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AAOMS ICD-10-CM Reference Card

The ICD-9 to ICD-10-CM Reference Card puts the new ICD-10-CM codes reliably at your fingertips! This two-sided, laminated chart lists the most commonly used OMS-related codes in the old ICD-9-CM coding system and compares them to their counterparts in the new ICD-10-CM system. With the increased specificity of ICD-10 and its additional diagnosis codes, this guide will become an essential tool for your entire coding and billing staff. Member cost: $35. http://www.aaomsstore.com/

    Rendering, Ordering or Referring Services for Medicare Beneficiaries: Are You Sure You’re Eligible?

    Many OMSs may not be aware that they are not eligible to render, order, or refer services for Medicare beneficiaries because of their Medicare enrollment status. The CMS requires all physicians and non-physician practitioners who render or order items or services, or refer Medicare beneficiaries to other Medicare providers or suppliers for services, to have current enrollment records in Medicare or to have submitted a valid opt-out affidavit. If you have not enrolled or properly opted out, CMS does not consider you eligible to render, order or refer Medicare services.

    A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner's National Provider Identifier (NPI). A physician or non-physician practitioner who renders, orders, or refers and who does not have a current enrollment record that contains the NPI, will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected. Providers may enroll in Medicare via the CMS 855-O, CMS 855-I, or CMS 855-B or may formally opt out by submitting an opt-out affidavit to their local Medicare carrier.

    • CMS 855-O: For Eligible Physicians and Non-Physician Practitioners Who Only Order or Refer Services
      • For physicians and non-physician practitioners who do not and will not send claims to a Medicare carrier for the services they furnish. Physicians who complete this application cannot bill the Medicare beneficiary for any services performed that would have otherwise been covered by Medicare.
      • This application should only be submitted if the physician or non-physician practitioner renders excluded Medicare services and only plans to refer those beneficiaries to another Medicare physician, or order covered services for the Medicare beneficiary such as Part D prescriptions, surgery, pathology, or radiology.
    • CMS 855-I: For Physicians and Non-Physician Practitioners Who Render Covered Services
      • For physicians and non-physician practitioners who are interested in enrolling in the Medicare program and/or who may already be enrolled in the Medicare program, but have not submitted the 855-I for since 2003.
      • This application should be submitted by those who plan on treating Medicare beneficiaries and submitting claims to Medicare for the services rendered.
    • CMS 855-B: Medicare Enrollment Application for Clinics, Group Practices, and Certain Other Suppliers
      • A medical practice or clinic that will bill for Medicare Part B services (e.g., group practices, clinics, independent laboratories, portable x-ray suppliers).
      • Ambulatory surgical centers, group clinics or practices.
    • Opt-out Affidavit:
      • For physicians and non-physician practitioners who are interested in providing care to Medicare beneficiaries, but do not want to submit claims to Medicare.
      • This affidavit should be submitted to one’s local Medicare carrier when a physician or non-physician practitioner would like to forgo Medicare claims and enter into a private contract with each Medicare beneficiary they treat. The private contract must explain that they have opted out and will not submit claims to Medicare, therefore the Medicare beneficiary is responsible for payment. Opt-out periods are two years, therefore an affidavit must be submitted every two years if an OMS wishes to continue to privately contract with Medicare beneficiaries.
      • Physicians and non-physician practitioners who opt-out must refer any Medicare beneficiaries to a Medicare provider if the beneficiary chooses they do not want to be responsible for payment.
      • Opted-out provider are permitted to refer and order services such as pathology, radiology, and Part D prescriptions since formally opted out providers are added to Medicare’s provider database.

    Note: Opting-out of Medicare also applies to Medicare Advantage (MA) Plans and therefore may indirectly affect your plan participation with some dental plans, if those dental plans offer coverage under MA plans at an extra premium. Some dental plan contracts contain "all products" clauses which obligate a provider to accept beneficiaries from all of that plan's products, including MA Plans. One's decision to opt-out of Medicare and inability to submit to MA dental claims may be a contract violation causing termination from that dental plan. Also, contact any hospitals you may have hospital privileges with. The AAOMS has become aware that many hospitals will not allow physicians or non-physician practitioners who have hospital privileges to be opted-out of Medicare.

      Welcome Back

      ONE lucky winner will be notified in early September.
      Complete TWO SIMPLE STEPS:
      1. Visit AAOMS.org/WashingtonDC to register for the AAOMS 97th Annual Meeting. (Have you already registered? Then you're halfway there!)
      2. Complete the required fields and submit the online entry form below.  

      Drawing Eligibility Requirements

      1. Must be an AAOMS fellow or member who has not attended any of the past five AAOMS Annual Meetings.
      2. Must be registered for the 97th AAOMS Annual Meeting.
      3. Must complete both the annual meeting registration and online entry forms by August 31, 2015.

      Regulations

      The winner will be selected by a random drawing from among the eligible participants. The odds of winning can be expressed as the ratio of one entry to the total number of eligible entries for the drawing. Decisions of the AAOMS regarding selection of the winner and all other aspects of the drawing shall be final and binding in all respects. No substitutions are allowed by the winner. The conduct of the drawing and the disposition of prize are subject to all applicable federal, state and local laws including tax laws.

       †Includes general registration fee only. Excludes ticketed events.

      *Required Information

        The AAOMS PQRS Wizard

        The 2015 reporting period for the Physician Quality Reporting System (PQRS) is underway.   The AAOMS PQRSWizard can assist you in avoiding the 2017 Medicare payment reduction.  The PQRSWizard is a fast, convenient, and cost-effective online tool to help you collect and report quality measures and submit them to Centers for Medicare & Medicaid Services (CMS).  The PQRSWizard. The PQRS Wizard webpage contains a full instructional video for those who may be just getting started using the PQRS Wizard.  This video explains that the PQRS Wizard will recommend a reporting product based on your practice.  Please visit the AAOMS website for more information on both the PQRS program and the PQRS Wizard
         

          Continuing Education Provider Approval

            APME

            Enter the password you received with your registration confirmation to download the handouts.

              AASL

              Enter the password you received with your registration confirmation to download the handouts.

                AARC

                Enter the password you received via email to download the handout. Additional materials will be posted after the Anesthesia Assistants Review Course.

                  PMSA

                  Enter the password you received with your registration confirmation to download the handouts.

                    Corporate Support

                    About Corporate Support

                    The AAOMS wishes to thank the following companies for their generosity in supporting association events and activities throughout the year.

                      Federal Issues Summary - 2015-2016

                      FEDERAL HEALTH REFORM EFFORTS AND THE HEALTH REFORM LAW, THE AFFORDABLE CARE ACT (ACA)

                      The ACA was signed into law on March 23, 2010 and represents the most significant regulatory overhaul of the US healthcare system since the passage of Medicare and Medicaid. This law will impact the way in which OMSs practice in numerous ways. While the law was upheld by the Supreme Court in June 2012, AAOMS continues to remain active on efforts to influence/amend specific provisions of the law through the legislative/regulatory process.

                      HEALTH INSURANCE EXCHANGES

                      The ACA creates insurance exchanges run by the state or federal government where consumers who do not have employer-sponsored coverage are required to purchase insurance to qualify for gov’t subsidies.

                      AAOMS ACTION:

                      1. AAOMS maintains a resource document for membership on key information about the Exchanges that they might be interested in as an individual or an employer.
                      REPEAL OF THE MEDICAL DEVICE EXCISE TAX

                      The ACA includes a provision that requires a 2.3% excise tax on medical devices that is collected at the point of sale. This tax applies to many of the devices used by OMSs.

                      AAOMS ACTION:

                      1. Sent letters in 2015 to Rep. Erik Paulsen (R-MN) and Sen. Orrin Hatch (R-UT) expressing support for their legislation (HR 160, S 149) to repeal the device tax.
                      2. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
                      3. AAOMS members advocated for this issue as an AAOMS priority at the 2015 Day on the Hill.
                      REPEAL OF THE MEDICARE INDEPENDENT PAYMENT ADVISORY BOARD (IPAB)

                      The 15-member IPAB, which was conceived as a cost control mechanism for the Medicare program and created under the ACA, does not adequately understand the needs of providers and their patients. It holds a great deal of power over Medicare and health care decisions, yet is completely unaccountable to the public.

                      AAOMS ACTION:

                      1. Joined a 2015 coalition comment letter that expressed support for repeal of the IPAB.
                      2. AAOMS members advocated for this issue as a secondary priority at the 2015 Day on the Hill.
                      3. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
                      FLEXIBLE SPENDING ACCOUNTS AND HEALTH SAVINGS ACCOUNTS

                      The ACA imposed several restrictions on employee contributions to FSAs and HSAs.

                      AAOMS ACTION:

                      1. Sent a letter to Rep. Steve Stivers (R-OH) expressing support for his legislation (HR 1185) to (1) cancel the FSA "use-it-or-lose-it" rule (2) increase the annual FSA contribution limit to $5,000 and (3) allow families with more than two dependents to deposit up to $500 a year to their FSA for each additional dependent.
                      2. Sent a letter to Rep. Michael Burgess (R-TX) expressing support for his legislation (HR 1196) to (1) double the annual HSA contribution limit to $6,600 per year for individuals and $13,200 per year for families and (2) expand HSA availability beyond just those with high deductible plans.
                      3. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the RAISE Health Benefits Act (HR 1185), which would eliminate certain burdensome limitations on FSAs.
                      4. AAOMS members advocated for this issue as an AAOMS priority at the 2015 Day on the Hill.
                      5. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
                      ANTITRUST REFORM

                      The "Competitive Health Insurance Reform Act" would amend the McCarran-Ferguson Act to revoke the federal antitrust exemption for health insurance companies. This would help to prohibit unfair competitive business practices in the health insurance industry.

                      AAOMS ACTION:

                      1. Sent a letter to Congressman and dentist Paul Gosar (R-AZ) expressing support for his legislation (HR 494) to repeal the McCarran-Ferguson Act’s exemption of health insurance companies from federal antitrust laws.
                      2. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the Competitive Health Insurance Reform Act (HR 494), which would authorize the Federal Trade Commission and the Justice Department to enforce the federal antitrust laws against health insurance companies engaged in anticompetitive conduct.
                      3. AAOMS advocated in support of antitrust reform as a secondary priority at the 2015 Day on the Hill.
                      ERISA REFORM

                      Some dental benefit plans employ unfair practices that hinder patients' ability to receive the full benefits for which they pay. The “Dental Insurance Fairness Act” would improve value and transparency in health coverage by applying uniform benefits requirements to self-insured group health plans that provide dental benefits.

                      AAOMS ACTION:

                      1. Sent a letter to Congressman and dentist Paul Gosar (R-AZ) expressing support for his legislation (HR 1677) to apply uniform coordination and assignment of benefits requirements to self-insured group health plans that provide dental benefits.
                      2. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the Dental Insurance Fairness Act (HR 1677), which would apply uniform coordination and assignment of benefits requirements to self-insured group health plans that provide dental benefits.
                      STUDENT LOAN REPAYMENT REFORM

                      Student loan debt is a significant national problem, particularly for new graduates, and can play an influential role in career decisions, including with OMS residents.

                      AAOMS ACTION:

                      1. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the Student Loan Interest Deduction Act (HR 509), which would increase the allowable student loan interest deduction from $2,500/year to $5,000/year and also eliminate the legal limit on how much income an individual can earn to claim the deduction.
                      2. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the Indian Health Service Health Professions Tax Fairness Act (S 536), which would amend the tax code to provide health care professionals who receive student loan repayments from the Indian Health Service (IHS) the same tax free status enjoyed by those who receive National Health Service Corps (NHSC) loan repayments.
                      3. AAOMS members advocated for this issue as an AAOMS priority at the 2015 Day on the Hill.
                      4. AAOMS maintains an active grassroots congressional letter-writing campaign on the student debt reform issue.
                      ACCESS TO CARE

                      Oral and maxillofacial surgery is a unique dental specialty confronted by a number of issues that impact our ability to provide quality care for our patients. AAOMS encourages members of Congress to ensure oral health care services are given the utmost consideration in legislative proposals and actions when addressing access to care issues.

                      AAOMS ACTION:

                      1. Joined a 2015 Organized Dentistry Coalition (ODC) comment letter that expressed support for the Action for Dental Health Act (HR 539), which would allow organizations to qualify for Centers for Disease Control and Prevention (CDC) oral health grants to support activities that improve oral health education and dental disease prevention.

                        2015 President’s Event

                        A Night at the Newseum!

                        Enjoy this special evening of good food, dancing, and camaraderie amid the exhibits and features of Washington, DC’s newest interactive museum.

                        Located between the White House and the US Capital building, the Newseum offers a unique look at the five freedoms of the First Amendment

                        Dynamic exhibits include:

                        • A special 150th anniversary retrospective of Abraham Lincoln’s assassination news coverage
                        • The unforgettable Berlin Wall Gallery
                        • Pulitzer Prize-winning photographs
                        • Many more historic news and journalism moments
                         

                        You won’t want to miss this spectacular evening!

                        Tickets for this event are only $95, or $115 after July 31. Tickets for children (under 21 years old) are $60 and must be purchased with an adult ticket. Subject to availability.

                          Space Request Form

                          • Deadline for event space request submission is May 1
                          • Requests will be processed in order of receipt; space is limited
                          • Space will be assigned at the Marriott Marquis Washington DC
                          • Space confirmations will be sent on or by May 15 via e-mail and will list the room name and hotel contact information
                          • Event space is complimentary; all additional costs are your responsibility.
                          • You will work directly with the hotel in planning your event.

                          If your event is being held at another location during the hours stipulated below and would like it published in the final program submit the form including the event name, contact, event date & time and the location in the "Comments" section.

                          Contact the AAOMS Meetings Department with any questions.

                          Please note: This year the President's Event will occur on Friday evening. Thursday will be the main evening for Exhibitor hosted events.

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                            If you need additional assistance, please contact us and we'll be glad to help you find what you're looking for.

                              Continuing Education Provider Approval

                              Anesthesia Update Preconference

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 7.25 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 7.25 AMA PRA Category 1 Credit(s)™trade;. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


                              Cosmetic Surgery Preconference

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 4.5 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 4.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


                              Maxillofacial Oncology and Reconstructive Surgery
                              Preconference

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 7.0 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


                              Annual Meeting

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 24.5 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 24.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


                              Beyond the Basics Coding Workshop

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 13.0 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 13.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

                              This program has been approved for 13.0 continuing education unit(s) for use in ful¬filling the continuing education requirements of the American Health Information Management Association (AHIMA). For AAPC credit, please contact AAOMS Coding and Reimbursement Staff at 800/822-6637.


                              ICD-10-CM Coding Workshop

                              Continuing Education Provider Approval

                              The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

                              ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

                              The American Association of Oral and Maxillofacial Surgeons designates this activity for 7.0 continuing education credits.

                              AGD - Accepted Program Provider
                              FAGD/MAGD Credit
                              5/1/14 - 6/30/18
                              Provider ID# 214680

                              The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

                              The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

                              This program has been approved for 7.0 continuing education unit(s) for use in ful¬filling the continuing education requirements of the American Health Information Management Association (AHIMA). For AAPC credit, please contact AAOMS Coding and Reimbursement Staff at 800/822-6637.

                                Practice Management and Allied Staff Sessions Day Pass

                                The Practice Management and Allied Staff Sessions Day Pass lets you and your team members attend as many practice management and allied staff sessions as your schedules will allow for one low daily registration fee. Say "goodbye" to per-course fees that limit your program options. With the Day Pass, each team member pays one flat fee for an unlimited array of choices, including morning and afternoon sessions, a variety of topics that address the unique needs of your practice, and a renowned faculty of experts eager to share their knowledge with you. Maximize your time in Washington, DC this September and October. Order a Practice Management and Allied Staff Sessions Day Pass for every member of your team!

                                Practice Management and Allied Staff Sessions are available Thursday, Friday, and Saturday, October 1–3.

                                Please note that all registrants must pay the general registration fee in addition to the Day Pass cost. Seating for practice management clinics and professional allied staff sessions is on a first-come, first-served basis.

                                See the General Information page for more details.

                                  Clinical Modules

                                  Three full-day module programs, focusing on a different topic each day, will be offered during this year’s Annual Meeting.

                                  The Dental Implant Module on Thursday, October 1 will concentrate on management of implant-related complications.

                                  The Dentoalveolar Module on Friday, October 2, will focus on management of patients with unerupted teeth.

                                  The Anesthesia Module on Saturday, October 3, will examine airway management in the IV sedated patient.

                                  Each program will begin with a large audience plenary session.

                                  The program will then continue into a number of smaller breakout sessions as the morning progresses. Audience interaction will be prompted and encouraged during these in-depth presentations.

                                  After lunch, the Dental Implant and Dentoalveolar module sessions will include scientific oral abstracts that highlight cutting edge research followed by fast-paced "How I Do It" presentations demonstrating procedural pearls and practical techniques. The Anesthesia module afternoon session will consist of a morbidity and mortality conference featuring a review of OMSNIC closed case files.

                                  Tickets are not required for these module programs. Space will be available on a first-come, first-served basis. Please indicate your intention to attend on your meeting registration form.

                                  For complete session details, please visit www.aaoms.org/amprogram15

                                  Questions can be directed to the AAOMS Continuing Education Department.

                                    Faculty and Planner Disclosure

                                    The American Association of Oral and Maxillofacial Surgeons (AAOMS) adheres to the Accreditation Council for Continuing Medical Education (ACCME) Essentials and Guidelines, including the ACCME Standards for Commercial Support, and the American Dental Association Continuing Education Recognition Program (ADA CERP) Standards and Procedures in its development and delivery of continuing medical and continuing dental education activities.

                                    It is the policy of AAOMS to ensure balance, independence, objectivity and scientific rigor in scientific/educational activities. All faculty and others who participate in the planning and execution of an AAOMS educational activity are required to disclose all commitments to or relationships with industry. This requirement includes relationships with pharmaceutical companies, biomedical device manufacturers or distributors, or others whose products or services may be considered to be related to the subject matter of the scientific/educational activity. The principal intent of requiring disclosure is not to prevent a faculty member with conflicts of interest from making a presentation. Disclosure is required so that course directors may reasonably decide whether to make adjustments in the program and its faculty, and so that participants in the activity may formulate their own judgments regarding the presentation in the light of full disclosure of related information.

                                    All faculty and others who participate in the planning and execution of an AAOMS educational activity have been informed of the AAOMS Policy on Disclosure of Relevant Conflicts of Interest. Faculty who have disclosed industry relationships have been counseled, in writing, of the necessity to deliver their presentations in a manner free of commercial bias. Written notification is made, in accordance with AAOMS Policy, to resolve and relevant conflicts of interest.

                                     

                                    Planning Committee Disclosures

                                     

                                    In accordance with ACCME guidelines, the following disclosures are provided for members of the AAOMS Board of Trustees, AAOMS educational planning committees and AAOMS staff. Members of the groups identified below have participated in the planning, development and implementation of this educational activity.

                                     

                                    Board of Trustees

                                     

                                    The following members of the AAOMS Board of Trustees have reported that they have no industry relationships to disclose:

                                    DiFabio, Vincent E., DDS, MS
                                    Fain, Douglas W., DDS, MD
                                    Ferguson, Brett L., DDS
                                    Geist, Eric T., DDS
                                    Indresano, A. Thomas, DMD
                                    Johnson, J. David, Jr., DMD
                                    Lambert, Paul M., DDS
                                    Nannini, Victor, L., DDS
                                    Nelson, Steven R., DDS, MS
                                    Nelson, William J., DDS
                                    Rafetto, Louis K., DMD
                                    Tiner, B.D., DDS, MD

                                     

                                    Committee on Anesthesia (CAN)

                                     

                                    The following members of the CAN have reported the following industry relationship disclosures:

                                    Weber, Charles R., DMD
                                    Stocks/Bonds (Johnson & Johnson)

                                    The following members of the CAN have reported that they have no industry relationships to disclose:

                                    Chung, William, DDS, MD
                                    Ellis, Michael,DDS
                                    Krishnan, Deepak, BDS
                                    Sarasin, Daniel, DDS
                                    Todd, David W., DMD, MD
                                    Treadway, Antwan, DMD

                                     

                                    Committee on Continuing Education and Professional Development (CCEPD)

                                     

                                    The following members of the CCEPD have reported the following industry relationship disclosures:

                                    Baur, Dale A., DDS, MD
                                    Consultant (Novartis Pharmaceuticals and Checkpoint Surgical, LLC)

                                    Shafer, David, DMD
                                    Speakers Bureau (Synthes CMF)

                                    Kademani, Deepak, DMD, MD
                                    Consultant (Biomet)

                                    The following members of the CCEPD have reported that they have no industry relationships to disclose:

                                    Covello, Paul, DDS
                                    Grogan, David M., DDS, MSD
                                    Hossaini-Zadeh, Mehran, DMD
                                    Hudson, John-Wallace, DDS
                                    Meara, Daniel, MS, MD, DMD
                                    Sabino, MaryAnn C., DDS, PhD
                                    Schreiber, Andrea, DMD
                                    Steinberg, Mark J., DDS, MD
                                    Waite, Peter D., DDS, MD

                                     

                                    CCEPD Subcommittee on Dental Implant Conference (SCDIC)

                                     

                                    The following members of the SCDIC have reported the following industry relationship disclosures:

                                    Le, Bach, DDS, MD
                                    Consultant (Biohorizons, Nobel Biocare, Zimmer Dental)
                                    Research Grant (Biohorizons, Nobel Biocare, Zimmer Dental)
                                    Speakers’ Bureau (Biohorizons)

                                    Malmquist, Jay, DMD
                                    Consultant (Nobel Biocare)
                                    Speakers’ Bureau (Nobel Biocare)

                                    Martin, Richard, DDS
                                    Royalty (KLS Martin)

                                    Misch, Craig, DDS, MDS
                                    Consultant (Biohorizons, Dentsply, Carestream)

                                    Moy, Peter, DMD
                                    Speakers’ Bureau (Biohorizons, Nobel Biocare, Osstell)

                                    The following members of the SCDIC have reported that they have no industry relationships to disclose:

                                    Block, Michael, DMD

                                     

                                    Committee on Cleft, Craniofacial & Pediatric OMS (CCCPOMS)

                                     

                                    The following members of the CCCPOMS have reported the following industry relationship disclosures:

                                    Costello, Bernard, DMD, MD
                                    Honoraria (Stryker)

                                    Tiwana, Paul, DDS, MD, MS
                                    Speakers’ Bureau (Biomet)

                                    The following members of the CCCPOMS have reported that they have no industry relationships to disclose:

                                    Farbod, Frank, DMD, MD
                                    Padwa, Bonnie, DMD, MD
                                    Portnof, Jason, DMD, MD
                                    Ricalde, Pat, DDS, MD
                                    Woerner, Jennifer, DMD, MD

                                     

                                    Committee on Health Care and Advocacy (CHCA)

                                     

                                    The following members of the CHCA have reported that they have no industry relationships to disclose:

                                    Asdell, Bernard J., DDS
                                    Batal, Hussam, DMD
                                    Banks, Kathy A., DMD
                                    Boyle, James M., DDS, MS
                                    Brown, Kenneth, DDS
                                    Candelaria, Lionel M., DDS
                                    Clark, Robert S., DMD
                                    Everts, Joshua E., DDS, MD
                                    Gossett , Donald L., DDS
                                    Hillgen, John J., DMD, MBA
                                    Kaye, Alan H., DDS
                                    Lee, N. Ray, DDS
                                    Mercer, James E., DDS
                                    Mulrean, Joseph C., DMD
                                    Nustad, Robert A., DDS, MS
                                    Pietz, Wendy M., MS, DDS
                                    Spina, Anthony M., DDS, MD
                                    Startzell, James M., DMD, MS

                                     

                                    Committee on Hospital and Interprofessional Affairs (CHIA)

                                     

                                    The following members of the CHIA have reported the following industry relationships to disclose:

                                    Werther, John, DMD, MD
                                    Royalty (W. Lorenz/Biomet)

                                    The following members of the CHIA have reported that they have no industry relationships to disclose:

                                    Ferneini, Elie, DMD, MD, MHS
                                    Haghighi, Kayvon, DDS, MD
                                    Kushner, George M., DMD, MD
                                    Klene, Carrie Ann, DDS
                                    Lang, Melanie, DDS, MD
                                    Lytle, John L., DDS, MD
                                    Perrott, David, DDS, MD
                                    Robinson, Randolph, DDS, MD

                                    Committee on Practice Management & Professional Allied Staff (CPMPAS)

                                    The following members of the CPMPAS have reported the following industry relationships to disclose:

                                    Haggerty, Christopher, DDS, MD
                                    Author (Wiley-Blackwell Publishing)

                                    The following members of the CPMPAS have reported that they have no industry relationships to disclose:

                                    Barone, Lucy, MS
                                    Fenton, David A., DDS, MD
                                    Jui, Vivian, DMD
                                    Lewis, Donald, DDS
                                    Platt, Jay, DDS
                                    Sacco, Debra M., DMD, MD
                                    Smith, J. Alexander, DMD
                                    Smith, Stanley, DDS
                                    Stigall, Larry, DDS
                                    Stucki-McCormick, Suzanne, MS, DDS
                                    Walsh, Susan
                                    Wilson, Monty, DDS
                                    Yates, David, DMD

                                    Committee on Research Planning & Technology Assessment (CRPTA)

                                    The following members of the CRPTA have reported the following industry relationships to disclose:

                                    Aghaloo, Tara, DDS, MD
                                    Reseach Grant (Amgen, Biohorizons, Straumann)

                                    Dodson, Thomas, DMD, MPH
                                    Consultant (Journal of Oral & Maxillofacial Surgery)

                                    The following members of the CRPTA have reported that they have no industry relationships to disclose:

                                    Basi, David, DMD, PhD
                                    Bouloux, Gary, MD, BDS
                                    Cillo, Joseph, DMD
                                    Cunningham, Larry, DDS, MD
                                    Edwards, Sean P., DDS, MD
                                    Hale, Robert, DDS
                                    Kademani, Deepak, DMD, MD
                                    Peacock, Zachary, DMD, MD
                                    Read-Fuller, Andrew, DDS

                                     

                                    OMS Faculty Section (FS)

                                     

                                    The following members of the FS have reported the following industry relationships to disclose:

                                    Bell, R. Bryan, DDS, MD
                                    Consultant (Stryker CMF)

                                    Tiwana, Paul, DDS, MD, MS
                                    Speakers’ Bureau (Biomet)

                                    The following members of the FS have reported that they have no industry relationships to disclose:

                                    Bouloux, Gary, MD, BDS
                                    Cunningham, Larry, DDS, MD
                                    D’Innocenzo, Richard, DMD, MD
                                    Ness, Gregory, DDS
                                    Steed, Martin, DDS
                                    Ward, Brent, DDS, MD

                                     

                                    Executive Committee, Resident Organization, AAOMS (ROAAOMS)

                                     

                                    The following members of the ROAAOMS have reported that they have no industry relationships to disclose:

                                    Brown, Kenneth, DDS
                                    Chalak, Amir M., DDS
                                    Covello, Paul, DDS
                                    Hammer, Daniel A., DDS
                                    Massaro, Anthony, DMD
                                    Read-Fuller, Andrew, DDS
                                    Retana, Armando, DDS
                                    Roquette, Krista L., DDS
                                    Shah, Gaurav Ashok, DMD
                                    Sonnichsen, Brittany, DMD
                                    Vyas, Harshiv J., BDS
                                    Yetzer, Jacob, DDS, MD

                                     

                                    Special Committee on Maxillofacial Oncology and Reconstructive Surgery (SCMORS)

                                     

                                    The following members of the SCMORS have reported the following industry relationships to disclose:

                                    Fernandes, Rui, DMD, MD
                                    Consultant (Biomet, OsteoMed)

                                    Bell, R. Bryan, DDS, MD
                                    Consultant (Stryker CMF)

                                    The following members of the SCMORS have reported that they have no industry relationships to disclose:

                                    Ghali, G.E., DDS, MD
                                    Helman, Joseph, DMD
                                    Kademani, Deepak, DMD, MD
                                    Schmidt, Brian L., DDS, MD, PhD
                                    Ward, Brent B., DDS, MD

                                     

                                    AAOMS Staff

                                     

                                    The following members of AAOMS Staff have reported that they have no industry relationships to disclose:

                                    Abel, Martha
                                    Adams, Mark, JD
                                    Armour, Yolanda
                                    Bonfield, Heidi
                                    Brenman, Adam
                                    Choyke, Barbara S., CAE
                                    Dreiske, Leslie
                                    Dunham, Janie
                                    Farrell, Scott C.
                                    Gonzalez, Martin
                                    Gunether, Sandy
                                    Jones, Samantha E.
                                    Lee, Caroline P.
                                    Motrenko, Marina
                                    Murray, Shannon
                                    O'Brien, Kelly
                                    Peterson, Shannon
                                    Rinaldi, Robert C., PhD, CAE
                                    Schnitzer, Mary
                                    Serpico, Patricia
                                    Smith, Eric
                                    Smith, Kyle
                                    Steuer, Becky
                                    Teplitz, Janice K.
                                    Tuerk, Jeanne
                                    Treccia, Bridget
                                    Wittich, Karin K.
                                    Wochos, Katie

                                    All reported relevant conflicts of interest have been resolved by the Committee on Continuing Education and Professional Development and other planning committees as of 4/10/2015.

                                      Corporate Support Inquiries

                                        Proceedings of Past Research Summits

                                          Resident Educational Program

                                          Purpose/Objectives

                                          The ROAAOMS executive committee believes that residents need to be provided with essential non-clinical information that will assist them as they transition from residency to practice. This program is designed for senior residents to provide supplemental learning for OMS residents. Core educational topics include disability income/life insurance, professional liability/malpractice insurance, variety of practice management resources that provide essential skills for surgical practice, coding and billing information and more. In addition, residents will learn valuable information about AAOMS membership benefits and the board certification process.

                                          Resident Scholarships

                                          The AAOMS is pleased to announce resident scholarships, supported by Geistlich Pharma and Osteo Science Foundation, to provide assistance to OMS residents to attend the Resident Educational Program to be held May 8-9, 2015. The award will be granted to support thirty (30) residents at $750 each.

                                          The Resident Educational Program will provide essential non-clinical information to assist residents as they transition from residency into practice. The program will also provide supplemental learning for OMS residents such as contract negotiation, evaluation of practice models, professional liability insurance, and coding compliance and attaining optimal reimbursement. While this program is geared towards senior residents, it is open to all OMS residents. The registration is free!

                                          Please see the guidelines and application for more information. The application is due to Penny Evans by April 1, 2015. For more information, visit Research and Education Conference. We look forward to seeing you in May.

                                            New Investigators’ Day

                                            Creating Success in an Academic Career. The influence of advanced training.

                                            The 2015 New Investigators' Day Program is sponsored by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the Oral and Maxillofacial Surgery Foundation (OMSF). Developed by the Committee on Research Planning and Technology Assessment, the New Investigators' Day program promotes careers in education and research and provides mentoring opportunities for new faculty and residents and includes presentations on academic surgery as a career path.

                                            Related External Links
                                            Research Summit Scholarship
                                            For More Information

                                            For more information about this event please contact Kyle Smith (800/822-6637 ext. 4330) or Martin Gonzalez.

                                              Health IT Bytes

                                              Health IT Bytes
                                              March/April 2015

                                                Health Policy Perspectives

                                                Health Policy Perspectives
                                                March/April 2015

                                                  Practice Management Matters

                                                    Practice Management Notes

                                                    Practice Management Notes
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                                                      test grid

                                                        Annual Meeting

                                                          List of State and Regional Societies

                                                            Application for New Clinical Speakers: How I Do It Presentations

                                                            Application for Clinical Speakers: How I Do It Presentations 

                                                            Deadline: applications must be submitted by Friday, March 13th 

                                                            Have something you've discovered that works really well in your practice? Share your knowledge with your colleagues at the 2015 Annual Meeting!

                                                            The Committee on Continuing Education and Professional Development is actively seeking clinical speakers to present fast-paced "How I Do It" presentations as part of the module programs at this year's annual meeting. Two topics will be covered: Dental Implants and Dentoalveolar.

                                                            The Dental Implant module will take place on Thursday, October 1st and the Dentoalveolar module on Friday, October 2nd. Each module program begins with a large audience plenary session and continues into smaller breakout sessions as the day progresses. The "How I Do It" presentations will be an integral part of each module's afternoon session. If you are interested – even if you have never formally presented at an AAOMS conference before – this opportunity could be just what you are looking for.

                                                            Guidelines:
                                                            • Applications without the required information indicated on the form will not be considered. 
                                                            • Presentations must be evidence- and clinical-based. 
                                                            • Application summaries are limited to 200 words or less. 
                                                            • At least two references are required. 
                                                            • Application submissions and presentations must be in English. 
                                                            • Presentations must be 7 minutes in length each with an additional 3 minutes for discussion. 
                                                            • Must be presented in PowerPoint. 
                                                            • Presentations will be evaluated and given feedback by audience. 
                                                            • If accepted, the presenter is responsible for all associated costs and registration fees to attend the Annual Meeting. 
                                                            • Presenters are not required to be members of the AAOMS. 
                                                            • If you have spoken for AAOMS before, you are more than welcome to apply, but we strongly encourage new speakers. 

                                                            Submit an Annual Meeting How I Do It Application
                                                            Application deadline: March 13

                                                            If you have any questions, please contact Samantha Jones, Senior Associate, Continuing Education or 847/233-4386.

                                                              Exhibition

                                                              Shortcuts to Exhibition Information:

                                                                Hotel & Travel

                                                                Hotel Reservations

                                                                Use the links below to secure your accommodations for the 2015 Dental Implant Conference at special room-block rates reserved exclusively for AAOMS members and guests.

                                                                Sheraton Chicago Hotel & Towers (headquarters hotel)
                                                                301 East North Water Street
                                                                Chicago, IL 60611
                                                                312/464-1000
                                                                877/242-2558

                                                                Fairmont Chicago Millennium Park
                                                                200 North Columbus Drive
                                                                Chicago, IL 60601
                                                                312/565-8000
                                                                800/441-1414

                                                                  Sessions Materials

                                                                  Session Materials

                                                                  Educational session presentation materials are available as downloadable files on aaoms.org for meeting registrants only.

                                                                  IMPORTANT: To access session materials you will need the Reg/Member ID number that is noted on your registration confirmation letter and your conference badge.

                                                                  1.  Visit aaoms.org/DICprogram or, from the main conference page under Conference Program, select Pre-Conference Courses or 
                                                                       General Session.

                                                                  2.  Search for the specific educational session(s) that you plan to attend. If materials are available for a given session, links to 
                                                                       downloadable PDFs will appear on that session’s detailed information page.

                                                                  3.  The first time you click to access a handout, you will be prompted to enter your Reg/Member ID number. Once you have logged in 
                                                                       with your Reg/Member ID, materials for the sessions you plan to attend will be available for you to download.

                                                                  Note that many sessions do not have materials available. Session presentation materials will be posted as they are submitted by speakers, so please check back periodically for updates.

                                                                  Presentation materials will be available online for 90 days following the close of the meeting for all registered attendees.

                                                                  TIP: Before printing session materials, please consider file size and number of pages. We recommend saving documents to your computer or mobile device, if possible, and printing only those pages that you need.

                                                                    Conference Program

                                                                    View the Course Descriptions & Schedule of Events

                                                                    DENTAL IMPLANT CONFERENCE SEARCH PAGE

                                                                      General Info

                                                                      Shortcuts to Information:

                                                                        AAOMS Dental Implant Conference

                                                                        The 2015 Dental Implant Conference
                                                                        December 3-5, 2015

                                                                        The 2015 Dental Implant Conference offers an intensive educational program of innovative techniques and procedures for the entire implant team, presented by an internationally renowned faculty of leaders in implant dentistry.

                                                                        You'll also experience an exhibition of the most technologically advanced products and services available in the field, and the opportunity to network with colleagues from around the country

                                                                        Registration will open in August.

                                                                         

                                                                          AAOMS Education Staff Contact Information

                                                                          If you have any questions regarding your scheduled presentation or about getting involved in future meetings, please contact any of the AAOMS staff below:

                                                                            Government Affairs Information & Materials

                                                                            AAOMS Governmental Affairs advocates on behalf of the specialty by monitoring federal and state legislative and regulatory issues, encouraging member action through grassroots participation, and backing candidates who support the goals of the specialty through OMSPAC. For additional governmental affairs updates please check out the AAOMS Advocacy E-Newsletter.

                                                                              Research Summit

                                                                                Tools

                                                                                Powerpoint Template:

                                                                                Tips for a Successful PowerPoint Presentation – Your PowerPoint will greatly aid you in presenting your information to your audience.
                                                                                The AAOMS requests that all speakers utilize the AAOMS Annual Meeting PowerPoint Templates. If you are unsure which format your presentation should be in, please confirm with your staff contact.

                                                                                • 4:3 Standard PowerPoint Template
                                                                                • 16:9 PowerPoint Template
                                                                                • 3:1 PowerPoint Template

                                                                                  Opportunities

                                                                                  Shortcuts to Opportunities:

                                                                                    Anesthesia Links

                                                                                      Parameters of Care

                                                                                        OSHA Releases Respirator safety videos on YouTube

                                                                                        OSHA posted two videos that address key safety concerns for healthcare workers using respirators and masks for protection from H1N1 influenza. The "Respirator Safety" video shows how to safely put on and take off common respirators including the N95 disposable respirator, and "The Difference between Respirators and Surgical Masks" explains how to use these types of personal protective equipment to prevent exposure to infectious diseases.

                                                                                        For more information, please visit OSHA's Respiratory Protection page or the Department of Labor's YouTube channel.

                                                                                          NIOSH and OSHA Release Safety Bulletin on Blunt-Tip Needles

                                                                                          July 17th, 2007

                                                                                          National Institute of Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) have jointly published a Safety and Health Information Bulletin (SHIB) designed to help protect surgical personnel from needle stick injuries while using suture needles. For more information, please visit the NIOSH Web site.

                                                                                            What is the relationship between OSHA and NIOSH

                                                                                            March 9th, 2009

                                                                                            The National Institute for Occupational Safety and Health (NIOSH) is the division of the Centers for Disease Control and Prevention (CDC) that researches and publishes worker safety recommendations. NIOSH does not publish "regulations" or enforce them, but NIOSH recommendations contain the latest U.S. Public Health Service guidelines. OSHA requires compliance with the latest U.S. Public Health Service guidelines for standards, such as bloodborne pathogens, so it is good a good idea to follow NIOSH recommendations so that you are in compliance with the corresponding OSHA regulation.

                                                                                              Hazardous drug resource in Spanish

                                                                                              May 19th, 2009

                                                                                              The National Institute for Occupational Safety and Health (NIOSH) has translated its "Workplace Solution-Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs" into Spanish. The article covers gloves; gowns; respiratory protection; eye and face protection; sleeve, hair, and shoe covers; and personal protective equipment disposal.

                                                                                                CDC

                                                                                                  Postdoctoral Dental Matching Program

                                                                                                  Matching programs have been implemented in a wide variety of professions and competitive recruitment situations, including: medicine, law, dentistry, accounting, pharmacy, podiatry, placement of university co-op students, and sororities.

                                                                                                  Understand the Ethics and Professionalism Associated with the National Match

                                                                                                  With a matching program, candidates continue to apply directly for positions, and applicants and recruiters evaluate each other in the usual manner, independent of the matching program. However, no offers are made to applicants during this process. Instead, after all evaluations are complete, each candidate submits to the matching program a list of desired positions in numerical order of preference (first choice, second choice, etc.). Similarly, each recruiter submits a list of desirable applicants, in preference order. The matching program then places individuals into positions based on these stated preferences; all offers, acceptances, rejections and final placements occur simultaneously.

                                                                                                  What a matching program will accomplish

                                                                                                  A matching program is an effective and fair means of implementing a standardized acceptance date. It allows recruiters and applicants to evaluate each other fully before offers are made, thus eliminating premature decisions based on incomplete information. All offers, acceptances or rejections occur at the same time. Therefore many common adverse situations are eliminated from the recruitment process, such as applicants hoarding multiple offers, applicants reneging on a prior acceptance in order to accept a more preferred subsequent offer, and recruiters overfilling the number of positions available.

                                                                                                  What a matching program will not do

                                                                                                  A Matching Program will not affect the number or quality of applicants or applications for positions, the number of applicants selected for interview, or the recruiters' ability to evaluate applicants. It is not a placement or executive search service, a centralized application service, or an advertising service. A Matching Program will not reduce the flexibility or freedom of choice applicants and recruiters now have in the selection process, and will not remove the control recruiters currently have in selecting applicants. It is not an impersonal, computerized assignment of applicants to positions; matches are based strictly on the preference lists submitted by both recruiters and applicants.

                                                                                                  Services provided by NMS

                                                                                                  National Matching Services Inc. provides both turnkey and consulting services to assist professions and organizations in the development, implementation and administration of Matching Programs.

                                                                                                  Turnkey administration

                                                                                                  Generally working under the supervision of one or more organizations representing the profession, NMS will take full responsibility for the administration of all aspects of a Matching Program, including development of educational materials, participant registration, data collection, performance of the match, distribution of results and preparation of statistics. NMS has experience in operating Matching Programs ranging from a large match involving more than 30,000 applicants for 25,000 positions offered by 4,000 different recruiters, to smaller matches involving less than 200 applicants for less than 100 positions offered by fewer than 30 recruiters.

                                                                                                  Consulting services

                                                                                                  NMS offers consulting services on all aspects of Matching Programs, including: the advisability and feasibility of initiating a Matching Program; assessment of the organization and resources required to implement and administer a Matching Program; and, operational review of the administration of a Matching Program to ensure it is functioning efficiently and effectively and in the best interests of both applicants and recruiters.

                                                                                                  NMS has developed sophisticated proprietary software, operating on a range of computers from mainframes to microcomputers, that enables us to automate all aspects of Matching Programs that we administer. Alternatively, NMS will license this unique software to organizations that administer their own Matching Program, and will also customize the software to address any specific requirements.

                                                                                                  How to contact the NMS

                                                                                                  For further information on the application of a Matching Program, or on the services provided by National Matching Services Inc., please contact:

                                                                                                  National Matching Services Inc.
                                                                                                  595 Bay St., Suite 301, Box 29
                                                                                                  Toronto, Ontario, M5G 2C2
                                                                                                  Canada
                                                                                                  Telephone: 416-977-3431
                                                                                                  Fax: 416-977-5020 Email: matchinfo@natmatch.com
                                                                                                  http://www.natmatch.com/dentres/

                                                                                                  Sponsors
                                                                                                  • American Academy of Pediatric Dentistry
                                                                                                  • American Association of Oral & Maxillofacial Surgeons
                                                                                                  • American Association of Orthodontists
                                                                                                  • American Association of Hospital Dentists
                                                                                                  • American Student Dental Association
                                                                                                  • American Dental Education Association
                                                                                                  • Commission on Dental Accreditation

                                                                                                    Postdoctoral Application Support Service (PASS)

                                                                                                    What is the Postdoctoral Application Support Service (PASS)?

                                                                                                    ADEA PASS is a centralized application service, which has been designed by the American Dental Education Association (ADEA) for individuals applying to advanced dental education programs. The ADEA PASS Service is available to all individuals applying to the over 600 participating advanced dental education programs. ADEA PASS simplifies the application process by providing one standardized format, relieving applicants of the need to complete multiple applications. Dental programs benefit by receiving uniform information on all applicants.

                                                                                                    Most (but not all) programs that participate in the Match also participate in ADEA PASS. However, ADEA PASS and Match are separate and distinct services. Completing and submitting an application through ADEA PASS will not automatically register you for the Match. Similarly, applicants are not required to complete an ADEA PASS application in order to register for and participate in the Match. To obtain a position at a program that is participating in the Match you must register separately for the Match, which includes agreeing to the Match Applicant Agreement and paying the Match registration fee.

                                                                                                    Which postdoctoral programs can participate?

                                                                                                    To be eligible to participate in ADEA PASS, advanced dental education programs must be accredited by the Commission on Dental Accreditation or be offered by a dental school that is accredited by the Commission on Dental Accreditation. Learn more...

                                                                                                    Join today and experience the benefits that include:
                                                                                                    • A fully online operation
                                                                                                    • Recruitment support through the ADEA PASS Program Search Engine that makes your program visible to prospective applicants throughout North America and beyond
                                                                                                    • Access to the comprehensive application management tool (WebAdMIT) that enables ADEAPASS participating programs to administer their application processing, applicant evaluation and selection, reporting, and candidate communication completely online.
                                                                                                    • Utilize the special faculty reviewer feature through WebAdMIT that will allow you to securely designate your selection committee members to receive applicant files for on-screen read-only review.
                                                                                                    • No cost to programs
                                                                                                    How does ADEA PASS work?

                                                                                                    There are two components to the full ADEA PASS application. The applicant must submit both (1) the electronic application and (2) the Required Documents listed below to initiate the processing of the application. ADEA PASS will only process complete applications.

                                                                                                    Program directors receive a complete application. The application includes:

                                                                                                    Documents ACCEPTED:

                                                                                                    • Processing Fee
                                                                                                    • One ETS® PPI for ADEA Report Learn more...
                                                                                                    • Up to 2 Official Professional Evaluations (paper or eForms)
                                                                                                    • Official Dental School Transcript(s)
                                                                                                    For More Information

                                                                                                    To obtain further information about PASS, and the programs which participate in PASS, please contact:

                                                                                                    ADEA PASS Customer Service

                                                                                                    ADEA PASS Customer Services Representatives are available Monday through Friday, 9:00 a.m. - 5:00 p.m. Eastern time except federal holidays.

                                                                                                    Email: passinfo@passweb.org
                                                                                                    Phone: 617/612.2065
                                                                                                    ADEA PASS Application: portal.passweb.org

                                                                                                      Coding Certificate Program

                                                                                                      The AAOMS Coding Certificate Program (CCP) offers a coding instruction series for OMSs and their staff unmatched in scope and detail anywhere else. This specialty-specific certificate program consists of three course levels - Basic, Beyond the Basics and Advanced. Development of this offering stems from an Association wide belief that those who successfully complete the entire program should be recognized for their accomplishment and proficiency in OMS coding. While not certification, those AAOMS members and staff that complete the program will be awarded a certificate of completion and special lapel pin, visible proof of these individuals' extensive knowledge of coding principles. Knowledge that will show immediate results - measurable, significant results - for your practice! For more information view frequently asked questions about the program.

                                                                                                        HIPAA Transaction Operating Rules

                                                                                                        April 29, 2013

                                                                                                        The Affordable Care Act (ACA) requires all HIPAA covered entities to be compliant with the applicable HIPAA standards and associated operating rules. The ACA defines the operating rules for the HIPAA transaction standards as "the necessary business rules and guidelines for the electronic exchange of information that are not defined by a standard or its implementation specifications". There are three sets of operating rules that were created by the Committee on Operating Rules for Information Exchange (CORE). CORE is an initiative implemented by the Council for Affordable Quality Healthcare (CAQH). The CAQH describes the operating rules as an addition to existing standards to make electronic transactions more predictable and consistent, regardless of the changing technology. Beyond reducing cost and administrative hassles, operating rules foster trust among all participants.

                                                                                                        The CAQH CORE operating rules will offer physician practices the ability to determine a patient's eligibility and financial responsibility for specific services prior to or while the patient is still in the office so they may accept payment from patients at the time of service. Electronic eligibility verification will now provide the patient's co-payment, co-insurance and remaining deductible amounts, while the claim status feature will provide for timely acknowledgment and status reporting, including error and remark codes.

                                                                                                        The first set of operating rules (Phase I and Phase II), implemented on January 1, 2013 were enforced March 31, 2013. Phase I and Phase II specify eligibility and claim status for HIPAA covered entities. More information on the first two phases can be found below:

                                                                                                        The second set of operating rules (Phase III) has a compliance date of January 1, 2014 for all HIPAA covered entities. Phase III is for the implementation of the national operating rules for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). More information on Phase II can be found below:

                                                                                                        The third and final set of HIPAA operating rules effective as of January 1, 2016, will mandate health claims or equivalent encounter information, enrollment and disenrollment in a health plan, health plan premium payments, referral certification and authorization, and claims attachment. The third set of HIPAA operating rules is not categorized as a specific phase. More information on the third set of rules that will be implemented in 2016 can be found on the CAQH Timeline at http://www.caqh.org/ORMandate_timeline.php.

                                                                                                        The CORE Phase descriptions can be found at on the Operating Rules page of the CAQH website at http://www.caqh.org/CORE_operat_rules.php. Those providers that electronically check patient eligibility or claims status are encouraged to work with their software vendors and/or clearinghouses to determine readiness.

                                                                                                          NPI Guidelines for Practices with Multiple Locations

                                                                                                          March 18, 2013

                                                                                                          When a practice has multiple locations they often operate independently of each other and usually do their own billing. Many health plans consider each separate physical location to be a health care provider itself; and many of these health plans, including Medicare, reimburse for these items based on the geographic location where the items are dispensed to patients and not on the geographic location of the corporate headquarters.

                                                                                                          When applying for an NPI, there are two different entity types to choose from. The first is Entity Type 1 that would be assigned to an individual who provides health care services using their individual SSN, and the second is an Entity Type 2 assigned for an organization providing health care services using their organization's Employer Identification Number (EIN). The NPI final rule, released in 2004 states that a designated health care component may in essence be assigned multiple NPIs if the health care component is made up of multiple health care providers at separate locations or "subparts". Therefore, if each practice location or "subpart" has its own EIN, then each location would require its own Type 2 NPI. However If each practice site or "subpart" operates under the same EIN, there would be certain criteria to determine if each "subpart" should have its own NPI. The separate locations generally:

                                                                                                          • operate independently from the "parent "organization
                                                                                                          • conduct its own HIPAA standard transactions (are assigned their own unique Entity Type 2 NPI)
                                                                                                          • certified by the State separately from the "parent" organization

                                                                                                          Every OMS/practice is responsible for determining the number of NPIs necessary, therefore AAOMS encourages all members to consult with a practice attorney, accountant, or consultant when applying for NPI's to ensure that claims processing is not interrupted.

                                                                                                            HIPAA Security Guidance for Remote Use of and Access to Electronic Protected Health Information

                                                                                                            January 29, 2007

                                                                                                            CMS would like to announce the publication of the "Security Guidance for Remote Use" paper. This document is intended to provide HIPAA covered entities with general information on the risks and possible mitigation strategies for remote use of Electronic Protected Health Information (EPHI), such as through the use of laptops, other portable and/or mobile devices and external hardware. This guidance document also explains CMS' minimal compliance expectations for covered entities seeking to safeguard EPHI that is accessed, stored or transported offsite. Please note this document only provides a general list of suggestions and is not meant to be comprehensive.

                                                                                                              OCR releases privacy rule disclosure guides for providers and patients

                                                                                                              March 9, 2009

                                                                                                              HHS' Office for Civil Rights has published two guides (one for healthcare providers, "Communicating with a Patient's Family, Friends, or Others Involved in the Patient's Care," and one for patients, "When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved in Your Care") that discuss when it is appropriate for providers to disclose PHI under HIPAA. The guides, address common questions about HIPAA privacy rule disclosures in a Q&A format. To access the guides, please visit http://www.hhs.gov/ocr/privacy/.

                                                                                                                HIPAA Version 5010 Non-specific Procedure Code Guidelines

                                                                                                                January 31, 2013

                                                                                                                The HIPAA Version 5010 is a new set of standards to replace the current standards that regulate the electronic transmission of specific healthcare transactions, including eligibility, claim status, referrals, claims and remittances. All HIPAA covered entities are required to comply. Failure to comply will result in interruptions with your business operations and rejected claims. The 5010 version has many requirements when filing a claim.

                                                                                                                The HIPAA Version 5010 Implementation guide is now mandating that unlisted codes provide a description of the procedure in order to be HIPAA compliant. An unlisted code is one that contains terms in their descriptor such as, "Not otherwise classified (NOC), unlisted, unspecified, unclassified, other, miscellaneous, prescription drug generic, or prescription drug brand name." When a code containing one of these descriptions is reported on the Version 5010 form, a procedure description of "Not otherwise classified" is needed. If this description is not included on the 5010 form, the claim may not be rejected, but the claim may be delayed for review.

                                                                                                                Along with the non-specific procedure code description, those filing a claim using the 5010 form must use a full address in the billing field (Not a PO Box), submit the full 9-digit zip code, and report anesthesia in minutes instead of units. The HIPAA Version 5010 was scheduled for a compliance date of January 1, 2012, but that date has been deferred until March 31, 2012.

                                                                                                                For a full list of the "Not Otherwise Classified (NOC)" code set, visit the CMS website at http://www.cms.gov/ElectronicBillingEDITrans/40_FFSEditing.asp. Also, for more information pertaining to the implementation of the HIPAA Version 5010 guide, visit the CMS Website.

                                                                                                                  WHO surgery checklist

                                                                                                                  In 2009, a study released by the World Health Organization (WHO) shows that when implementing the use of their surgical checklist, surgical deaths and complications were lowered by one third. The WHO trialed the use of its surgical checklist in eight operating rooms (OR) in hospitals around the world and found that the death rate dropped from 1.5% to .8% and the rate of major complications from surgery fell to 7% from 11%. The study, published in the New England Journal of Medicine, touches on aspects of the checklist that foster better communication in the OR. Taking time to make sure that all members of the operating team are on the same page and can voice any concerns they have proved to be a key part in lowering error rates. The WHO Checklist can be found at www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf. An Implementation Manual can be found at www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Manual_finalJun08.pdf. More information can be found at www.who.int.

                                                                                                                    COBRA

                                                                                                                    The Department of Labor released on March 19, 2009 a notice announcing the availability of four COBRA model notices and 25 frequently asked questions regarding the COBRA health care continuation coverage premium reduction. More information can be found on the Department of Labor website.

                                                                                                                      CPR Guidelines

                                                                                                                      CPR guidelines were updated in 2012. For more information, please visit the American Heart Association’s website.

                                                                                                                        OMS Key Legislative Contacts - Thank you

                                                                                                                        Your application has been submitted!

                                                                                                                        A confirmation notice will be sent to the email provided in the application.

                                                                                                                          OMS Key Legislative Contacts

                                                                                                                          Becoming an OMS Key Contact allows AAOMS members an opportunity to get involved in the specialty's advocacy efforts and provides AAOMS staff with access to valuable "go-to" contacts who have cultivated relationships with key legislators that may bolster the specialty's legislative and regulatory affairs efforts. OMS Key Contacts can play a vital role in helping to educate and activate lawmakers on legislation, regulation, or other actions on Capitol Hill that impact the specialty.

                                                                                                                          As a key contact, your involvement may include:

                                                                                                                          •  Adding a name and face to the specialty's voice on Capitol Hill by fostering an ongoing relationship with your 
                                                                                                                              federal legislator;
                                                                                                                          •  Helping to shape policy at the federal level by communicating AAOMS's advocacy priorities through direct contact   
                                                                                                                              with federal lawmakers and their staff

                                                                                                                            Allied Staff Member

                                                                                                                            Allied Staff members shall be staff of current U.S. AAOMS fellows, members and candidates. The allied staff member must complete an application for membership. Allied staff members must pay a one-time application fee, and following election, annual membership dues. Upon receipt of the completed application and fee, allied staff members will be automatically admitted to membership. Allied staff members who leave the employment of their sponsoring member must provide updated employment information to the AAOMS. Should an allied staff member drop his/her AAOMS membership, they will be required to submit an application and sponsorship information in order to reinstate their membership. Allied staff members shall not have the right to vote or hold office.

                                                                                                                            Benefits of Allied Staff membership:

                                                                                                                            • Discounted registration fees for AAOMS educational offerings, including the annual meeting, Dental Implant Conference and practice management and coding educational programs
                                                                                                                            • Participation in the AAOMS Career Line
                                                                                                                            • Access to AAOMS Today, ASI newsletters, OMS Staff Communique, and other electronic communications via e-mail
                                                                                                                            • Access to the exclusive Allied Staff Member LinkedIn Group available only to current AAOMS allied staff members

                                                                                                                            Application Fee: $40 for applications received between January 1 - September 30; Applications received October 1 - December 31 pay annual fee amount and receive benefits through the following year.

                                                                                                                            Annual Fee: $55 (initial application fee covers the calendar year following application)

                                                                                                                            Fees applicable for new applicants only; not eligible for reinstated membership. Contact AAOMS Membership Department for information on reinstatement.

                                                                                                                            Rates effective for 2015 Membership Year

                                                                                                                              Provisional Fellow Member

                                                                                                                              A provisional Fellow/Member shall fulfill all qualifications for membership except one or more of the following: 1) application/election to the component society; 2) fulfillment of the component society’s on-site office anesthesia evaluation; and 3) attendance at a component society meeting if this is a membership requirement of the component society. 

                                                                                                                              Provisional membership should only apply for a two-year period. If all membership requirements are not fulfilled within this two-year period, the provisional Fellow/Member must reapply and document acceptable reasons to continue his status as a provisional Fellow/Member.

                                                                                                                              A provisional Fellow/Member shall enjoy the same privileges as a member of this Association. Upon successfully fulfilling all membership requirements, the provisional Fellow/Member shall automatically be transferred to the proper membership classification as determined by the Committee on Membership.

                                                                                                                              Annual Fee: $1,250 (unless eligible for graduated fees or a federal service discount)
                                                                                                                              Journal of Oral and Maxillofacial Surgery (required): $118

                                                                                                                              Please note: All newly elected members and fellows are charged a building assessment fee of $50 for the first 10 years of AAOMS membership. The charge will be reflected on the annual dues statement.

                                                                                                                                Affiliate member

                                                                                                                                An individual who meets all of the following requirements:

                                                                                                                                • Resides and practices or is engaged in an administrative or research position in a country outside the United States, and, where applicable, is recognized as an Oral and Maxillofacial Surgeon by the country's appropriate agencies.
                                                                                                                                • Completed specialty training in Oral and Maxillofacial Surgery equivalent to that required of applicants for Fellowship or Membership.
                                                                                                                                • Membership in the country's national and specialty professional organizations, or other such evidence which verifies that the individual is practicing within the professional, moral and ethical framework of the specialty of Oral and Maxillofacial Surgery.

                                                                                                                                Affiliate Members pay dues and assessments and shall have the same privileges as Members except the right to vote or hold office.

                                                                                                                                Application Fee: $535

                                                                                                                                Application fees are required at time of submission and will be applied to the current calendar year if received between January 1 – June 30. If application is made between July 1 – December 31, the application fee will be applied to the following year’s membership fees. Applications received without an application fee will be held for a maximum of 30 days. If the application fee is not received within that time, reapplication will be required.

                                                                                                                                Dues: $535
                                                                                                                                Journal of Oral and Maxillofacial Surgery (required): $162, plus $8.10 JOMS Tax for Canada.

                                                                                                                                  Faculty Fellow and Member

                                                                                                                                  A Fellow or Member who serves full-time in a faculty position (defined as the primary occupation or primary salary source) at an OMS training program and who meets the eligibility requirements for a Fellow or Member, including membership in their OMS state society. Full-time faculty are eligible for discounted membership dues for the first six years of their academic position. Contact the Membership Department or call toll-free, 800/822-6637 for more information.

                                                                                                                                  1st - 3rd Year Dues: $417
                                                                                                                                  4th - 6th Year Dues: $833
                                                                                                                                  Following Years: $1,250
                                                                                                                                  Journal of Oral and Maxillofacial Surgery (required): $118

                                                                                                                                    Federal Service Fellow and Member

                                                                                                                                    A Fellow or Member who serves full-time in the federal service (Air Force, Navy, Army, Federal Public Health Service and Veterans Administration) and who meets the eligibility requirements for a Fellow or Member. Federal service Candidates must furnish an affidavit certifying the occupational specialty of Oral and Maxillofacial Surgery and limitation of practice to OMS or to administration. Full-time federal service Fellows and Members are not required to hold and maintain Membership in their OMS state society.

                                                                                                                                    Dues: Dependent on Military Rank or Grade Level; contact the Membership Department or call toll-free, 800-822-6637 for more information.
                                                                                                                                    Journal of Oral and Maxillofacial Surgery (required): $118

                                                                                                                                      Member

                                                                                                                                      An individual who meets the eligibility requirements as outlined (above) for a Fellow. Upon ABOMS certification, Members are automatically transferred to Fellow status. A Member has the same privileges as a Fellow except the right to vote or hold office.

                                                                                                                                      Dues: $1,250
                                                                                                                                      Journal of Oral and Maxillofacial Surgery (required): $118

                                                                                                                                        Fellow

                                                                                                                                        A Fellow has the right to vote and hold office. An individual shall have the following qualifications:

                                                                                                                                        • Certified as a Diplomate of the American Board of Oral and Maxillofacial Surgery.
                                                                                                                                        • Membership in the American Dental Association or other such evidence which verifies that the individual is functioning within the professional, moral and ethical framework of the specialty of Oral and Maxillofacial Surgery.
                                                                                                                                        • Completion of an advanced Oral and Maxillofacial Surgery education program accredited by the American Dental Association's Commission on Dental Accreditation.
                                                                                                                                        • Compliance with the American Association of Oral and Maxillofacial Surgeons' Code of Professional Conduct and Official Advisory Opinions.
                                                                                                                                        • Practices in the United States or its possessions.
                                                                                                                                        • Membership in his/her OMS state society in which he/she practices.
                                                                                                                                        • Submission of additional written evidence of qualifications as requested.

                                                                                                                                        Dues: $1,250
                                                                                                                                        Journal of Oral and Maxillofacial Surgery (required): $118

                                                                                                                                          Candidate Status

                                                                                                                                          An individual who has a membership application on file with Headquarters which reflects meeting the educational requirements, and whose application has been provisionally approved for Candidate status by the Committee on Membership, has satisfied all the eligibility requirements and submitted all supporting documents. Election to Fellowship or Membership occurs once annually at the Annual Meeting. Candidates do not attend the election process.

                                                                                                                                          After the election, a congratulatory letter will be sent. Candidates pay an annual fee and assessments in accordance with policy and receive the Journal of Oral and Maxillofacial Surgery at Fellow/Member subscription rate. Candidates are elected to one of the following categories of Membership: Fellow, Member, Federal Service Fellow or Member, Faculty Fellow or Member, or Affiliate Member.

                                                                                                                                          Annual Fee: $1,250 (unless eligible for graduated fees or a federal service discount)
                                                                                                                                          Journal of Oral and Maxillofacial Surgery (required): $118 (US) or $162 (non-US), plus $8.10 JOMS Tax for Canada.

                                                                                                                                            CMS develops new EHR Incentive for Health Professional Shortage Areas

                                                                                                                                            April 15th, 2011

                                                                                                                                            CMS has developed a new EHR Health Professional Shortage Area (HPSA) Modifier -AZ (Physician providing a service in a Dental health professional shortage area for the purpose of an Electronic Health Record Incentive Payment) which will allow eligible professionals (EP) to report claims rendered in a dental HPSA when the ZIP code does not fully fall within that dental HPSA.

                                                                                                                                            An EP who furnishes services predominately in a HPSA is eligible for a 10 percent increase in the maximum Electronic Health Record (EHR) incentive payment amount, regardless of the type of HPSA in which the services were rendered. This means that any EP can perform services in any type of HPSA (primary care, mental health, or dental) and receive the increase in the maximum EHR HPSA incentive payment amount, as long as 50 percent or more of his/her services are performed in a HPSA.

                                                                                                                                            In order to allow EPs to report claims rendered in a dental HPSA when the ZIP code does not fully fall within that dental HPSA, EPs must use the new EHR HPSA modifier, -AZ which is effective for dates of service on or after January 1, 2011. The new modifier will not affect the payment or calculation of the FFS geographic quarterly HPSA bonus. However, before using the modifier -AZ, be certain that your EHR meets all meaningful use criteria required for earning the EHR incentive. For more information visit the CMS website.

                                                                                                                                             

                                                                                                                                              E-Prescribing Incentive and Penalty Reminder

                                                                                                                                              June 17th, 2011

                                                                                                                                              As a reminder, oral and maxillofacial surgeons are eligible for the Medicare E-Prescribing Incentive that became effective under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). To be eligible, 10% of an OMS' Part B charges must be comprised of codes considered to be a "denominator" of performance measure G8553 (at least one e-prescription generated and transmitted electronically using a qualified e-prescribing system). Denominators include Evaluation and Management codes that are not part of a global surgical package.

                                                                                                                                              In order to successfully e-prescribe (eRX) and earn the incentive, an OMS must generate and report via a "qualified e-prescribing system" one or more e-prescriptions associated with a patient visit with a minimum of 25 unique visits per year. However, in order to avoid the 2012 eRx payment adjustment of -1%, an eligible OMS must report on a minimum of 10 unique visits via claims from January 1, 2011 through June 30, 2011. Each visit must be accompanied by the eRx G-code attesting that during the patient visit at least one prescription was electronically prescribed.

                                                                                                                                              CMS has established three hardship exemption codes for eligible providers to report in order to avoid the payment adjustment.

                                                                                                                                              G8642-practices in a rural area without sufficient high speed internet access;

                                                                                                                                              G8643-practices in an area without sufficient available pharmacies for e-prescribing;

                                                                                                                                              G8644- does not have prescribing privileges.

                                                                                                                                              CMS released a proposed rule on May 26, 2011 that may extend the reporting period to October 1, 2011 which will allow eligible OMS more time to submit the minimum of 10 visits as well as more hardship exemption options to avoid the payment penalty in 2012. Proposed exemptions include:

                                                                                                                                              • Plan to participate in the Electronic Health Records (EHR) Incentive program in 2011 but delayed buying an e-Rx system.
                                                                                                                                              • Providers cannot e-prescribe due to state or federal law restrictions.
                                                                                                                                              • An eligible professional who does not prescribe often.
                                                                                                                                              • Physicians who prescribe frequently but only for ineligible types of visits, such as surgical procedures.

                                                                                                                                              Until this proposed rule is final, eligible providers will have to submit e-RXs for a minimum of 10 patient visits by June 30th in order to avoid the payment penalty. You may visit the AAOMS website for additional information on the E-Prescribing Incentive Program or the CMS website for complete details on the incentive program including a list of reportable denominators.

                                                                                                                                                EHR Penalties Set to Take Effect in 2015

                                                                                                                                                June 14th, 2013

                                                                                                                                                Beginning January 1, 2015, eligible providers (EPs), including OMSs who are Medicare providers, who do not demonstrate meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program may be subject to payment adjustments. These adjustments will be applied to the Medicare physician fee schedule amount for covered professional services furnished in 2015. Because the adjustments will begin on the first day of the 2015 calendar year, CMS will determine their amount based on meaningful use data submitted prior to the 2015 calendar year. Please note, these adjustments apply only to Medicare providers.

                                                                                                                                                EPs may avoid the payment adjustment as follows

                                                                                                                                                • If you began participating in the incentive program in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid payment adjustments in 2015;
                                                                                                                                                • If you began participating in the incentive program in 2013, you must demonstrate meaningful use for a 90-day reporting period in 2013 to avoid payment adjustments in 2015; or
                                                                                                                                                • If you begin participating in 2014, you must demonstrate meaningful use for a 90-day reporting period to avoid payment adjustments in 2015. This reporting period must occur in the first nine months of calendar year 2014, and you must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustments.

                                                                                                                                                EPs must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

                                                                                                                                                For more information on payment adjustments, view the Payment Adjustments and Hardship Exceptions Tipsheet for EPs and the How Payment Adjustments Affect Providers Tipsheet. Want more information about the EHR Incentive Programs? Visit the EHR Incentive Programs Web site for the latest news and updates.

                                                                                                                                                  Hospital Credentialing Guidelines

                                                                                                                                                  OBJECTIVE

                                                                                                                                                  Develop a strategy to aid practicing oral and maxillofacial surgeons (OMS) in successful application for hospital surgical privileges.

                                                                                                                                                  PREAMBLE

                                                                                                                                                  Fundamental understanding of the processes involved in gaining hospital surgical privileges for the practicing OMS should follow a specific outline which ensures adequate preparation prior to the actual application processes. These are reflected in various levels in the Addendum attached to this document, and can be highlighted as:

                                                                                                                                                  1. Documentation of literature review, videotape, and observational experiences (preferably within accredited or recognized programs with certificates);
                                                                                                                                                  2. Documentation of accredited CME and recognized didactic and didactic-dissection coursework (preferably dedicated to privileges being sought) ;
                                                                                                                                                  3. Participation in recognized observation training programs in facilities that have recognized residency or fellowship programs that offer certificates or a letter of confirmation from program director;
                                                                                                                                                  4. Documentation of oral and maxillofacial surgeons serving as first assistant or cosurgeon on multiple cases with a surgeon who currently has credentials to perform such procedures within the hospital setting;
                                                                                                                                                  5. Documentation of oral and maxillofacial surgeons serving as primary surgeon on multiple cases, under the supervision of a surgeon who currently has credentials to perform such procedures within the hospital setting . It is recommended that a proctoring form or confirmation letter be obtained from the supervising surgeon, confirming the experience and quality of performance.

                                                                                                                                                  (NOTE: Documentation should include surgical log, operative dictation, and standardized photographic documentation of pre- and post-operative cases incorporated into a 3-ring binder and/or in electronic format.)

                                                                                                                                                  SEQUENTIAL STRATEGY

                                                                                                                                                  1. Preliminary Considerations
                                                                                                                                                  2. Preparation of Presentation Portfolio
                                                                                                                                                  3. Local Hospital Rules, Regulations, and Bylaws including Due Process
                                                                                                                                                  4. Documentation of Educational and Clinical Experience
                                                                                                                                                  5. Appeals Process and Legal Considerations
                                                                                                                                                  1. PRELIMINARY CONSIDERATIONS
                                                                                                                                                    1. Review states Dental Practice Act and pertinent laws/regulations to ascertain compliance with existing state statutes pertaining to the specific surgical privileges desired.
                                                                                                                                                    2. Usually prudent to initiate discussion with your State Dental Association, State Board of Dentistry, OMS State organization, and local OMS practitioners regarding your intentions. This will preclude many potential misunderstandings that may arise during the application process, and may be pertinent when some of these agencies may be contacted by your hospital or other individuals concerning your efforts or application.
                                                                                                                                                    3. Carefully evaluate your area hospital relative to the most favorable situation and medical staff relationships prior to any application or contacts. It is recommended to approach only one hospital unless economic or logistic circumstances dictate otherwise.
                                                                                                                                                    4. Be certain that the current definition and scope statement of OMS is addressed in the Dental/OMS Department/Committee, and written acceptance placed in the minutes.
                                                                                                                                                  2. PREPARATION OF PRESENTATION PORTFOLIO

                                                                                                                                                    Provide a portfolio to include: comprehensive surgical log (patient identifier in compliance with HIPAA, date, surgeon or assistant, location, list of specific diagnosis, list of specific procedures performed); current CME within curriculum vitae and copies of certificates or agenda of subjects/experiences; standardized photographs pre- and postsurgery of, at least, all cases as primary surgeon; copies of proctor evaluations and/or certification letters provided by credentialed surgeon(s) involved in your clinical experiences.

                                                                                                                                                  3. LOCAL HOSPITAL RULES, REGULATIONS, BYLAWS
                                                                                                                                                    1. Review and become thoroughly knowledgeable about the hospital’s Medical/Dental Staff structure, rules, regulations, and bylaws, particularly regarding items of credentialing, denial of privileges, the appeal process, and expectations of membership.
                                                                                                                                                    2. Become familiar with medical staff standards of the hospital’s accrediting organization. (The Joint Commission, the Health Facilities Accreditation Program, and DNV Healthcare are currently recognized as national accreditation programs that meet the Medicare Conditions of Participation for Hospitals.)
                                                                                                                                                    3. Become knowledgeable about specific regulations or rules relative to extension of additional privileges and by which committee and process your application will be reviewed. Some hospitals have no such protocol or precedents, but are managed on case-by-case basis.
                                                                                                                                                    4. Become familiar with the staff political structure and activity level of pertinent staff members.
                                                                                                                                                    5. Develop a working relationship with the Chief of the OMS Dental Department, or equivalent, before beginning the application process. Dialog at this level may be essential to your ultimate success.
                                                                                                                                                    6. Know the exact make-up of the pertinent committees such as Surgery, Credentials, Medical Executive, Board of Directors, and the Hospital Administration. You should try to determine as much as possible the names, specialty, and training.
                                                                                                                                                    7. Make an effort to establish relationships with as many of the individuals mentioned above as is practical, including conversations relative to how staff members go about obtaining additional privileges with continuing education (e.g., liposuction, laser treatment, etc.)
                                                                                                                                                    8. Determine the annual financial contributions of in-hospital surgery performed by you and/or your associates. This is a potentially important issue relative to the Administration’s support and willingness to help facilitate the application process. i. Perform procedures in the hospital(s) to ensure there are performance data for the reprivileging process.
                                                                                                                                                  4. DOCUMENTATION OF EDUCATIONAL AND CLINICAL EXPERIENCE FOR NON-CORE PRIVILEGES
                                                                                                                                                    1. Maintain concise and complete documentation of any and all pertinent education, dissection experience, and clinical activities to justify request.
                                                                                                                                                    2. Determine current recommendations by equipment vendors if applicable.
                                                                                                                                                    3. Determine any current recommendations by the American College of Surgeons or other appropriate bodies.
                                                                                                                                                    4. Determine if the privilege is offered at other nearby hospitals and what their criteria is if any
                                                                                                                                                    5. Determine specific numerical or other criteria, which would be desired by the committee(s) concerned with privileging in OMS or any other surgical specialties requesting addition of specific procedure privileges that cross specialty lines. If no guidelines exist, it is important to see that the same criteria that will apply to your application be applied uniformly for future requests for privileges by staff members of any specialty.
                                                                                                                                                    6. When the application process begins, consider requesting attendance at the Credentials, Medical Executive , or other committee(s) meeting(s) where your request for additional privileges is presented. A slide presentation and personal answers to any questions may be advisable.
                                                                                                                                                  5. APPEALS PROCESS AND LEGAL CONSIDERATIONS WITH PARTICULAR ATTENTION TO DENIAL OF NON-CORE (ADDTIONAL) PRIVILEGES
                                                                                                                                                    1. It may be advantageous to seek legal advice with experienced counsel (specific expertise in hospital and privileging matters) from the beginning of your application process for additional privileges. This advice may provide you with specific items to be considered, statutes which affect your application rights, and the components and format of ideal documentation methods which may vary by state.
                                                                                                                                                    2. If the original request for additional privileges is denied, you should request, in writing, the specific reasons for their denial and the type of denial (i.e. administrative, etc.) Transmit all communications to your hospital in a timely fashion by registered or certified mail.
                                                                                                                                                    3. All communications (phone, verbal, or otherwise) should be carefully documented soon after their occurrence. It is advised you maintain a very detailed, written diary, which identifies the parties, date, time, and details.
                                                                                                                                                    4. All conversations should be followed by a written reiteration of the content to the appropriate source so that any objections to your interpretation will be identified.
                                                                                                                                                    5. Review the Medical Staff Bylaws for appeals process regarding denial or limitation of privileges, and the National Practitioner Data Bank (NPDB) reporting requirements as they apply.
                                                                                                                                                    6. Initiate your appeal, in accordance with your hospital’s bylaws, in a timely manner in consultation with your legal counsel.
                                                                                                                                                    7. The ADA Council on Access, Prevention and Interprofessional Relations (CAPIR) has been informed by the AMA that administrative denials of privileges are not reportable. A letter from HCFA and NPDB criteria explain and support this position.
                                                                                                                                                    8. If there is to be an administrative appeal, your legal counsel is essential to ensure your rights. This appeal pathway mechanism is mandatory before any actual filing of legal action is appropriate.
                                                                                                                                                    9. AAOMS should be kept informed of your circumstances and be provided copies of all materials pertaining to your experiences. This will facilitate assistance from AAOMS to you and your legal counsel in your efforts to obtain additional privileges.
                                                                                                                                                    10. In any appeals process, it is strongly recommended that you request to record or otherwise transcribe the events associated with the process, and to bring legal counsel with you to any meetings.
                                                                                                                                                    11. Consider legal intervention on the basis of restraint of trade issues, and discriminatory credentialing in a non-uniform manner without due process.
                                                                                                                                                  CREDENTIALING IN MAXILLOFACIAL COSMETIC SURGERY
                                                                                                                                                  Example

                                                                                                                                                  In recent years the specialty of OMS has evolved into multiple areas of surgical interest and expertise in response to the needs and requirements of the patients served. Esthetic and cosmetic surgical procedures have been performed by oral and maxillofacial surgeons as a primary procedure for over two decades. These procedures include, but are not limited to, forehead/browlifting, blepharoplasty, facelifting, rhinoplasty, skeletal alloplastic augmentation, otoplasty, scalp reduction and hair transplants, scar and skin flap procedures. In addition, other adjunctive procedures such as liposculpture, mechanical and chemical abrasion, collagen injections, etc., are recognized procedures by OMS.


                                                                                                                                                  If a practicing OMS elects to obtain additional education and clinical experience in the area of esthetic (purely cosmetic) surgery, it is suggested that the review of the AAOMS recommendations for hospital credentialing be followed. The process should include appropriate documentation of experience and may, at the minimum, include the following:

                                                                                                                                                  1. Proof of education and training in each of the specific procedures requested. This can either be in a letter from the OMS Residency or Fellowship Director, or from appropriate documented experiences with qualified surgeons. It is recommended that such documents contain language relative to the fact that the OMS has completed certain guidelines suitable to allow the director or faculty to use the terms “experienced in the following” or, preferably, to state “in his/her experience, that said OMS is currently TRAINED TO COMPETENCE in specific procedures.”
                                                                                                                                                  2. Documentation and certificates from all CME, Observational Teaching Programs, etc., should be meticulously maintained. It is suggested that a minimum of 50 hours of CME be documented in the form of didactic-dissection courses dedicated to the subject of esthetic surgery.
                                                                                                                                                  3. A detailed surgical log of all experiences should be maintained for any and all cases having esthetic components.
                                                                                                                                                  4. It has been suggested that OMS should accumulate a minimum of five (5) experiences as primary surgeon, assisted or supervised by a credentialed surgeon as first assistant for each procedure in which the OMS is requesting privileges. The credentialed first assistant or supervisory surgeon should be expected to provide written confirmation of this fact, and a proctoring-type review of performance in each instance to cover diagnosis, treatment planning, surgical management, and clinical outcome.

                                                                                                                                                   

                                                                                                                                                  ADDENDUM

                                                                                                                                                  LEVEL ONE: Documentation of literature review, videotape review, and appropriate textbook acquisition.

                                                                                                                                                  LEVEL TWO: Documentation of completion of CME credits in accredited didactic coursework, to include pure “dedicated” (i.e. subject specific) courses offered within and out of specialty.

                                                                                                                                                  LEVEL THREE: Documentation of completion of accredited didactic-dissection (e.g. surgical skills workshop with hands-on experiences) courses, provided by clinicians who are appropriately credentialed (i.e. hospital privileges for all procedures presented and in a Q/A-PRO setting) and recognized experts in the particular areas of clinical interest.

                                                                                                                                                  LEVEL FOUR: Documentation of completion of observational training programs which are formally recognized (by AACS, AAFRS, AAOMS, or ASPRS) or their equivalent, and provided by clinicians who are appropriately credentialed (as above) and recognized experts in the particular areas of clinical interest.

                                                                                                                                                  LEVEL FIVE: Documentation of completion of actual surgical experiences on patients, acting in the capacity of assistant surgeon (first assist) or co-surgeon, where the primary surgeon is appropriately credentialed (as above) and preferably in a Q/A-PRO setting.

                                                                                                                                                  LEVEL SIX: Documentation of multiple surgical experiences as the primary surgeon, actually first assisted or closely supervised by a surgeon who is appropriately credentialed (as above) and who is recognized to be surgically competent in that area of clinical interest. The “consultant” surgeon(s) would be expected to provide written substantiation of such experiences within levels five and six. It is recommended that procedure specific accreditation be provided such that the “consultant” will verify that the surgeon-in-training has substantial experience, or, preferably that, in the opinion of the consultant, the surgeon has been “trained to competence” in particular area(s).

                                                                                                                                                  LEVEL SEVEN: Documentation of actual surgical experience as primary surgeon in an outpatient setting (i.e. surgicenters, clincial surgical suites, or ambulatory “day” surgery facility). It is at this point that the surgical experience and training becomes commensurate with submission of application for hospital privileges.

                                                                                                                                                  LEVEL EIGHT: The surgeon has hospital privileges to perform such surgery within a hospital which is accredited by a CMS-approved accrediting organization, and thereby operating in a documented Q/A-PRO setting.

                                                                                                                                                  Guidelines (levels seven and eight) exclude residents completing oral and maxillofacial surgery training who can fulfill only levels 1-6 of the guidelines as they cannot legally function as a primary surgeon during residency.

                                                                                                                                                    Resident Member

                                                                                                                                                    Individuals in training in an American Dental Association (ADA) Commission on Dental Accreditation (CODA) accredited training program in oral and maxillofacial surgery in the United States or Canada shall automatically become Resident Members after completion of a Resident Member Application Form. Resident Members have until July 1 of the year in which they complete training to apply for AAOMS membership so that they may have their names published as Candidates for AAOMS Membership.

                                                                                                                                                     

                                                                                                                                                    Resident Member Benefits:
                                                                                                                                                    • May attend the AAOMS annual meeting with waiver of the general registration fee.
                                                                                                                                                    • May attend clinics free of charge on a space available basis.
                                                                                                                                                    • Receive all the benefits as offered by the Resident Organization, AAOMS (ROAAOMS).
                                                                                                                                                    • Receive a complimentary subscription to the Journal of Oral and Maxillofacial Surgery.
                                                                                                                                                    • Are not required to pay the Membership application fee.

                                                                                                                                                     

                                                                                                                                                    Dues:

                                                                                                                                                    None.
                                                                                                                                                    Journal of Oral and Maxillofacial Surgery: Free while attending OMS training program

                                                                                                                                                     

                                                                                                                                                    Graduated Fees & Assessments For Senior Residents*

                                                                                                                                                    Available to Residents who apply for Candidate membership prior to completion of their training.

                                                                                                                                                    1st Year Dues: Waived
                                                                                                                                                    2nd Year Dues: One-third (1/3) of the full dues level established for AAOMS Fellows/Members.
                                                                                                                                                    3rd Year Dues: Two-thirds (2/3) of the full dues level.
                                                                                                                                                    Following Years: Full amount of Fellow/Member dues and fees.

                                                                                                                                                    (Currently, Fellow/Member dues are $1,250 annually.)

                                                                                                                                                    * An Oral and Maxillofacial Surgeon who applies for Membership after completion of his/her training is not eligible for the graduated fee and assessments. His/her fee as a Candidate will be equal to the full amount of dues, fees and assessments for a Fellow or Member.

                                                                                                                                                      FDA Updates Safety Alert for Steris Processor

                                                                                                                                                      FEBRUARY 4TH, 2010

                                                                                                                                                      The U.S. Food and Drug Administration (FDA) previously issued a safety alert in December for users of the Steris System 1 (SS1), which is a system for disinfecting and sterilizing instruments in healthcare facilities. The SS1 system is commonly used for surgical and endoscopy device disinfection and sterilization. After further consideration, the Food and Drug Administration (FDA) has extended the deadline from a three-six month transition period to 18 months for healthcare facilities to transition away from using the Steris System 1 (SS1) processor. The "FDA now understands that a three-to-six-month transition period may present significant difficulties for some healthcare facilities, which could, in turn, adversely affect patient care," the agency said. Using the FDA's original December 2009 announcement of the six-month period, this week's extension would bring the deadline to August 2011. Steris has been critical of the FDA's stance, saying there has been no documented case of infection caused by the SS1 when the equipment is used properly. For additional information, including information on FDA cleared or approved medical devices, see the "Questions and Answers" document and list of FDA-cleared alternatives to the STERIS System 1 (SS1) device processing system on the FDA Web site.

                                                                                                                                                        OSHA and CDC Posters

                                                                                                                                                        JULY 17TH, 2007

                                                                                                                                                        Advertisements suggesting that workplace posters must be purchased from private companies continue to mislead offices. OSHA reminds places of employment that official OSHA posters are available free on their publications page. The CDC reports that healthcare facilities are receiving notices regarding hand hygiene requirements from private companies. Guidelines for Hand Hygiene in Healthcare Settings and accompanying educational posters may be downloaded, copied (without alteration) and distributed free of charge from the CDC's hand hygiene Web page. CDC encourages healthcare facilities who have additional questions about these advertisements to contact their state or local health department.

                                                                                                                                                          CDC Released New Guidelines for Disinfection and Sterilization

                                                                                                                                                          MARCH 9TH, 2009

                                                                                                                                                          The U.S. Centers for Disease Control and Prevention (CDC) recently released its "Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2008." The guidelines present evidence-based recommendations on the preferred methods for cleaning, disinfection and sterilization of patient-care medical devices and for cleaning and disinfecting the healthcare environment. The brand-new 2008 guidelines do have a section on Dental Instruments. New subjects in the guidelines include inactivation of emerging pathogens; bioterrorist agents and bloodborne pathogens; toxicologic, environmental and occupational concerns associated with disinfection and sterilization practices; disinfection of patient-care equipment used in ambulatory and home care; inactivation of antibiotic-resistant bacteria, and new sterilization processes. More information about the guidelines can be found on www.cdc.gov and www.osap.org .

                                                                                                                                                            CDC Updates H1N1 Guidance

                                                                                                                                                            DECEMBER 2ND, 2009

                                                                                                                                                            CDC has updated its guidance on preventing transmission of 2009 H1N1 influenza in dental health care settings. Specific recommendations include encouraging all personnel to receive the seasonal and H1N1 influenza vaccines, screening patients through reminder calls and at check-in for possible flu-like symptoms in order to reschedule non-urgent care for patients with influenza-like illness, and using an airborne infection isolation room, N95 respirators, and infection control measures for personnel or urgent care patients with influenza-like illness.

                                                                                                                                                              CDC Guidelines for Infection Control in Dental Health Care Settings

                                                                                                                                                              Infection Control in Dental Settings

                                                                                                                                                              Although the principles of infection control remain unchanged, new technologies, materials, equipment, and data require continuous evaluation of current infection control practices. The unique nature of many dental procedures, instruments, and patient care settings also may require specific strategies directed to preventing pathogen transmission among dental health care personnel and their patients.

                                                                                                                                                              CDC published the Guidelines for Infection Control in Dental Health-Care Settings — 2003 for dental health care personnel. CDC's evidence-based recommendations guide infection control practices in dental offices nationally and globally; provide direction for the public, dental health care personnel and policymakers; and affect technology development in the dental industry.

                                                                                                                                                              Recommended infection control practices are applicable to all settings in which dental treatment is provided.

                                                                                                                                                              Spotlight

                                                                                                                                                              A recent report describes a cluster of acute hepatitis B virus (HBV) infections among attendees of a 2-day portable dental clinic held in West Virginiain 2009.

                                                                                                                                                              Hepatitis B Frequently Asked Questions
                                                                                                                                                              These FAQs cover hepatitis B infections, vaccinations, chronic hepatitis B, serology, traveler’s health, and more.

                                                                                                                                                              Other Recommendations

                                                                                                                                                              Tuberculosis Infection Control Recommendations
                                                                                                                                                              The changing epidemiology of tuberculosis (TB) and discovery of new diagnostic methods prompted a revision of CDC's guidelines to prevent TB transmission in healthcare settings. View CDC's TB infection control recommendations for dental settings and learn how they should be incorporated into an infection control program.

                                                                                                                                                              Additional Resources

                                                                                                                                                              Prevention of Methicillin-Resistant Staphylococcus Aureus (MRSA) Transmission in Dental Health Care Settings
                                                                                                                                                              In health care settings, MRSA most often is spread indirectly from patient to patient on the transiently contaminated hands of health care professionals. Standard Precautions has been shown to be an effective strategy in preventing transmission. Learn more at CDC’s About MRSA Skin Infections.
                                                                                                                                                               

                                                                                                                                                              If Saliva Were Red: A Visual Lesson on Infection Control
                                                                                                                                                              The video training system, If Saliva Were Red, features an 8-minute video (VHS, CD-ROM) that uses dental professionals to highlight common infection control and safety flaws; the cross contamination dental personnel would see if saliva were red; and how controlling contamination by using personal barrier protection, safe work practices, and effective infection control products reduces the risk of exposure. Produced by the Organization for Safety, Asepsis and Prevention (see link below).

                                                                                                                                                              Related Links

                                                                                                                                                              American Dental Association Infection Control Resources

                                                                                                                                                              National Institute for Occupational Safety and Health

                                                                                                                                                              Organization for Safety, Asepsis and Prevention

                                                                                                                                                              Safety and Health Topics for Dentistry from the Occupational Safety and Health Administration (OSHA)

                                                                                                                                                              USAF Dental Evaluation and Consultation Service

                                                                                                                                                                Blunt-Tip Needs

                                                                                                                                                                JULY 17TH, 2007

                                                                                                                                                                National Institute of Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) have jointly published a Safety and Health Information Bulletin (SHIB) designed to help protect surgical personnel from needle stick injuries while using suture needles. For more information, please visit the NIOSH Web site.

                                                                                                                                                                  Member Alert: I-Flow ON-Q Pump with ONDEMAND Bolus Button: Class I Recall - Risk of Continuous Infus

                                                                                                                                                                  September 5th, 2012

                                                                                                                                                                  The FDA has notified healthcare professionals that the I-Flow ON-Q Pump with ONDEMAND Bolus Button may not lock in the down position when depressed and/or the orange bolus refill indicator may stay in the lowest most position. When this occurs, the patient may receive continuous infusion at a rate greater than expected. As a result, this product may cause serious adverse health consequences, including death. See the Recall Notice for a listing of affected product numbers.

                                                                                                                                                                  BACKGROUND: The On-Q pump with ONDEMAND bolus button is used for continuous and intermittent delivery of medicines (such as local anesthetics or narcotics) to or around surgical wound sites and/or to nearby nerves for pre-operative, during the procedure/surgery (perioperative), and for post-operative regional anesthetic and pain management.

                                                                                                                                                                  RECOMMENDATION: On May 8, 2012, the firm sent an IMPORTANT VOLUNTARY RECALL NOTICE to its customers who purchased the ON-Q pump with ONDEMAND bolus button. Customers should identify all affected products within your inventory and Quarantine the affected products.

                                                                                                                                                                  Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

                                                                                                                                                                  • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
                                                                                                                                                                  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

                                                                                                                                                                  [Recall Notice - FDA]

                                                                                                                                                                    Member Alert: Pallimed Solutions, Inc. Sterile Compound Products: Recall - Visible Particulates Obse

                                                                                                                                                                    April 1st, 2013

                                                                                                                                                                    Pallimed Solutions, Inc. of Woburn, MA, doing business as Pallimed Pharmacy, is voluntarily recalling all sterile compound products dispensed since January 1, 2013, to the user level, including all strengths, all dose forms, and all products within expiry date. Recent inspections conducted by the FDA and the Massachusetts Board of Registration in Pharmacy found visible particulates (filaments) observed in vials of several different sterile compounded products.

                                                                                                                                                                    The recall applies to the following sterile compound products dispensed since January 1, 2013, including all strengths, all dose forms, and all products within expiry date:


                                                                                                                                                                    Acetylcysteine Ophthalmic Solution Methylcobalamin - PF
                                                                                                                                                                    Alprostadil in Ns Injection Mic with B6 & B12 Nandrolone Decanoate Injectible
                                                                                                                                                                    Atropine Injection Quadmix Injection
                                                                                                                                                                    Bacteriostatic Water for Injection Bimix Injection Tacrolimus Ophthalmic
                                                                                                                                                                    Buprenorphine Hcl, Veterinary Injection Testosterone Cypionate/Testosterone Enanthate Injection
                                                                                                                                                                    Cidofovir Oph Solution Testosterone Cypionate Injection
                                                                                                                                                                    Diazepam Injectible Trimix Injection
                                                                                                                                                                    Dmso Aqueous Irrigation 50% Vancomycin Opthalmic PF
                                                                                                                                                                    Gentamicin Sulfate Irrigation Verapamil Injection
                                                                                                                                                                    Hcg Chorionic Gonadotropin Hydroxyprogesterone Capr. (GS)

                                                                                                                                                                    The potential public health risks are unknown as the particulate matter has not yet been identified. However, particulate matter has the potential to damage or obstruct blood vessels, which could induce emboli, cause systemic allergic reaction, or cause tissue responses to the foreign material.

                                                                                                                                                                    BACKGROUND: The products are used for a wide range of therapeutic uses, including for treatment of erectile dysfunction, testosterone replacement therapy, vitamin injections and ophthalmic preparations. All products are packaged in glass vials. All products were distributed to patients and/or physicians' offices through Friday, March 22, 2013.

                                                                                                                                                                    Products were distributed directly to patients and/or physicians' offices located in some or all of the following states: California, Connecticut, Florida, Georgia, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, and Wisconsin.

                                                                                                                                                                    RECOMMENDATION: Users or recipients should discontinue use and return the recalled products to Pallimed. All users who received any of the recalled products have been or will be notified by telephone, fax, electronic mail and/or regular mail of the recall. To return product, request assistance, or report complaints related to this recall, users should contact Pallimed at www.pallimed.com and by telephone at (781) 937-3344, Monday through Friday, between 10:00 a.m. and 5:00 pm.

                                                                                                                                                                    Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

                                                                                                                                                                    • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
                                                                                                                                                                    • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

                                                                                                                                                                    Pallimed Solutions, Inc Press Release

                                                                                                                                                                     

                                                                                                                                                                      Member Alert: FDA reports safety risk from tissue recovered at the Pacific Coast Tissue Bank of Los

                                                                                                                                                                      November 16th, 2012

                                                                                                                                                                      An FDA inspection conducted between April 24 and June 19, 2012, of Pacific Coast Tissue Bank in Los Angeles, California, a registered establishment that manufactures and distributes human cells, tissues and cellular and tissue-based products (HCT/Ps), uncovered significant violations of 21 CFR 1271. The FDA has determined that the establishment does not provide adequate protections against the risks of communicable disease transmission due to these significant violations and that there are reasonable grounds to believe that the HCT/Ps pose a danger to health. As a result, on November 5, 2012, FDA issued an Order to Cease Manufacturing, Recall and Destroy of HCT/Ps to Pacific Coast Tissue Bank and its Medical Director, Eli Gendler, MD, PhD. The Order requires:

                                                                                                                                                                      1. the immediate cessation of all manufacturing until compliance with the regulations in 21 CFR 1271 has been achieved and FDA provides written authorization to resume such operations;
                                                                                                                                                                      2. the destruction of all HCT/Ps that are in the establishment's possession; and
                                                                                                                                                                      3. within five working days from the date of receipt of the Order, the recall and destruction of all HCT/Ps distributed since March 19, 2009, the date the establishment began manufacturing HCT/Ps.

                                                                                                                                                                      Specifically, FDA's inspection and record review noted significant noncompliance with the relevant federal regulations pertaining to HCT/Ps including, but not limited to, the following:

                                                                                                                                                                      • Failure to evaluate each incoming HCT/P for the presence and significance of microorganisms.
                                                                                                                                                                      • Failure to validate and approve manufacturing processes according to established procedures.
                                                                                                                                                                      • Failure to process each HCT/P in a way that does not cause contamination or cross-contamination during processing, and that prevents the introduction, transmission, or spread of communicable disease through the use of the HCT/P.
                                                                                                                                                                      • Failure to adequately control and monitor environmental conditions and provide proper conditions for operations, where environmental conditions could reasonably be expected to cause contamination or cross-contamination of HCT/Ps or equipment.
                                                                                                                                                                      • Failure to clean, sanitize and maintain equipment according to established schedules.
                                                                                                                                                                      • Failure to maintain the processing facility in a good state of repair, adequate to prevent contamination of HCT/Ps.

                                                                                                                                                                      Based on the inspection findings, FDA believes the establishment has not taken adequate steps to provide protection against the risks of communicable disease transmission due to these serious violations.

                                                                                                                                                                      Recommendations for Tissue Recipients

                                                                                                                                                                      FDA recommends that recipients of tissues manufactured at this establishment discuss with their primary care provider any illnesses or adverse reactions experienced after receiving the tissue.

                                                                                                                                                                      Recommendations for Health Professionals

                                                                                                                                                                      • Review the Order to Cease Manufacturing, Recall and Destroy issued to the Pacific Coast Tissue Bank and its Medical Director, Dr. Eli Gendler, for information on the nature of the establishment's violations.
                                                                                                                                                                      • Promptly comply with the recall notification from Pacific Coast Tissue Bank.
                                                                                                                                                                      • Be alert for any adverse reactions occurring in tissue recipients.

                                                                                                                                                                      Related Information

                                                                                                                                                                      Contact FDA at (800) 835-4709 or (301) 827-1800; ocod@fda.hhs.gov

                                                                                                                                                                        Member Alert: FDA Recalls Accutron, Inc. Ultra PC% Cabinet Mount Flowmeters for Nitrous Oxide-Oxygen

                                                                                                                                                                        October 25th, 2012

                                                                                                                                                                        Model Numbers: Affected Model and Serial numbers are available on the FDA's website

                                                                                                                                                                        Manufacturing and Distribution Dates: The affected product was manufactured from November 2009 to April 2009 and distributed from November 26, 2008, to June 9, 2011.

                                                                                                                                                                        Intended Use: The Ultra PC% flowmeter is used to control the flow of gases used in nitrous oxide-oxygen sedation systems. Nitrous oxide-oxygen sedation systems are used to sedate patients during certain dental procedures.

                                                                                                                                                                        Recalling Firm:
                                                                                                                                                                        Accutron, Inc.
                                                                                                                                                                        1733 West Parkside Lane
                                                                                                                                                                        Phoenix, Arizona 85027-1382

                                                                                                                                                                        Reason for Recall: The flowmeter may continue to release nitrous oxide gas when the oxygen is turned off. When not mixed with oxygen, inhaling nitrous oxide can lead to temporary and permanent brain damage and death.

                                                                                                                                                                        FDA Comments:
                                                                                                                                                                        Consumers with the affected flowmeters should stop using them and return the flowmeters to Accutron for a free replacement. The company notified distributors and customers of this recall by mail and is arranging for return and replacement of all recalled products.

                                                                                                                                                                        Accutron voluntarily recalled the products after learning through two customer complaints that the flowmeter was flowing nitrous oxide gas without any oxygen gas flow. The company has reported that two complaints have been received for this flowmeter defect. No injuries have been reported to date.

                                                                                                                                                                        This is a Class I recall. Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death.

                                                                                                                                                                        Health care professionals and consumers may report adverse reactions or quality problems they experienced using these products at http://www.fda.gov/Safety/MedWatch/ HowToReport/default.htm, by regular mail, by telephone, or by FAX.

                                                                                                                                                                        Additional Information:
                                                                                                                                                                        Company Press Release

                                                                                                                                                                          Member Alert: FDA to submit formal recommendation to reclassify hydrocodone combination products int

                                                                                                                                                                          October 25th, 2013

                                                                                                                                                                          Janet Woodcock, MD, Director, FDA Center for Drug Evaluation and Research, has released a statement that, “by early December, FDA plans to submit our formal recommendation package to HHS to reclassify hydrocodone combination products [including Vicodin] into Schedule II.  We anticipate that the National Institute on Drug Abuse (NIDA) will concur with our recommendation. This will begin a process that will lead to a final decision by the DEA on the appropriate scheduling of these products.”

                                                                                                                                                                          Director Woodcock’s statement further notes that “the FDA has become increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States. While the value of and access to these drugs has been a consistent source of public debate, the FDA has been challenged with determining how to balance the need to ensure continued access to those patients who rely on continuous pain relief while addressing the ongoing concerns about abuse and misuse.”

                                                                                                                                                                          The FDA’s decision comes in response to a 2009 request from the Drug Enforcement Administration to reschedule hydrocodone from Schedule III to Schedule II. As of today, there is no opportunity for AAOMS to provide official comment; however, we have commented on this specific issue several times in the past and will continue to seek opportunities to comment on this latest action.

                                                                                                                                                                          The AAOMS has worked closely with the ADA and others to alert the agencies about the benefits of hydrocodone for oral and maxillofacial surgery patients and the difficulties involved in making legitimate pain prescriptions available for these individuals should hydrocodone combination products be rescheduled. On October 16, 2012 the AAOMS and the ADA provided joint comments to the FDA and in January of 2013, the FDA accepted our joint testimony during a hearing on this important matter. 

                                                                                                                                                                          We recognize that the FDA’s announcement will create a potential burden to the practicing oral and maxillofacial surgeon. AAOMS will continue to monitor the situation closely and advocate for the specialty. 

                                                                                                                                                                            Member Alert: FDA issues safety communication on HeartStart automated external defibrillators from P

                                                                                                                                                                            December 11th, 2013

                                                                                                                                                                            Certain HeartStart automated external defibrillator (AED) devices made by Philips Medical Systems, a division of Philips Healthcare, may be unable to deliver needed defibrillator shock in a cardiac emergency situation, according to a new safety communication issued by the U.S. Food and Drug Administration to users of these previously recalled devices.

                                                                                                                                                                            These devices were manufactured and distributed between 2005 and 2012 under the names HeartStart FRx, HeartStart HS1 Home, and HeartStart HS1 OnSite. Users, who may include consumers and first responders, should contact Philips Healthcare immediately for a replacement AED unit.

                                                                                                                                                                            The safety communication includes recommendations to better inspect and monitor the readiness of these devices, as well as steps to follow if someone must use a recalled device in an emergency situation.

                                                                                                                                                                            "The FDA advises keeping all recalled HeartStart AEDs in service until you obtain a replacement from Philips Healthcare or another AED manufacturer, even if the device indicates it has detected an error during a self-test," said Steve Silverman, director of the Office of Compliance in the FDA's Center for Devices and Radiological Health. "Despite current manufacturing and performance problems, the FDA considers the benefits of attempting to use an AED in a cardiac arrest emergency greater than the risk of not attempting to use the defibrillator."

                                                                                                                                                                            In September 2012, Philips Healthcare initiated the recall of HeartStart FRx, HeartStart HS1 Home, and HeartStart HS1 OnSite AEDs due to the failure of an internal electrical component. The recall affected approximately 700,000 devices. In a Medical Device Safety Notice dated November 19, 2013, Philips provided consumers with updated information about the failure of an internal electrical component that could cause the AEDs to fail to deliver a shock. The notification also directed users to a Maintenance Advisory.

                                                                                                                                                                            In March 2013, the FDA issued a proposed order that if finalized would require manufacturers of AEDs and accessories to submit premarket approval applications that focus specifically on the critical requirements necessary to assure AEDs are safe and effective. The main objective of this proposed regulatory approach is to improve the reliability of AEDs so that they can continue to save lives.

                                                                                                                                                                            The FDA will continue to closely monitor all AED manufacturers' quality system practices and manufacturing changes that have persistently contributed to recall and adverse events associated with AEDs.

                                                                                                                                                                            For more information:

                                                                                                                                                                              Member Alert: Acetaminophen Prescription Combination Drug Products with more than 325 mg: FDA Statem

                                                                                                                                                                              January 15th, 2014

                                                                                                                                                                              FDA is recommending health care professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325mg of acetaminophen per tablet, capsule or other dosage unit. There are no available data to show that taking more than 325 mg of acetaminophen per dosage unit provides additional benefit that outweighs the added risks for liver injury. Further, limiting the amount of acetaminophen per dosage unit will reduce the risk of severe liver injury from inadvertent acetaminophen overdose, which can lead to liver failure, liver transplant and death.

                                                                                                                                                                              Cases of severe liver injury with acetaminophen have occurred in patients who:

                                                                                                                                                                              • took more than the prescribed dose of an acetaminophen-containing product in a 24-hour period;
                                                                                                                                                                              • took more than one acetaminophen-containing product at the same time; or
                                                                                                                                                                              • drank alcohol while taking acetaminophen products.

                                                                                                                                                                              When making individual dosing determinations, health care providers should always consider the amounts of both the acetaminophen and the opioid components in the prescription combination drug product.

                                                                                                                                                                              The FDA also recommends that pharmacists who receive a prescription for a combination product with more than 325 mg of acetaminophen per dosage unit contact the prescriber to discuss a product with a lower dose of acetaminophen. A two tablet or two capsule dose may still be prescribed, if appropriate. In that case, the total dose of acetaminophen would be 650 mg (the amount in two 325 mg dosage units).

                                                                                                                                                                              Acetaminophen is also widely used as an over-the-counter (OTC) pain and fever medication, and is often combined with other ingredients, such as cough and cold ingredients. FDA will address OTC acetaminophen products in another regulatory action. Consumers are often unaware that many products (both prescription and OTC) contain acetaminophen, making it easy to accidentally take too much.

                                                                                                                                                                              Health care providers and pharmacists who have further questions are encouraged to contact the Division of Drug Information at 888.INFO.FDA (888-463-6332) or druginfo@fda.hhs.gov.

                                                                                                                                                                              Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

                                                                                                                                                                              • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
                                                                                                                                                                              • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

                                                                                                                                                                              [01/14/2014 - FDA Statement - FDA]
                                                                                                                                                                              [Acetaminophen Information - FDA]

                                                                                                                                                                                Member Alert: Glycopyrrolate Injection Shortage

                                                                                                                                                                                February 10th, 2014

                                                                                                                                                                                A number of AAOMS fellows and members are reporting a shortage of glycopyrrolate injection (Robinul®). Used by many OMSs as a preoperative antimuscarinic to reduce salivary, tracheobrachial and pharyngeal secretions, and to block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation, the drug is currently manufactured solely by West-Ward Pharmaceuticals in Eatontown, NJ.

                                                                                                                                                                                American Regent, which had produced the drug, temporarily suspended manufacture of most drug products in April, 2011, and has yet to resume production. There is no estimate on when they will resume manufacturing glycopyrrolate.

                                                                                                                                                                                The American Society of Health-System Pharmacists, notes that while there is a shortage of the drug, no official reason has been given for the problem.

                                                                                                                                                                                Southern Anesthesia & Surgical (SAS) reports they are currently receiving periodic allocations of glycopyrrolate from West-Ward and are using these shipments to fulfill customer backorders in the order they were received. Until these backorders are filled, glycopyrrolate will remain in out-of-stock status at SAS.

                                                                                                                                                                                In addition, a SAS Alert dated January 14, 2014 states that Robinul is on manufacture backorder and that SAS is not accepting orders for Robinul at this time.

                                                                                                                                                                                AAOMS will continue to monitor the situation and keep members informed of new developments.

                                                                                                                                                                                  Member Alert: Propofol Injectable Emulsion, USP by Hospira: Recall - Visible Particulates

                                                                                                                                                                                  April 21st, 2014

                                                                                                                                                                                  Hospira, Inc. has announced a nationwide recall of seven lots of Propofol Injectable Emulsion, USP, due to a glass defect located on the interior neck of the vial, which was identified during a sample inspection where the glass vial contained visible embedded metal particulate. Free-floating metal particulates were also identified in vials upon further analysis.

                                                                                                                                                                                  Injected particulate matter may result in local inflammation, phlebitis, and/or low level allergic response through mechanical disruption of tissue or immune response to the particulate. Capillaries, which may be as small as the size of a red blood cell, may become occluded. Chronically, following sequestration, particulate matter may lead to granulomatous formation, most likely in the lungs. Long term clinically meaningful impact is low if a patient has normal lung function. While extremely rare, embedded stainless steel may put a patient at risk from MRI (strong magnetic field exposure) as particulate, if in the lung, could potentially dislodge and be pulled through tissue.

                                                                                                                                                                                  The affected lots were distributed nationwide to distributors/wholesalers, hospitals and clinics from August 2013 through December 2013. The lot numbers affected by the recall are:

                                                                                                                                                                                  Product

                                                                                                                                                                                  NDC Number

                                                                                                                                                                                  Lot

                                                                                                                                                                                  Expiration Date

                                                                                                                                                                                  Propofol Injectable Emulsion, 1%, 200 mg /
                                                                                                                                                                                  20 mL (10 mg/mL)

                                                                                                                                                                                  0409-4699-30

                                                                                                                                                                                  29-614-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-615-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-616-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-617-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-628-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-629-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  29-630-DJ

                                                                                                                                                                                  1MAY2015

                                                                                                                                                                                  Hospira has notified its customers via recall letter that the company has implemented corrective actions to the manufacturing process to prevent recurrence. Customers are advised to check inventory and immediately quarantine any affected product. Affected product should be returned to Stericycle, which can be contacted at 1-877-272-2158 (M-F, 8 a.m. - 5 p.m. ET).

                                                                                                                                                                                  Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA’s MedWatch Adverse Event Reporting Program either online, by regular mail or by fax.

                                                                                                                                                                                    Member Alert: Manufacturers increasing cost of scarce saline solution

                                                                                                                                                                                    July 3rd, 2014

                                                                                                                                                                                    There appears to be no immediate relief for the nationwide shortage of sterile saline solution, a product used primarily in hospitals to clean wounds, mix medications and treat dehydration. In a recent issue of Kaiser Health Care News, manufacturers report they will not be able to catch up with demand until sometime next year. The FDA has approved imported saline from Spain and Norway to help ease the situation, but that will not solve the issue long-term since those countries must supply their own hospitals.

                                                                                                                                                                                    ASI partner Southern Anesthesia & Surgical, Inc. has been notified by their manufacturer, Hospira, that costs for various presentations of IV Fluids and Irrigation products will more than double, effective immediately. Hospira indicates that price increases on IV Fluids are required to improve profitability and provide for future investment; without the increases, Hospira indicates they would not be able to continue manufacturing these products.

                                                                                                                                                                                    At present, SAS has been able to obtain some of the FDA-approved saline solution from Spain. Although there are some minor differences between the products imported from Spain and saline solution manufactured by Hospira in the US, the products are similarly priced.

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                                                                                                                                                                                        Member Alert: FDA Reschedules Hydrocodone Combination Products from Schedule III to Schedule II

                                                                                                                                                                                        August 22nd, 2014

                                                                                                                                                                                        The Final Rule rescheduling hydrocodone combination products (HCPs) from schedule III to schedule II of the Controlled Substance Act was published in the August 22, 2014 Federal Register. The new Rule takes effect October 6, 2014, 45 days from publication. Oral and Maxillofacial Surgeons who prescribe hydrocodone combination products should be aware of the following prescribing requirements now that these drugs are in schedule II:

                                                                                                                                                                                        • Schedule II controlled substances require a written prescription that must be signed by the practitioner.
                                                                                                                                                                                        • Refilling a prescription for a schedule II controlled substance is prohibited.
                                                                                                                                                                                        • Prescribers may transmit a Schedule II prescription to the pharmacy by facsimile. The original Schedule II prescription must be presented to the pharmacist for review prior to the actual dispensing of the controlled substance.
                                                                                                                                                                                        • In an emergency, a practitioner may phone-in a prescription for a Schedule II controlled substance to the pharmacy, and the pharmacist may dispense the prescription provided that the quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period. The prescribing practitioner must provide a signed, written prescription to the pharmacist within seven days.
                                                                                                                                                                                        • While some states and many insurance carriers limit the quantity of controlled substance dispensed to a 30-day supply, there are no specific federal limits to quantities of drugs dispensed via a prescription.
                                                                                                                                                                                        • As of December 19, 2007, an individual practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a schedule II controlled substance.

                                                                                                                                                                                        Specific conditions permitting such multiple prescriptions may be found at http://www.deadiversion.usdoj.gov/faq/mult_rx_faq.htm.

                                                                                                                                                                                        The FDA's Final Rule to reschedule HCP from Schedule III to Schedule II originated in 2009 with a request from the Drug Enforcement Administration. In response, the FDA held several public hearings on the proposed move. AAOMS responded to these hearings as follows:

                                                                                                                                                                                        October 16, 2012: the AAOMS and the ADA provided joint comments to the FDA, and in January 2013, the FDA accepted our joint testimony during a hearing on this important matter.

                                                                                                                                                                                        February 2013: Then-AAOMS president Miro A. Pavelka, DDS, MSD, testified before a separate FDA panel about the benefits of HCPs for oral and maxillofacial surgery patients and the potential difficulties of making legitimate pain prescriptions available to patients once HCPs are rescheduled.

                                                                                                                                                                                        In addition to providing comments at the FDA's hearings, the AAOMS, ADA and others submitted comments noting our opposition to DEA's proposed action in February 2014.

                                                                                                                                                                                          Medical Terminology

                                                                                                                                                                                          Medical Terminology

                                                                                                                                                                                            Member Alert: ACS “Surgical Protocol for Possible or Confirmed Ebola Cases”

                                                                                                                                                                                            October 15th, 2014

                                                                                                                                                                                            Ebola hemorrhagic fever, the infectious disease that has led to the death of more than 3,800 West Africans, has recently been diagnosed in two patients in the United States. At this time, there is no indication of an Ebola epidemic in the United States.

                                                                                                                                                                                            The AAOMS reminds fellows and members, however, that Ebola can be potentially fatal. All OMSs and professional allied staff who assist in the operatory need to be aware of patients with possible or confirmed Ebola infection.

                                                                                                                                                                                            The AAOMS offers the following American College of Surgeons' "Surgical Protocol for Possible or Confirmed Ebola Cases" to the membership as a precaution.

                                                                                                                                                                                            Surgical Protocol for Possible or Confirmed Ebola Cases

                                                                                                                                                                                            Online October 7, 2014 | Sherry M. Wren MD, FACS, FCS (ECSA) and Adam L. Kushner MD, MPH, FACS

                                                                                                                                                                                            Ebola is an infectious disease caused by a filovirus (Ebola virus), whose normal host species is unknown. Infection can be potentially fatal and operating room personnel (nurses, surgeons, technicians, and anesthesia staff) all need to be aware of patients with possible or confirmed Ebola infection.

                                                                                                                                                                                            Elective surgical procedures should not be performed in cases of suspected or confirmed Ebola. In cases where an emergency operation must be performed this protocol should be implemented to minimize risk to hospital personnel. The choice of operative approach (open or MIS) should take into consideration minimizing potential hazards to all members of the OR team.

                                                                                                                                                                                            Although protocols for Personal Protective Equipment (PPE) are in place to protect health care workers, there is no guideline for operating room personnel and surgical providers who might need to perform an operation on a patient with confirmed or suspected Ebola infection, therefore we have adapted relevant Centers for Disease Control Recommendations and apply them specifically to the OR environment.

                                                                                                                                                                                             

                                                                                                                                                                                            Protocol

                                                                                                                                                                                            1. Patient Transport and Transfer to OR
                                                                                                                                                                                            All healthcare providers should wear the following PPE to transport and transfer a patient to the OR with confirmed or suspected Ebola infection.

                                                                                                                                                                                            • Gloves
                                                                                                                                                                                            • Level 3 Association for the Advancement of Medical Instrumentation (AAMI) fluid resistant gown
                                                                                                                                                                                            • eye protection (goggles or face shield)
                                                                                                                                                                                            • Facemask

                                                                                                                                                                                            2. Surgical Checklist
                                                                                                                                                                                            Suspected or confirmed Ebola status should be discussed in the pre and post operative briefing as an integral part of the Safe Surgery Checklist so all personnel are aware of potential risks of exposure.

                                                                                                                                                                                            3. OR Staff Personal Protection Equipment
                                                                                                                                                                                            Due to the significant risk of exposure to blood or bodily fluids all OR room personnel should wear:
                                                                                                                                                                                            Personal Protective Gear

                                                                                                                                                                                            • AAMI Level 4* Impervious Surgical Gowns
                                                                                                                                                                                            • Leg coverings that have full plastic film coating over the fabric not just over the foot area.
                                                                                                                                                                                            • Full face shield
                                                                                                                                                                                            • Mask
                                                                                                                                                                                            • Double gloves
                                                                                                                                                                                            • Surgical hood

                                                                                                                                                                                            4. Surgical Drapes
                                                                                                                                                                                            AAMI Level 4* drapes should be used.
                                                                                                                                                                                            *Level 4 AAMI rated gowns, drapes, and protective apparel demonstrate theability to resist liquid and viral penetration in a laboratory test, ASTM F1671 (Standard test method for resistance of materials used in protective clothing to penetration by blood-borne pathogens using Phi-X174 bacteriophage penetration as a test system).

                                                                                                                                                                                            5. Instrumentation and Sharps

                                                                                                                                                                                            • Keep sharps to a minimum
                                                                                                                                                                                            • Use instruments, rather than fingers, to grasp needles, retract tissue, and load/unload needles and scalpels
                                                                                                                                                                                            • Give a verbal announcement when passing sharps
                                                                                                                                                                                            • Avoid hand-to-hand passage of sharp instruments by using a basin or neutral zone that has been agreed upon at the case start
                                                                                                                                                                                            • Use alternative cutting methods such as blunt electrocautery
                                                                                                                                                                                            • Substitute endoscopic surgery for open surgery when possible
                                                                                                                                                                                            • Use round-tipped scalpel blades instead of pointed sharp-tipped blades
                                                                                                                                                                                            • Use electrocautery preferentially to scalpel for incisions
                                                                                                                                                                                            • No needles or sharps on the Mayo stand
                                                                                                                                                                                            • No recapping of needles
                                                                                                                                                                                            • Use blunt tip suture needles when possible
                                                                                                                                                                                            • Continue “sharps safety” techniques during OR table clean up post procedure

                                                                                                                                                                                            6. OR Staff Exposure (adapted from CDC guidelines)
                                                                                                                                                                                            Persons with percutaneous or mucocutaneous exposures to blood, body fluids, secretions, or excretions from a patient with suspected or confirmed Ebola should:

                                                                                                                                                                                            • Stop working and immediately wash the affected skin surfaces with soap and water.
                                                                                                                                                                                            • Mucous membranes (e.g., conjunctiva) should be irrigated with copious amounts of water or eyewash solution
                                                                                                                                                                                            • Immediately contact Infectious Disease consultant in your hospital for post exposure evaluation.

                                                                                                                                                                                            Guideline Creation Version 1 October 6, 2014
                                                                                                                                                                                            Updates will be made if and when new data are available.


                                                                                                                                                                                            References

                                                                                                                                                                                            http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf
                                                                                                                                                                                            http://www.cdc.gov/sharpssafety/resources.html
                                                                                                                                                                                            http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

                                                                                                                                                                                             

                                                                                                                                                                                             

                                                                                                                                                                                              Affordable Care Act: Implementation Checklist

                                                                                                                                                                                              Beginning January 1, 2014, health care coverage offered through the Accountable Care Act’s (ACA) health insurance exchanges, also referred to as marketplaces, took effect. The ACA exchanges/marketplaces allow patients who do not currently have employer-provided health care coverage to compare and purchase their health insurance coverage to fit their needs and budget.  Some states are operating their own marketplace, and other states are allowing the federal government to run theirs.  Regardless, oral and maxillofacial surgeons must know if the carriers they contract with are now a part of an ACA insurance marketplace and whether their patients are insured through one of these marketplace plans.  Knowing this will make all the difference in identifying your patients’ out of pocket expenses.   Below is a checklist that AAOMS has developed to help OMS offices adequately prepare for and accommodate this new patient population. For more information on the insurance marketplaces visit www.healthcare.gov .
                                                                                                                                                                                              1.  Confirm if you are participating with ACA exchange/marketplace products and verify coverage.

                                                                                                                                                                                              • Check with your state to verify which insurance carriers are involved within the insurance exchange/ marketplace. 
                                                                                                                                                                                              • Review all your provider contracts with those carriers involved within the marketplace.
                                                                                                                                                                                                • Were you automatically enrolled into the marketplace due to an all-products clause within your existing contract with the insurance carrier?
                                                                                                                                                                                                • Check the fee-schedules of those carriers included within the marketplace that you are contracted with.  While you may be contracted with a plan, what the plan covers and what they reimburse in and out of the marketplace may differ.  Plans offered through the exchange/marketplace may reimburse according to a different fee schedule and offer only what is required under the ACA in order to keep premiums lower within the exchange. 
                                                                                                                                                                                                • If you were not auto-enrolled, but are interested in becoming a participating provider with a plan offered through your state exchange/marketplace, keep in mind some exchange/marketplace plans are offering limited provider networks in attempts to keep premiums low.  In such states, providers and hospitals may find themselves being released of their provider contracts without cause. 

                                                                                                                                                                                               2.  Verify the type of insurance each patient has as well as current eligibility status.

                                                                                                                                                                                              • Ask each patient what type of medical/dental insurance they carry:
                                                                                                                                                                                                • Are they insured by their state insurance exchange/marketplace?
                                                                                                                                                                                                • Are they insured by their employer?  
                                                                                                                                                                                                • Do they have indemnity insurance or have purchased benefits independently
                                                                                                                                                                                              • If the patient is insured through the insurance exchange/marketplace, determine what type of dental plan the patient has from the following: 
                                                                                                                                                                                                • Embedded Dental Coverage: the dental benefits are included within the medical policy;
                                                                                                                                                                                                  •  Medical plans with an embedded dental plan typically have one deductible and a combined maximum out-of-pocket, so the dental benefits may not kick in until the medical deductible has been met.
                                                                                                                                                                                                • Bundled Dental Coverage: dental benefits are considered a separate plan with a separate deductible, but sold with a medical plan;
                                                                                                                                                                                                • Stand-alone Dental Coverage: These are dental benefits which can be purchased separately from the patient’s medical insurance.
                                                                                                                                                                                              • Have a formal office policy in place to discuss any or all expenses your patients may be responsible for per visit, including coinsurance, copayments, and deductibles. 
                                                                                                                                                                                                • Many insurance plans included within the exchange/marketplace have high deductibles, which should be explained to each patient to prepare them for their financial obligations. 
                                                                                                                                                                                              • Train office staff on how best to communicate with patients regarding your state’s insurance exchange/marketplace, their coverage, and their responsibility when they schedule their appointment. 

                                                                                                                                                                                               3.  Be aware of the Essential Health Benefits (EHBs) in your state.

                                                                                                                                                                                              • All health plans within the insurance exchange/marketplace must offer the core EHBs including physician visits, hospital and emergency services, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, rehabilitative services and devices, laboratory services, preventive and wellness services, and pediatric services including vision and dental care. Note: there is no defined list of covered OMS procedures and coverage is handled on a state by state basis.
                                                                                                                                                                                              • The scope of pediatric dental benefits that exchange/marketplace plans in any given state are required to cover is modeled after either benefits provided via the Federal Employee Dental and Vision Insurance Plan (FEDVIP) or the state’s Children’s Health Insurance Program (CHIP). You can find a full list of each state’s chosen EHB model at https://www.statereforum.org/analyses/state-progress-on-essential-health-benefits
                                                                                                                                                                                              • Compare your state’s exchange/marketplace coverage and costs. This information can typically be found on your state’s marketplace Web site through specific comparison tools.

                                                                                                                                                                                               4. Consider complying with the HIPAA operating rules which went into effect March 31, 2013. Doing so may provide you real-time access to patient eligibility and benefits.

                                                                                                                                                                                              • The Committee on Operating Rules for Information Exchange (CORE) created the operating rules with the vision of giving providers access to eligibility and benefits information before or at the time of service for any patient or health plan.
                                                                                                                                                                                              • By determining a patient’s eligibility and financial responsibility while the patient is still in the office so they may accept payment from the patient’s at the time of service.
                                                                                                                                                                                              • For more information on the HIPAA CORE operating rules speak with your software vendors.

                                                                                                                                                                                               5.  Have a policy in place relating to coordination of the patient’s benefits if they present with more than one insurance plan.

                                                                                                                                                                                              • Do not assume that dental is always primary, or that medical is always primary. 
                                                                                                                                                                                              • Always verify benefits with all insurance carriers presented to confirm which is considered the primary carrier and which is secondary.
                                                                                                                                                                                                • The handling of your contractual obligations remains the same regardless if the patient is insured through the marketplace or employer plan.   
                                                                                                                                                                                              • Check out AAOMS’s full summary on coordinating your patient’s benefits on the AAOMS website. 

                                                                                                                                                                                               6.  Continue to stay abreast on Medicare and Medicaid program enhancements stemming from the ACA.

                                                                                                                                                                                              • The Physician Quality Reporting System (PQRS) program:
                                                                                                                                                                                                • A Medicare incentive program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals.  The ACA continues to apply penalties for not reporting quality performance measures on 2014 claims. A full summary along with a list of OMS related quality measures can be found on the AAOMS website.
                                                                                                                                                                                                • The AAOMS partnered with CECity to offer the PQRSwizard, a fast, convenient, and cost-effective online tool to help collect and report quality measure data for the Centers for Medicare & Medicaid Services (CMS) PQRS incentive payment program.
                                                                                                                                                                                              • The ACA now allows states the option to expand Medicaid to all individuals under 65 who have incomes up to 133% FPL based on a modified adjusted gross income.
                                                                                                                                                                                                • If you are a Medicaid provider, you may begin to see an increase in Medicaid patients within your practice.   

                                                                                                                                                                                              Make sure you are aware of how your state exchange/marketplace effects you from an employer’s standpoint.  OMS’s can review the document found on the Governmental Affairs page of the AAOMS website, “A summary of the Health Insurance Marketplace and their impact on your practice.”

                                                                                                                                                                                                Insurance Marketplace (Insurance Exchanges) and Your Provider Contracts

                                                                                                                                                                                                The Affordable Care Act (ACA) mandates that all individuals obtain insurance effective January 1, 2014. Many individuals and families who currently do not have insurance will be purchasing their coverage through insurance marketplaces created under the ACA. Previously referred to as exchanges, these insurance marketplaces, whether state-operated or federally-operated, will be a single, online source where consumers may obtain information about their health coverage options in an easy, side-by-side comparison of private insurance plans and coverage options. The number of payers participating in the marketplaces varies by state. Visit the Kaiser Family Foundation’s interactive map at http://kff.org/health-reform/state-indicator/health-insurance-exchanges/#map to check your state’s decision regarding insurance marketplaces.

                                                                                                                                                                                                As patients insured through your state marketplaces present to your practice, keep in mind that your current managed care contracts may automatically make you a participating provider within the plan offered through the marketplace. This may be due to an “all products clause” written into the provider contract. “All product clauses” typically state that if the provider is interested in participating in any particular product offered by the plan, the provider must participate in all of the health plan products as a condition of participation. There are only 10 states that prohibit “all products clauses” from being written into provider contracts. In the remaining 40 states, while sporadically practiced, plans have the freedom to incorporate such clauses into their contracts. Given the infancy of insurance marketplaces, it is likely that those payers that did not previously incorporate such clauses into the contract language, may do so to assure beneficiary access to healthcare providers. 

                                                                                                                                                                                                Additionally, while you may be contracted with a plan, what the plan covers and what they reimburse in and out of the exchange may differ.  Plans offered through the exchange may reimburse according to a different fee schedule and offer only what is required under the ACA in order to keep premiums lower within the exchange. 

                                                                                                                                                                                                On the contrary, while some marketplaces may “force” providers to participate resulting from these all-product clauses, some marketplaces are offering limited provider networks in attempts to keep premiums low.  In such states, providers and hospitals may find themselves being released of their provider contracts without cause. 

                                                                                                                                                                                                Finally, policies purchased through the marketplace carry a 90-day grace period for beneficiaries to pay their premiums before the policy lapses or terminates. Regardless if you are a participating or non-participating physician, please keep this in mind as you verify benefits for patients insured through the marketplace. They may be deemed covered at the time of service; however, payment may be delayed or even denied depending upon when or if the beneficiary pays their premium. While this is a risk with any plan, as most provide a 60-day grace period, the additional grace period may prove more burdensome, particularly if your practice treats a large number of patients insured through the marketplace.

                                                                                                                                                                                                The Centers for Medicare and Medicaid Services offers the two publications which can be found at:

                                                                                                                                                                                                http://marketplace.cms.gov/getofficialresources/publications-and-articles/10-things-providers-need-to-know.pdf

                                                                                                                                                                                                http://marketplace.cms.gov/getofficialresources/publications-and-articles/10-things-to-tell-your-patients.pdf

                                                                                                                                                                                                  ACOs-Accountable Care Organization Overview

                                                                                                                                                                                                  On October 20, 2011, the Department of Health and Human Services (HHS) released its long awaited final rule on Accountable Care Organizations (ACOs), which are scheduled to launch in January 2012. ACOs are groups of doctors, hospitals, and long-term care facilities, who come together voluntarily to provide high quality care to the Medicare patients they serve. The intention is that the coordinated care these ACOs provide, will ensure patients, especially the chronically ill, get the right care at the right time with the goal of avoiding unnecessary duplication of services and unnecessary costs. When an ACO succeeds in both delivering high quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.

                                                                                                                                                                                                  In Medicare's traditional fee-for-service payment system, doctors and hospitals generally receive most of their income for the extensive amount of tests and procedures performed during one visit, which drives up the costs of health care. ACOs do not replace fee-for-service but, create savings incentives by offering bonuses that providers may earn when they benchmark costs and focus on prevention and carefully managing patients with chronic diseases. In other words, providers would get paid more for keeping their patients healthy and out of the hospital. Once providers clear a savings target created by CMS, the ACO members will receive a bonus consisting of all the shared savings. However, if the benchmark performance measure has not been met, the ACO can be held accountable for losses. HHS estimates that ACOs could save Medicare between $510 million and $960 million in the first three years. If the program is successful, it can be expanded by the Secretary of Health and Human Services.

                                                                                                                                                                                                  ACOs may choose one of Medicare's incentive options under the final rule. Many organizations are at different stages in their ability to move towards ACO participation. Three models were created by the CMS to encourage all different providers and organizations to get started. The three models of an Accountable Care Organization would be:

                                                                                                                                                                                                  • Medicare Shared Savings Program- facilitates coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) and reduce unnecessary costs. The Shared Savings Program is designed to improve beneficiary outcomes and increase value of care by:
                                                                                                                                                                                                    • Promoting accountability for the care of Medicare FFS beneficiaries
                                                                                                                                                                                                    • Requiring coordinated care for all services provided under Medicare FFS
                                                                                                                                                                                                    • Encouraging investment in infrastructure and redesigned care processes
                                                                                                                                                                                                  • Advanced Payment Initiative- through the Advance Payment Model, selected participants in the Shared Savings Program will receive advance payments that will be recouped from the shared savings they earn. Under the Advance Payment ACO Model, participating ACOs will receive three types of payments:
                                                                                                                                                                                                    • An upfront, fixed payment: Each ACO will receive a fixed payment.
                                                                                                                                                                                                    • An upfront, variable payment: Each ACO will receive a payment based on the number of its historically-assigned beneficiaries.
                                                                                                                                                                                                    • A monthly payment of varying amount depending on the size of the ACO: Each ACO will receive a monthly payment based on the number of its historically-assigned beneficiaries.
                                                                                                                                                                                                  • Pioneer ACO Model- population-based payment initiative for health care organizations and providers already experienced in coordinating care for patients across care settings.

                                                                                                                                                                                                  For more information on Accountable Care Organizations, visit the CMS website at http://www.cms.gov/ACO/.

                                                                                                                                                                                                   

                                                                                                                                                                                                    Avoid the 2015 PQRS Payment Penalty

                                                                                                                                                                                                    What is PQRSwizardSM?

                                                                                                                                                                                                    The PQRSwizard is a fast, convenient, and costeffective online tool to help collect and report quality measure data for the Centers for Medicare & Medicaid Services (CMS) PQRS incentive
                                                                                                                                                                                                    payment program. Similar to online tax preparation software, the PQRSwizard guides you through a few easy steps to help rapidly collect, validate, report, and submit your results to CMS for payment. The PQRSwizard is powered by the CECity Registry®, a CMS qualified registry for PQRS reporting.

                                                                                                                                                                                                     

                                                                                                                                                                                                    What is PQRS?

                                                                                                                                                                                                    The Physician Quality Reporting System (PQRS) was developed by CMS in 2007 as a voluntary reporting program that provides a financial incentive to physicians and other eligible professionals who report data on quality measures for covered services furnished to Medicare beneficiaries.

                                                                                                                                                                                                     

                                                                                                                                                                                                    What is the incentive/penalty schedule?

                                                                                                                                                                                                    Eligible providers who participate in PQRS can receive an incentive payment of 0.5% of their total allowed charges for Physician Fee Schedule (PFS) covered services.*

                                                                                                                                                                                                    Providers who have not reported PQRS measures in 2013 will incur a 1.5% negative adjustment in their 2015 Medicare reimbursements; the negative adjustment will increase to 2% for each year thereafter.

                                                                                                                                                                                                     

                                                                                                                                                                                                    What Measures Are Available?

                                                                                                                                                                                                    The AAOMS PQRSwizard features 11 quality measures that are relevant to AAOMS members, including measures on perioperative care, coordination of care, patient safety, and oncology. To report on any of these individual measures, simply select three measures and report on 80% of your Medicare Part B Fee-For-Service (FFS) patients that apply to the measures you selected.

                                                                                                                                                                                                    •  If you are unable to meet the reporting requirements for the incentive program but would still like to avoid the penalty, please contact CECity at 1-877-509-7774.

                                                                                                                                                                                                     

                                                                                                                                                                                                    Why use PQRSwizardSM?

                                                                                                                                                                                                    PQRSwizard has a built-in Progress Monitor that checks for missing data to validate your report. The Progress Monitor also tracks your data to provide you with continuous feedback regarding valid patients. The system even calculates your measures and provides a printable report of your measure results in real-time.

                                                                                                                                                                                                     

                                                                                                                                                                                                    How Do I Participate?

                                                                                                                                                                                                    All you need to do is complete a registration form, select your measures, and either answer a few questions per patient or upload your data file! PQRSwizard takes the guessing out of PQRS
                                                                                                                                                                                                    participation - just follow the simple steps and let the wizard do the rest!

                                                                                                                                                                                                      2015 OIG Work Plan

                                                                                                                                                                                                      The Health and Human Services (HHS) Office of the Inspector General (OIG) is responsible for policing all HHS agencies, such as the Centers for Medicare and Medicaid Services.  Its main focus is to detect and/or eliminate fraud and abuse. The OIG conducts investigations in conjunction with other law enforcement agencies such as the Federal Bureau of Investigations (FBI), U.S. Postal Inspection Service and various state Medicaid Fraud Control units. Responsibilities include auditing, investigating and inspecting HHS programs and operations, identifying program weaknesses; leading activities to prevent fraud and abuse from occurring; finding wrongdoers and abusers of HHS programs and applying sanctions when necessary. The OIG may investigate individuals, facilities and entities for services claimed but not rendered or not medically necessary, claims that manipulate codes in an effort to inflate reimbursement amounts and other false claims submitted to obtain program funds.

                                                                                                                                                                                                      In January, the OIG released its work plan for the 2015 fiscal year.  Below are direct excerpts from the 2015 OIG Work Plan that may potentially relate to an OMS office or an individual oral and maxillofacial surgeon.   This area of focus may later result in policy or reimbursement changes.  Being familiar with these areas in which the OIG is monitoring improper payments or abuse may help in understanding why Medicare requests overpayments to be refunded or claim audits may be performed.    Being familiar of these issues also serves as a reminder to be sure that claims are coded appropriately.

                                                                                                                                                                                                      Hospitals- New Inpatient Admission Criteria

                                                                                                                                                                                                      Policies and Practices. The OIG will determine the impact of new inpatient admission criteria on hospital billing, Medicare payments, and beneficiary copayments. This review will also determine how billing varied among hospitals in FY 2014. Previous OIG work identified millions of dollars in overpayments to hospitals for short inpatient stays that should have been billed as outpatient stays. Beginning in FY 2014, new criteria state that physicians should admit for inpatient care those beneficiaries who are expected to need at least 2 nights of hospital care (known as the “two midnight policy”). Beneficiaries whose care is expected to last fewer than 2 nights should be treated as outpatients. The criteria represent a substantial change in the way hospitals bill for inpatient and outpatient stays. (OEI; 00-00-00000; expected issue date: FY 2016)

                                                                                                                                                                                                      Hospitals- Medicare oversight of provider-based status

                                                                                                                                                                                                      Policies and Practices.  The OIG will determine the extent to which provider-based facilities meet CMS’s criteria. Provider-based status allows facilities owned and operated by hospitals to bill as hospital outpatient departments.  Provider-based status can result in higher Medicare payments for services furnished at provider-based facilities and may increase beneficiaries’ coinsurance liabilities. In 2011, the Medicare Payment Advisory Commission (MedPAC) expressed concerns about the financial incentives presented by provider-based status and stated that Medicare should seek to pay similar amounts for similar services. (OEI; 04-12-00380; expected issue date: FY 2015)

                                                                                                                                                                                                      Hospitals- Outpatient Dental Claims

                                                                                                                                                                                                      Billing and Payments. The OIG will review Medicare hospital outpatient payments for dental services to determine whether such payments were made in accordance with Medicare requirements. Current OIG audits have indicated that hospitals received Medicare reimbursement for noncovered dental services, resulting in significant overpayments. Dental services are generally excluded from Medicare coverage, with a few exceptions. (Social Security Act, § 1862(a)(12).) For example, Medicare reimbursement is allowed for the extraction of teeth to prepare the jaw for radiation treatment (CMS’s Medicare Benefit Policy Manual, Pub. No. 100‐02, ch. 15, § 150). (OAS; W‐00‐14‐35603; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                       Hospitals- Outpatient Evaluation and Management Services Billed at the New-Patient Rate  

                                                                                                                                                                                                      Billing and Payments. The OIG will review Medicare outpatient payments made to hospitals for evaluation and management (E/M) services for clinic visits billed at the new-patient rate to determine whether they were appropriate and will recommend recovery of overpayments. Preliminary work identified overpayments that occurred because hospitals used new-patient codes when billing for services to established patients. The rate at which Medicare pays for E/M services requires hospitals to identify patients as either new or established, depending on previous encounters with the hospital.

                                                                                                                                                                                                      According to Federal regulations, the meaning of “new” and “established’ pertains to whether the patient has been seen as a registered inpatient or outpatient of the hospital within the past 3 years.

                                                                                                                                                                                                      (73 Fed. Reg. 68679 (November 18, 2008).) (OAS; W-00-14-35627; expected issue date: FY 2015)

                                                                                                                                                                                                      Ambulatory Surgical Centers—Payment System

                                                                                                                                                                                                      Policies and Practices.  The OIG will review the appropriateness of Medicare’s methodology for setting ambulatory surgical center (ASC) payment rates under the revised payment system. We will also determine whether a payment disparity exists between the ASC and hospital outpatient department payment rates for similar surgical procedures provided in both settings. A change in Federal law required the Secretary to implement a revised payment system for payment of surgical services furnished in ASCs beginning January 1, 2008. Accordingly, CMS implemented a revised ASC payment system modeled on the Outpatient Prospective Payment System. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), § 626.) (See also 42 CFR § 416.171.) (OAS; W-00-13-35423; W-00-14-35423; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Anesthesia Services—Payments for Personally Performed Services

                                                                                                                                                                                                      Billing and Payments. The OIG will review Medicare Part B claims for personally performed anesthesia services to determine whether they were supported in accordance with Medicare requirements. We will also determine whether Medicare payments for anesthesia services reported on a claim with the “AA” service code modifier met Medicare requirements. Physicians report the appropriate anesthesia modifier code to denote whether the service was personally performed or medically directed. (CMS, Medicare Claims Processing Manual, Pub. No. 100-04, ch. 12, § 50) Reporting an incorrect service code modifier on the claim as if services were personally performed by an anesthesiologist when they were not will result in Medicare's paying a higher amount. The service code “AA” modifier is used for anesthesia services personally performed by an anesthesiologist, whereas the QK modifier limits payment to 50 percent of the Medicare-allowed amount for personally performed services claimed with the AA modifier. Payments to any service provider are precluded unless the provider has furnished the information necessary to determine the amounts due. (Social Security Act, §1833(e).)

                                                                                                                                                                                                      Diagnostic Radiology—Medical Necessity of High-Cost Tests

                                                                                                                                                                                                      Billing and Payments. The OIG We will review Medicare payments for high-cost diagnostic radiology tests to determine whether the tests were medically necessary and to determine the extent to which use has increased for these tests. Medicare will not pay for items or services that are not “reasonable and necessary.” (Social Security Act, § 1862 (a)(1)(A).) (OAS; W-00-13-35454; W-00-14-35454; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Imaging services—Payments for practice expenses

                                                                                                                                                                                                      Billing and Payments.  The OIG will review Medicare Part B payments for imaging services to determine whether they reflect the expenses incurred and whether the utilization rates reflect industry practices. For selected imaging services, we will focus on the practice expense components, including the equipment utilization rate. Practice expenses may include office rent, wages, and equipment. Physicians are paid for services pursuant to the Medicare physician fee schedule, which covers the major categories of costs, including the physician professional cost component, malpractice insurance costs, and practice expenses. (Social Security Act, § 1848(c)(1)(B).) (OAS; W-00-13-35219; W-00-14-35219; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Physicians: Place-of-Service Errors

                                                                                                                                                                                                      Billing and Payments. The OIG will review physicians’ coding on Medicare Part B claims for services performed in ASCs and hospital outpatient departments to determine whether they properly coded the places of service. Prior OIG reviews determined that physicians did not always correctly code nonfacility places of service on Part B claims submitted to and paid by Medicare contractors. Federal regulations provide for different levels of payments to physicians depending on where services are performed. (42 CFR § 414.32.) Medicare pays a physician a higher amount when a service is performed in a nonfacility setting, such as a physician’s office, than it does when the service is performed in a hospital outpatient department or, with certain exceptions, in an ASC. (OAS; W-00-13-35113; W-00-14-35113; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Covered Uses for Medicare Part B Drugs

                                                                                                                                                                                                      Quality of Care and Safety. The OIG will review the oversight actions that CMS and its claims processing contractors take to ensure that payments for Part B drugs meet the appropriate coverage criteria. We will also identify challenges contractors face when making coverage decisions for drugs. If Part B MACs do not have effective oversight mechanisms, Medicare and its beneficiaries may pay for drugs with little clinical evidence of the drugs’ safety and effectiveness. Medicare Part B generally covers drugs when they are used to treat conditions approved by FDA, referred to as “on-label” uses. Part B may also cover drugs when an “off-label” use of the drug is supported in major drug compendia or when an “off-label” use is supported by clinical evidence in authoritative medical literature. (Medicare Benefit Policy Manual, Pub. No. 100-02, ch. 15, § 50.4.2.) (OEI; 03-13-00450; expected issue date: FY 2015)

                                                                                                                                                                                                      Enhanced Enrollment Screening Process for Medicare Providers

                                                                                                                                                                                                      Provider Eligibility. The OIG will determine the extent to which and the way in which CMS and its contractors have implemented enhanced screening procedures for Medicare providers pursuant to the ACA, § 6401. We will also collect data on and report the number of initial enrollments and enrollment revalidations approved and denied by CMS before and after the implementation of the enhanced screening procedures. As part of an effort to prevent fraud, waste, and abuse resulting from vulnerabilities in the Medicare enrollment process, CMS is implementing new authorities that include site visits, fingerprinting, and background checks, as well as an automated provider screening process. (OEI; 03-13-00050; expected issue date: FY 2015; ACA.)

                                                                                                                                                                                                      Risk Assessment of CMS’ Administration of the Pioneer Accountable Care Organization Model (new)

                                                                                                                                                                                                      New Models.  The OIG will conduct a risk assessment of the Pioneer Accountable Care Organization (ACO) Model. An ACO is a group of providers and suppliers of services (e.g., hospitals and physicians and others involved in patient care) that will work together to coordinate care for the Medicare fee-for-service beneficiaries they serve. The Centers for Medicare & Medicaid Innovation was created to test innovative care and service delivery models and is administering the Pioneer ACO Model. (ACA, §3021.) We will conduct a risk assessment of internal controls over administration of the Pioneer ACO Model. (OAS; W-00-00-00000; expected issue date: FY 2015; ACA)

                                                                                                                                                                                                      Medical Equipment and Supplies—Opportunities to Reduce Medicaid Payment Rates for Selected Items

                                                                                                                                                                                                      Policies and Practices. The OIG will determine whether opportunities exist for lowering Medicaid payments for some medical equipment and supplies. We will also determine the amount of Medicaid savings that could be achieved for selected items through rebates, competitive bidding, or other means. Prior work found that State Medicaid programs negotiated rebates with manufacturers that reduced net payments for home blood glucose test strips. Similarly, CMS reduced Part B rates of payment in selected areas through competitive bidding. (OAS; W-00-13-31390; W-00-15-31390; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Dental Services for Children—Inappropriate Billing

                                                                                                                                                                                                      State Claims. The OIG will review Medicaid payments by States for dental services to determine whether States have properly claimed Federal reimbursement. Prior OIG work indicated that some dental providers may be inappropriately billing for services. Dental services are required for most Medicaid-eligible individuals under age 21 as a component of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services benefit. (Social Security Act, §§ 1905(a)(4)(B) and 1905(r).) Federal regulations define “dental services” as diagnostic, preventative, or corrective procedures provided by or under the supervision of a dentist. (42 CFR § 440.100.) Services include the treatment of teeth and the associated structure of the oral cavity and disease, injury, or impairment that may affect the oral cavity or general health of the recipient. (OAS; W-00-13-31135; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Access to Pediatric Dental Care for Children Enrolled in Medicaid

                                                                                                                                                                                                      Quality of Care and Safety. The OIG will review billing patterns of pediatric dentists and their associated clinics in selected States and describe the extent to which children enrolled in Medicaid received dental services in these States. In recent years, a number of dental providers and chains have been prosecuted for providing unnecessary dental procedures and causing harm to Medicaid children. In addition, children’s access to dental services has been a longstanding Medicaid problem. Medicaid covers comprehensive dental care for approximately 37 million low-income children through the EPSDT benefit. Under EPSDT, States must cover dental services and dental screening services for children. (OEI; 02-14-00480; 02-14-00490; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Utilization of Preventive Screening Services for Children Enrolled in Medicaid

                                                                                                                                                                                                      Quality of Care and Safety. The OIG will determine what steps CMS has taken to address OIG’s recommendations to improve the provision of Medicaid EPSDT services. We will also determine whether the underuse of EPSDT services continues to be a challenge for children enrolled in Medicaid. Previous OIG work found that, in nine States, three out of four children did not receive all required medical, vision, and hearing screenings. OIG made several recommendations to CMS to increase participation in EPSDT screenings and to increase the completeness of medical screenings. (OEI; 05-13-00690; expected issue date: FY 2015)

                                                                                                                                                                                                      Review of Affordable Care Act enrollment safeguards at additional State marketplaces (new)

                                                                                                                                                                                                      ACA, § 1411. In FY 2014, OIG issued two reports that identified vulnerabilities in eligibility and enrollment systems at the FFM and State-based marketplaces. Our new work will assess the effectiveness of internal controls in place at seven State-based marketplaces to ensure that accurate information is used to determine consumer eligibility for enrollment and financial assistance payments. We will determine whether internal controls implemented by the selected marketplaces were effective in ensuring that individuals were enrolled in a qualified health plan (QHP) according to Federal requirements. Using a statistically valid sample of applicants, we will review whether each marketplace has performed the required verifications to determine eligibility for enrollment in a QHP and has appropriately resolved inconsistencies between applicant information and data sources used for verification. (OAS; W-00-14-42024; various reviews; expected issue date: FY 2015)

                                                                                                                                                                                                      Medicare incentive payments for adopting electronic health records

                                                                                                                                                                                                      Adoption of Electronic Health Records.  The OIG will review Medicare incentive payments to eligible health care professionals and hospitals for adopting EHRs and the Centers for Medicare & Medicaid Services (CMS) safeguards to prevent erroneous incentive payments. We will review Medicare incentive payment data from 2011 to identify payments to providers that should not have received incentive payments (e.g., those not meeting selected meaningful use criteria). We will also assess CMS’s plans to oversee incentive payments for the duration of the program and corrective actions taken regarding erroneous incentive payments. Medicare incentive payments are authorized over a 5-year period to physicians and hospitals that demonstrate meaningful use of certified EHR technology. (Recovery Act, §§ 4101 and 4102.) Incentive payments were scheduled to begin in 2011 and continue through 2016, with payment reductions to health care professionals who fail to become meaningful users of EHRs beginning in 2015. (§ 4101(b).) As of August 2014, Medicare EHR incentive payments totaled more than $16 billion. (OAS; W-00-14-31352; expected issue date: FY 2015; Recovery Act)

                                                                                                                                                                                                      Security of Certified Electronic Health Record Technology under Meaningful Use

                                                                                                                                                                                                      Systems and Information Security. The OIG will perform audits of various covered entities receiving EHR incentive payments from CMS and their business associates, such as EHR cloud service providers, to determine whether they adequately protect electronic health information created or maintained by certified EHR technology. A core meaningful-use objective for eligible providers and hospitals is to protect electronic health information created or maintained by certified EHR technology by implementing appropriate technical capabilities. To meet and measure this objective, eligible hospitals, including critical access hospitals, must conduct a security risk analysis of certified EHR technology as defined in Federal regulations and use the capabilities and standards of Certified Electronic Health Record Technology. (45 CFR § 164.308(a) (1) and 45 CFR §§ 170.314(d) (1) – (d) (9).) Furthermore, business associates that transmit, process, and store EHRs for Medicare and Medicaid providers are playing a larger role in the protection of electronic health information. Therefore, audits of cloud service providers and other downstream service providers are necessary to ensure compliance with regulatory requirements and contractual agreements. (OAS; W-00-14-42020; W-00-15-42020; various reviews; expected issue date: FY 2015; Recovery Act)

                                                                                                                                                                                                        Summary of Medicare’s Physician Quality Reporting System (PQRS)

                                                                                                                                                                                                        Medicare’s Physician Quality Reporting System (PQRS) is a voluntary reporting program that uses payment adjustments to promote reporting of quality information by eligible professionals through the use of PQRS measures and their correlating Quality Data Codes (QDC).

                                                                                                                                                                                                        Oral and maxillofacial surgeons and other eligible professionals who render services for which PQRS measures exist (see list of measures applicable to OMSs) are eligible to report those measures.

                                                                                                                                                                                                        What are the PQRS Measures?

                                                                                                                                                                                                        Quality measures help quantify healthcare processes, patient outcomes and/or perceptions as well as address various aspects of care, such as prevention, chronic- and acute-care management, procedure-related care, resource utilization, and care coordination.  Providers may report either individual measures or measure groups.  Twenty-three measures groups have been established for the 2015 Physician Quality Reporting System, but at this time there are no measure groups applicable to oral and maxillofacial surgery.    

                                                                                                                                                                                                        Individual Measures:  There are over 250 individual PQRS measures for claims- or registry-based reporting, 17 of which are applicable to OMS. To avoid a payment adjustment, an applicable measure is to be reported each time a procedure is performed during the reporting period. 

                                                                                                                                                                                                        For example, when the physician reports a mandibular fracture repair code (i.e., 21461-21462) and documents the order for prophylactic parenteral antibiotics prior to the fracture repair within the patient’s record- PQRS measure #20: Perioperative Care: Timing of Antibiotic Prophylaxis-Ordering Physician can be reported.  This measure is to be reported each time a procedure is performed during the reporting period. 

                                                                                                                                                                                                        For a complete list of the individual measures and instructions on their use and reporting, visit the Measure List Implementation Guidelines found on the CMS Web site. 

                                                                                                                                                                                                        National Quality Strategy Domains:  Quality measures selected must cover at least 3 of the 6 available National Quality Strategy (NQS) domains, which represent the Department of Health and Human Services’ (HHS) NQS priorities for health care quality improvement.

                                                                                                                                                                                                        The 6 NQS domains are:

                                                                                                                                                                                                        1. Patient and Family Engagement
                                                                                                                                                                                                        2. Patient Safety
                                                                                                                                                                                                        3. Care Coordination
                                                                                                                                                                                                        4. Population/Public Health
                                                                                                                                                                                                        5. Efficient Use of Healthcare Resources
                                                                                                                                                                                                        6. Clinical Process/Effectiveness

                                                                                                                                                                                                        Cross-Cutting Measures:

                                                                                                                                                                                                        Beginning in 2015, eligible professionals or group practices are required to also report at least 1 of 18 cross-cutting measures if they have a face-to-face encounter with at least one Medicare patient. The Centers for Medicare & Medicaid Services (CMS) defines a face-to-face encounter as an instance in which the EP billed for services that are associated with face-to-face encounters under the Physician Fee Schedule (PFS). This includes general office visits, outpatient visits, and surgical procedure codes. CMS does not consider telehealth visits as face-to-face encounters.

                                                                                                                                                                                                        What are PQRS Payment Adjustments?

                                                                                                                                                                                                        PQRS payment adjustments are made two years after the reporting calendar year.  For example, if an OMS failed to participate in the 2014 PQRS program, their Medicare payment in 2016 will reflect a 2% reduction.

                                                                                                                                                                                                        In addition to the PQRS payment reduction of 2%, the Affordable Care Act established the “value-based payment modifier,” which will also be applied to all doctors beginning with the 2015 PQRS program Those who do not successfully report for PQRS during the 2015 calendar year, will receive a value-based modifier payment reduction of 2% for solo practitioners and groups with two to nine EPs and for groups with 10 or more EPs in 2017. For more information on the Value Based Modifier, visit the CMS Web site.  

                                                                                                                                                                                                        Reporting Options

                                                                                                                                                                                                        Medicare providers may report quality measures as an individual or under the Group Practice Reporting Option (GPRO).  Under the 2015 Physician Quality Reporting, a GPRO consists of a physician group practice, using a single Tax Identification Number (TIN), with 2 or more individual eligible professionals each identified by a different National Practitioner Identifier (NPI) who have reassigned their billing rights to the group TIN.  Group practices reporting via GPRO must register for their selected reporting method by June 30, 2015.   For information on how to become a selected group practice, refer to the Group Practice Reporting Option section of the CMS PQRS Web site at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Group_Practice_Reporting_Option.html.  
                                                                                                                                                                                                        Note: If the eligible professional or the GPRO changes the TIN, the participation does not carry over to the new TIN.

                                                                                                                                                                                                        An individual OMS may choose from the following methods to submit data to the Centers for Medicare and Medicaid Services (CMS): 

                                                                                                                                                                                                        • Medicare Part B claims,
                                                                                                                                                                                                        • Qualified registry, 
                                                                                                                                                                                                        • Qualified Electronic Health Record (EHR), 
                                                                                                                                                                                                        • Qualified PQRS data submission vendor (new for 2014), 
                                                                                                                                                                                                        • Qualified Clinical Data Registry (new for 2014), or
                                                                                                                                                                                                        • The Group Practice Reporting Option (GPRO). 

                                                                                                                                                                                                        Individual EP’s may report individual PQRS quality measures by submitting the PQRS data via:

                                                                                                                                                                                                        • Claims-based ReportingProfessionals who choose to participate by reporting quality measures data through claims can simply report the appropriate quality-data codes on service lines of a Medicare Part B Physician Fee Schedule (PFS) claim form.  See CMS examples at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2013_PQRS_sampleCMS1500claim_12-19-2012.pdf.
                                                                                                                                                                                                        • Under the 2015 reporting period an individual EP must report at least 9 individual measures covering at least 3 NQS domains for at least 50% of Medicare Part B patients seen within the reporting period to avoid a payment adjustment in 2017,

                                                                                                                                                                                                        OR

                                                                                                                                                                                                        If fewer than 9 measures apply, the eligible professional would report up to 8 measures  for at least 50% of Medicare Part B patients seen within the reporting period, AND
                                                                                                                                                                                                        • Report 1 cross-cutting measure if they have at least 1 Medicare patient with a face-to-face encounter to avoid a payment adjustment in 2017
                                                                                                                                                                                                        • Qualified Clinical Data Registry (QCDR):  The QCDR will collect an EP’s medical and/or clinical data for patient and disease tracking, and submit it to CMS.  The data submitted to CMS is not limited to Medicare.  A list of CMS-approved registries is available on the CMS Web site.
                                                                                                                                                                                                        • Under the 2015 reporting period an individual eligible professional must report at least 9 measures available for reporting under a QCDR covering at least 3 NQS domains for at least 50% of Medicare Part B patients seen within the reporting period to avoid the 2017 payment adjustment, 
                                                                                                                                                                                                        • Of these QCDR measures, the eligible professional must report on at least 2 outcome measures (or if less than 2 outcome measures, report on at least 1 outcome measure and at least 1 of the following types of measures: patient safety, resource use; patient experience of care; or efficiency/appropriate use).

                                                                                                                                                                                                        Groups may report individual PQRS quality measures by submitting the PQRS data via:

                                                                                                                                                                                                        • GPRO Web Interface
                                                                                                                                                                                                        • Qualified PQRS Registry 
                                                                                                                                                                                                        • EHR Direct Product that is certified electronic health record technology (CEHRT)
                                                                                                                                                                                                        • EHR data submission vendor that is CEHRT
                                                                                                                                                                                                        • CMS-certified survey vendor
                                                                                                                                                                                                        • GPRO Web Interface: Successful completion of the Web Interface measures for the required number of patients will determine PQRS incentive eligibility and performance rates for the measures. To avoid the 2017 PQRS payment adjustment, group practices taking part in PQRS GPRO via the Web Interface must meet the requirements for satisfactory reporting.
                                                                                                                                                                                                        • Groups of 25-99 eligible professionals must report on all 18 measures included in the Web Interface; AND

                                                                                                                                                                                                        Populate data fields for the first 218 consecutively ranked and assigned beneficiaries in the order in which they appear in the group’s sample for each module or preventive care measure. If the number of eligible assigned beneficiaries is less than 218, then report on 100 percent of assigned beneficiaries.

                                                                                                                                                                                                        • Groups of 100+ eligible professionals must report on all measures included in the Web Interface; AND

                                                                                                                                                                                                        Populate data fields for the first 411 consecutively ranked and assigned beneficiaries in the order in which they appear in the group’s sample for each module or preventive care measure. If the number of eligible assigned beneficiaries is less than 411, then report on 100 percent of assigned beneficiaries.

                                                                                                                                                                                                        • CMS- Certified Survey Vendor: A CMS-certified survey vendor is available to group practices of 25 or more EPs who would like to report the 12 Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG CAHPS) summary survey modules. CAHPS are patient experience surveys that ask respondents to evaluate their experience with providers. 
                                                                                                                                                                                                        • The CG CAHPS summary survey modules will be considered the equivalent of 3 individual measures and 1 NQS domain. Therefore, group practices that register for this method of reporting will need to report on at least 6 additional measures covering at least 2 additional NQS domains via qualified registry, direct EHR product, or EHR data submission vendor. Group practices of 25 or more eligible professionals that select to have the CG CHAPS summary survey modules reported on their behalf will need to complete 6 measures covering at least 2 NQS domains using a qualified registry, direct EHR product, EHR data submission vendor, or GPRO Web Interface.

                                                                                                                                                                                                        Both an Individual EP and a GPRO may report individual PQRS quality measures by submitting the PQRS data via:

                                                                                                                                                                                                         

                                                                                                                                                                                                         

                                                                                                                                                                                                        Individual EP

                                                                                                                                                                                                        GPRO

                                                                                                                                                                                                         

                                                                                                                                                                                                        Avoid
                                                                                                                                                                                                        Payment Adjustment

                                                                                                                                                                                                        Report at least 9 measures covering 3 NQS domains for at least 50% of the Medicare Part B patients seen within the reporting period
                                                                                                                                                                                                        AND
                                                                                                                                                                                                        Report on at least 1 cross cutting measure if you see at least 1 Medicare patient in a face-to-face encounter

                                                                                                                                                                                                        Report at least 9 measures covering 3 NQS domains for at least 50% of the group’s Medicare Part B patients seen within the reporting period
                                                                                                                                                                                                        AND
                                                                                                                                                                                                        Report on at least 1 cross cutting measure if you see at least 1 Medicare patient in a face-to-face encounter

                                                                                                                                                                                                         

                                                                                                                                                                                                        • Qualified EHR-based Reporting:  Eligible professionals will submit their PQRS data through an EHR product that is Certified EHR Technology (CEHRT) or through an EHR data submission vendor what is CEHRT. A list of CEHRT vendors and their products is available on the CMS Web site.

                                                                                                                                                                                                         

                                                                                                                                                                                                        Individual EP

                                                                                                                                                                                                        GPRO

                                                                                                                                                                                                         

                                                                                                                                                                                                        Avoid
                                                                                                                                                                                                        Payment Adjustment

                                                                                                                                                                                                        Report on at least 9 individual measures covering 3 NQS domains. If the EP’s CEHRT does not contain patient data for at least 9 measures covering at least 3 domains, then the EP must report the measures for which there is Medicare patient data.

                                                                                                                                                                                                        Report on at least 9 individual measures covering 3 NQS domains.

                                                                                                                                                                                                         

                                                                                                                                                                                                        What is the PQRS Measure Applicability Validation (MAV)?

                                                                                                                                                                                                        The MAV process is for those EPs who submit two or fewer PQRS measures across at least 1 NQS domain for at least 50 percent of their patients or encounters eligible for each measure and who do not submit any other measure. Once the EP submits fewer than 3 PQRS measures, the Centers for Medicare and Medicaid Services (CMS) will begin the MAV process.   The MAV process will determine whether providers should have submitted additional measures.  Eligible professionals who fail MAV may still avoid a payment adjustment if they had reported at least one valid measure if that 1 measure is all that would apply to the EP.  For more information on the MAV process, visit the Analysis and Payment page of the CMS Web site at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html.  

                                                                                                                                                                                                        Complete details on the PQRS program can be found on the http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html. 

                                                                                                                                                                                                        • 2016 Day on the Hill

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