PPS historical archive

PPS and Mr. Eriksen is not afraid of taking risks which is evident by the fact that PPS was started in 2008 while most businesses were shutting doors and laying workers off. PPS has been very successful over the past few years and is launching a new marketing campaign in the form of Porsche Road Racing. Mr. Eriksen started racing go-karts at age 8 and cars by the age of 16, so it was only a matter of time before he got back at it again.

PPS will be partnering with Broadfoot Racing (http://broadfootracing.com) to bring our desires to fruition and we hope to be on a track near you by early 2012. We will be building a 450hp Porsche 951 Turbo and will provide free advertising to our favorite clients. You can track the progress of our Racing Program at broadfootracing.com.

I had an interesting opportunity a couple weeks ago to speak with the purveyor of consumer advocacy, Clark Howard. Myself and a friend/client of PPS (Dr. Ali Kasraeian MD http://kasraeianurology.com) met with Clark to discuss our idea of creating a radio program that will help patients take ownership of their health while sharing insight into the healthcare world from the physician’s point of view. Our hope is to create interest and awareness of what goes on behind the scenes while providing patients an opportunity to ask important health questions. I enjoyed meeting him and hope to have him on the show once when it is launched in 2011.

Today, 1/31/2011, a federal judge in Pensacola, Florida declared the Healthcare Reform Law unconstitutional. Specifically, he pointed to the individual mandate requiring citizens to purchase healthcare coverage as unconstitutional and that Congress exceeded the bounds of their authority under the constitution.

You can view the full ruling here: Federal Judge Declares Healthcare Reform Unconstitutional

Florida, as part of the Affordable Care Act (ObamaCare), has increased their primary care fee schedule to reflect that of the current Medicare fee schedule. Here are spreadsheets with 2013 fee schedules for Physicians, Physician Assistants, and Nurse Practitioners. Medicaid Enrollment in Florida is a challenge so we are offering a 15% discount to our services for any new providers who would like to participate in the Florida Medicaid program. This discount will be good for the first six months of 2013. The fee schedule increase does not apply to specialists but as primary care providers, you should request that some of your preferred referral sources participate to ensure they have good specialists to see. The last thing you need is a bunch of patients as a primary care physician without specialists to refer them to.

Immunization Fee Schedule

Physician Surgical Fee Schedule

Physician Medicine Fee Schedule

ARNP Fee Schedule

Physician Assistant Fee Schedule

Affordable Care Act 2014 Overview

We have put together this overview of the Affordable Care Act to help our physicians understand what to expect in 2014 and beyond. The ACA has a number of provisions that dramatically impact physicians and it is critical that you possess an understanding of these provisions to assure you are not surprised when a new regulation takes effect.

Some of the topics we cover are included below:

• Overview of Accountable Care Organizations (ACOs)
• We cover the Performance Initiatives for Physicians and Value Based Purchasing Payments for hospitals
• Exchange products and how to ensure your patients don’t disappear
• Overview of the ACA’s impact on Primary Care Physicians (PCPs) & Specialists
• Medicaid expansion and how it impacts your office
• Explanation of Shared Savings, Captitated and Pay-for-Performance (P4P) insurance contracts
• How to mitigate the financial impact of High Deductible Health Plans

Download Here

Please enter your name and email below If you missed the presentation and would like more information on the replay.

Ask PPS about current services and availability

For the estimated 716,000+ residents of Colorado who still haven’t got health insurance coverage, the state’s Division of Insurance recently released rates of various health plans that comply with the overhaul of the America’s health care system. Eighteen insurance companies currently operating in Colorado will offer 541 separate plans for individuals and small groups.

To help the uninsured shop for insurance, the state of Colorado will open its insurance marketplace on October 1 this year. The health insurance exchange will be called Connect For Health Colorado and has hired “navigators” to explain the health insurance options at various community events, including health fairs. The exchange also has promotional efforts like TV and radio ads planned to get the word out about shopping for insurance.

Many of the states uninsured will be eligible for free healthcare through Medicaid or subsidized health insurance depending on their incomes. But for those choosing to skip health insurance altogether – be warned – they will be fined a minimum of $95 from 2014 onwards , and the fines will go up in subsequent years. So health officials are hoping the exchange will help sign up thousands of uninsured Coloradans by explaining to them the new benefits under the overhaul.

According to this AP article: “… young and healthy customers can now find cheaper premiums for catastrophic health insurance. Health officials are trying to soften the sticker shock by talking up additional benefits those young and healthy consumers will see under the new health insurance plans, such as lower out-of-pocket costs and free preventive care and cancer screenings”

In another example, “… monthly premiums for a 40-year-old customer will range from $177 a month to more than $1,000 a month. The wide range of rates is because premiums depend on the level of coverage and wherein the state a person lives.”

It is also important to note, rates and options available under the new marketplace will depend on where in Colorado a customer lives. By 2015, insurers will also be charging different rates for smokers and non-smokers. The Colorado Insurance Division also approved rates for small group plans, affecting businesses with more than 50 employees. For the least expensive small group plan, monthly base rates for premiums range from $224 with Kaiser Permanente, going all the way up to $1,003 with Humana.

Colorado state officials insist customers will have plenty of help through the state exchange in understanding the new health care landscape. As for how popular and effective the marketplace will be for the uninsured, we’ll only know once it goes live later this year.

Source: Yahoo! News

As you know, there has been a lot of shifting in payers around the country because of the recent healthcare legislation. We received notice from PPO USA Network that they will be terminating operations effective January 2013. This does not come as a surprise but is a disappointment because they have always been very fair to providers when it comes to rates. These smaller networks really lack the financial backing to cope with the overhauls required under the Affordable Care Act (Obama Care). We are seeing a lot of consolidation and a lot of the little players being forced out of the game. This goes for insurance companies and for small physician practices.

Here is the full Press Release/Notice:

Notice of Termination of the PPO USA Network

To:	PPO USA Network Participating Providers in the following states:
	Alabama Alaska Idaho Iowa Louisiana Minnesota Mississippi Montana Nebraska New Mexico North Dakota South Dakota Tennessee West Virginia Wisconsin Wyoming
From:	Government Employees Health Association, Inc. (GEHA)
Date:	September 2012
Re:	PPO USA Network Termination

GEHA has made the decision to cease operating its PPO USA Network in all states on December 31, 2012. Beginning January 1, 2013, GEHA will enter into a shared administration arrangement with UnitedHealthcare in the above states that includes access to UnitedHealthcare Options PPO physicians and hospitals.

Please check GEHA member identification cards for a new claims remittance address and helpful phone numbers for dates of service beginning January 1, 2013. You can also visit GEHA’s website at www.geha.com to find out more about the GEHA Health Plans.

If you are interested in being a preferred provider for GEHA medical members in the states listed above in 2013, you will need to participate with the UnitedHealthcare Options PPO. To find out more about joining the UnitedHealthcare Options PPO network, please call (877) 842-3210.

On behalf of the PPO USA Network Credentialing, Network Development and Provider Relations staff members, we want to thank you for partnering with us to provide PPO services to GEHA Health Plan members during the last 13 years. Please call us at (800) 821-4991, Option 1, if you need additional information or have questions about your current Participating Provider Agreement with GEHA.

For more information you can visit: http://www.ppousanetwork.com/