Mitchell D. Forman, D.O., FACR, FACOI, MACP
NSMA President 2014-2015

Every Nevadan is affected in some way by the members of the NSMA. They are not only your physicians, but your neighbors, friends and advocates in the health care delivery system.

Nevada physicians organized into a state medical society in 1875. As the state's oldest and largest physician advocacy group, today's NSMA mission remains consistent with those pioneer doctors: to serve the practice and professional needs of Nevada physicians so they can serve the needs of their patients. Our diverse membership includes practicing physicians and surgeons, medical researchers, educational faculty and institutional administrators.

Though this site has information restricted to our membership, there is also much information available for the public and the health care community. Development of this site and available resources will continue to expand, so bookmark the NSMA and come back often!

We are proud to represent organized medicine in Nevada, and proud to be your physicians of the Nevada State Medical Association. Is your physician a member?

Third Party Payer Conference

The third annual Third Party Payer Roundtable Conference will be held on Thursday, November 13, 2014.  There will be two half day conferences, registration for the first will start at 8.00 a.m., and registration for the second will start at 1.00 p.m.  The events will be held at 5400 Mill St, Reno, NV 89502.

This event will be free for all NSMA, WCMS and MGMA members and their staff, and the cost for non-members will be $99.

For additional information, please contact Susan Lynch at susan@nsmadocs.org -or- (702) 493-1384.

Event Flyer

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CMSto reopen Meaningful Use Hardship Exemption

Due to significant pressure from the AMA, the Centers for Medicare & Medicaid Services (CMS) has announced the reopening of its Meaningful Use (MU) hardship exception application for physicians and hospitals to avoid the 2015 penalty.  The new deadline will be November 30, 2014.  Previously, the hardship exception application deadline was April 1, 2014 for hospitals and July 1, 2014 for physicians.

While all Medicare physicians have until February 28, 2015 to attest to any 90-day reporting period in 2014 to obtain an MU incentive, Medicare physicians who started the program this year were required to attest by October 1, 2014 to avoid a penalty of up to 2 percent in 2015.  Those new to the MU program can now apply for a hardship exception to avoid this penalty if they missed the October 1 deadline.  In addition, even if you are prepared to attest by February 28, 2015, you can still apply for a hardship exception as a fallback precaution to avoid the penalty.  We believe this hardship exemption will be interpreted broadly by CMS and we therefore encourage all physicians who meet the following criteria to apply by the November deadline.

The hardship exception, however, only provides relief from the MU penalty and will not earn you an incentive.  Meaningful Use incentives are still available for those who are able to meet and attest to the Stage 1 or Stage 2 measures by the February deadline.

This reopened hardship exception period is for Medicare physicians and hospitals that:

·         Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; and

·         Physicians who were unable to attest by October 1, 2014 and hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

The CMS 2014 CEHRT Flexibility Rule allows physicians to use older certified EHR technology (Version 2011), a combination of old and new technology (Version 2011 and Version 2014), or just new technology (Version 2014) to attest for their 2014 reporting period.  A more in-depth review of the rule can be found on our website under “Avoiding meaningful use penalties / Hardship Exceptions.”  Unfortunately, the CMS system was not ready to accept attestations by the October 1, the last date Medicare physicians new to MU could attest to avoid a penalty.  This is part of the reason why CMS elected to re-open the hardship filing period, ensuring more doctors avoid a 2015 penalty.

For more information, and for a link to the hardship exemption application, visit the CMS website.

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Ebola – Open Letter to All U.S. Healthcare Professionals

As a frontline healthcare provider, you play an essential role in protecting the health and well-being of our nation. In light of the recent presentation of an Ebola-positive patient in Texas, we wanted to remind all healthcare professionals that simple steps can be taken to prevent the spread of this disease. You can contribute to our country’s response by being ready to detect a potentially infected patient; protect yourself, your colleagues, and other patients from exposure; and respond with appropriate patient care. Specifically, you should be ready to:

·         Detect: Ask All Patients with Non-Specific Complaints About Recent Travel

A travel history should be taken as early as possible in your encounter with all patients.

Although the signs and symptoms of Ebola are nonspecific (e.g., fever, headache, muscle pain, weakness, vomiting, diarrhea, etc.), Ebola can be virtually eliminated from your differential by ruling out travel to the affected area.

·         Protect: Use Good Infection Control Practices

Consistent and correct use of personal protective equipment (PPE), frequent hand washing, and proper decontamination of surfaces and equipment are key to reducing or eliminating the transmission of Ebola and other communicable diseases (e.g., HIV, influenza, hepatitis, and Enterovirus-D68).

·         Respond: Have a Plan

All healthcare workers should know what to do when encountering a suspected Ebola patient.  It is critical to know who to notify and to make that notification immediately.  Remember, Ebola is a nationally notifiable disease and must be reported to local, state, and federal public health authorities.

The CDC website has many important resources for clinicians to learn more about Ebola.  In addition, the CDC Emergency Operations Center (EOC) is always available at 770-488-7100 or eocreport@cdc.gov.

In the last decade, our nation has made great strides in healthcare system and public health emergency preparedness. As a result of our efforts, we are confident in our collective ability to control the spread of Ebola domestically. Thank you for your continued partnership and dedication to national health security.

Best regards,

Nicole Lurie, M.D., M.S.P.H.

RADM, U.S. Public Health Service

Assistant Secretary for Preparedness and Response

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Southern Nevada Candidate Mixer TONIGHT

The Southern Nevada Meet the Candidates Legislative Mixer will be held tonight, October 2, between 5:30 p.m. and 7:30 p.m. at the Mercedes Benz – Fletcher Jones Imports on 7300 W. Sahara Avenue.  Come meet the candidates for the 2014 general elections.

Event Flyer

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CCMS Margin Tax Town Hall Meeting

The Clark County Medical Society Margin Tax Town Hall Meeting will be held on October 9, 2014 between 5:30 p.m. and 7:00 p.m. Before you go to the polls please attend this Town Hall to hear how the Margin Tax will impact you and your business practice.


Town Hall Flyer

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UNSOM Distinguished Speaker Series 2014

Dr. Bill Thomas
“The Second Wind: Navigating the Passage to a Slower, Deeper and More Connected Life”
Dr. Thomas is an international expert on elderhood and geriatric medicine. The Wall Street Journal highlighted Dr. Thomas as one of the nation’s “top 12 innovators,” changing the future of retirement in America, and US News and World Report named him as one of “America’s best leaders.” The magazine noted his “startling common-sense ideas and his ability to persuade others to take a risk,” and concluded that “this creative and wildly exuberant country doctor has become something of a culture changer – reimagining how Americans will approach aging in the 21st century.” Dr. Thomas is the founder of the Eden Alternative and Green House Project, an author and musician. His most recent book, Second Wind, will be available for purchase and signing at both event locations.

Please register by Tuesday, October 28 at http://bit.ly/thomas14

Reno Event
Tuesday, November 4, 2014
Reception 5:00 p.m.
Presentation 5:30 p.m.
Milt Glick Ballrooms, 4th floor
Joe Crowley Student Union
University of Nevada, Reno
Information for community guest parking available at: http://bit.ly/reno-map
Reno streamed live at: http://dhs.unr.edu/watch-live

Las Vegas Event
Wednesday, November 5, 2014
Reception 5:30 p.m.
Presentation 6:00 p.m.
Keep Memory Alive Event Center
Cleveland Clinic
Lou Ruvo Center for Brain Health
888 W. Bonneville Avenue
Las Vegas, NV 89106
Parking and directional map at: http://bit.ly/lv-map

Presented by the University of Nevada, Reno Division of Health Sciences, University of Nevada School of Medicine, Sanford Center for Aging, and Cleveland Clinic Lou Ruvo Center for Brain Health

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The 2014 Northern Nevada Candidate Mixer will be held Tonight at 5:30 p.m.

The 2014 Northern Nevada Candidate Mixer will be held TONIGHT, September 25.

The event will start at 5:30 p.m. and will be held at The Washoe Steakhouse Gathering Room, 4201 W. Fourth Street, Reno, Nevada.

Event Flyer

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2014 Northern Nevada Candidate Mixer

The 2014 Northern Nevada Candidate Mixer will be held tomorrow, September 25.

The event will start at 5:30 p.m. and will be held at The Washoe Steakhouse Gathering Room, 4201 W. Fourth Street, Reno, Nevada.

Event Flyer

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Things to Know About Hydrocodone Reclassification

If you prescribe hydrocodone combination products, prescribing these medications to the patients who need them to alleviate pain just became more complicated. A new rule from the Drug Enforcement Administration (DEA) taking effect Oct. 6 reclassifies these drugs as Schedule II controlled substances, prohibiting refills and establishing other restrictions that will require major changes to prescribing practices.

  • Refills aren’t allowed for prescriptions that are written beginning Oct. 6. Be prepared to issue new hard-copy or electronic prescriptions for patients. Note that eScripts can only be used if state law permits and the prescriber is certified to ePrescribe Schedule II substances. Pharmacies also must be certified to accept eScripts for controlled substances.
  • Prescriptions issued before Oct. 6 won’t necessarily qualify for refills. The DEA rule and Nevada regulation allow for refills of prescriptions issued before Oct. 6 to continue until April 8, 2015, but other factors, including some pharmacy quality and safety processes, could prevent patients from getting those refills. Some states also have stricter requirements than Nevada does.
  • Prescriptions can’t be called in or faxed. Make sure to plan ahead for any patients who may need refills. The new rule prohibits pharmacies from filling prescriptions delivered over the phone or via fax, so you’ll need to issue written scripts.  The only exception to this rule is emergency treatment, which would allow physicians to call in a limited quantity of the medication to cover the emergency period only. Pharmacies are required to report prescribers to the DEA if they make such a request and do not give the pharmacy a written prescription within seven days.
  • Multiple prescriptions may be issued at one time under certain circumstances. The new rule does allow a patient to receive prescriptions that would total a 90-day supply, if the prescriber has determined it is appropriate to see the patient only once every 90 days. Each prescription must include written instructions that specify the earliest date it may be filled.  In addition to sound medical judgment and established medical standards, make sure to base your practice’s policy on issuing multiple prescriptions on relevant federal and state laws.
  • Patients should be notified of the new requirements and processes. Make sure your patients understand that their new prescriptions will not be refilled and are aware of the procedures they will need to follow going forward.

For more information navigate to the AMA’s page on hydrocodone rescheduling.

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Employed Physician Seminar

The Nevada State Medical Association Employed Physician Seminar will be held on Wednesday, September 17, 2014 between 5:00 p.m. – 8:00 p.m at the Sunrise Auditorium, 3186 South Maryland Parkway, Las Vegas, NV 89109.  The event will feature a selection of national healthcare experts and will focus on physician integration options, physician practice integration concerns, and employment contract considerations.

Event Agenda, Flyer, and Registration

The Nevada State Medical Association Employed Physician Seminar will be held on Wednesday, September 17, 2014 between 5:00 p.m. – 8:00 p.m at the Sunrise Auditorium, 3186 South Maryland Parkway, Las Vegas, NV 89109.  The event will feature a selection of national healthcare experts and will focus on physician integration options, physician practice integration concerns, and employment contract considerations.

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