News & Updates: December 2022
Happy Holidays from SCOA
Kick off 2023 with a Webinar!
Strategies to Assess & Mitigate Unstable Patient Behavior 
When: Thursday, January 5th
1:00-2:00 PM (ET)
Speaker: David Ring, MD, PHD 
Dell Medical School, The University of Texas at Austin
People don’t seek care for a symptom. People seek care when a symptom becomes a concern. When the symptom is particularly unsettling, people may think magically: “the specialist is my only hope.” Guiding people to a collaborative, active, practical approach to health is no easy task. That is a relationship threatening moment. This places the emphasis in specialty care on healthy relationships. Specialists and care teams can enter encounters with the mindset “soothe, not solve.” There are several useful communication strategies that specialists can master one-by-one to decrease stress in their day and help them enjoy even the most cranky patient. 
The webinar is a free educational offering for our members.
Please follow the instructions to register for the event.
After registering, you will receive a confirmation email containing information about joining the webinar
SC Legislative News: Meet the Members
2023-2024 House of Representatives
Medical, Military and Municipal Affairs Committee
Chairman Sylleste Davis (R, Berkeley, House District 100) Elected 2016, previously served on Judiciary Committee and Rules Committee
Vice Chairman Bobby Cox (R, Greenville, House District) Elected 2020, previously served on Labor, Commerce and Industry Committee 
Defeated West Cox in June Primary
BIO per his website: Beach is a former airborne infantryman. He is a realtor and lives in Piedmont with his wife and three children. KEY ISSUES: protect against CRT and sexual propaganda in schools; protect Right to life and 2nd Amendment; cut taxes
Elected 2022, previously a member of 3M  
Fills seat left open by Joe Daning
BIO per his website: CEO at Threat Management Group, former member of Berkeley County Council, former US Air Force, former City Council of Goose Creek, married to Hannah
KEY ISSUES: veterans and military issues
Wendell Gilliard (D, Charleston, House District 111) Elected 2009, previously a member of 3M.  
Defeated Rita Allison in the June Primary
BIO per his website: married to Janice Harris; father to 6 children; registered nurse
KEY ISSUES:  Personhood, Medical Freedom, Constitutional Carry, Election Integrity, School Choice, Road Repair, Tax cuts using budget surplus, Sales Tax vs. Income Tax
Elected 2007, previously a member of 3M.  
Fills open seat left by Leola Robinson
BIO per his website: father to 3; Founder and Sr. Pastor at Changing Your Mind Ministries; Founder of Wendell Jones Leadership Institute which trains and mentors African-American business owners; former owner of Nationwide Insurance Services; former VP of Wachovia Bank (now Wells Fargo)
KEY ISSUES: Protecting voting rights, affordable housing, criminal justice reform, livable wage/minimum wage
Fills open seat left by Steve Moss
BIO per his website: Director of Operations at American TransMed, Inc.; former Reserve Police Officer; National Registered Paramedic; former President of Ambulance Provider’s Association; lifelong resident of Spartanburg; married to Karen Lawson; father to 2 children
KEY ISSUES: Support for first responders; veterans; improve roads; education
JA Moore (D, Berkeley & Charleston, House District 15) Elected 2020, previously served on Agriculture, Natural Resources, and Environmental Affairs Committee  
Fills new seat drawn during redistricting
BIO per his website: retired from US Army after 20 years of service; served as Tega Cay City Council Mayor and Mayor pro temp for 6 years; served as district director for Congressman Ralph Norman; married to Linda O’Neal; father to 2 children
KEY ISSUES: roads, schools, public safety
Defeated Krystle Matthews in the General Election
BIO per his website: realtor and teacher; married to Mary Pace; they have 1 child
KEY ISSUES: limited government
Defeated Kimberly Johnson in the General Election
BIO per her website: lifelong resident of SC; owns IT business in Manning with her husband; 2 children
KEY ISSUES: parental rights; education; pro-life; voter integrity
Elected 2017, previously served on Agriculture, Natural Resources, and Environmental Affairs Committee and Legislative Oversight Committee 
Fills seat left by Gary Simrill’s retirement
BIO per his website: businessman; Vice President of a local land clearing contractor; married with three children
KEY ISSUES: Public Safety, Education, Infrastructure
Elected 2022, previously served on Education and Public Works Committee and Regulations and Administrative Procedures Committee
Defeated Rick Martin in the June Primary
BIO per his website: veteran; small business owner; married to Linda White; father to 2 children
KEY ISSUES: support law enforcement; protect 2nd Amendment; parental rights in classrooms; 100% pro-life; term limits, election integrity
Federal Healthcare News
Omnibus Spending Package Implications for Physician Practices
President Biden signed the omnibus package Friday, December 23, 2022. This massive spending package included several provisions relevant to physician practices:

  • 4% PAYGO cut to physician Medicare payments is eliminated through 2024.
  • The scheduled 4.5% physician fee schedule cut effective 1/1/2023 is reduced to 2%.
  • Telehealth waivers continue through 2024.
Unfortunately, prior authorization reform did not make it into the omnibus package.
CMS Will Not Enforce Advanced Requirements of Good Faith Cost Estimates
The Centers for Medicare & Medicaid Services (CMS) has clarified that it will not enforce the 01/01/2023 requirement to include co-provider and co-facility charges in good faith cost estimates to uninsured and self-pay patients. In a FAQ document specific to this requirement, CMS said it wants to extend enforcement discretion pending future rulemaking.  
Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers
A November 2022 Office of Inspector General (OIG) audit report revealed that Medicare has overpaid many physicians for co-surgery and assistant-at-surgery services billed without appropriate modifiers. The audit indicated Medicare contractors lacked appropriate safeguards to stop payment of claims submitted by two different providers for the identical procedure code for the same patient on the same date of service. Surgery practices should expect increased scrutiny of co-surgery and assistant-at-surgery services given the publication of these audit results.
HHS Office for Civil Rights Issues Bulletin on Requirements under HIPAA for Online Tracking Technologies
All physician practices should review this bulletin as recent breach notices impacting almost 6.5 million patients from WakeMed Health, Advocate Aurora Health, Community Health Network and Novant Health were directly linked to pixel tracking tools utilized in conjunction with their websites, apps and patient portals to mine patient data. These incidents have brought tracking technologies to the HIPAA enforcement forefront prompting OCR to issue a bulletin specific to this topic.
Future Events
Add the SCOA Annual Meeting to Your 2023 Calendar
6th Annual Athletic Trainers in the Physician Practice Society Meeting & Conference
February 23rd - 25th, 2023
USC Alumni Center - Columbia, SC
19.5 CEUs
Helpful Resources for Patients & Staff
Medicare Plans Patient Resource Center
Well-organized site that compiles easy-to-understand explanations about Medicare (original and advantage plan) coverage. While written for patients, it’s a good resource for billing staff also.
Get Started with Medicare
Official CMS site designed for patients. The site is organized into 3 sections: Basics, Health & Drug Plans and Providers & Services. The Providers & Services section includes covered services, cost information and a physician/facility comparison tool. Another resource designed for patients that may be helpful to billing staff – especially employees who are new to that role.
WATCH: A Terrible Guide to the Terrible Terminology of U.S. Health Insurance
In this hilarious and sadly accurate YouTube video, Brian David Gilbert offers a video guide to US health insurance terms and acronyms, including but not limited to HMO, PPO, EPO, POS, HSA, FSA, MSA and HRA. The video is 30 minutes and was released before the No Surprises Act was implemented, but it provides an entertaining overview of key health insurance terminology. This resource was also created for patients, but it could be a good training tool for staff members new to billing roles.
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Leadership Book Nook
The 48 Laws of Power 
by Robert Greene
The 48 Laws of Power is a handbook which illustrates how to assert authority through various tactics. Each of the 48 laws has a thorough explanation followed by an observance of the law illustrated by a historical event, interpretation of the law by applicable event, and the positive and negative attributes of the law. 
The 20th law, do not commit to anyone, is one that I firmly stand behind. When situations arise that I need to mediate, I do not directly support any of the parties involved or even show bias. I am interested and supportive in both parties’ perspective, but I always attempt to stay neutral. Staying indeterminate allows the parties to find a resolution amongst themselves.
By having a neutral stance in mediation, I encounter respect, as opposed to anger from all parties. Once the people acknowledge your independence, you are more desirable, causing others to commit to you (Greene & Elffers, 2000). 
I was hesitant to read this book, as I do not like to hold power over anyone or have it held over me. To be an effective leader, having power over people is not the answer, so I assumed this book would be aggressive in its morals. However, while reading this book, I was able to relate to the laws based on personal situations, embracing the lessons taught throughout its 48 Laws. I recommend this book for anyone in leadership, management, or just intrigued by the history presented in the book. 
Greene, R., & Elffers, J. (2000). The 48 Laws of Power (pp. 1-452). Penguin Books
Summary submitted by:
Ariana Casanova, MBA
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Learn on Demand
Our Webinar Archive Includes:
  • Stocking Stuffers from CMS and Other New Year’s Surprises
  • Information Sharing Under the Information Blocking Regulations: What Healthcare Providers Need to Know
  • Lunch, Laugh, Learn & Lead featuring ​comedian Robert Mac!
  • Replay AI in MSK Care Delivery: Potential vs Risk
  • Marketing, Social Media, & The Physician Practice: Legal Implications
  • Physician Financial Relationships & Conflict of Interest Policies
  • And more!
Member Benefit: Discover OrthoEvidence
Our members receive complimentary access to OrthoEvidence (OE), which is the global online source for high quality and timely orthopaedic-only evidence-based summaries, pre-appraised by orthopaedic medical experts.
Thank You To Our Corporate Partner:
South Carolina Orthopaedic Association