JULY/AUGUST 2010 | Volume 16 | Number 4
SCCMA PAST PRESIDENT HOWARD SUTKIN, MD, PASSES THE GAVEL TO SCCMA INCOMING PRESIDENT THOMAS DAILEY, MD INSIDE: JOHN JAMESON, MD, STARTS HIS NEW TERM AS MCMS PRESIDENT
The Santa Clara County Medical Association, Monterey County Medical Society and CMA are pleased to announce a new 10-year and 20-year Term Life program for members. You now have a choice of locking in your premium rate for the first 10 or 20 years of your policy,* enabling you to achieve dramatic premium savings. And you can apply for limits of up to $1,000,000! Now is the time to take a good look at the SCCMA/MCMS/CMA plan if:
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• The amount of coverage provided by your medical group isn’t enough and you can’t take it with you if you leave
Call Marsh today at 800-842-3761 for information on this new program and to determine how you can save on your life insurance! Underwritten by:
and 29 County Medical Associations & Societies
Administered by:
Insurance is provided by ReliaStar Life Insurance Company, a member of the ING family of companies.
*The initial premium will not change for the first 10 or 20 years unless the insurance company exercises its right to change premium rates for all insureds covered under the group policy with 60 days advance written notice. 49815 (5/10) ©Seabury & Smith Insurance Program Management 2010 • d/b/a in CA Seabury & Smith Insurance Program Management 777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.Insurance@marsh.com • www.MarshAffinity.com
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BULLETIN THE
Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society
700 Empey Way • San Jose, CA 95128 • 408/998-8850 • www.sccma-mcms.org
MEMBER BENEFITS
From the Editor’s Desk.................................................................................5 Joseph Andresen, MD
Legal Services/On-Call Library
Message From the New SCCMA President.................................................6
Reimbursement Advocacy/ Coding Services
Message From the New MCMS President...................................................7
Billing/Collections
Thomas Dailey, MD
John Jameson, MD
Discounted Insurance
2010-2011 MCMS/SCCMA Seminars & Events............................................8
Referral Services With Membership Directory/ Website
The Diabetes and Cardiovascular Disease Provider Reference Guide Is
Legislative Advocacy/MICRA House of Delegates Representation Practice Management Resources and Education Financial Services Professional Development Health Information Technology Resources
Now Available!........................................................................................10 Carol A. Lee, President & CEO, CMA Foundation
Coding Qs.................................................................................................... 11 Sandie Becker, CMC
Are You in Control of Your Workers’ Compensation Costs?....................13 MCMS’s Annual Meeting and Installation Dinner...................................14 2010 SCCMA Award Presentations and Installation...............................19 SCCMA Awards Banquet Photos...............................................................24 MEDICO News.............................................................................................32
Publications
SCCMA Alliance News................................................................................35
CME Tracking
Classified Ads..............................................................................................36
Physicians’ Confidential Line
Welcome New Members / In Memoriam..................................................38
Verizon Discount Human Resources Services PAGE 3 | THE BULLETIN | JULY / AUGUST 2010
The Santa Clara County Medical Association Officers
AMA Trustee - SCCMA
Councilors
President Thomas Dailey, MD President-Elect William Lewis, MD Past President Howard Sutkin, MD VP-Community Health Cindy Russell, MD VP-External Affairs Rives Chalmers, MD VP-Member Services Scott Benninghoven, MD VP-Professional Conduct Eleanor Martinez, MD Secretary Sameer Awsare, MD Treasurer James Crotty, MD
James G. Hinsdale, MD
El Camino Hospital of Los Gatos: To Be Appointed El Camino Hospital: Lynn Gretkowski, MD Good Samaritan Hospital: Jeff Kaplan, MD Kaiser Foundation Hospital - San Jose: Efren Rosas, MD Kaiser Permanente Hospital: Allison Schwanda, MD O’Connor Hospital: Jay Raju, MD Regional Med. Center of San Jose: Emiro Burbano, MD Saint Louise Regional Hospital: John Saranto, MD Stanford Hospital & Clinics: Peter Cassini, MD Santa Clara Valley Medical Center: John Siegel, MD
Tanya W. Spirtos, MD (Alternate)
SCCMA/CMA Delegation Chair Tanya W. Spirtos, MD (District VII)
CMA Trustees - SCCMA Martin L. Fishman, MD (District VII) Susan R. Hansen, MD (Solo/Small Group Physician) James G. Hinsdale, MD (President-Elect) Randal Pham, MD (Ethnic Member Organization Societies) Tanya W. Spirtos, MD (District VII)
Chief Executive Officer William C. Parrish, Jr.
BULLETIN THE
Official magazine of the Santa Clara County Medical Association and the Monterey County Medical Society
Printed in U.S.A.
THE MONTEREY COUNTY MEDICAL SOCIETY OFFICERS
Editor
Joseph S. Andresen, MD
Managing Editor Pam Jensen
Opinions expressed by authors are their own, and not necessarily those of The Bulletin or the Santa Clara County Medical Association and the Monterey County Medical Society. Acceptance of advertising in The Bulletin in no way constitutes approval or endorsement by the Santa Clara County Medical Association or the Monterey County Medical Society of products or services advertised. Address all editorial communication, reprint requests, and advertising to: Pam Jensen, Managing Editor 700 Empey Way San Jose, CA 95128 408/998-8850, ext. 3012 Fax: 408/289-1064 pjensen@sccma.org
President John Jameson, MD President-Elect James Ramseur, MD Past President William Khieu, MD, MBA Secretary Eliot Light, MD Treasurer John Clark, MD
CHIEF EXECUTIVE OFFICER William C. Parrish, Jr.
DIRECTORS Paul Anderson, MD
Patricia Ruckle, MD
Valerie Barnes, MD
Scott Schneiderman, DO
Ronald Fuerstner, MD
Kurt Sliger, MD
David Holley, MD
Steven Vetter, MD
R. Kurt Lofgren, MD
CMA TRUSTEE – MCMS
© Copyright 2009 by the Santa Clara County Medical Association. PAGE 4 | THE BULLETIN | JULY / AUGUST 2010
Valerie Barnes, MD
FROM THE EDITOR’S DESK
July 4th... By Joseph Andresen, MD On this fourth day of July 2010, we celebrate the two hundred and thirty-fourth anniversary of our nation’s independence. It is a perfectly fitting day here in Palo Alto. A warm breeze and sunny blue sky beckon one to step outside. After many hours in the hospital this past week, I quickly respond to this temptation. Soon on a morning bike ride, ascending Page Mill Road, the city landscape disappears far below. The occasional motorcycle, station wagon filled with camping gear, and soaring hawk interrupt the solitude of the moment. My mind wanders with each curve and switch back in the increasingly steep pitch of the asphalt grade.
Once a logging road, Page Mill is now a route to the coast with rural open space parks. The majestic slopes sit as obstacles to the urban sprawl of Silicon Valley. This path was cut through the fields and forests hugging the side of the coastal range in the 1800s. A century earlier, 13 colonies, 3,000 miles away, formed a new nation and declared independence as the United States of America.
As a national holiday, we celebrate our independence with pride. It is a time for family and friends, picnics, barbeques, and fireworks. It is also a time to recognize the thousands of men and women who are overseas in uniform and unable to share this holiday with their families. May we also remember our fellow Americans who cannot find work and the thousands who have been adversely affected by the Gulf oil disaster.
Two hundred and thirtyfour years ago, our nation’s future was uncertain. It was the resilience and spirit of past generations that led us to become the greatest democracy in the world. On this Fourth of July, let us again remember and recognize that we too have the resilience and determination to overcome the many challenges of the twenty-first century.
With this new chapter in mind, it is a pleasure to recognize the incoming presidents of the Santa Clara County Medical Association, Dr. Thomas Dailey, and Monterey County Medical Society, Dr. John Jameson.
PAGE 5 | THE BULLETIN | JULY / AUGUST 2010
Joseph Andresen, MD is the editor of The Bulletin. He is board certified in anesthesiology and is currently practicing in the Santa Clara valley area.
MESSAGE FROM THE NEW SCCMA PRESIDENT
PRESENTED AT SCCMA’S ANNUAL AWARDS BANQUET ON JUNE 8, 2010 AT THE FAIRMONT By Thomas M. Dailey, MD, FCCP 2010-2011 SCCMA President Good evening fellow physicians, friends, sponsors, and families. It is a great privilege to stand here and address you as president of the SCCMA. “May you live in interesting times.” This Chinese proverb has been interpreted by some as a curse. Another school of thought is that Confucius originally intended this as a warning to his followers. This fairly summarizes recent events in health care. After decades of presidents from Johnson to Clinton attempting to restructure health care delivery in our country, who would have predicted a one-term senator from Illinois could ride an overwhelming wave of support into the presidency and oversee sweeping reform of health care in America. For those who had the insight to have foreseen this, who would have predicted the politician who came closest to derailing these efforts would come from the Senate seat of Massachusetts, for decades the bastion of health care, advocate Ted Kennedy. You couldn’t make up story lines like what has transpired in the past year.
•
• • •
• •
While we can take pride in the fact that many of the positive elements of the health care bill I have enumerated were championed by California’s Senate and House representatives, in collaboration with the CMA and our Washington lobbyist Elizabeth McNeil, there is much work yet to be done. The Reconciliation Bill itself, while passed on March 30, mandates few immediate changes. Most are implemented gradually over time. The following are examples: •
Where does this leave us today? The Health care and Education Reconciliation Act of 2010, the reconciliation bill passed by House and Senate and signed into law by President Obama on March 30 of this year, in its current form would result in the following: •
Expands health care insurance coverage to 32 million Americans currently uninsured.
Allows children to continue to be covered under their parents’ health care insurance until age of 26. Eliminates denial of insurance for preexisting conditions. Eliminates lifetime caps on health care coverage. Eliminates “rescission” − insurance coverage cannot be cancelled once one becomes ill. Eliminates the Medicare prescription drug coverage gap. Eliminates co-pays for preventative care.
•
The practice of denying insurance for preexisting conditions is eliminated for children, six months after the bill was ratified; for adults, this does not take effect until 2014. While proposing to close the gap, Medicare seniors must pay out-ofpocket for prescription drugs (the so-called “doughnut hole”). This $3,454 gap is only reduced by $250 in 2011. Ten years from now, the gap
Thomas Dailey, MD, FCCP, is the 2010-2011 President of the Santa Clara County Medical Association. He is board certified in pulmonary disease and critical care medicine and is currently practicing with The Permanente Medical Group.
•
is scheduled to still exist, having only been reduced by 75% by 2020! The “luxury” health insurance tax does not begin until 2018. What will happen between now
and then? • • • • •
The 2010 congressional elections The 2014 congressional elections The 2018 congressional elections The 2012 presidential election The 2016 presidential election There is much work yet to be done.
Even if fundamental aspects of the recent Congressional Reconciliation Bill are not altered or overturned by subsequent members of Congress, it is clearly just a limited first attempt at health care reform. This bill has proposed no fundamental improvements in the delivery of health care. While it has increased the number of individuals eligible for health care, it does nothing to improve health care access. Finally, it suggests nothing to constructively address health care cost increases. Continued on page 16
PAGE 6 | THE BULLETIN | JULY / AUGUST 2010
MESSAGE FROM THE MCMS PRESIDENT
AS A NEW FISCAL YEAR BEGINS… By John T. Jameson, MD 2010-2011 MCMS President As a new fiscal year begins, and with the passage of the mammoth health care reform legislation, we can look forward to continued discussions about what consequences will shake out and whether our nation can afford to pay for all it has promised itself. My personal approach is to wait and see, help if I can, and, if need be, make lemonade out of lemons, although I won’t be surprised if some of us choose to add vodka! Whatever your attitude, the MCMS and its parent organization, the CMA, are here to serve you, the membership, and even all doctors who are not members. Ours is a worthy profession, but it constantly faces challenges from other entities, particularly from those who don’t want to pay fairly for our services: government programs and insurance companies are the main culprits here. Then
there are the trial lawyers who want to gut MICRA, the hospitals that want to end the corporate bar on the practice of medicine (so they can hire their own docs and compete with private practitioners), and the chiropractors and their ilk who want to take on our work without the training and skills to do it, etc. The CMA, in particular, is regularly going to bat for us in all these and other areas. But I would be remiss if I didn’t mention other useful services provided by MCMS and the CMA: patient referrals, assistance in billing and collecting, contract analysis, legal and practice information, continuing education for you and your office staff, public health updates, assistance in setting up electronic medical records for your office – and the list goes on! I know that in these difficult economic times, with everyone struggling to keep their noses above water, keeping
John Jameson, MD, is the 20102011 President of the Monterey County Medical Society. He is board certified in pathology and is currently practicing at Natividad Medical Center. informed about issues and communicating with your professional organizations may seem like a luxury. But please, let us hear from you if there is something that you think needs our attention and we can help do something about it. In return, I pledge that the MCMS and CMA will keep you informed about what you need to know in your professional environment, so that we can all effectively do our work and best serve our patients.
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www.1027design.com • 530.941.4706 PAGE 7 | THE BULLETIN | JULY / AUGUST 2010
CALENDAR OF EVENTS
2010-2011 MCMS/SCCMA Seminars & Events Note: All members may attend events held in Monterey and Santa Clara counties, regardless of location of membership. This is a tentative schedule and may change through out the year. For more information, go to sccma-mcms.org.
Month
Date
Day
Time
Sponsoring Society
Description
August
18
Wednesday
12:00pm – 2:00pm
SCCMA
Medical Identity Theft & Breach Prevention (Office Managers Forum) John Chapman
August
18
Wednesday
6:00pm – 8:30pm
SCCMA
Medical Identity Theft & Breach Prevention (MDs) John Chapman
September
28
Tuesday
12:00pm – 2:30pm
MCMS
OSHA (Office Managers Forum/MDs) EnviroMerica
September
29
Wednesday
12:00pm – 2:30pm
SCCMA
OSHA (Office Managers Forum/MDs) EnviroMerica
October
2–4
Saturday – Monday
All Day
October
20
Wednesday
12:30pm – 1:30pm
SCCMA/ MCMS
Webinar “Updating Partnership Agreements” Practice Liability & Consultants
November
10
Wednesday
9:00am – 5:00pm
MCMS
“MBA in 1 Day” (Operations/Finances) Physicians and Office Managers Practice Liability & Consultants
November
17
Wednesday
9:00am – 5:00pm
SCCMA
“MBA in 1 Day” (Operations/Finances) Office and Practice Managers Practice Liability & Consultants
December
9
Thursday
12:00pm – 2:30pm
SCCMA
OSHA (Office Managers Forum/MDs) EnviroMerica
January
26
Wednesday
12:00pm – 2:00pm
SCCMA
Updates/New Medicare Changes Mary Jean Sage Practice Liability & Consultants
January
27
Thursday
12:00pm – 2:00pm
MCMS
Updates/New Medicare Changes Mary Jean Sage Practice Liability & Consultants
February
16
Wednesday
12:30pm – 1:30pm
SCCMA
“Bring Your Own HR Questions – Getting the Most Out of an HR Consultant!” TPOHR
House of Delegates (HOD) Sacramento, CA
PAGE 8 | THE BULLETIN | JULY / AUGUST 2010
Month
Date
Day
Time
Sponsoring Society
Description
February
23
Wednesday
12:30pm – 1:30pm
MCMS
“Bring Your Own HR Questions – Getting the Most Out of an HR Consultant!” TPOHR
March
23
Wednesday
12:00pm – 2:00pm
SCCMA
OSHA (Office Managers Forum/MDs) EnviroMerica
March
24
Thursday
12:00pm – 2:00pm
MCMS
OSHA (Office Managers Forum/MDs) EnviroMerica
April
5
Tuesday
6:00am – 6:30pm
April
12
Tuesday
6:00pm – 8:00pm
SCCMA
Avoiding Burn-Out Practice Liability & Consultants
April
13
Wednesday
6:00pm – 8:00pm
MCMS
Avoiding Burn-Out Practice Liability & Consultants
April
15 – 17
Friday – Sunday
May
3
Tuesday
6:00pm – 8:30pm
SCCMA
Town Hall Meeting CMA’s 2011 President-Elect Will be the Guest Speaker
May
18
Wednesday
12:00pm – 2:00pm
SCCMA
Case Based General Malpractice Scenarios and Ways to Minimize Risk (Office Managers Forum) NORCAL
May
18
Wednesday
6:00pm – 8:00pm
SCCMA
Case Based General Malpractice Scenarios and Ways to Minimize Risk (MDs Only-CME) NORCAL
May
25
Wednesday
12:00pm – 2:00pm
MCMS
Case Based General Malpractice Scenarios and Ways to Minimize Risk (Office Managers Forum) NORCAL
May
25
Wednesday
6:00pm – 8:00pm
MCMS
Case Based General Malpractice Scenarios and Ways to Minimize Risk (MDs Only-CME) NORCAL
June
7
Tuesday
6:00pm – 8:30pm
SCCMA
Awards Banquet at the San Jose Fairmont
CMA’s 38th Annual Legislative Day @ Sacramento (Chartered Bus Trip)
CMA’s Leadership Academy Indian Wells, CA
PAGE 9 | THE BULLETIN | JULY / AUGUST 2010
PRACTICE MANAGEMENT
The Diabetes and Cardiovascular Disease Provider Reference Guide Is Now Available! By Carol A. Lee, President & CEO, CMA Foundation
•
Health care provider and patient education resources
The California Medical Association (CMA) Foundation’s Advancing Practice Excellence in Diabetes Program is aware that many physicians feel overwhelmed and frustrated by the daunting task of addressing diabetes with their patients, given the physical, emotional, social, and environmental factors associated with this disease. Health care providers hear a variety of messages about the prevention, treatment, and management of diabetes that make it increasingly difficult to determine the best plan of action to take with patients.
•
Billing and procedure codes
To access the Diabetes and Cardiovascular Disease Provider Reference Guide, go to http://www.thecmafoundation.org/ projects/aped/Provider_DiabetesRefGuide2010.html.
In an effort to address these issues and improve patient care and outcomes, this reference guide was developed in cooperation with expert panels of physicians and other health care providers to determine the most effective ways to prevent, assess, and treat diabetes and related cardiovascular disease.
Your input is valuable in planning and updating future versions of the Reference Guide. Please take a moment to complete the survey by downloading the PDF form or completing the on-line survey posted on the Project web site.
To learn more about the Foundation’s Advancing Practice Excellence in Diabetes Program, please contact Senely Navarrete, MPH, Project Director, at snavarrete@thecmafoundation. org.
The reference guide includes: •
Guidelines supporting the screening and diagnosis of type 2 diabetes, dyslipidemia & hypertension
•
Approaches to the clinical management of type 2 diabetes and related cardiovascular complications
•
Effective communication techniques PAGE 10 | THE BULLETIN | JULY / AUGUST 2010
practice management
CODING QS By Sandie Becker, CMC Coding & Reimbursement Specialist
Q
: I was underpaid for a service by a payer. The check that accompanied the EOB states that the amount constitutes “payment in full.” Does acceptance of the check mean that the physician has waived her right to appeal the claim for additional payment?
A
: No. If you strike out or otherwise delete that notation before it is cashed, acceptance of the check does not mean that the payer’s liability on the claim is satisfied (Civil Code §1526). Thus, physicians who receive such checks should strike out the notation and pursue their appeal rights.
Q
: I understand that if a payer does not pay my claim within the statutory time frame, they are to pay interest. How do I calculate interest due?
A
: Interest is calculated beginning with the first calendar day after the 30- or 45-working-day- period has elapsed. Example: contracted rate is $325.84. 1. Determine the interest rate. In this example, it is a PPO claim, so interest is 10% per year. 2. Determine amount not paid − in this example it is $325.84. 3. Multiply amount not paid by the interest percent per annum: $325.84 x .10 = $32.58/year.
4. Divide interest due in a year by 365 days to get the daily interest due: $32.58/365 days = $.089/day. 5. Determine the number of days the payment is late. Remember, the clock starts ticking from the 31 (or 46) working day from the day the payer received a clean claim. 6. Multiply the daily interest due by the number of days the payment is late to calculate the interest due − $.089 x 237 days = $21.09. Remember – if the issue is with a Knox-Keene plan that fails to automatically include interest due on a claim, they must pay a $10.00 per claim penalty in addition to the interest due.
Q A
: How should the insertion of ear wicks be reported?
: Per AMA/CPT, ear wick(s) saturated with medication (e.g., antibiotic) is placed into the ear canal to reach an infected area. When performed at the time of another intervention (e.g., 69000, 69020), ear wick insertion is considered inclusive of that procedure, therefore, not warranting additional reporting. Ear wick removal would be inclusive of the follow-up care performed during the postoperative period. When the insertion and/or removal of an ear wick(s) is performed in the absence of another
Would you like to receive updated coding & reimbursement news by email? If so, please call the SCCMA/MCMS office to provide your email address at: 408/998-8850 ext. 3007 or email: sandie@sccma. org. You may also visit our website at: www.sccma-mcms.org. PAGE 11 | THE BULLETIN | JULY / AUGUST 2010
For coding questions and reimbursement issues, contact Sandie @ 408/9988850 or MCMS 831/455-1008 or email sandie@ sccma.org.
intervention, then it is considered a minor procedure not otherwise reported by CPT, and included in the E/M service.
Billing Tip: Are your in-patient initial hospital visits getting denied? Because Medicare no longer pays for consult codes for in-patient hospital visits, physicians who are consulting must now also use code 99221-99223; the same codes used by the admitting physicians. If you are billing for the admitting physician, be sure to use modifier AI to let Medicare know you are billing this code for the admitting physician. If you are billing this code for the consulting physician, do not use modifier AI when billing for the consulting physician’s initial hospital visit. For consulting physicians’ claims, continue to place the referring physician’s name and NPI in blocks 17 and 17b of the 1500 claim form.
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PAGE 12 | THE BULLETIN | JULY / AUGUST 2010
PRACTICE MANAGEMENT
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MEMBER NEWS & HAPPENINGS
MONTEREY COUNTY MEDICAL SOCIETY’S ANNUAL MEETING AND INSTALLATION DINNER The Monterey County Medical Society held its annual meeting and installation dinner on Tuesday evening, June 29, 2010, at the Pasadera Country Club in Monterey. Over 70 members and special guests attended to hear keynote speakers James Hinsdale, MD, president-elect of the California Medical Association, and Dustin Corcoran, CMA chief executive officer, present an update on the CMA.
in the current fiscal year with Dr. Jameson are: James Ramseur, MD, as president-elect; William Khieu, MD, as past president; Eliot Light, MD, as secretary; and John Clark, MD, as treasurer. The MCMS board of directors are Paul Anderson, MD; Patricia Ruckle, MD; Kurt Sliger, MD; Steven Vetter, MD; Valerie Barnes, MD; Ronald Fuerstner, MD; David Holley, MD; R. Kurt Lofgren, MD; and Scott Schneiderman, DO.
William Khieu, MD, 2008-2010 MCMS president, was honored as the outgoing president and John Jameson, MD, was welcomed as MCMS’s incoming president for 2010-2011. Serving
The annual meeting was a great success! MCMS members enjoyed a fantastic meal, comraderie, and entertainment/dancing to wrap up the evening.
PAGE 14 | THE BULLETIN | JULY / AUGUST 2010
Our special thanks to the following sponsors for contributing to the success of this event: GOLD NORCAL Mutual Insurance Company
SILVER Marsh
MCMS members and special guests enjoying food, wine, good company, and entertainment
BRONZE Community Health Care Central Coast VNA Bureau of Medical Economics gloStream Heartland Payment Systems SunPower/Solar Technologies Comerica Bank Santa Clara County Medical Association Community Hospital of the Monterey Peninsula
SCCMA President’s Message, from page 6 Let us not forget what else this bill does create: The Independent Payment Advisory Board. This 15-member board is charged to submit legislative proposals if Medicare cost increases exceed Consumer Price Index for five-year period. As innovations in health care succeed in allowing us to live longer and longer, in what five-year period have Medicare cost increases not exceeded the CPI? There is much work yet to be done. As much as ever in our history, Americans are asking questions and searching for answers about health care in the United States. One of the logical first groups to turn for answers is organized medicine. Unfortunately, it is not typically in our nature to speak in unison. There is a reason why it is said “Ask three doctors a question, and you will receive four opinions”… Well ladies and gentlemen, America is asking questions. If we are unprepared to step forward with answers or, worse yet, if our answers display division, conflict, and contradictory recommendations, the chaos of divergent individual opinions will drown out one another, with the net effect of silencing the voice of physicians.
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If, however, we can rise to the occasion and continually find our common ground; if specialist and generalist, pediatrician and geriatrician, soloist and group practitioner can speak with one voice, that is a voice that millions of confused and frustrated voters − our patients who trust that voice every day − are waiting to hear. I began with a quote from Confucius, and I wanted to end with a quote from another philosopher. This, from a philosopher a bit younger, but no less sage. An individual who has been a mentor to me, and whose counsel I will seek in the coming year, our CMA President-elect Dr. Jim Hinsdale. “The great thing about organized medicine is being able to look out over the landscape, see the diversity of practitioners, both in types of specialties and in ways of practicing, and be able to savor those things that unite us as physicians. It doesn’t mean we can’t be different as individuals. But it does mean that we, as individuals, should temper the self-interest that naturally occurs within us at times to achieve value-oriented goals that are for the better of our patients and society.” Let us move forward. There is much work yet to be done.
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MEMBER NEWS AND HAPPENINGS
2010 Santa Clara County Medical Association Award Presentations and Installation The Fairmont Hotel’s Club Regent, in San Jose, provided the setting this year for Santa Clara County Medical Association’s Annual Awards Banquet. Howard Sutkin, MD, 2008-2010 SCCMA President, following his outgoing president’s speech, presented Thomas Dailey, MD, with the presidential gavel for 2010-2011. Serving in the current fiscal year with Dr. Dailey are: William Lewis, MD, as President-Elect; Cindy Russell, MD, as Vice President of Community Health; Rives Chalmers, MD, as Vice President of External Affairs; Scott Benninghoven, MD, as Vice President of Member Services; Eleanor Martinez, MD, as Vice President of Professional Conduct; Howard Sutkin, MD, as Past President; James Crotty, MD, as Treasurer; and Sameer Awsare, MD, as Secretary. The SCCMA Councilors are: To Be Appointed (El Camino Hospital Los Gatos); Lynn Gretkowski, MD (El Camino Hospital); Jeff Kaplan, MD (Good Samaritan Hospital); Efren Rosas, MD (Kaiser Foundation Hospital – San Jose); Allison Schwanda, MD (Kaiser Permanente Hospital); Jay Raju, MD (O’Connor Hospital); Emiro Burbano, MD (Regional Medical Center); John Saranto, MD (Saint Louise Regional Hospital); Peter Cassini, MD (Stanford Hospital & Clinics); and John Siegel, MD (Santa Clara Valley Medical Center). The evening’s festivities culminated with the recognition of those who have dedicated their lives to furthering the high quality of medical care. Dr. Dailey made the following presentations:
Howard Sutkin, MD – Presidential Appreciation Plaque Appreciation in recognition of his extraordinary service to the Santa Clara County Medical Association. Dr. Howard Sutkin received his medical degree from the University of Chicago Pritzker School of Medicine in 1989. He completed his surgical internship and plastic surgery residency at Stanford University. Dr. Sutkin received specialty training in aesthetic surgery and microscopic surgery, and set up his practice in the South Bay specializing in plastic surgery, hand surgery,
and facial plastic surgery, maintaining offices both in San Jose and Los Gatos. In his spare time, he joined Interplast and headed one of their missions to repair cleft lips and palates in Laos. He joined the Santa Clara County Medical Association in 1995 and immediately immersed himself in the functioning of the medical association. In 1996, Howard served on the Professional Standards Committee, the first of many positions in which he has served our county. In his career, Howard has served on the Finance Committee, Awards Committee, Nominating Committee, Medical-Legal Liaison Committee, Well Being of Physicians Committee, Membership Committee, and Executive Committee. He has served as a delegate to the CMA House of Delegates, and as Region 1 Councilor. From 2001-2007, he served as vice president for Member Services, before being elected president in 2008. As you know, Howard has served in that capacity not for the traditional one-year term, but for the past two years. Dr. Sutkin is only the third two-term president in the history of the Santa Clara County Medical Association. With gratitude to our CEO Bill Parrish for the historic research, Howard joins Dr. Raymond Wayland, who served a two-year term following World
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SCCMA Awards Presentation and Installation, from page 19 War I, and Dr. R. Stanley Krenshaw, who similarly was asked to serve a two-year term during the prelude to World War II. Just as the medical association sought the stability of consistent leadership during those troubled times, the Santa Clara County Medical Association has benefited no less from the stability, honesty, evenhanded open-minded approach that Howard has brought to the medical association throughout his noteworthy two years in office. He has set a very high standard of achievement for anyone foolhardy enough to follow in his footsteps. I look forward to being reminded of that continually throughout the coming year. It is a great honor to present Dr. Howard Sutkin with the Presidential Plaque of Appreciation in recognition of his extraordinary service to the Santa Clara County Medical Association. Congratulations, Howard, and thank you.
Melvin Britton, MD – Benjamin J. Cory, MD Award This award is given to a physician member of the Association who has displayed forward-looking, pioneering ideas, enterprise, enthusiasm, and prolonged professional stature and ability. Dr. Britton has had a long and distinguished career, both with the Palo Alto Medical Clinic, and in leadership roles within the medical association. He has served for 20 years as delegate and alternate delegate to the American Medical Association for the American College of Rheumatology, serving over 500 days! He has been on the Governing Council and also served as chair of the Specialty and Services Society Delegation. He has served as chairman of the board for the Institute for Medical Quality and has been a surveyor in the hospital program, the HMO survey group,
and ambulatory survey group for more than 35 years. Dr. Britton was SCCMA president from 1980-81 and has been a member of SCCMA for 40 years. He still serves as a member of the Medical Review Advisory Committee and Leon P. Fox Medical History Committee. Dr. Britton has given a lifetime of service to medicine and to the medical association. Dr. Britton is being recognized for his exemplary service and wonderful work that he has done, on behalf of all of us in medicine. This honor is very well-deserved!
Gary Steinberg, MD, PhD – Outstanding Achievement in Medicine Award This award is given to a physician member of the Association who, during his/her medical career, has made unique contributions to the betterment of patient care, for which he/ she has achieved widespread recognition. Consideration is given to research and/or the development of procedures, methods of treatment, pharmaceutical agents, or technological advances in the field of medicine. In 1987, Dr. Gary Steinberg joined the faculty at Stanford as an assistant professor in Neurosurgery, being promoted to associate professor with tenure in 1993 and professor in 1997. He founded the Stanford Stroke Center in 1991 and is currently the co-director. He was appointed chairman of the Department of Neurosurgery at Stanford in 1995 and holds the Bernard and Ronni Lacroute–William Randolph Hearst Endowed Chair of Neurosurgery and the Neurosciences. In October 2008, Dr. Steinberg was appointed director of the Stanford Institute for Neuro-Innovation and Translational Neurosciences (SINTN).
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Dr. Steinberg’s experimental research investigates the pathophysiology and treatment of acute cerebral ischemia, as well as methods to restore function after stroke. His laboratory has studied the role of excitatory amino acids, oxidative stress, inflammation and gene expression on experimental stroke, and has explored various therapeutic and restorative strategies such as NMDA antagonists, anti-inflammatory agents, mild brain hypothermia, gene transfer therapy, and stem cell transplantation. He has received numerous grants including NIH NINDS R01 and P01 grants, with continuous NIH funding as Principal Investigator since 1987. He was recently awarded a $20 million grant from the California Institute of Regenerative Medicine to investigate neural stem cells for treatment of motor deficits following sub-cortical stroke and translate this into a Phase I clinical trial. Dr. Steinberg maintains a busy clinical practice specializing in cerebrovascular surgery, with patient referrals nationally and internationally. His clinical research is focused on developing innovative surgical, endovascular, and radiosurgical approaches for treating patients with difficult intracranial aneurysms, complex vascular malformations, and occlusive cerebrovascular disorders including Moyamoya disease. He is heavily involved in teaching, serving as neurosurgery program director from 1995–2004 and training more than 120 residents, clinical fellows, post-doctoral research fellows, graduate students, and medical students. He has published over 230 peer reviewed articles and 95 book chapters, and edited three books primarily related to clinical and basic aspects of cerebrovascular disease. We can think of no one who would be more deserving of the Outstanding Acievement in Medicine Award.
James Hinsdale, MD – Outstanding Contribution to the Medical Association This award is given to a physician member of the Association who has exhibited sustained interest and participation in one or more activities of the Association over and beyond that expected of the membership at-large. After receiving his medical degree from the University of Illinois College of Medicine in 1974, Dr. Hinsdale came to California, where he completed his surgical internship and residency at Stanford University 1974-80. He joined the faculty there and is currently assistant clinical professor of Surgery. He is the founder and president of the Northern California Trauma Medical Group. He serves as the director of Trauma at Marin General Hospital, the executive director of Trauma at Regional Medical Center, and has served as the medical director of California Shock/Trauma Air Rescue for the past 23 years. Dr. Hinsdale joined the Santa Clara County Medical Association in 1987, and it is fair to say we have never been the same. Dr. Hinsdale has touched the lives of many of us in
SCCMA. His positions and contributions to organized medicine are too numerous to list. His rise from SCCMA president to both CMA and AMA trustee to CMA Executive Committee vice-chair, chairman of the Board of Trustees, and now to his current position as CMA president-elect is a testimony to his tenacity, perseverance, and the trust he inspires with his unique communication skills. In trying to do justice to that unique communication style, I surveyed my colleagues for their favorite quote from Jim, coined “Hinsdaleisms” by our CEO Bill Parrish. Needless to say, a few were not appropriate to share, but I thought I would share one with you tonight. After all the Hinsdaleisms that have broadened our understanding of health care, shed insight into the political process, and never failed to bring smiles to our faces, my favorite Hinsdaleism is actually from his daughter as the two discussed continually falling reimbursements: “Daddy, you’ve got to suck it up. Either get used to it, or do something about it.” Clearly, the apple doesn’t fall far from the tree.... Jim, thank you for being someone who always “does something about it.” Thank you for being an inspiration not just to your daughter, but to all of us. Congratulations on an honor welldeserved!
David Levin, MD – Outstanding Contribution in Medical Education This award is given to a physician member of the Association who has exhibited sustained interest and participation in one or more medical education activities over and above that expected of the membership atlarge. Dr. David Levin was born and raised on the East Coast. He graduated Cum Laude from the University of Pittsburgh in 1973, and received his medical degree from Georgetown University
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SCCMA Awards Presentation and Installation, from page 21 Leo Strutner, MD – Outstanding Contribution in Community Service
in Wahington D.C. in 1977. He stayed at Georgetown for his internship, then moved to California where he completed his residency in OB/GYN at the Kaiser Permanente Medical Center in Santa Clara, and was promoted to a staff position in 1981.
This award is given to a physician member of the Association who has exhibited sustained interest and participation in one or more activities of the community over and above that expected of the membership atlarge.
A Fellow of the American College of Obstetricians and Gynecologists, in addition to his published articles and textbook chapters, he has received awards for Outstanding Clinical Instruction in 1984, Excellence in Surgical Teaching in 1988, Special Recognition of Excellent Clinical Teaching in 1990, and the council of Resident Education in OB/GYN National Faculty Award for Excellence in Resident Education in both 1997 and 1999. Dave became the OB/GYN residency director in 1988 and subsequently fashioned what has been recognized as one of the finest OB/GYN residencies in the nation. His program has twice received maximum 5-year accreditations, an honor reserved for the most exemplary of training programs. Throughout his career, Dr. Levin has been an advocate for his residents, nurturing their professional, educational, and personal needs. He has served as a mentor and role model, not only by his clinical excellence, but also his work life balance. An avid skier, hiker, and cyclist, Dave is known for his daily bicycle commute to and from home, regardless of weather. In the words of his chief, Dr. Martin Wong, who is here to honor him tonight, “Dr. Levin’s legacy of excellence for more than a quarter century will surely be enduring in the careers of all our residency graduates and colleagues.” Congratulations, Dr. Dave Levin!
Dr. Strutner is an active member of the Order of Malta (a service organization), as well as the Serra Club of Santa Clara (focused on generating religious vocations). He has volunteered as a server, feeding the poor at Martha’s Kitchen twice a week for over 10 years. Dr. Strutner has also served weekly as spiritual minister for multiple nursing homes in the county for many years. Over the last 10 years, this ministry has grown from volunteers from two parishes and a few skilled nursing facilities (SNF) in Santa Clara County to now involve 16 parishes, 26 SNFs, and 80 volunteers. It is Dr. Strutner’s dedication and unselfish commitment which has nurtured the growth of this ministry, touching the lives of hundreds of elderly every week. Dr. Strutner treats the poor with dignity at Martha’s. As he did in his practice, he continues to demonstrate a spirit of caring. This honor is very well-deserved!
Judge Lawrence Terry – Citizen’s Award For an individual who is not a member of the Medical Association, who has achieved public recognition for a significant contribution in the health field. Judge Lawrence Terry has created a drug court that is a national model, treating addiction as a disease instead of just a legal
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problem. He has affected countless lives and has created a system that is ongoing in our community, getting individuals appropriate treatment. He served the courts of Santa Clara County for over 32 years. Appointed in 1973 to the Municipal Court by Governor Ronald Reagan, he joined the Superior Court in 1979, appointed by Governor Jerry Brown. Judge Terry was assigned to all divisions of the court and has also served as presiding judge of the Municipal Court and the Juvenile Court, as well as supervising judge of the Criminal Division and the Drug Treatment Courts. In 1994, he distinguished his service by establishing the first drug treatment court for the Superior Court. The Drug Treatment Court has gained state and national recognition for its innovative work in introducing treatment and recovery in criminal drug cases. The Drug Treatment Court has grown from a pilot program in 1994 into a major division of the Court, responsible for over 7,000 cases each year with six full-time judges serving in the Drug Treatment Court. It has expanded to meet community needs with specialized components for mental health clients and military veterans. Although retired since 2005, Judge Terry has continued to remain active in community affairs as a member of San Jose Rotary. He also serves on the Oversight Committee for the Lawyer Assistance Program for the State Bar of California; the board of directors of We Care of Santa Clara County; the board of directors of the Other Bar of California; and the Advisory Council for the Salvation Army, Adult Rehabilitation Center (ARC) of San Jose. This honor is very well-deserved!
William Lewis, MD – Dedicated County Alliance Member of the Year Santa Clara County Medical Association Alliance is fortunate to have an active physician member like Dr. William Lewis. Before he joined the Alliance in 2004, Dr. Lewis’s wife, Dr. Sandhya Yadav, had been a longtime Alliance member. Then, in 2004, Bill decided that he wanted to be the one in the family who was listed as the official member, and has been actively participating ever since. Dr. Lewis has served as the chief of staff for Good Samaritan Hospital in San Jose and has served on the Council of the Santa Clara County Medical Association as a council member from 2006-07, VP of External Affairs, 2008-2010, and as chair of the Santa Clara County Political Action Committee, 2008-2010. Dr. Lewis will be installed as the incoming president-elect for the Santa Clara County Medical Association for 2010-11. From his positions on the Council of the SCCMA, Dr. Lewis has provided support for the work of the Alliance by encouraging other members of the medical association to join in events. He has proven to be the Alliance advocate at all the SCCMA meetings and activities. Dr. Lewis is such a giving person with his time and dedication. He and his wife have hosted political fundraisers at their home. He has attended Alliance coffee socials and bunko nights in honor of Doctors’ Day. He and his wife, along with their two daughters, have participated in the community fundraisers, helping to raise thousands of dollars, and have participated in the annual “Christmas Tree Decorating” at the county hospital. When asked to comment on the Alliance, Dr. Lewis stated that “the Alliance is the face of the medical association in the community.” The SCCMAA is certainly privileged to have Dr. Lewis and his family as part of their “family of medicine.”
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SCCMA Has History....
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Twelve SCCMA past presidents, incoming president, and CEO joined together at the 2010 SCCMA Annual Awards Banquet and Installation. Left to Right: Past Presidents Melvin Britton, MD; Martin Fishman, MD; Robert Andonian, MD; Tanya Spirtos, MD; Fred Armstrong, MD; Anthony Nespole, MD; R. Hewlett Lee, MD; Bill Parrish, Jr. (SCCMA CEO); James Hinsdale, MD; John Longwell, MD; Steve Fountain, MD; William Siegel, MD; Thomas Dailey, MD (Incoming President); and Howard Sutkin, MD. PAGE 25 | THE BULLETIN | JULY / AUGUST 2010
T H A N K
Y O U !
Our special thanks to the following sponsors for contributing to the success of this event:
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Law Offices of Hinshaw, Marsh, Still & Hinshaw
Standard Business Machines PAGE 26 | THE BULLETIN | JULY / AUGUST 2010
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2010 Annual Awards Banquet June 8, 2010
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SCCMA Award Honoree, Leo Strutner, MD, and family appreciated the elegant atmosphere of the Fairmont Hotel.
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Awardee Dr. Strutner chats with family.
Incoming SCCMA President Dr. Thomas Dailey enjoys the evening with his significant other, Rosemary.
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Dustin Corcoran, CMA’s CEO gives an update on CMA.
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SCCMA Past President and Award Honoree, James Hinsdale, MD, speaks with Past President R. Hewlett Lee, MD.
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SCCMA Past Presidents and guests enjoy the camaraderie.
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SCCMA Award Honoree, Judge Lawrence Terry and family enjoying good food, wine, and good company. 3
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SCCMA Award Honoree, Judge Lawrence Terry and family.
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SCCMA Award Honorees, Melvin Britton, MD, and Gary Steinberg, MD, PhD, compare notes with SCCMA President Thomas Dailey, MD.
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SCCMA Award Honoree, Dr. Gary Steinberg celebrates his honor with wife Sandy Garritano and colleagues/friends from Stanford Hospital.
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Dr. Roger Hayashi and wife Mary Hayashi (SCCMA Alliance President).
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William Parrish (SCCMA’s CEO) presents thank you gifts to outgoing president Dr. Howard Sutkin and his wife Erika, for supporting her husband during his two-year term and significant time away from home. 3
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L to R: Dr. William Ricks, Debbi Ricks (CMA & SCCMA Alliance Past President), Dan Doore, and Merrily Doore.
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Dr. Howard Sutkin presents his outgoing president’s speech.
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Head Table: L to R clockwise: Erika Sutkin, Dr. Howard Sutkin (SCCMA President 2008-2010), Dustin Corcoran (CMA’s CEO), Rosemary Kamei, Dr. Thomas Dailey (SCCMA President 2010-2011), Luanne Parrish, William Parrish, Jr. (SCCMA’s CEO), Seymour Sutkin, and Bernice Sutkin.
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Additional photos can be viewed and/ or purchased at the following website: http:// brandonvaccarophoto.com/ sccma2010
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Incoming SCCMA President Dr. Thomas Dailey accepts the gavel from Outgoing President Dr. Howard Sutkin.
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SCCMA Award Honoree, David Levin, MD, enjoys the evening with his wife Susie.
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SCCMAA Award Honoree, Dr. William Lewis, won the raffle drawing for a free Ipad (donated by sponsor Chris Foley from Standard Business Machines).
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SCCMA Award Honoree, SCCMA Past President, and CMA President-Elect, James Hinsdale, MD, and his wife Bonnie.
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Dr. Leo Strutner poses with his wife Genevieve.
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MEDICO NEWS
MEDICONEWS Preliminary list of certified EHRs expected this fall Medicare and Medi-Cal physicians who demonstrate “meaningful use” of certified electronic health records (EHRs) will qualify for incentive payments under the 2009 federal economic stimulus package. Federal health officials recently established a temporary EHR certification program. The Office of the National Coordinator for Health IT will immediately begin accepting applications from organizations interested in certifying EHRs under this temporary program. It is expected that lists of certified EHR products will be available in early to mid-fall. For physicians, now is a good time to prepare for the transition to EHR. Until the first list of certified EHR systems is published, physicians can spend time assessing their practices’ EHR needs, mapping office work-flow, and researching potential vendors. Such preparation will enable practices to move quickly once vendors are certified. For more information, see Chapter 7 of the California Medical Association’s Best Practices toolkit, “Successful Preparation and Implementation of an Electronic Health Records System.” The toolkit is free to all physicians at http://www.cmanet.org/ bestpractices.
While the temporary EHR certification program is in place, the federal government will be working on the rules and regulations for a permanent certification program. The permanent program will be more comprehensive and would begin in January 2012. The way the rules governing the EHR certification program are constructed, an EHR system could potentially be certified under the temporary program, and not under the permanent one. It is also conceivable that a system could be certified to achieve stage 1 of meaningful use, but not stages 2 and 3. This was one of the issues that the California Medical Association (CMA) raised when submitting comments on the proposed rule. Because of this possibility, CMA is recommending that physicians ask EHR vendors for meaningful use guarantees for all three stages of meaningful use. On July 13, the federal government is expected to release the final “meaningful use” guidelines, which detail the criteria that physicians will have to meet in order to qualify for incentive payments. CMA will be analyzing the 500+ page meaningful use definition and will prepare an analysis for members as soon as possible. Contact: David Ford, 916/551-2554 or dford@cmanet.org. (CMA Alert, July 12, 2010 issue)
CMS extends PECOS enrollment deadline The Centers for Medicare & Medicaid Services (CMS) recently extended the PECOS (Provider Enrollment, Chain and Ownership System) enrollment deadline to September 1, 2010, to ensure contractors have adequate time to complete enrollment applications before the January 3, 2011, enforcement deadline. Between now and January 3, 2011, if claims are submitted with ordering or referring physicians who are not in the system, the billing provider will receive an informational message explaining that the claim failed the “ordering/referring provider edits.” Affected claims will, however, continue to be processed and paid. Claims received on or after January 3, 2011, will not
be paid if the ordering or referring provider is not enrolled in PECOS. Palmetto, California’s Medicare carrier, recently identified California physicians who do not have a record in PECOS. Over the next several weeks, these physicians will receive letters from Palmetto notifying them of the need to enroll. Physicians are urged to complete the application process as soon as possible, especially those who plan on applying for incentive payments under the health information technology program. Applications are generally processed within 60 days, but can take longer if the application is incomplete or additional information is needed.
CMA has also developed a step-bystep guide to walk physicians through the process, from determining if they are already in PECOS to helping them navigate the Internet-based PECOS enrollment system. This guide is available at the members-only website. CMA also hosted a PECOS enrollment webinar with Palmetto, California’s Medicare contractor. The previously recorded webinar is available for on-demand viewing at the members-only website. Physicians who need help with the enrollment process can contact CMA’s member service center, 800/786-4CMA (4262) or memberservice@cmanet.org, for assistance. (CMA Alert, July 12, 2010 issue)
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MEDICO NEWS
New 2011 Medicare payment rule implements key provisions of reform law The Centers for Medicare & Medicaid Services (CMS) recently issued proposed rules detailing Medicare physician payment policies for 2011. The proposed regulations, which will be published July 13 in the Federal Register, implement a number of health reform provisions, including the elimination of deductibles and coinsurance for most preventive services, new coverage of annual wellness visits, and new payment incentives. CMS will be accepting public comment on the proposed rule until August 24. The proposed rule projects a 6.1% reduction to physician payment rates in 2011 under the sustainable growth rate (SGR) formula, absent additional congressional intervention. The rule also contains significant changes to the geographic payment formula. It significantly de-weights the impact of rent on practice expenses, so
physicians in regions with higher office rents will be paid less. The rule also uses different data sources to calculate rent, wages, and physician work. These geographic payment changes will result in an average payment reduction in California of 4%. The proposed rule also clarifies which physicians qualify for the 10% primary care bonus. According to the rule, the 10% payment bonus is available to primary care practitioners for whom more than 60% of Medicare Part B allowed charges are attributable to a defined set of outpatient and nursing visits. To be eligible in 2011, physicians must have met the 60% threshold in 2009 and must have listed family practice, internal medicine, pediatrics, or geriatrics as their primary specialty designation at the time the service was provided. The bonus will be paid on a quarterly basis.
Eligibility will be redetermined each year based on claims patterns and specialty designations from two years earlier. This means new Medicare physicians will not be eligible until two years after they enroll in Medicare, although CMS is looking for suggestions on how to get around this problem. The California Medical Association is doing a thorough analysis of the impact of the proposed rule on California and will report back. In the meantime, additional details on the proposed 2011 payment policies are available at the American Medical Association website (http:www.ama-assn.org/ama/pub/healthsystem-reform/resources/insight/july2010/01july2010.shtml). Contact: Elizabeth McNeil, 415/8823376 or emcneil@cmanet.org. (CMA Alert, July 12, 2010 issue)
President Obama highlights insurance market reforms President Obama recently unveiled a “Patient’s Bill of Rights,” calling attention to the implementation of certain provisions of federal health care reform. Obama highlighted many of the legislation’s insurance industry reforms and consumer protections in his bill of rights. He said they would put American consumers back in charge of their health coverage and care. Many of the provisions take effect in September. The announcement drew praise from consumer advocates and health reform advocates, but was criticized by Republicans who called it a publicity stunt. Obama’s bill of rights focuses on new bans on such practices as excluding children from insurance coverage based on preexisting medical conditions, dropping people from plans when they get sick, and issuing limits on lifetime benefits. Plans also cannot restrict choices of primary care physicians from plan networks, require referrals for ob-gyn care, or charge more for out-of-network emergency care. Those regulations take effect September 23, 2010. Also on that date, children under 26 years of age will be allowed to stay on their parents’ family policy, or be added to it. Beginning January 1, 2011, individual and small group insurers will be required to spend at least 80%, and large group insurers to
spend at least 85% of premium dollars on direct medical care. The Obama administration says mandating that insurers meet these minimum spending requirements will improve transparency and limit spending on overhead, salaries, and bonuses paid to insurance company executives. Some provisions of health care reform have already taken effect. Starting July 1, Americans locked out of the insurance market because of preexisting medical conditions could begin enrolling in the Preexisting Condition Insurance Plan (PCIP). The program ends in 2014, when the ban on insurers refusing to cover adults with preexisting conditions takes effect. The California Medical Association (CMA) strongly supported these insurance market reforms in the health care reform legislation and will work closely with federal regulators to ensure their enforcement. For more information on health care reform, visit CMA’s health reform resource center at http://www.cmanet.org/healthreform. Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet. org.
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(CMA Alert, July 12, 2010 issue)
MEDICO NEWS
FTC temporarily exempts physicians from “red flags” rule The Federal Trade Commission (FTC) has agreed to temporarily exempt physicians from the commission’s “red flags” rule, pending a ruling from the U.S. Court of Appeals over the rule’s scope. The red flags rule requires financial institutions and “creditors” to implement identity theft detection and prevention programs. Despite objections from the California Medical Association (CMA), the American Medical Assocation (AMA), and others in organized medicine, the FTC insists that physicians who regularly bill their patients for services (including copayments and coinsurance) are considered “creditors” and must develop and implement written identity theft prevention programs for their practices by the December 31, 2010, deadline. CMA believes the red flags rule imposes an unnecessary burden on physician practices, which often already operate under severely strained conditions. CMA also believes the new rule is unnecessary for most physicians because the Health Insurance Portability and Accountability Act (HIPAA) imposes strict requirements to
safeguard the confidentiality and security of electronic patient information. AMA filed a lawsuit to stop the FTC from extending its red flags rule to physicians. The suit, filed May 21, 2010 in the U.S. District Court for the District of Columbia, contends that the FTC, by concluding that physicians are covered by the rule, has exceeded its statutory powers and acted in a way that is “arbitrary, capricious, and contrary to the law.” The court has already barred the FTC from applying the red flags rule to attorneys in response to a similar complaint from the American Bar Association. The FTC has appealed that decision. For more information, see CMA’s red flags rule toolkit and webinar, available free to members at http://www.cmanet.org. Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet. org. (CMA Alert, July 12, 2010 issue)
President signs six-month Medicare patch President Obama signed legislation last month stopping the 21% cut in Medicare payments to physicians and retroactively raising rates by 2.2%, effective June 1. The new Medicare rate applies only through November. If Congress fails to intervene, Medicare cuts mandated by the sustainable growth rate (SGR) will take effect on December 1, 2010. The Centers for Medicare & Medicaid Services (CMS) has directed contractors to hold all claims for services rendered June 1 and later until the new 2.2% update can be loaded into claims processing systems. CMS announced that it expects to start processing June claims at the new rates no later than July 1. CMS also said that June claims already paid at the reduced rates will be reprocessed as soon as possible. Physicians who submitted June claims with charges less than the 2.2%
update amount will need to contact their local Medicare contractor to request an adjustment. Charges on claims cannot be altered without a request from the physician or provider. CMS directed physicians not to resubmit claims already submitted to their Medicare contractor. The U.S. House of Representatives passed the six-month patch last month after days of political intrigue and congressional maneuvering over a larger bill containing tax breaks and an extension of jobless benefits that would have blocked Medicare cuts for 19 months. A scaled-back version of that legislation – HR 4213, the “American Jobs and Closing Tax Loopholes Act of 2010” – failed to garner the 60 votes needed in the Senate for that body to take up the measure. HR 4213 sought to stop Medicare cuts for 19 months, extend extra federal Medicaid
matching (FMAP) funds to cash-strapped states, extend unemployment insurance, restore some tax breaks and raise taxes on managers of buyout funds and other investment partnerships. HR 4213 also included the California geographic payment (GPCI) fix, which would have provided $400 million so that 14 currently underpaid counties would be reimbursed based on more accurate geographic practice costs. The legislation signed does not include the California GPCI fix. CMA will pursue that provision in other legislation. An extension of extra Medicaid funding is not in the bill either, and it may be placed into separate legislation. CMA will continue to advocate as strongly as possible for the GPCI fix and for a repeal of SGR.
PAGE 34 | THE BULLETIN | JULY / AUGUST 2010
(CMA Alert, June 28, 2010 issue)
sccMA ALLIANCE
SCCMA Alliance News With the arrival of summer, SCCMA Alliance members are distributing posters, magnetic cards, and bookmarks that remind drivers that it is unsafe to leave infants and children in a car alone. The materials have been prepared in three languages. The project is funded by grants provided through the SCCMA and the CMAA Foundation. The materials are being distributed by Alliance volunteers in doctor’s offices, public health clinics, storefront windows, and school programs. In addition, these educational materials will be placed in postpartum gift bags where offered in local hospitals. Alliance volunteers are also spending one morning per month helping with the Health Trust food distribution program in Santa Clara County. This program provides groceries for the county’s HIV/AIDS population. The Alliance members also will volunteer at the Health Trust’s annual Health Fair in September.
2010-2011 Officers for the SCCMA Alliance were installed in May. Pictured are Siggie Stillman, Public Relations; Kathleen Miller, Secretary; Carolyn Miller, Treasurer; Suzanne Jackson, Legislation; Sally Normington, Health Projects; Mary Hayashi, President; and Debbi Ricks, Past State and County President.
On April 27, members of SCCMA Alliance joined physicians in visiting Sacramento to provide input on proposed and current medical legislation. In addition, the California Medical Association Alliance held its annual session in Sacramento from April 29 −May 1. William Lewis, MD, was honored as the SCCMAA Dedicated County Alliance Member at that meeting. CMAA President Debbi Ricks was also honored, as she completed a two-year term as the CMAA President and is returning to work with the county organization as its Membership chair. Grant proposals are still being accepted for county health programs. Any local health organization or project requesting funds of up to $1,000 may apply through contacting Alliance President Mary Hayashi at mjhayashi@msn.com or Jean Cassetta at jean@sccma.org. To learn more about the grant requirements and current projects, please visit the website at www.sccmaa.org.
On April 27, CMA Alliance members representing several counties attended Legislative Day to provide feedback regarding current and proposed legislation impacting medical practice.
Upcoming Events: July: Registration begins for membership for 20102011. All current and prospective members may register online at www.sccmaa.clubexpress.com. October: Participation in annual Health Fair.
William Lewis, MD, received the SCCMAA Dedicated County Alliance Member award in May. Members shown here include Siggie Stillman; SCCMAA President Mary Hayashi; William Lewis, MD; William Ricks, MD; and state CMAA President Debbi Ricks.
PAGE 35 | THE BULLETIN | JULY / AUGUST 2010
CLASSIFIED ADS office space for rent/lease TWO UNITS AVAILABLE IN PRESTIGIOUS BUILDING • BY REGIONAL MEDICAL CENTER One has 1,200 sq. ft., at 244 North Jackson, with a big waiting room, spacious reception and secretarial area, with possible four examining rooms and private doctor’s consultation room, two bathrooms, carpet recently changed. Building has elevator, Quest Laboratories and xrays in the premises, and pharmacy on the corner of Montpellier for the convenience of your patients. Asking $2,400 per month, no triple net. The second one has 1,456 sq. ft. on the first floor, with a spacious waiting room and reception area, two bathrooms, with five examining rooms and consultation room. There is an area which was used for a full laboratory. The lease is not NNN. Please call Dr. Miranda about both units at 408/923-0257 for details.
MEDICAL SUITES • LOS GATOS – SARATOGA Two suites, ranging from 1,000 to 1,645 sq. ft., at gross lease cost. Excellent parking. Located next door to Los Gatos Community Hospital. Both units currently available. Call 408/355-1519.
MEDICAL OFFICE FOR LEASE/ SUBLEASE/SALE Office in close proximity to O’Connor Hospital for lease/sublease/sale. Please call 408/923-8098 for more information.
OFFICE SUITE AVAILABLE Location is highway 85 at De Anza. One suite available. Currently configured with six Tx rooms/offices, entry, large master office with balcony. Street signage to 100,000 cars a day. Marble entry. Zoned medical/office. No variance required. Looking for established business/practice
that values prime location in beautiful building. Please be qualified. No start ups. Contact Dr. Newman at 408/9968717. Brokers welcome if you have a client. Compare with space by Good Sam at $3.50 sq. ft. Located at 1196 South De Anza at Rainbow.
MEDICAL OFFICE SPACE FOR LEASE • SANTA CLARA Medical space available in medical building. Most rooms have water and waste. Reception, exam rooms, office, and lab. X-ray available in building. Billing available. 2,500–4,000 sq. ft. Call Rick at 408/228-0454.
OFFICE/LAB SPACE FOR LEASE • MTN VIEW One room space. Office/lab – upstairs. Located at 2500 Hospital Dr, Bldg I, Mtn View. Call 831/375-6105.
MEDICAL/DENTAL OFFICE SPACE FOR LEASE • MTN VIEW Medical/dental office space located at 2500 Hospital Dr, Bldg I, Mountain View. Call 831/375-6105.
OFFICE EXAM ROOMS TO LEASE Two nice and large exam rooms (dedicated), shared waiting room. Available five days a week, 2585 Samaritan Drive, San Jose. Please call 408/356-7788 for more information.
ATHERTON SQUARE MEDICAL/DENTAL BUILDING A newly upgraded Class A building offers a variety of spaces from 1,166 sq. ft. and up for medical/dental use at 3301-3351 El Camino Real, Atherton. Tenant improvement allowances available to design suite to meet your needs. Excellent onsite parking, close to Stanford and Sequoia. Trask Leonard, Bayside Realty Partners, 650/282-4620 or Alice Teng, Colliers, 408/282-3808. PAGE 36 | THE BULLETIN | JULY / AUGUST 2010
MEDICAL OFFICE TO SHARE • SUNNYVALE One exam room plus one large office, shared waiting room and front office. Newly built, 1,280 sq. ft. Call 408/4381593.
ELEGANT AND SPACIOUS LOS GATOS MEDICAL OFFICE Available to share with prominent aesthetic dermatologist. This upscale office has seven exam rooms, a lab, two large administrative offices, and a marble and granite waiting room with comfortable seating for eight patients. Call Irene at 408/358-5757 to schedule your private showing. Price is negotiable.
MEDICAL SUITES • GILROY First class medical suites available next to Saint Louise Hospital in Gilroy, CA. Sizes available from 1,000 to 2,500+ sq. ft. Time-share also available. Call Betty at 408/848-2525.
DOWNTOWN MONTEREY OFFICE FOR SUBLEASE Spacious, recently remodeled, excellent parking, flexible terms. Call Molly at 831/644-9800.
MEDICAL/DENTAL CONDOMINIUMS FOR SALE OR LEASE Two-story, medical/dental condominiums for sale or lease located in Willow Glen. Beautiful building completely renovated and remodeled. Suites range from 1,376 sq. ft. to 6,000 sq. ft. or full building for 13,170 sq. ft. Elevator served. Plenty of on-site parking and great visibility. Call brokers to tour: Alice Teng 408/282-3808 or Steve Hunt at 408/282-3846.
MEDICAL OFFICE TO SHARE IN MEDICAL BUILDING OF O’CONNOR HOSPITAL One large exam room and one office, shared waiting room, and receptionist area. Email at minasehhat@yahoo.com.
Furniture Dining Room Table in Brazilian Rosewood (2 side/2 arm chairs/2 leaves), 64 x 41 x 28, Part of a set. Sideboard in Brazilian Rosewood, 75 x 19 x 30, Part of a set. Hutch in Brazilian Rosewood (Sliding Glass Doors), 70 x 14 1/2 x 33 1/2, $4,700.00 Sofa Table in Walnut, 47 1/2 x 16 x 25, $375.00 Drop Leaf Table in Walnut, 27 x 15 x 20 1/2, $350.00 Call Lee at 408/866-0558
MEDICAL/PROFESSIONAL OFFICE FOR LEASE Medical/Professional office 2,600 sq. ft., ground floor near Santana Row. $2.00 sq. ft. Available now. Email at sksiddiqui@ yahoo.com.
MEDICAL SUITE NEAR O’CONNOR 840 sq. ft. and 900 sq. ft. near O’Connor Hospital, Santana Row, and Valley Fair. Three operative rooms, private doctor office, reception area, waiting room, two bath, two entrances, modified gross lease, $2.00 sq. ft. Available immediately. Call 408/891-6453.
Pajaro Dunes Beachfront Condo Shorebirds #58 2 Bedroom -- 2 Bath Top Level -- Great Ocean View Great for Families Owners Bill & Debbi Ricks 408-354-5613
MEDICAL OFFICE SPACE • EL CAMINO HOSPITAL Three exam rooms and consult room available in attractive suite. Larger room ideal for procedures. Located within multispecialty building. Short walk to hospital. Share reception/waiting area and back office. Rear door is adjacent to parking lot. Wheelchair accessible. Please contact ttricamo@hotmail.com or 650/3801253.
MEDICAL OFFICE SPACE TO SUBLET • MTN VIEW Adjacent to El Camino Hospital. Two treatment rooms, consult room. Available
Rental Agent Pajaro Dunes Company 1-800-564-1771 three days per week. Basement storage included. Contact cell 650/269-1030.
OFFICE SPACE NEEDED office space needed MD seeks office space for Quality Medical Evaluations on Saturday mornings, average once or twice a month, may be more frequent later. Please call 209/578-0476.
PRIVATE PRACTICE/ OFFICE for sale PRIVATE PRACTICE FOR SALE
Sports MemOrAbilia NAME & TITLE Joe Montana* Superbowl Legend: XVI-XIX-XXIII-XXIV
MEASUREMENT
PRICE
15 x 12
$495.00
Randall Cunningham* 13 x 24 Gameday 1992 Edition + Bonus Book Incl.
$250.00
Chicago Bulls, World Champions 1990-91, 1991-92, 1992-93
15 x 12
$175.00
Michael Jordan Retirement Photo & Program
8 3/4 x 11 1/4
$95.00
Michael Jordan, Blow up Card
10 x 11 1/2
$75.00
Joe DiMaggio*, Images of a Legend
12 x 15
$1,195.00
“The Kid”* meets “The Babe” 15 x 12 A young Ted Williams* meets George Herman “Babe” Ruth
$395.00
Pete Rose*, Hit King
12 x 15
$250.00
Nolan Ryan*, 27 Years of Excellence
15 x 12
$595.00
Players of the Decade, 1980’s Ltd. Edt. 12 x 15 $1,580.00 Nolan Ryan*, Joe Montana*, Larry Bird*, Wayne Gretsky* + Bonus Book Incl. Call Lee at 408/866-0558 PAGE 37 | THE BULLETIN | JULY / AUGUST 2010
IM/FP/GP. Primary care practice for sale, including inventory and equipment. Close to O’Connor Hospital. If interested, please call Stacy at 408/297-2910.
EMPLOYMENT OPPORTUNITY OCCUPATIONAL MEDICINE PHYSICIANS • PRIMARY CARE, ORTHOPEDICS, & PHYSIATRY Our occupational medical facilities offer a challenging environment with minimal stress, without weekend, evening, or “on call” coverage. We are currently looking for several knowledgeable and progressive primary care and specialty physicians (orthopedist and physiatrist) interested in joining our team of professionals in providing high quality occupational medical services to Silicon Valley firms and their injured employees. We can
Classifieds, from page 37 provide either an employment relationship including full benefits or an independent contractor relationship. Please contact Dan R. Azar MD, MPH at 408/790-2907 or e-mail dazar@allianceoccmed.com for additional information.
condo/COTTAGE rentals OCEAN FRONT CONDO ON KONA COAST
MEMBER NEWS AND HAPPENINGS
Welcome 6 New SCCMA Members! Name
Specialty City
Luis Alvarez Lori Kandel Steven Kim Mojgan Morshedi Paul Wang James Watson
NEP PD *FP IM CCE OBG
Beautiful setting on the big island of Hawaii. Sleeps four. Great views. Call 408/354-3253 for more info.
FOR SALE BEAUTIFUL HAWAIIAN CONDO Poipu Beach, Kauai. Lovely 2 BR/2 BA condo, across street from ocean. Recently remodeled bathroom and kitchen with granite countertops, new carpeting throughout. Three lanais with ocean and mountain views, and the tropical gardens which make the Nihi Kai complex so special. Price reduced to $695,000. Call 650/949-3353.
*Board Certified; US -- Unspecified; [ ] Not Practicing
Welcome New MCMS Member! Name
Specialty City
Lena Malik
*PD
WANTED PEDIATRIC PRACTICE Will buy Pediatric practice in South Bay. Call 408/455-2959.
METRO MEDICAL BILLING, INC. • Full Service Billing • 25 years in business • Bookkeeping • ClinixMIS web-based software • Training and Consulting • Client References Contact Lynn (408) 448-9210 lynn@metromedicalbilling.com Visit our Website www. metromedicalbilling.com
Salinas
*Board Certified; US -- Unspecified; [ ] Not Practicing
In Memoriam
MEDICAL EXAM TABLES Hamilton exam table, $350. IE Industries power exam table, Model 110, $850. Contact Angie at 650/969-2116.
Palo Alto Sunnyvale San Jose Los Gatos Stanford Gilroy
Joseph C. Brozda, MD *General Surgery 10/17/25 – 5/21/10 SCCMA member since 1960 Steven Duwe, MD *General Surgery 7/25/39 – 5/15/10 SCCMA member since 1974 Dean H. Harding, MD *Family Practice 1/1/29 – 5/9/10 SCCMA member since 1961 Larry E. Hayes, MD *Pediatric Surgery *General Surgery 9/4/37 – 7/11/10 SCCMA member since 1973
PAGE 38 | THE BULLETIN | JULY / AUGUST 2010
John J. McCue, MD *Internal Medicine Occupational Medicine 7/27/21 – 4/26/10 SCCMA member since 1958 William J. Weller, MD *Family Practice 2/2/22 – 4/16/10 SCCMA member since 1959
When was the last time a doctor came to YOU?
At California Pacific Medical Center’s Atrial Fibrillation and Arrhythmia Center we are com-
mitted to a comprehensive team approach in treating your patient. Whether a patient is having debilitating palpitations, recurrent syncope or severe heart failure, sensitive and difficult challenges await – for them and their family. We are Andrea Natale, M.D., Steven Hao, M.D. and Richard Hongo, M.D., electrophysiologists who specialize in complex ablation procedures. In fact, we have the highest atrial fibrillation ablation volume on the West Coast; last year, we performed over 450 procedures. We would
The Atrial Fibrillation and Arrhythmia Center offers:
like to make an appointment to see you in your office. Why?
•
Board certified, fellowship trained cardiac electrophysiology specialists
We’d like the opportunity to acquaint you with our facilities, staff and equipment – including
•
State of the art technology and facilities for the treatment of arrhythmias
•
Nationally and internationally recognized expertise in complex ablations, providing care for patients and education for physicians throughout the world
•
In 2009, 3-star rated (top honor) by United Healthcare for Electrophysiology
•
Dedicated arrhythmia nurse and nurse practitioner to provide continuity from the consultation through the procedure to follow ups
California Pacific’s new Stereotaxis lab. We’d also like to help familiarize you with referral indicators for your patients with arrhythmias, particularly atrial fibrillation.
Let’s schedule an appointment for a visit to your office: 415-600-7459
www.cpmc.org/services/heart PAGE 39 | THE BULLETIN | JULY / AUGUST 2010
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