Those using Google Chrome have been experiencing intermittent issues viewing links on CMS.org. We recommend using a different Internet browser such as Safari if you receive an error message. Thank you for your patience.

Did your physicians complete a CMS DEI program? Anthem requires reporting on 2023 training 

Anthem recently sent a communication to their network requiring providers and front-office staff to attest to completing a cultural sensitivity and anti-bias training in 2023. The response deadline is June 15, 2024. The Colorado Medical Society provided several programs in 2023. Ask your providers if they completed one of the following programs, and CMS will confirm attendance. Reply to this email with questions.

• Dr. David Newhouse, Feb. 28, 2023; "CMS Virtual Grand Rounds webinar: Using data to improve the physician-patient visit experience;" 1 AMA PRA Category 1 Credit™
• Dr. Regina Richards, March 10, 2023; “Got Bias? Of course we do; now what?”; 1.5 AMA PRA Category 1 Credits™
• Dr. Rita Lee, HEAL: Foundations in Equity Series
• "DEI 101;" July 27, 2023; 1.5 AMA PRA Category 1 Credits™
• "Implicit Bias;" Aug. 23, 2023; 1.5 AMA PRA Category 1 Credits™
• "Microaggressions, Allyship and Upstanding;" Sept. 23, 2023 (CMS Annual Meeting); 1.5 AMA PRA Category 1 Credits™
• "Equity in Action;" Oct. 26, 2023; 1.5 AMA PRA Category 1 Credits™

If you are looking for DEI training in 2024, the CMS DEI Committee recommends a program by Maricopa County Medical Society, "Implicit Bias and its Impact on Healthcare." It is available on YouTube; the recording is not accredited for enduring CME.

Trainings accredited for CME can also be found on AMA Ed-Hub or through the Accreditation Council for Continuing Medical Education (ACCME)'s CME Passport platform. Create a free CME Passport account to search for DEI courses (or any type of CME accredited course) and add filters for those that have Maintenance of Certification (MOC) points, for format (live or online), etc.

Medicaid RAC audit officially fixed

For more than a year and a half the Colorado Medical Society has been working to address issues with a Medicaid RAC audit that were thought to have been addressed at the beginning of 2024.

In a May 1, 2024 communication, HCPF officially confirmed the fix to the initial hospital care code audit: “We have halted mailing on this audit and will ensure that no other notices are mailed for medical claims billed before 2023. Overpayments will only be identified for claims billed in 2023 when a physician from the same specialty and subspecialty who belongs to the same group practice billed the initial hospital care code (99221-99223) for the same patient during the same inpatient admission. This same criteria will be applied to all existing informal reconsideration requests and appeals identified through this audit. Going forward, we will use the E&M medical coding that was in place at the time the claim was billed, which is the normal process for any RAC audits.”   

While it has taken longer than expected, the Colorado Medical Society is pleased to receive this official confirmation. We are grateful to physicians that raised concerns about this issue and encourage their ongoing dedication to providing care for Medicaid patients. CMS appreciates HCPF’s work on this issue. 

Insurance commissioner calls on Anthem and CommonSpirit to reach a deal for Colorado consumers

Anthem Blue Cross and Blue Shield and health care system CommonSpirit Health have been unable to agree to a new contract that would allow CommonSpirit Health facilities to continue to be part of the Anthem provider network, and as of May 1, CommonSpirit facilities and its physicians in Colorado are no longer in-network for patients with Anthem’s commercial, Medicare Advantage, and self-insured health plans. CommonSpirit reported that as of May 13 they hare having "positive conversations" and Anthem reported that they are committed to reaching a new agreement. Read more from the Colorado Division of Insurance.

Events and resources from AMA Professional Satisfaction and Practice Sustainability

Resources for Mental Health Awareness Month

• Behavioral Health Integration (BHI) Compendium, a tool to help physicians and their practices learn about and implement behavioral health integration. Learn more.
• BHI Practice Guides, recently updated and addressing suicide prevention, care for substance use disorder, psychopharmacology, and designing a BHI workflow. Learn more.

Private Practice Simple Solutions: Revenue Cycle Management Part 2

June 4 | 9:15 a.m. MT

Check out the Revenue Cycle Management Part 1 webinar at your convenience, and then join us live for the Part 2 webinar and Q&A with subject matter experts Sea Chen, MD, PhD, and Asa Lockhart, MD, MBA. Learn more.

Reducing Barriers to Physician PTO

June 18 | 11 a.m. MT

Curious about how to overcome barriers to personal time off (PTO) at your health care organization? Join us for a webinar and live Q&A with Jill Jin, MD, MPH, and Marie Brown, MD, MACP. Learn more.

How Integrated Behavioral Health Can Strengthen Value-Based Care

June 20 | 9 a.m. MT

In this webinar from the BHI Collaborative, speakers Caroline Carney, MD, and Maria Wilson, MD, discuss leveraging behavioral health integration within value-based care arrangements. Learn more.

Private Practice Playbook

This recently updated AMA STEPS Forward® playbook includes new guides on revenue cycle management and patient scheduling, as well as updated information on behavioral health integration, recruitment strategies, marketing and branding, and more. Learn more.

The CSU Health Network is recruiting for a Director of Psychiatry Services - The Director of Psychiatry Services has administrative responsibility for the management of Psychiatry Services and provides leadership, direction, and clinical supervision in accordance with departmental, organizational, and University goals and objectives.

This position provides patient care; supervises, assesses, plans, implements and evaluates the delivery of patient care; develops and implements programmatic plans, including performance improvement activities and compliance with current regulations; develops and administers comprehensive programs that responds to patient demographic needs; supervises and evaluates all personnel assigned to Psychiatry Services; and effectively utilizes employee resources and time responsibilities for the department.

This position reports directly to the Executive Director of the CSU Health Network and serves as a member of the Leadership Team, which is responsible for strategic planning, assessment, accreditation, and other large scope initiatives. Read more here. 

Do you have a position open at your practice? Space to sub-let? Selling your practice? Place a job board or classified ad with CMS! CMS members receive the first month free. Contact debra_will@cms.org for more information!