspect of the Somerset model is the managerial component of the model. Learn more about PRO-Forum and contact Reggie Elkins or Dale Eichelman for more information.

NY Makes ASCs Repay Overpayments
As reported in a recent MGMA article, "Waiver of copays causes trouble in New York, holds lessons for all groups," the New York Office of the Comptroller recently forced four New York ambulatory surgery centers (ASCs) to repay insurer United HealthCare for overpayments that resulted when they waived copayments for patients covered by a state employee health plan administered by United HealthCare. Visit MGMA's web site to read the full article.

Proposed CMS Revisions Affecting ASCs
A Centers for Medicare and Medicaid Services (CMS) proposed rule may be imposed in 2008 that would revise the conditions for coverage for ambulatory surgical centers (ASCs). If approved, these regulations would prevent any ASC that keeps ANY patients for overnight stay or observation from being a Medicare-certified ASC, regardless of the patient's coverage. We encourage you to contact your Federal representatives and request they send a letter to Kerry Weems, Administrator of CMS, in opposition to this prohibition.

On March 10, 2008, CMS updated their online document, "Calendar Year (CY) 2008 Revised Ambulatory Surgical Center (ASC) Payment System Questions and Answers."  Download the document here.

Google Unveils More Information on Health Initiative
In a recent Healthcare IT News article, Eric Schmidt, CEO and chairman of Google, Inc., told attendees of the HIMSS08 conference that Google has made a serious commitment to healthcare. By their design, data will be liberated from provider and payer databases, follow the patient and be stored in Google's data centers. Data will only be accessible with the patient's consent. They announced a pilot project with the Cleveland Clinic that could ultimately involve creating data profiles for up to 10,000 patients. Click here for the full article.

House Passes Bill Restricting Physician-Owned Hospitals
On March 5, 2008, the House of Representatives passed H.R. 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, by a 268-148 vote. The bill now goes on to be voted on in the Senate. Keep in mind that debate may be taking place on a companion bill in the Senate, rather than on this particular bill. Per an article by the MGMA, the Senate passed similar legislation last fall, which did not include restrictions on specialty hospitals. The House and Senate will now work to reach a compromise between the two bills. The White House has expressed opposition to the restriction on physician-owned hospitals. Click here for a full copy of H.R. 1424.

Somerset Health Care Team News

AAOE Annual Conference. Mike McCaslin, Steve Dobias, Steve Diagostino, Jeff Boomershine and George Kellum will be attending the American Association of Orthopaedic Executives (FKA BONES Society) conference in Charlotte, NC from April 13 to 16, 2008.  On Tuesday, April 15, Mike McCaslin will conduct a breakout session entitled "Succession Planning for Buy-In and Buy-Out Approaches," and he and Steve Dobias will present a half-day Strategic Planning course. We hope to see you there. Please visit us at Booth #323.

IFASC Spring Conference and Tradeshow. On April 18, Cathy Weaver, Mandi Clossey and Sharron Hubbard will be attending and exhibiting at the Indiana Federation of Ambulatory Surgical Centers conference. It is being held at the Forum Conference Center in Fishers, IN. We hope to see you there.

Indiana HFMA Spring Vendor Show and Educational Institute. Somerset will be exhibiting at the Indiana Pressler Memorial Chapter of the Healthcare Financial Management Association conference on April 22. It is being held at the Indianapolis Marriott East Hotel in Indianapolis, IN. Please stop by our booth to speak with Jeff Boomershine and Dale Eichelman and learn more about our Health Care Team services.

Estes Park Institute Future Forum. Charlie Mason and Jim Hamilton will be speaking at this conference that is being held in Orlando, FL from April 25 to 26. Charlie will be presenting "The Physician-Hospital Relationship." Both Charlie and Jim will be presenting "A New Structure for Physician Organization and Governance: Setting up a Group Practice" and "Working Through the Health Care Delivery Transition."

RBMA Radiology Summit. Jeff Boomershine and David Wolfe will be attending the 2008 Radiology Summit in Las Vegas, NV from May 4 to 7, 2008. Please visit us at our booth in the exhibit hall.

IMGMA Spring Conference & Vendor Show. Somerset CPAs is a Gold Sponsor of the Indiana Medical Group Management Association. Regina Elkins of our Health Care Team will be presenting “Revenue Cycle Performance – Managing for Maximum Performance” on Thursday, May 22 at the Spring Conference &  Vendor Show in Bloomington, IN. Several other members of our Health Care Team will be there as well. Please stop by and visit us at our exhibit booth.

IMGMA Salary & Benefits Survey. We will launch the Annual IMGMA Salary & Benefits Survey for participation on April 1. IMGMA members should visit the Surveys page of our web site to participate. 

Annual MGMA Conference. Cathy Weaver will be speaking at the annual Medical Group Management Association conference in San Diego, CA. Her presentation will be on October 21, and the topic is "High Deductible Health Plans and Health Savings Accounts: How to Understand and Manage These Emerging Products That Have Patients and Providers Mutually-Mystified."

Health Care Commentaries is provided by Somerset’s Health Care Team for our clients and other interested persons upon request. Since technical information is presented in generalized fashion, no final conclusion on these topics should be made without further review. For additional information on the issues discussed, please contact a member of our Health Care Team. This document is not intended or written to be used, and cannot be used, for the purpose of avoiding tax penalties that may be imposed on the taxpayer.

Somerset CPAs, P.C.
3925 River Crossing Parkway, Third Floor
Indianapolis, Indiana 46240
317.472.2200 • 800.469.7206 • FAX 317.208.1200
http://healthcare.somersetcpas.com