The Latest on ACOs, eRx, and Pre-Existing Insurance Plans

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June 17, 2011
In this issue
» Medicare Urged to Adjust Its Accountable Care Program

» E-Prescribing Rules May Be Eased Some

» Government to Cut Premiums for Coverage of People With Pre-Existing Conditions

About this newsletter

The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to

Welcome to The ACP Advocate.

To start off this issue we have more to tell you about the Accountable Care Organization (ACO) program from Medicare.  At the beginning of June the College submitted our comments on the proposed rule for the program to CMS.  Our article today details for you exactly what we think needs to be changed in order to make the program successful.  Also, read to the end of the article for information on new initiatives related to ACOs that CMS has recently announced.
We have some promising news to report in our second story.  CMS has recently issued a proposed change to their E-Prescribing (eRx) Incentive Program that may provide an exemption for some physicians.  The change is still in the proposed regulation stage and won’t be finalized until this fall, so any relief from the payment penalty will likely have to be retroactive.  The proposed hardship exemption will not apply to most physicians, so if you have not started eRx already I urge you to check out our resources to help you with the process.  You can find a link to our eRx tools to the right of this letter.
Finally, in our last story this week we tell you about a change the federal government has announced to its new Pre-Existing Condition Insurance Plans (PCIP) that were created as part of the ACA.  In order to allow more people to take advantage of them, the government will be reducing the premium costs and making the enrollment process easier.  This program is meant to act as a bridge to allow those who have previously been denied coverage a means to access it while the states are in the process of setting up their health Exchanges.
For more coverage of what’s happening in Washington, take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty.  You can also follow me on Twitter @BobDohertyACP

And, as always, please send your feedback and suggestions on this newsletter to:

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians   


In the news
» Medicare Urged to Adjust Its Accountable Care Program
  ACP suggests lowering start-up requirements and ramping up over time to make participation realistic for more practices

To make it possible for a more diverse group of primary care physicians to take part in accountable care organizations, or ACOs, the American College of Physicians is calling on the Centers for Medicare & Medicaid Services to create a "ladder" approach... » Click to read the full article

» E-Prescribing Rules May Be Eased Some
  Doctors still encouraged to meet Medicare's June 30 deadline

Physicians who are concerned about their ability to meet new electronic prescribing requirements set to go into effect June 30 could get some breathing room, thanks to a new proposal from the Centers for Medicare & Medicaid Services.

If imple... » Click to read the full article

» Government to Cut Premiums for Coverage of People With Pre-Existing Conditions
  ACP leader urges physicians to spread the word about available insurance option

Hoping to bolster participation in high-risk insurance plans for people with pre-existing conditions, the federal government intends to cut premiums for the plans by up to 40 percent and make it easier to enroll.

The changes will take effect July... » Click to read the full article

In focus
Interested in ACOs?
To keep up with the latest news on Accountable Care Organizations (ACO), or for help deciding if you want to pursue becoming an ACO, check out the College’s new page all-about ACOs. There you’ll find information to help you understand the concept, information about resources from CMS, and ACP’s latest advice.

Are you ready for eRx?
The payment penalties under the Medicare e-Prescribing Incentive Program are set to begin at the end of the month. If you have not yet started eRx you still have time to qualify and avoid the penalty. Check our resource page for information on what you need to do to participate. Also, make sure to read the eRx article in this issue to see if you may qualify for a hardship exemption.

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