The Wyoming Department of Health has released a weekly email regarding statistics on Medicaid ICD-10 implementation, claims processing and payment. In its first update on Oct. 2, Medicaid said as of 4 a.m. on Thursday, Oct. 1, the WY Medicaid claims processing system was updated to support full ICD-10 implementation.
The first processing cycle was completed Oct. 2. Medicaid received 55 claims coded in ICD-10. All claims were accepted in to the system without issue. Of importance to note is that all claims with dates of service prior to Oct. 1 coded in ICD-9 were accepted and processed appropriately as well.
Of the 55 claims received, 11 suspended, and 44 processed through successfully. Forty-two of the 44 are set to pay in the upcoming payment cycle and 2 will deny. Of these claims, 39 were medical claims and 3 were institutional claims. Lindsey Schilling with WDH reports there were no ICD-10 related denials in this first batch of claims.
By this week, Wyoming Department of Health said they were seeing an increase in the number of denials related to provider coding and sent a list of coder issues they are seeing. That information can be seen here.
Healthy Wyoming met again this week in Cheyenne. Healthy Wyoming is a coalition of membership organizations and groups representing healthcare industry personnel who are working for quality, affordable healthcare for all Wyoming. Among the tenants of this work is the support of Medicaid Expansion. Conversation this week centered around a grassroots effort to make the case that the state’s budget shortfall could be aided by Medicaid Expansion. If you missed it, Governor Matt Mead announced the need to cut between $100-200 million from the current budget due to a lack of commodity prices and then announced a hiring freeze for state government. Joint Appropriations Chair Tony Ross suggested it could be worse than that for the biennium budget which will start next year.
The Wyoming Board of Medicine will hold its regular meeting on Oct. 9-10 at the Board of Medicine Office in Cheyenne starting at 8 a.m. Click here to see the agenda.
The CMS’ Provider News once again offers a section on ICD-10 as well as stories on HHS Issues Rules to Advance Electronic Health Records with Added Simplicity and Flexibility.
The American College of Physicians (ACP) offered an update on the American Board of Internal Medicine’s MOC program through ABIM’s 2020 Task Force. The detailed Assessment 2020 Task Force Report is publicly available on the web here. Here is a very brief summary of what ACP CEO Steve Weinberger believes are the most important recommendations:
• Replace the high stakes examination every 10 years with a series of low-stakes assessments that could be taken at home or in the workplace, and that could have some open-book and some closed-book portions. A longer examination (or some other form of evaluation) would be necessary only in the absence of satisfactory completion of the low-stakes assessments. This model would likely eliminate the current self-assessment component of MOC.
• Focus the assessments on relevant cognitive and technical/procedural skills, with the opportunity to customize MOC according to the physician’s area(s) of practice. Note that ABIM has already eliminated the need for maintaining an underlying certificate (e.g., Cardiology) for physicians maintaining a more specialized certificate (e.g., Interventional Cardiology).
• Continue to demonstrate non-cognitive skills such as communication, teamwork, quality improvement, etc., as part of primary certification, not MOC. These important competencies are often dependent upon the teams and systems in which the physician practices, and it is currently unclear how and by whom they can best be assessed at the individual physician level.