Endocrine Insider: January 14, 2016

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Past Issues


Advocacy News

Help Us Celebrate 100 Years

Clinical News

Apply Now for the 2016 Harold Vigersky Practicing Physician Travel Award
Congress Grants CMS Expedited Exemption Authority for Meaningful Use Participants
CMS Releases Reporting Guidance for Quality Reporting Programs
AMA Offers Guide to Physician-Focused Alternative Payment Models

Research News

Endocrine Society Submits Comments on Proposed Common Rule Update
Society Members Elected to National Academy of Medicine


Advocacy News

Help Us Celebrate 100 Years

Throughout 2016 we will honor 100 years of contributions in the field during the Endocrine Society's Centennial and use the occasion to highlight global achievements in endocrinology by reflecting on the past, making predictions on the future, sharing success stories, and shaping plans for building a better tomorrow. We encourage your participation and contributions. Here's how you can play a role:

  • Visit and bookmark the Centennial website at ESCentennial.org to test your knowledge of the history and accomplishments in endocrinology and reacquaint yourself with the seminal moments of the past 100 years.
  • Join the journey as we highlight the most prevalent endocrine diseases and conditions in a new monthly feature called the 2016 Endocrinology Calendar, beginning in January with Thyroid Health and Thyroid Cancer.
  • Celebrate our Centennial while also learning about the latest scientific and practice information available in the field by attending ENDO 2016 in Boston, MA on April 1.
  • Show your pride in April as we launch Endocrinology Month, a new annual observance to gain recognition and support for our discipline, and raise the profile of important work done on your behalf by the Endocrine Society leaders, members, and staff.
  • Look for updates each month about our Centennial initiatives which will be added to regular programming via email, Endocrine.org, the Centennial website, ENDO 2016, Hormone Health Network, Endocrine News, our journals, the news media, and through our social media sites. Become a part of the celebration on Twitter by using #Endo100.

Participate in our advocacy efforts related to the Centennial. We will be hosting special events in Washington, D.C. and working with policy makers to acknowledge achievements in endocrinology. More details will be provided in future editions of Endocrine Insider.

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Clinical News

Apply Now for the 2016 Harold Vigersky Practicing Physician Travel Award

The Endocrine Society is now accepting applications for the 2016 Harold Vigersky Practicing Physician Travel Award. Named for Past-president Robert Vigersky’s father, the award assists clinical practitioners operating in private practice by offsetting the cost associated with attending the Endocrine Society’s annual meeting (ENDO) or Clinical Endocrinology Update (CEU).

The award recipient will receive complimentary registration to either ENDO or CEU and a $1,500 allowance for travel and lost productivity. Physicians working in private practice who are not reimbursed for travel to clinical meetings or CME conferences are encouraged to apply. Specific eligibility requirements apply and can be found with the online application form on the Society’s website.

Applications are due by Friday, January 29, 2016.

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Congress Grants CMS Expedited Exemption Authority for Meaningful Use Participants

Congress passed the “Patient Access and Medicare Protection Act,” (S. 2425) in late 2015, which included a provision granting the Centers for Medicare and Medicaid Services (CMS) the authority to expedite applications for exemptions from Meaningful Use (MU) Stage 2 requirements for the 2015 calendar year.

In order to avoid a penalty under the MU program, eligible professionals (EPs) must attest that they met the requirements for Meaningful Use Stage 2 for a period of 90 consecutive days during calendar year 2015. However, CMS did not publish the Modifications Rule for Stage 2 of the program until Oct. 16, leaving fewer than 90 days in the calendar year.

A provision of the legislation grants CMS the authority to process requests for hardship exemptions through a more streamlined process. CMS had previously stated that it would grant hardship exemptions for 2015 if eligible providers were unable to attest for 90 consecutive days due to the lateness of the rule.

Look for additional information on applying for a hardship exemption in future editions of Endocrine Insider.

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CMS Releases Reporting Guidance for Quality Reporting Programs

The Centers for Medicare and Medicaid Services (CMS) offered eligible professionals (EPs) two resources to support participation in quality reporting programs.

Submission Timeframes for 2015 PQRS Data Announced

CMS announced the 2015 Physician Quality Reporting System (PQRS) data submission timeframes:

  • EHR Direct or Data Submission Vendor (QRDA I or III) - 1/1/16 - 2/29/16
  • Qualified clinical data registries (QCDRs) (QRDA III) - 1/1/16 - 2/29/16
  • Group practice reporting option (GPRO) Web Interface - 1/18/16 - 3/11/16
  • Qualified registries (Registry XML) - 1/1/16 - 3/31/16
  • QCDRs (QCDR XML) - 1/1/16 - 3/31/16

Submission ends at 8:00 P.M. Eastern Time on the end date listed.

EPs who do not satisfactorily report quality measure data to meet the 2015 PQRS requirements will be subject to a negative PQRS payment adjustment on all Medicare Part B Physician Fee Schedule services provided in 2017.

Additional information on the PQRS program can be found on the CMS website.

Guidance for Reporting Diabetes: Hemoglobin A1c Measure

CMS is providing guidance relating to measure CMS122 (Diabetes: Hemoglobin A1c Poor Control) included in the 2014 measure set for the Electronic Health Record (EHR) Incentive Program for Eligible Professionals due to an error in the original posting. CMS122 measures the percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0 percent during the measurement year. A patient meets the numerator condition if any of the following are true: (1) the most recent HbA1c reading is > 9.0 percent; (2) the most recent HbA1c result is missing; or (3) if there are no HbA1c tests performed and results documented during the measurement period. CMS122 is an inverse measure, meaning that lower scores indicate better performance. In 2014, this measure was updated as CMS122v3 to include logic and specifications for numerator condition (2), where there is evidence of a laboratory test’s having been performed, but the result of the test was not recorded. This logic introduced an error, which results in patients with HbA1c laboratory results of less than 9.0 percent as being numerator compliant, artificially inflating the (inverse) performance score.

Additional information on what EPs should do if they report the measure can be found on the CMS website.

PQRS Web-Based Measure Search Tool

CMS has recently announced the availability of the new Physician Quality Reporting System (PQRS) Web-Based Measure Search Tool located directly at https://pqrs.cms.gov/#/home and via the PQRS Measures Codes webpage.

This tool will assist EPs and PQRS group practices identify claims and registry measures that may be applicable, and help identify measures that meet reporting requirements for the 2016 PQRS program year. Users may search measure-related keywords as well as search and filter important measure-related information such as:

  • Measure Number
  • Reporting Methods
  • National Quality Strategy (NQS) Domain
  • Cross-Cutting Measures
  • Measure Steward

The PQRS Web-Based Measure Search Tool allows users to click on a measure to view the individual claims and registry measure specifications available for 2016.

Additional information on the search tool can be found on the CMS website.

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AMA Offers Guide to Physician-Focused Alternative Payment Models

The Medicare Access and CHIP Reauthorization Act (MACRA) created new opportunities to advance alternative payment models (APMs). For services furnished from 2019 through 2024, MACRA provides a 5 percent annual bonus payment to physicians who participate in APMs and exempts those physicians from participating in the Merit-Based Incentive Payment System (MIPS).

In addition to accountable care organizations (ACOs), medical homes, and bundled payments for hospital-based episodes, MACRA also provides for the development of “physician-focused” APMs. The American Medical Association (AMA) and the Center for Healthcare Quality and Payment Reform developed a “Guide to Physician-Focused Alternative Payment Models” describing seven different APMs that can help physicians in every specialty redesign the way they deliver care in order to improve patient care, manage health care spending, and qualify for APM annual bonus payments.

These seven APMs have been designed to meet the MACRA eligibility criteria for APMs. Under each APM, physicians would take accountability for specific aspects of spending and quality they can control or influence. Unlike many APMs that have been implemented to date, however, the physician-focused APMs would not place physicians at financial risk for costs they cannot control. Each of the APMs in this report would give the participating physicians the resources and flexibility to redesign care to successfully improve care and manage spending for the particular patients, conditions and episodes for which they would be accountable.

In addition to describing the APM designs, the guide also provides examples of how the APMs are being used by different specialties and how they could be applied to diverse patient populations, including cancer care, cardiovascular care, chronic disease management, emergency medicine, gastroenterology, maternity care, and surgery.

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Research News

Endocrine Society Submits Comments on Proposed Common Rule Update

On September 2, the Department of Health and Human Services (HHS) announced a notice of proposed rulemaking (NPRM) to the set of ethical rules that broadly apply to Federal Agencies that conduct human subjects research (the Common Rule). The Endocrine Society’s Research Affairs Core Committee discussed the proposed updates to the rule and identified several encouraging provisions in the rule. However, members also expressed concern with the proposed expansion of the definition of human subjects research to include research involving biospecimens, and thought that several other provisions should be further clarified. On January 4, the Endocrine Society submitted a letter to the Office of Human Research Protections emphasizing the following key points:

  • The clause that “grandfathers” research before the rule takes effect is important and should be clarified.
  • The revisions should avoid introducing barriers that might be more onerous for under-resourced institutions, because these institutions serve populations that are critical for addressing gaps in health disparities research.
  • It should be recognized that there is a “beneficence” aspect to human subjects research, and that patients value the opportunity to contribute meaningfully to the biomedical research enterprise.
  • More data needs to inform the proposals for limits on broad consent for biospecimens. Patients might not want to be re-consented, or have incidental findings reported. The 10-year follow-up proposal is not feasible for researchers.
  • There should be a standard proposed length for consent forms with suggested language where possible.
  • Yearly reviews and check-ins should be minimal for studies in which data collection has been completed or in which the only risk is privacy.

The full text of the letter can be found on the Society’s webpage. The Endocrine Society will continue to monitor and report on any proposed updates to the Common Rule, and we wish to extend our thanks to those members who provided input in response to the Society’s earlier call to action.

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Society Members Elected to National Academy of Medicine

The National Academy of Medicine (NAM, formerly the Institute of Medicine), was established in 1970 to address “critical issues in health, science, medicine, and related policy.” In 2015, the NAM elected 70 new domestic and 10 international members, in recognition of major contributions to the advancement of medical sciences, health care, and public health. Newly elected members of the NAM include Endocrine Society members E. Dale Abel, M.B.B.S., D.Phil; and Christopher K. Glass, M.D., Ph.D.

The Academy has addressed many issues of importance to Endocrine Society members, including testosterone replacement therapy in men, Medicare coverage of routine thyroid screening, and contraceptive research and development. The Society is encouraged by the election of Endocrine Society members to the NAM. We extend our congratulations to Dr. Abel and Dr. Glass and look forward to the impactful work that they will contribute to as members of the Academy.

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