California Podiatric Physician April/May/June 2014 by California Podiatric Medical Association

California Podiatric Physician The

a p r i l | m ay | j u n e | 2014

THE western foot and ankle conference

june 19 – 22, 2014 disneyland hotel & convention center anaheim, california

PRESIDENT’S MESSAGE Friends:

As I come to the end of my term as CPMA president, I am grateful to have been the recipient of your trust, confidence and enthusiastic support. Please join me in thanking your committed Board of Directors and staff, consultants, society presidents, committee chairs and all the members who have volunteered and carried out our mission to protect our patients and advance our specialty. visit TheWestern.org for more information and to register online

registration

brochure

2430 K Street • Suite 200 • Sacramento, CA 95816 • (800) 794-8988

See Page 7 For The Western 2014 Registration Details!

It was my goal this year to be very clear that the California Podiatric Medical Association is THE association for every student, resident, and Doctor of Podiatric Medicine in California and to fulfill our obligation to provide resources and value for ALL. None of us can meet the challenges of this complex and transformative health care environment alone. It is our duty to prepare and assist CPMA members so that they may thrive in the changing health care environment. It is together, with all of the experience, innovation, passion, and skill that each See PRESIDENT’S MESSAGE on Page 53

Get Ready, Get Set, Go to The Western Get it all at The 2014 Western Foot and Ankle Conference: ICD- 10 Workshop. PICA Presentation. Practice Management. Pain Management Workshop. Hands-On Flatfoot Reconstruction Workshop. Sports Medicine. Biomechanics. Wound Care. Surgical and Medical Topics. Over 25 Continuing Education Contact Hours including 10+ radiology CECH to meet California license requirements. Full program including up to 14.75 radiology for Podiatric Medical Assistants. And More. Set in the Happiest Place on Earth, The Western offers high class education at affordable rates with access to an exhibit hall full of vendors with products and services for every type of podiatric medical office. Easy to get to from anywhere on the map, attendees come to the meeting from California, the United States, and abroad. The family-friendly location isn’t the only reason podiatric medical professionals prefer The Western; they also come for the exhilarating lectures and workshops offered. Get Ready for ICD-10 The 2014 Western Foot and Ankle Conference is offering an on-site intensive workshop after general sessions on Thursday, June 19 for Doctors of Podiatric Medicine and their assistants. Doctors and billers will learn together to get prepared for the looming change ahead. With no time to waste, The Western

- In This Issue -

2014 Legislative Leadership Conference; CPMA Storms Capitol Corridors

Where Have We Been, Where are We Now, and Where are We Going?

Jon A. Hultman, DPM, MBA, CVA

See go to the western on Page 77

Hiring the Right Person for The Job

Tina Del Bouno, PMAC

Protecting Your Practice C. Keith Greer, Esq.

Annual Health Policy Report

Franklin Kase, DPM, FACFAS

Thank you

CPMA for your

endorsement!

Contact PICA for more information on medical professional liability insurance or to request a quote.

www.picagroup.com â&#x20AC;˘ (800) 251-5727

A ProAssurance Company 7000

C Da ea l riCfPMA o rM n em i aberPs: o d i a t r i c

M e d i c a

l A s s o c i a t i o I am looking fo n rward to seeing you at the 2014 (The Western), Western Foot June 19-22 at th and Ankle Con e Disneyland H ference otel in Anaheim The Western Sc , California. ientific and Educ ation Committee program featur has once again ing a dynamic ar planned an outs ra y of the latest surg to enhance your tanding ery, medicine an practice skills an d managemen d patient servic t topics es. I would especia lly like to remin d CPMA memb Lessons Learned ers of the PICA from a Podiatr Risk Managemen ic Malpractice a PICA policyhol t program: Se ttlement*, Satu der and a CPMA rday June 21. If member, you ca on your PICA p you are n receive up to olicy premium a 15 percent dis at your next ren receiving 2.0 CEC count ewal by attend H. If you have al ing this program ready received attending anot as w ell as PICA’s standard her program or 10 percent disco by purchasing a receive an addit unt by home study co ional 5 percent urse, CPMA mem (for a total of 15 this year’s Weste b ers can percent) by atte rn. nding the PICA p rogram at PICA’s enhance d discount prog ram is available endorsement ag to CPMA memb reement with th ers through its e California Pod addition to offer exclusive iatric Medical A ing the discoun ss ociation (CPMA t to policyholder significantly to ). In s, PICA’s generou our Association s sponsorship co . This source of activities and p ntributes non-dues incom rograms like Th e helps suppor e Western – on management co t CPMA and its e of the premie nferences and ex r podiatric surg hibitions in the er y, medicine, country. The 2014 Weste rn will feature 2 5 PLUS CECH, both doctors an including X-ray d assistants; vita CME contact hou l in formation on b workshops; inn rs for illing and codin ovative instruct g, hands-on surg ional courses; ex assistants’ prog ical citing cutting-e ram covering b dge lectures; a oth the front an exhibition hall fe d yn am d ic 3-day back office, and aturing the late the world-class st tools and tech Western nologies in med Conference goe icine and manag rs will enjoy sub ement. stantially reduc as well as signifi ed room rates at cant savings on D is n park passes to b eyland Resort h Adventure them oth Disneyland otels, e parks. and Disney’s Ca lif o rn ia Thank you for yo ur support,

2430 K Street

Suite 200

Sacramento

California

95816

fon 916/448.0 248 800/794.8988 fax 916/448.02 58

web www.ca .polpm diatri a.osts rg.org

Carolyn E. McA loon, DPM President *PICA Program attendees MUST register to atte in with the PICA nd The Western representatives general meetin onsite during th g, AND MUST si e PICA program gn to receive the ex tra discount.

A p r i l | m ay | j u n e | 2014

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Come for the Meeting, After a day of stimulating c.e., Western conference goers can relax with family and friends at the Disneyland Resort. With three distinct hotels, each with its own unique sparkling pool; the vibrant entertainment, shopping and dining district Downtown Disney and two theme parks – Disneyland and Disney’s California Adventure, the Disneyland Resort is a true destination location. Western attendees will enjoy deep discounts off the resort’s hotels room rates, as well as substantial savings on tickets to Disney’s California Adventure and Disneyland theme parks. Come for The Western Foot and Ankle Conference meeting – June 19-22. And, stay for the magic of The Happiest Place on Earth.

Mickey and the Gang

Sit back and relax on the Monorail

New Orleans Jazz Band

Disneyland Hotel Pool

Character Dining

Stay after you learn and play 4|

Renowned Restaurants

Mandera Spa

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Stay for the Magic!

Meet your favorite Disney Princess

Gateway to Downtown Disney

Disney Nightlife Lego Store Visit The LEGOÂŽ Store at the Downtown Disney - itâ&#x20AC;&#x2122;s the second largest Lego Store in the country.

Private Cabana by the Pool

Romantic Dinners A p r i l | m ay | j u n e | 2014

Strolling in Downtown Disney | 5

Foot & Ankle

Dedicated to the

Foot and Ankle Surgeon

Memometal Implants

Anchorage / CP

VariAx Fibula

MEMOMETAL IMPLANTS INTRAMEDULLARY NAILS

SCREW SYSTEMS

Hoffmann

Vitoss

PLATING SYSTEMS

EXTERNAL FIXATION SYSTEMS

BIOLOGICS

For more information on these or other Stryker Foot & Ankle products call 866. 682. 7577 or go to www.Stryker.com A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. • The information presented is intended to demonstrate the breadth of Stryker product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area. • Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Anchorage, Hoffmann, Memometal, Smart Toe, Stryker, VariAx, Vitoss. All other trademarks are trademarks of their respective owners or holders. 201367 Copyright ® 2013 Stryker

western foot and ankle conference

june 19 – 22, 2014 disneyland hotel & convention center anaheim, california

visit TheWestern.org for more information and to register online

registration

brochure

2430 K Street • Suite 200 • Sacramento, CA 95816 • (800) 794-8988

4 ICD-10

4 PMA Program

4 Healthy Snacks

4 25+ CECH

4 Hands-On Workshops

4 Family Destination

4 Radiology

4 PICA Discount

4 Award Winning Meeting

Come see what makes

The Western THE BEST Not just in The West. Besides being ranked among the three largest meetings of its kind in the

country, the Western Foot and Ankle Conference offers revered faculty and hottest topics at the lowest price for the most continuing education contact hours, making it the greatest value for foot and ankle specialists from all over the United States and abroad! You appreciate the education. You enjoy the tradition. You love the location. Why go anywhere else? We can’t answer that. If you do find a better continuing education meeting and exhibition for doctors of podiatric medicine and their staff, we hope you will come back to tell us about it. If you have never attended The Western, why not register today and experience what the best has to offer? The Western has become not only an annual tradition for members of the podiatric community to come together, but also the ideal place for doctors and medical staff from all areas of expertise to earn continuing medical education contact hours, including radiology CECH, for their license requirements while gaining a top notch education. As always, The Western’s educational program will help all attendees meet their educational needs. Office staff and medical assistants will learn how to run the office and care for patients when they attend the Assistants’ Program. The Western welcomes an esteemed faculty who will no doubt provide the latest and greatest tips and techniques on hot topics including but not limited to biomechanics, sports medicine, wound care, pain management, and changes in healthcare. The plethora of workshops available this year include a special ICD-10 evening workshop you won’t want to miss, a practice management lecture series offered to DPMs as Track II and PMAs as part of their program, and the popular hands-on labs to give attendees experience while learning new and important techniques. The enticing exhibit hall will provide you with an opportunity to not only see the latest in medical and surgical advancements and a host of other products to aid in the success of your practice and patient care, but also take a nice break between lectures and workshops. The Western provides free refreshments to attendees, including healthy snacks to keep you on your toes the duration of the meeting. The 2014 Western Foot and Ankle Conference will be hosted by the updated 4 Diamond Disneyland Hotel & Convention Center in Anaheim, California. Beautiful pools and outdoor lounges, modern guest amenities, and entertaining dining facilities provide even more areas for catching up with colleagues and friends before and after the meeting. So come reacquaint yourself with - or educate yourself on - what makes The Western the most successful program and exhibition west of the Mississippi. Explore the opportunities and join your colleagues at the premier event at a superb destination. Register today! Sincerely,

Jonathan M. Labovitz, DPM Chair, Western Foot and Ankle Conference

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2014 Western Foot and Ankle Conference Registration Brochure

Shannon M. Rush, DPM Chair, CPMA Science and Education Committee

western sponsors platinum DermaTran Health Solutions Stryker Orthopaedics

The California School of Podiatric Medicine cordially invites you to celebrate the history and accomplishments of the California School of Chiropody, the California Podiatry College, the California College of Podiatric Medicine, and the California School of Podiatric Medicine at the

diamond Wright Medical Technology, Inc.

gold The Tetra Corporation

silver Arthrex, Inc. Integra LifeSciences Volcano Corporation Valeant

Centennial Gala Dinner

bronze Bako Integrated Physician Solutions Merz Pharmaceuticals Smith and Nephew TEI Medical, Inc.

copper Amniox Medical Solana Surgical, LLC

Friday, June 20, 2014 Disneyland Hotel Magic Kingdom Ballrooms 1 & 4 6 pm Wine and Hors d’Oeuvres 7 pm Dinner, Program, and Dancing All net proceeds to benefit current students through the Podiatric Medicine Scholarship Fund unless otherwise designated.

For tickets and more information Visit: www.samuelmerritt.edu/cspm_gala Call: (510) 869-8628

program Podiatric Insurance Company of America (PICA)

table of contents General Information ......................4 Theme Park Tickets .......................4 Meeting at a Glance .......................5 Continuing Education ................6-7 Invited Faculty ..............................8-9

Scientific Objectives .................... 10 Doctors’ General Sessions .. 11-13 Doctors’ Workshops .................... 14 Fellowship Application ............... 14 Assistants’ Program ...............15-17

Doctor Registration Form .......... 18 Assistant Registration Form ...... 19 Past Presidents .............Back Cover

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

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general information

TICKE

theme park tickets

Reservation cut-off date: June 4, 2014

Disneyland® and Disney’s California Adventure™ TICKE parks offer fun for you and your family. Purchasing tickets through The Western will save you valuable time and money. Tickets for theme park admittance are available in advance from the Disney ticket website or by phone for attendees. These discounted tickets are valid beginning Friday, June 13, 2014 through Tuesday, June 24, 2014.

The 2014 Western Foot and Ankle Conference will once again be hosted by the Disneyland Resort in sunny Anaheim, California! A block of rooms is reserved for attendees of The Western. These rooms will be available at the special rates listed until June 4, 2014 ONLY if available, so reserve your room at this popular resort early! Be sure to mention The Western to get these exceptional rates:

Disneyland® Hotel: $189 single or double Disney’s Grand Californian® Hotel and Spa: $253 single or double

Online: http://tinyurl.com/2014Western Phone: (714) 520-5005 Disneyland Resort Hotel and Convention Center 1150 W. Magic Way • Anaheim, CA 92802

refreshments The Western provides attendees with complimentary morning and afternoon coffee, tea, and refreshments to keep them on their toes throughout the meeting. Enjoy whole grain muffins, whole wheat croissants, fresh fruit, granola and energy bars, mixed nuts, yogurt, and more.

hotel information

Online: http://tinyurl.com/2014Western (Online ticket store closes at 9 pm PST on Tuesday, June 16, 2014.) Phone: (714) 520-5005 (Monday through Friday, 8 am - 5 pm PST) Some tickets will also be available for purchase on-site at The Western while supplies last.

ticket prices

Adult tickets are for those ages 10 and up. Child tickets are for ages 3 to 9 years. Children under 3 are admitted free of charge. More ticket options available in the online ticket store. Prices and schedule are subject to change. adult child

all guests $55

spouse & guest registration

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1 Day Theme Park Ticket. A one-day admission to either Disneyland® Park or Disney’s California Adventure® Park. Not a Park Hopper.

Disneyland® Resort Park Hopper Ticket. Admission is valid for either Disneyland® Park or Disney’s California Adventure™ Park. Guests may visit both parks on the same day. These tickets are valid for the appropriate number of visits within a 14 consecutiveday period.

Concession lunch will be available in the exhibit hall during all lunch breaks.

Admittance to the exhibit hall requires a badge. Badges for spouses and guests of the 2014 Western attendees are complimentary and may be acquired at the registration desk. Due to liability issues, such as the possibility of injury from surgical equipment, The Western strongly discourages attendees from bringing anyone under the age of 16 into the exhibit hall. Children must be accompanied by an adult. Strollers are not permitted in the exhibit hall.

$85 $79

# of days

adult

child

1 day

$123

$118

2 day

$185

$174

3 day

$211

$198

4 day

$236

$219

5 day

$251

$233

Twilight Ticket. Admission is valid for either Disneyland® Park or Disney’s California Adventure™ Park after 4:00 p.m., or four hours before park closing, whichever is earlier. Not a Park Hopper.

tickets will be sold at the ticket counter in the center lobby: wednesday, june 18 7:30 am - 4 pm

2014 Western Foot and Ankle Conference Registration Brochure

thursday, june 19

7:30 am - 4 pm

friday, june 20

7:30 am - 4 pm

saturday, june 21

7:30 am - 4 pm

meeting at a glance wednesday, june 18

friday, june 20

9 am – 6 pm California Podiatric Medical Association House of Delegates

6:30 am - 6 pm Conference Registration

thursday, june 19

7:30 am - 6 pm General Sessions

6:30 am - 6 pm Conference Registration

7:30 am - 6 pm Podiatric Medical Assistants’ Program

8 am - 5 pm Podiatric Medical Assistants’ Workshop: Radiology Review Course

8:30 am - 12 pm Workshop: Ankle Arthroscopy

8 am - 6 pm General Sessions

9:30 am - 4 pm Exhibit Hall Open

8:30 am – 12 pm Workshop: New Technology Improving Outcomes in Sports Medicine

1:30 - 5 pm Workshop: The Top 5 Most Useful Procedures in Flatfoot Reconstruction

9:30 am - 4 pm Exhibit Hall Open

4 - 6 pm Podiatric Medical Assistants’ Workshop: Anatomy

3 - 5 pm Workshop: Taking the Pain out of Treating Pain Patients

6 pm CCPM/CSPM Centennial Gala

4 - 5 pm California Podiatric Medical Association Past Presidents’ Meeting

saturday, june 21

5 - 8 pm Workshop: Learning ICD-10

6:30 am - 6 pm Conference Registration 7:30 am - 6 pm General Sessions 7:30 am - 3:15 pm Podiatric Medical Assistants’ Program 8 am - 3 pm Workshop: Trauma Conference 9:30 am - 4 pm Exhibit Hall Open 4 - 6 pm Podiatric Medical Assistants’ Workshop: Padding and Strapping

sunday, june 22 8 am - 12:30 pm General Sessions

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

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continuing education credits podiatric physicians California Podiatric Medical Association is approved by the Council on Podiatric Medical Education as a sponsor of continuing education in podiatric medicine. Attendees of The Western Foot and Ankle Conference may earn up to 26 Continuing Education Contact Hours (CECH).

radiology Doctors of Podiatric Medicine will be able to attain a maximum of 10.41 Radiology Continuing Education Contact Hours to meet California Radiology Continuing Education requirements. The radiology continuing education lectures are included in the Doctorsâ&#x20AC;&#x2122; General Sessions.

important Badges are barcoded with your registration information and must be scanned twice daily at designated times for credit.

In accordance with the Council on Podiatric Medical Education (CPME), The Western is required to monitor educational session attendance for continuing education (CE) verification. Attendees will be sent transcripts reflecting only the number of Continuing Education Contact Hours earned by scanning for general sessions and/or attending workshops. To receive the maximum number of CECH, DPMs must have their badges scanned at each of the listed scanning times. Continuing education verification transcripts will be sent to the email provided at registration by August 31, 2014. If you did not provide an email address with your registration, please send it to jsteed@calpma.org. Each registrant is responsible for reporting attendance to all appropriate licensing boards and agencies requiring continuing education. Retain the transcript sent to you. Electronic copies may be obtained by emailing a request to jsteed@calpma.org. A ten dollar ($10) fee will be charged for replacement hard copies faxed or mailed.

CECH scanning schedule To receive your Continuing Education Contact Hours (CECH), you must scan your badge during each of the noted scanning times for verification purposes. CPMA is providing up to 26 CECH during the 2014 Western Foot and Ankle Conference for Track I and up to 22.25 for Track II. Following are the scanning schedule, locations, and CECH available:

thursday, june 19

saturday, june 21

12 - 1:30 pm Exhibit Hall Booth 1125 3.25 CECH (.5 Radiology CECH)

12 - 1:30 pm Exhibit Hall Booth 1125 3.75 CECH (1.33 Radiology CECH)

2:30 - 4 pm Exhibit Hall Booth 1125 3.75 CECH (3.16 Radiology CECH)

2:30 - 4 pm Exhibit Hall Booth 1125 3.75 CECH (2.75 Radiology CECH)

friday, june 20

sunday, june 22

12 - 1:30 pm Exhibit Hall Booth 1125 3.75 CECH (0 Radiology CECH)

9:45 am - 12:30 pm Central Lobby Registration Desk 4 CECH (0 Radiology CECH)

2:30 - 4 pm Exhibit Hall Booth 1125 Track I: 3.75 CECH (2.67 Radiology CECH) Track II: 0 CECH (0 Radiology CECH)

western eHandouts Download your free handouts from The 2014 Western at your home or office! When speakers upload their presentations, notes, slides, etc. the files will be available for Western attendees to download for effortless access any time - much better than a stack of paper handouts waiting to be lost when the meeting is over. Simply find all available files right at your fingertips, saving time and trees. Create a login and save files easily. After you register for The Western, you will receive an email containing a link to create your eHandouts login. Follow the link in the email to create your account, or go to thewestern.org/program/ehandouts and follow the prompts to reset your password. Once logged into the eHandouts page at TheWestern.org, browse and save files you want to your computer.

It really IS easy being green. 12 6 |

2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure 2014

continuing education credits podiatric medical assistants radiology Podiatric Medical Assistants may earn a total of 14 Radiology Continuing Education Contact Hours (CECH) to meet California Radiology Continuing Education requirements by attending lectures, courses, and workshops shown to provide radiology credits. Assistants must sign in to get credits. Transcripts reflecting radiology credits earned will be sent to the email provided at registration by August 31, 2014. If you did not provide an email address with your registration, please send it to jsteed@calpma.org. Certified Podiatric Assistants and Certified Medical Assistants will be able to obtain up to 25.25 Continuing Education Contact Hours (CECH) for their ASPMA and CMA Certifications. Please sign in with the Assistants’ Program Director to obtain these credits.

To attain CECH, assistants may attend the following:

thursday, june 19 8 am - 5 pm Radiology Review Course

(Additional registration fee)

7.5 CECH for Certified Assistants (7.5 Radiology CECH)

friday, june 20 7:30 am - 6 pm Assistants’ Program 7.25 CECH (5.25 CECH if taking the Anatomy workshop) for Certified Assistants (1.5 Radiology CECH) 4 - 6 pm Anatomy

(Additional registration fee)

5 - 8 pm Learning ICD-10 Workshop

2 CECH for Certified Assistants (2 Radiology CECH)

3 CECH for Certified Assistants (0 Radiology CECH)

saturday, june 21

(Additional registration fee)

7:30 am - 3:15 pm Assistants’ Program 5.5 CE CECH for Certified Assistants (1 Radiology CECH) 4 - 6 pm Padding and Strapping

(Additional registration fee)

2 CECH for Certified Assistants (2 Radiology CECH)

2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure 2014

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invited faculty Bradley W. Bakotic, DPM, DO Alpharetta, GA Bako Pathology Associates

Sam Fowler, PMAC Bloomington, IL Heartland Foot and Ankle Associates, PC

Alan S. Banks, DPM Tucker, GA ABPS Village Podiatry Group Director, Residency Training, DeKalb Medical Center, Decatur, GA Senior Faculty, Podiatry Institute

Daniel C. Fulmer, DPM Tucson, AZ ABPS

Babak Baravarian, DPM Santa Monica, CA Private Practice

Graham Hamilton, DPM, FACFAS Clayton, CA Surgical Faculty, Kaiser San Francisco Bay Area Foot & Ankle Residency, Department of Orthopedics & Podiatric Surgery, Kaiser Permanente, Oakland, CA Attending Staff, The Permanente Medical Group, Oakland, CA

Tracy L. Basso, DPM Davis, CA ABPM, ABPS, ACFAS, AENS Davis Foot & Ankle Center Consultant, Cutting Edge Laser Technology Ronald J. Belczyk, DPM Van Nuys, CA Associate, ACFAS Valley Presbyterian Hospital Edward G. Blahous, Jr., DPM Seattle, WA ABPS, ACFAS Sports Medicine Clinic, Seattle, WA Christopher G. Browning, DPM, CWS Temple, TX Scott & White Healthcare Francis L.S. Chan, DPM Chino Hills, CA Western University Foot & Ankle Center, Pomona, CA Robert A. Christman, DPM, EdM Pomona, CA ABPM, ACFAOM Professor, Western University of Health Sciences College of Podiatric Medicine, Pomona, CA Tina C. Del Buono, PMAC, XT Santa Rosa, CA ASPMA Past President, American Society of Podiatric Medical Assistants Chair, Western Assistants Educational Program Santa Rosa Foot & Ankle Associates Lawrence A. Ford, DPM Berkeley, CA ABPS, ACFAS Program Director, Kaiser San Francisco Bay Area Foot & Ankle Residency, Department of Orthopedics & Podiatric Surgery, Kaiser Permanente, Oakland, CA Attending Staff, The Permanente Medical Group, Oakland, CA 14 | 8

Jordan P. Grossman, DPM Akron, OH N.E. OH Orthopaedic Associates

John D. Hollander, DPM Santa Rosa, CA ABPS, ASPS, ACFAS Santa Rosa Foot & Ankle Associates Richard E. Horsman, DPM Olympia, WA South Sound Foot & Ankle Rem Jackson Lititz, PA Top Practices Robert M. Joseph, DPM, PhD Lake Bluff, IL William M. Scholl College of Podiatric Medicine at Rosalind Franklin University Chul Kim, DPM Torrance, CA West Torrance Podiatrists Group, Inc Diane M. Koshimune, DPM, MS Pasadena, CA Faculty, Western University of Health Sciences School of Podiatric Medicine, Pomona, CA Jonathan M. Labovitz, DPM Pomona, CA ACFAS Medical Director, Foot & Ankle Center, Western University of Health Sciences Associate Professor, Western University of Health Sciences College of Podiatric Medicine, Pomona, CA Chair, Western Foot and Ankle Conference Visiting Scholar, Health Policy and Management, UCLA Fielding School of Public Health

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

Lawrence A. Lavery, DPM, MPH Georgetown, TX ACFAS Professor, Department of Surgery, Scot and White Hospital, Texas A & M University Health Science Center College of Medicine, Temple, TX Melissa J. Lockwood, DPM Bloomington, IL Heartland Foot and Ankle Associates, PC Robert B. McLafferty, MD Portland, OR Chief, Vascular Surgery, VAMC, Portland, OR

Anthony Poggio, DPM, MS Alameda, CA AAPSM, ABPM, ABPS, ASPS Medicare Committee Chair and CAC Representative, CPMA Alexander M. Reyzelman, DPM Castro Valley, CA ABPS, ACFAS Eden Podiatry Group Chair and Assistant Professor, Department of Medicine, Samuel Merritt University, Oakland, CA Shannon M. Rush, DPM, FACFAS Pleasanton, CA Palo Alto Medical Foundation, Mountain View, CA Director, Silicon Valley Reconstructive Foot and Ankle Fellowship Associate Professor, California School of Podiatric Medicine at Samuel Merritt University, Oakland, CA Chief, Podiatric Surgery, El Camino Hospital, Mountain View, CA

Kevin M. Miller, DPM Benicia, CA California School of Podiatric Medicine at Samuel Merritt University, Oakland, CA Cristian Neagu, DPM Los Altos, CA Kaiser Permanente Santa Clara

Naohiro Shibuya, DPM, MS Temple, TX Central Texas VHCS

Benno M. Nigg, Dr.sc.nat., Dr.h.c. Calgary, AB Member, IOC Medical & Science Commission Chair, Selection Committee, IOC Olympic Prize Member, Int. Soc. Biomechanics Member, Can. Soc. Biomechanics Member, Am. Soc. Biomechanics Member, Am. College of Sports Medicine Member, International Academy of Medical and Biological Engineering Member, Olympic Academy of Science Member, Swiss Academy of Medical Science Honorary Member, Canadian Chiropractic Association Co-Director, Human Performance Laboratory; Professor of Biomechanics; Joint appointment in the Faculties of Kinesiology, Engineering, and Medicine; University of Calgary, Calgary, AB, Canada

Ross E. Taubman, DPM Olney, MD President and Chief Medical Officer, Podiatry Insurance Company of America Nicholas W. Todd, DPM San Francisco, CA Palo Alto Medical Foundation Dan Totaro, MA, LMFT Upland, CA

Lawrence M. Oloff, DPM Redwood City, CA AAPPM, ABPS, ASPS Sports Orthopedic and Rehabilitation (SOAR) Surgery Group

Jesus C. Vazquez, PMAC Santa Rosa, CA Internet Manager, ASPMA Santa Rosa Foot & Ankle Associates

glossary of credentials: AAPPM: Member, American Academy of Podiatric Practice Management AAPSM: Fellow, American Academy of Podiatric Sports Medicine ABPM: Diplomate, American Board of Podiatric Medicine ABPS: Diplomate, American Board of Podiatric Surgery ACFAOM: Fellow, American College of Foot and Ankle Orthopedics and Medicine ACFAS: Fellow, American College of Foot and Ankle Surgeons AENS: Member, Association of Extremity Nerve Surgeons ASPMA: American Society of Podiatric Medical Assistants 2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

9 | 15

scientific objectives By attending the General Sessions, Doctors of Podiatric Medicine will be able to accomplish these medical education objectives. What’s New in Foot and Ankle Biomechanics Review and understand the concepts of running shoe biomechanics as well as the influence various biomechanical principles have followed for pathology including barefoot running minimalist shoe technology. In addition understand the importance of risk stratification for falls and the role of balance in vision. Develop an understanding between the biomechanics of articular cartilage wear and deformity. Sports Medicine Understand the role of new diagnostic and therapeutic means of providing patient care in active patients. Apply new technology and treatment options to sports injuries. This session will focus on various sports medicine pathologies and highlight new, innovative diagnostics, treatments, or technology being used to treat athletes and active people you treat on a regular basis. Medical Topics Affecting the Podiatric Patient Understand many podiatric misconceptions regarding dermatological conditions. Better relate to dermatological terminology regarding podiatric dermatology. Neuropathy: How Unnerving Better understand peripheral neuropathy and methods of treating pain it causes. Appreciate therapies presented including methods ranging from compounded medicine to surgical decompression of peripheral nerves. Don’t Do What I Did: Learning from Our Surgical Misadventures Improve understanding of the critical evaluation process for pre-operative patients and procedures. Analyze and understand the lessons learned to determine procedures to improve clinical outcomes through prevention of complications. Critical evaluation of surgical patients and the methods we use to correct deformity and pain is essential to maximizing outcomes. In this session we reflect back on what has worked and critically evaluate the reasons for successes and failures. Lessons Learned from a Podiatric Malpractice Settlement Understand the importance of collaborative care when managing patients with multiple medical conditions. Appreciate the significance of fail-safe office systems to track diagnostic tests, consultations and patients requiring surgical clearance. Understand the importance of obtaining and documenting patients’ informed consent. Acknowledge the importance of empathizing with patients in the event of an unexpected outcome. In this program, the deposition of a podiatrist who was named as a defendant in a malpractice lawsuit will be examined to identify risk issues associated the treatment of the patient and to discuss risk reduction techniques that the doctor could have utilized to improve the patient’s outcome and prevent the filing of a lawsuit.

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Keeping It Flowing: Issues in Vascular Disease Understand and apply the latest evidence for the proper treatment of deep venous thrombosis. Appreciate and understand the role of non-thrombotic venous disease and the relevance of proper diagnostic testing and treatments in podiatric patients. Improve understanding of the risk factors of peripheral arterial disease and the role of evaluating the epidemiology of the disease to improve patient outcomes. Appreciate the key differences of PAD in the diabetic patient. This session will provide insight into the vascular diseases, covering thrombotic and non-thrombotic venous disease in addition to the ever popular arterial disease discussions. Uh-Oh… Now What? Cases Through a case presentation protocol complications regarding foot and ankle surgery will be presented as well as appropriate therapies to address and manage complications. An understanding of the appropriate diagnostic protocols and treatment options will be presented including exam, physical findings, radiographic and advanced imaging protocols. Osteomyelitis Better understand the value of diagnostic methods that have long been considered the gold standards. Compare and contrast various medical and surgical methods of treatments. Understand the role of cost in healthcare as it is applied to the osteomyelitis patient and amputations. Osteomyelitis can be devastating and there is still much evidence lacking to optimize outcomes. This session will better explain the pros and cons of various diagnostic and therapeutic means of approaching osteomyelitis. Treating Wounds: Remembering the Old and Learning the New Understand the role of optimize the environment for wound healing. Understand the pathological changes in gait in the diabetic patient and apply this to treat patients by offloading ulcers. Understand the key principles and the role of debridement. Understand the evidence behind the latest wound care dressings and other new treatment options. Wound care is constantly evolving with new techniques and innovative materials on a regular basis. This session will provide information on the new but also provide new evaluations of the old information that remains critical to optimal patient care.

2014 Western Foot and Ankle Conference Registration Brochure

doctors’ general sessions thursday, june 19 8 am - 12 pm What’s New in Foot and Ankle Biomechanics 3.25 CECH (.5 Radiology CECH)

1:30 - 6 pm Sports Medicine 3.75 CECH (3.16 Radiology CECH)

• Keynote: Barefoot Running Benno M. Nigg, Dr.sc.nat., Dr.h.c.

• Update on Sports Specific Shoes* • Injuries and the Advancing Technology in Sports Playing Surfaces* • Ultrasound Imaging in the Foot and Ankle* • Peroneal Tendinopathy* • ICD-10 for Sports Medicine • Percutaneous Achilles Tendon Repair in the Athlete* • Appropriate Choice of Imaging in Sports Related Injuries* • Arthroscopic Lateral Ankle Stabilization* • Concentric Bone Grafting Technique for Non-Unions and Chronic Stress Fractures* • Performance Enhancing Drugs in Sports Performance: What a Sports Specialist Should Know* •Q&A

Biomechanist Benno M. Nigg, award winning and revered scholar and author of numerous research publications and books including Biomechanics of Sports Shoes, makes his Western debut in 2014. Faculty at the Human Performance Laboratory at the University of Calgary in Alberta, Canada for the past 30 years, Nigg hails from Zurich. He has consulted with numerous shoe, orthotics, and sports-surface companies and has been a leading expert on sports shoes for 40 years. The Western is happy to welcome him as the Keynote Speaker at The 2014 Western Foot and Ankle Conference. • Their Research on Balance and Eye Sight • Joint Mechanics and Arthritis: Can We Predict the Future?* • Orthotics: What Do We Know - Where Do We Go? •Q&A

friday, june 20 10:15 am - 12 pm Neuropathy: How Unnerving 1.75 CECH (0 Radiology CECH)

7:30 - 9:30 am Medical Topics Affecting the Podiatric Patient 2 CECH (0 Radiology CECH) • Righting the Wrong: Exploding the Myths in Podiatric Medicine • How Different Is the Diabetic Patient Really? • Lifestyle Modifications and Changing Patient Behavior

(Supported in part by an educational grant from DermaTran Health Solutions.)

• Peripheral Neuropathy in LE Prospective RCT • Nutritional Supplements in the Treatment of Peripheral Neuropathy • Surgical Decompression for Diabetic Peripheral Neuropathy •Q&A

*Denotes lecture which provides radiology continuing education contact hours (CECH). 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure 2014

| 17 11

doctors’ general sessions friday, june 20 1:30 - 6 pm Tracks I & II run simultaneously.

Track I

Don’t Do What I Did: Learning from Our Surgical Misadventures 3.75 CECH (2.67 Radiology CECH) • What Lessons Can We Learn from Locking Plates after 10 Years* • Orthobiologics in Foot and Ankle Reconstruction* • Revising Fracture Malunions and Nonunions* • A Surgical Case Review with ICD-10 in Mind • Cartilage Replacement Techniques: What Is Fantasy and What Is Good Science* • Arthroscopic Ankle Fusion: You Can’t Always Replace Us* • Ankle Arthroplasty: A Critical Look at What Works* • Charcot Reconstruction: A Critical Look at Reconstruction* • Medial Column Fusion* •Q&A

friday, june 20

Track II

How to Build Your Successful Practice Combined Session for Physicians and Staff 0 CECH (0 Radiology CECH) for Doctors of Podiatric Medicine Doctors of Podiatric Medicine must be registered for Track II to attend this session. • The ACA, Covered California, and You In this session participants will gain insight into the Affordable Care Act and how it is being implemented in California through Medi-Cal expansion and Covered California. Through these changes you will be better prepared to understand the impact of these significant changes on your practice, help your patients, and potentially find opportunities amidst all of the uncertainty. • Value Based Care: What Is It Really? Participants all learn the meaning of value-based care and how it will affect each of us in the future. It seems unfair to demand all of this data when it seems nobody knows what to do with it. You can learn about the impact of quality measures and other data, along with some of the concepts the government and third-party payers are starting to implement around this initiative. You will also learn how to use this same information to your advantage through marketing, supply chain management, and contract negotiations. • How to Stand Out in the Crowded Medical Marketplace without Shouting In this session participants will learn a practice marketing method that will enable them to attract new patients and turn them into referral engines for the practice. Using the Internet, referral sources, your patient base and some 18 | 12

advertising techniques, there is a way to build your practice in double your digits year after year. Participants will leave with an actionable plan they can implement immediately. • Transforming Your Staff into an “A” Team Three components in comprehensiveness of care are: - Running a practice by understanding and using key metrics - Using systems and protocols to drive those metrics - Empowering your staff to make it all happen In this session participants will gain and understanding of how these three components work together to accomplish the goals of the practice and how to insure you have the right people doing the right things to make it happen. Your staff can excel with the right training and understanding of how true practice management works. • Practice Management: Differentiation - The Slight Edge Most medical professionals will tell you that they are overwhelmed with the tsunami of paperwork, problems and roadblocks they face every day. They also know that this complexity is actually increasing because of all of the known changes that are coming (not to say anything about the unknown). Why, then, do some doctors and staff seem to navigate these turbulent seas with seeming ease? The answer is The Slight Edge: simple, seemingly insignificant actions that over time produce truly massive results. In this final session participants will learn, in an expert way, exactly how they can remove any and all of the roadblocks that have been stopping them in the past.

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

doctors’ general sessions saturday, june 21

sunday, june 22

7:30 - 9:30 am Lessons Learned from a Podiatric Malpractice Settlement (PICA Presentation) 2 CECH (0 Radiology CECH)

8 am - 12:30 pm Treating Wounds: Remembering the Old and Learning the New 4 CECH (0 Radiology CECH) (Supported in part by an educational grant from TEI Medical, Inc.)

(Supported by an educational grant from Podiatry Insurance Company of America.)

Doctors of Podiatric Medicine must register for The Western to attend this lecture. PICA policyholders who attend this lecture can earn a 10% discount on their insurance renewal premium. CPMA members earn an additional 5%. 10:15 am - 12 pm Keeping It Flowing: Issues in Vascular Disease 1.75 CECH (1.33 Radiology CECH)

• Optimizing the Diet for Healing • Smoking and Wound Healing • Altered Biomechanics in the Diabetic Patient and How to Fix It • The Principles of Off-Loading • An Evidence Based Strategy for the Debridement Arsenal • Evidence Based Decisions for Choosing Wound Dressings • The Latest in Negative Pressure Therapy •Q&A

(Supported in part by an educational grant from Volcano Corporation.)

• The Latest Treatment Protocols for Deep Vein Thrombosis • The Importance of Non-Thrombotic Disease in the Non-Healing Venous Ulcer* • Considerations and Treatment Options for the Non-Healing Venous Ulcer* • Evaluation and Staging of the Neuroischemic Limb: Who is at Risk for Amputation?* • Revascularization for Limb Salvage: Does Diabetes Influence Outcomes?* •Q&A 1:30 - 3:15 pm “Uh-Oh… Now What?” Cases 1.75 CECH (1.5 Radiology CECH) • Case Presentations* •Q&A 4 - 6 pm Probing into Osteomyelitis 2 CECH (1.25 Radiology CECH) • Probing to Bone and the Bone Culture Gold Standard: Fact or Fiction* • Medical Treatment of Osteomyelitis* • Surgical Approach to Osteomyelitis* • The Cost Effectiveness of Amputations •Q&A

| 19 13

doctors’ workshops thursday, june 19

friday, june 20

8:30 am - 12 pm New Technology Improving Outcomes in Sports Medicine (Cadaver) 3.5 CECH

8:30 am - 12 pm Ankle Arthroscopy (Cadaver) 3.5 CECH Limited to 16 participants

Limited to 16 participants

This workshop will cover contemporary arthroscopic techniques to address intra-articular pathology of the ankle and subtalar joint.

(Supported in part by an educational grant from Arthrex, Inc..)

The workshop will discuss diagnostic and therapeutic technologies for common sports medicine injuries. Some emerging technologies will be presented in this hands-on cadaver workshop. 3 - 5 pm Taking the Pain out of Treating Pain Patients 2 CECH

(Supported in part by an educational grant from DermaTran Health Solutions.)

Limited to 50 participants Registrants will interact with faculty in small groups to discuss various cases to better appreciate levels of pain and the variety of modalities to use when managing pain. This discussion includes cases regarding post-operative pain, pain syndromes, and challenges with the aging population and other comorbidities known to complicate treatments. 5 - 8 pm Learning ICD-10 0 CECH for Doctors of Podiatric Medicine

(Supported in part by an educational grant from Merz Pharmaceuticals.)

Limited to 120 participants In this workshop participants will learn the latest information on the new billing and coding. This ICD-10 workshop will prepare participants to deal with the upcoming implementation of ICD-10 and survive yet another change in the healthcare environment. Doctors and office staff are both welcome to register for this important workshop.

1:30 - 5 pm The Top 5 Most Useful Procedures in Flatfoot Reconstruction (Cadaver) 3.5 CECH

(Supported in part by an educational grant from Wright Medical Technology, Inc.)

Limited to 24 participants This workshop will provide hands-on training to enhance the practitioner’s skills in the surgical management of adult flatfoot reconstruction and a roundtable format presentation from faculty who will share their pearls in evaluating the adult flatfoot and their most useful reconstruction procedures.

saturday, june 21 8 am - 3 pm Trauma Conference (Saw Bones) Fellow and Third Year Resident Course 3.75 CECH

(Supported in part by an educational grant from Stryker Orthopaedics.)

Limited to 40 participants This saw bone workshop provides participants the training in new and well established techniques in fracture management using different types of internal fixation. This workshop is open to doctors of podiatric medicine who are currently in fellowship programs or in beginning or ending their third year of residency. Complete the form below and send in with your registration to attend this workshop at no cost! You may also register online at thewestern.org.

fellow/third year resident scholarship application

trauma conference • saturday, june 21, 2014 Limited to 40 participants applicant information

Please complete one form per registrant to register for this workshop and send to CPMA for approval along with your registration for The Western Foot and Ankle Conference. You will be sent a confirmation of registration via email. There is no charge to apply. Applicant must be in the beginning or ending of a Fellowship program or his/her third year of Residency. Applications are approved on a first come, first served basis. If workshop is full, you may be placed on a waiting list to be registered as space becomes available.

Last Name ______________________________ First Name ______________________________ License Number ______________ Daytime Phone _____________________________________ Email ____________________________________________________ institution information Name of Fellowship/Residency Program _________________________________Start Date ____________ End Date ____________ Program Address ______________________________________________________________________________________________ City _______________________________________ State ____________ Zip ____________ Program Director Name __________________ Director Daytime Phone __________________ Director Email __________________ 20 | 14

2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure 2014

assistants’ program The Whole Office Learns at The Western The Assistants’ Program at the Western Foot and Ankle Conference has something for every member of your staff. Office managers, podiatric medical assistants, front office and back, will have an enjoyable time learning from an educated and skilled faculty. Take a look at what the two-day program of general sessions has to offer; then consider extending the experience by taking one or more of the specialized workshops created to suit the individual needs of each staff member.

need radiology? The 2014 Western will provide podiatric medical assistants 14 Radiology Continuing Education Contact Hours (CECH) to meet California Radiology Continuing Education requirements. For assistants needing all possible Radiology CECH, register for the following: Thursday:

Pre-conference Radiology Review Course

Friday:

Assistants’ Program General Sessions Anatomy Workshop

Saturday:

Assistants’ Program General Sessions Padding and Strapping Workshop

certified? Certified Podiatric Assistants and Certified Medical Assistants will be able to get up to 21.25 Continuing Education Contact Hours (CECH) for ASPMA and CMA Certifications. If you are certified and need all possible CECH, make this your agenda: Thursday:

Pre-Conference Radiology Review Course Learning ICD-10 Workshop

Friday:

Assistants’ Program General Sessions

Saturday:

Assistants’ Program General Sessions Padding and Strapping Workshop

office manager? There are many topics covered in the general sessions just for you, including a special practice management track at no additional cost. Consider this your itinerary: Thursday:

Learning ICD-10 Workshop

Friday:

Assistants’ Program General Sessions

Saturday:

Assistants’ Program General Sessions

Whether new to podiatry or well-seasoned, The Western will supply cutting edge information to improve knowledge and skills for everyone in your office.

2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure 2014

| 21 15

assistants’ general sessions friday, june 20 7:30 am - 12 pm 3.5 CECH for Certified Assistants 1.5 Radiology CECH • The Current Standard of Care in Treating Diabetic Foot Ulcers* • Getting Paid for Dispensing DME • Further Your Education • Lasers Aren’t Just for Comics • Neuropathy* 1:30 - 6 pm How to Build Your Successful Practice Combined Session for Physicians and Staff 3.75 CECH (1.75 CECH if taking the Anatomy workshop) for Certified Assistants (0 Radiology CECH) • The ACA, Covered California, and You In this session participants will gain insight into the Affordable Care Act and how it is being implemented in California through Medi-Cal expansion and Covered California. Through these changes you will be better prepared to understand the impact of these significant changes on your practice, help your patients, and potentially find opportunities amidst all of the uncertainty. • Value Based Care: What Is It Really? Participants all learn the meaning of value-based care and how it will affect each of us in the future. It seems unfair to demand all of this data when it seems nobody knows what to do with it. You can learn about the impact of quality measures and other data, along with some of the concepts the government and third-party payers are starting to implement around this initiative. You will also learn how to use this same information to your advantage through marketing, supply chain management, and contract negotiations. • How to Stand Out in the Crowded Medical Marketplace without Shouting In this session participants will learn a practice marketing method that will enable them to attract new patients and turn them into referral engines for the practice. Using the Internet, referral sources, your patient base and some advertising techniques, there is a way to build your practice in double your digits year after year. Participants will leave with an actionable plan they can implement immediately.

• Transforming Your Staff into an “A” Team Three components in comprehensiveness of care are: - Running a practice by understanding and using key metrics - Using systems and protocols to drive those metrics - Empowering your staff to make it all happen In this session participants will gain and understanding of how these three components work together to accomplish the goals of the practice and how to insure you have the right people doing the right things to make it happen. Your staff can excel with the right training and understanding of how true practice management works. • Practice Management: Differentiation - The Slight Edge Most medical professionals will tell you that they are overwhelmed with the tsunami of paperwork, problems and roadblocks they face every day. They also know that this complexity is actually increasing because of all of the known changes that are coming (not to say anything about the unknown). Why, then, do some doctors and staff seem to navigate these turbulent seas with seeming ease? The answer is The Slight Edge: simple, seemingly insignificant actions that over time produce truly massive results. In this final session participants will learn, in an expert way, exactly how they can remove any and all of the roadblocks that have been stopping them in the past.

saturday, june 21 7:30 am - 3:15 pm 5.5 CECH for Certified Assistants (1 Radiology CECH) • Those Hammertoes* • How to Present Your Pediatric Practice • Should You Follow Your Leader? • ICD-10: Learning to Pick Your Codes • Compassion, Fatigue and Burnout • How Mood Impacts Results • Dealing with Autistic Patients • Feet: Fit or Fat

*Denotes lecture or workshop which provides radiology continuing education contact hours (CECH).

22 | 16

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

assistants’ workshops thursday, june 19

friday, june 20

Pre-Conference Workshops

4 - 6 pm Anatomy (Cadaver)* 2 CECH for Certified Assistants (2 Radiology CECH) Limited to 16 participants

8 am - 5 pm Radiology Review Course* 7.5 CECH for Certified Assistants (7.5 Radiology CECH) Limited to 75 participants

This is a fantastic opportunity for assistants to work with doctors in dissecting the human foot and studying the anatomy and the function of the foot. From toes to tendons this course reviews it all and is a hands-on workshop that you will never forget.

Attendees must be registered for the Assistants’ Program. This course will be a review on various topics from radiology protection and set-up to trauma.

saturday, june 21

5 - 8 pm Learning ICD-10 3 CECH for Certified Assistants (0 Radiology CECH)

4 - 6 pm Padding and Strapping* 2 CECH for Certified Assistants (2 Radiology CECH) Limited to 24 participants

(Supported in part by an educational grant from Merz Pharmaceuticals.)

From Lodi strapping to off-loading pre-ulcerative lesions, learn the how’s and why’s of padding and strapping. There will be hands-on demonstration and participation for all attendees. Learn new skills to help out in the office. This is a fun course to bring an office mate to so you can practice on each other.

Doctors and office staff are both welcome to register for this important workshop.

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

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doctor of podiatric medicine registration form 2014 western foot and ankle conference June 19 – 22, 2014 Disneyland Hotel and Convention Center Anaheim, CA

NOTE: Full contact information provided here will be bar-coded on your badge and available to exhibitors. If you do not wish to disclose this information, do not have exhibitors scan your badge.

registrant information Please complete one form per registrant. All communication regarding The Western coming from CPMA or exhibitors who purchase or capture registrant data onsite will be sent to the contact information given below. ____________________________________________________________________________________________________________ Last Name

First Name

Degree

____________________________________________________________________________________________________________ Mailing Address

____________________________________________________________________________________________________________ City/State/Zip or Province/Country/Postal Code

____________________________________________________________________________________________________________ Daytime Phone

Email - Required for eHandouts (see page 12)

Fax

  Please check here if you have a disability and may require special accommodations and CPMA will contact you. general sessions

Please select a track. If no track is specified, you will be registered for Track I. Includes refreshments & exhibit hall access.

m Track I

m Track II

if received on or between May 5 & June 11

CPMA Member

APMA Member

Life Member

Federal Services Member

NonMember

Resident Name of Program:

Student Name of School:

$299

$499

$125

$299

$729

$75

workshops Must be registered for general sessions. See page 20 for details. Sports Medicine Taking the Pain out of Treating Pain Patients Learning ICD-10

$149

$219

$149

$289

$149

$79

$149

$79

$299

$79

Ankle Arthroscopy

$299

$399

$299

$499

$299

Flatfoot Reconstruction

$149

$219

$149

$289

$149

Trauma Conference

$299

Get free registration! See page 20.

TOTAL

payment information o Check enclosed payable to The Western

o Visa / Master Card / Discover o American Express

___________________________________________________________________________________________________________ Credit Card Number

Exp. Date (mm/yy)

CVV Code

___________________________________________________________________________________________________________ Cardholder’s Name

Cardholder’s Signature

Date

___________________________________________________________________________________________________________ Credit Card Billing Address if Different from Above Mailing Address

mail fax

The Western 2430 K Street Suite 200 Sacramento, CA 95816

Registration confirmations and CECH transcripts will be sent via email. If no email address is provided CECH will be mailed to the address provided.

(916) 448-0258

Additional Notes: Space in workshops is limited. Registration policy is first come, first served. Pre-registration ends Wednesday, June 11, 2014. Payment must be received to secure registration. On-site registration will incur a $50 administration fee. Returned checks may incur service charges. If written confirmation is not received, please call CPMA at (800) 794-8988 to confirm registration.

online TheWestern.org 18 24 |

Cancelation Policy: Cancelations received on or between Monday, May 5 and Sunday, May 18, 2014 will receive a refund minus a $35 administration fee. No refunds will be issued on or after Monday, May 19, 2014. Refunds are not granted to no-shows.

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

podiatric medical assistant registration form 2014 western foot and ankle conference June 19 – 22, 2014 Disneyland Hotel and Convention Center Anaheim, CA

NOTE: Full contact information provided here will be bar-coded on your badge and available to exhibitors. If you do not wish to disclose this information, do not have exhibitors scan your badge.

First Name

Employer/Doctor’s Name

____________________________________________________________________________________________________________ Mailing Address

____________________________________________________________________________________________________________ City/State/Zip or Province/Country/Postal Code

____________________________________________________________________________________________________________ Daytime Phone

Email - Required for eHandouts (see page 12)

Fax

  Please check here if you have a disability and may require special accommodations and CPMA will contact you. general sessions Includes refreshments & exhibit hall access

General Sessions if received on or between May 5 & June 11

CPMA Member’s Assistant

APMA Member’s Assistant

Non-Member’s Assistant

$179

$229

$279

workshops Must be registered for general sessions. See page 23 for details. Radiology Review Course

$79

$129

$229

Learning ICD-10

$79

$149

$299

Anatomy

$59

$69

$89

Padding and Strapping

$49

$59

$79

TOTAL

payment information o Check enclosed payable to The Western

o Visa / Master Card / Discover o American Express

___________________________________________________________________________________________________________ Credit Card Number

Exp. Date (mm/yy)

CVV Code

___________________________________________________________________________________________________________ Cardholder’s Name

Cardholder’s Signature

Date

___________________________________________________________________________________________________________ Credit Card Billing Address if Different from Above Mailing Address

mail fax

The Western 2430 K Street Suite 200 Sacramento, CA 95816

Registration confirmations and CECH transcripts will be sent via email. If no email address is provided CECH will be mailed to the address provided.

(916) 448-0258

online TheWestern.org

2014 2014 Western Western Foot Foot and and Ankle Ankle Conference Conference Registration Registration Brochure Brochure

19 | 25

DermaTran H E A LT H S O L U T I O N S

Patients

THE TRIAD

Physicians

Pharmacist

DermaTran H E A LT H S O L U T I O N S

CPMA Storms Capitol Corridors PODIATRIC PHYSICIANS PROUDLY CARRIED THE FLAG OF PODIATRIC MEDICINE THROUGH THE CORRIDORS TO CALIFORNIA’S CAPITOL DURING CPMA’S 2014 LEGISLATIVE LEADERSHIP CONFERENCE Over 100 California Podiatric Medical Association (CPMA) member podiatric physicians, residents, and podiatric medical students from the California School of Podiatric Medicine (CSPM) at Samuel Merritt University and the College of Podiatric Medicine at Western University of Health Sciences gathered in Sacramento on March 5 to bring the voice of podiatric medicine to legislators. During the day doctors discussed the many challenges - and opportunities - facing the practice of medicine in California today. Assemblyman Jimmy Gomez (D, AD-51), author of Assembly Bill 1868 (Medi-Cal), which reinstates medical treatment and care provided by doctors of podiatric medicine as a covered service in Medi-Cal, addressed the attendees. Assemblyman Gomez spoke of the necessity of providing all Californians with access to quality, affordable health care. Following his address, Assemblyman Gomez was presented with the California Podiatric Medical Association’s 2014 Legislative Leadership Award. Assemblyman Scott Wilk (R, AD-38), another keynote speaker, encouraged those in attendance to visit their representatives back in their home districts, where their representatives would face fewer distractions and time constraints. Assemblyman Wilk was presented with CPMA’s 2014 Patient Advocate of the Year Award. In his keynote address, Lieutenant Governor Gavin Newsom noted the challenge that rising health costs pose for the state. He also spoke of the promising opportunities that come about by facing and addressing challenges head-on. After a morning of legislative briefings and guest speakers, which in addition to Lt. Governor Newsom, Assemblymen Gomez and Wilk, included Jim Rathlesberger, Executive Officer, Board of Podiatric Medicine (BPM) and Dustin Corcoran, Chief Executive, California Medical Association, the group headed to the Capitol building to speak to their representatives about critical legislative issues affecting the practice of medicine in California. In their marching orders members were urged to talk with their representatives about what they do every day in their practices - taking care of patients. They were also reminded that they were championing their patients and medicine, and by their presence and participation could have a positive impact on the patients and practice of podiatric medicine in California.

(l to r) Paul Weiner, DPM; Jonathan Uy, DPM, Director; Thomas Elardo, DPM, President-Elect; Assemblywoman Susan Bonilla; Jon Hultman, DPM, MBA, Executive Director; Karen Wrubel, DPM, Immediate Past President; Rebecca Moellmer, DPM, Secretary/Treasurer; Tobin Gallawa, DPM; Thomas Tanaka, DPM, Director CPMA armed members with information on the important role podiatric medicine plays in the health care delivery system. Among the issues discussed with legislators were AB 1868 (reinstating treatment and care provided by doctors of podiatric medicine as a covered service in Medi-Cal), the Duals Demonstration Project, MICRA, Access to Care, and the Physician and Surgeon certificate for doctors of podiatric medicine. CPMA thanks all those who took time from their busy schedules at their own expense to travel to Sacramento and proudly carry the Banner of Podiatric Medicine through the corridors of power in the Capitol, where the stroke of a pen can write podiatric physicians and the patients they serve into, or out of, the law. The California Podiatric Medical Association also wishes to thank Bako Integrated Physician Solutions, Honor Medical, and Pfizer for their unrestricted grants which helped to make CPMA’s 2014 Legislative Leadership Conference such a huge success!

See CPMA STORMS on Pages 28 - 33

A p r i l | m ay | j u n e | 2014

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CPMA Storms Capitol Corridors The California Podiatric Medical Association is proactive on both the state and national levels educating legislators about the critical role podiatric physicians play in healthcare delivery; the importance of patient access to treatment and care by podiatric physicians in order to save both lives and limbs, and the recognition of doctors of podiatric medicine as physicians and surgeons based on their education and training.

President McAloon

CPMA Past President Franklin Kase, DPM with CPMA Past President and Executive Director Jon Hultman, DPM, MBA, CVA

CPMA Directors Rebecca Moellmer, DPM and Devon Glazer, DPM

Kenneth Charp, DPM and Kenneth Rehm, DPM

CPMA President Carolyn McAloon, DPM and President-Elect Thomas Elardo, DPM 28 |

CPMA Director John Chisholm, DPM (2nd from left) with Kenneth Rehm, DPM (2nd from right) and Students C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

John Abordo, DPM and CPMA Immediate Past President Karen Wrubel, DPM (l to r) Thomas Elardo, DPM, President-Elect; Thomas Tanaka, DPM, Director; Carolyn McAloon, DPM, President; Alexandra Salgado, Sr. Legislative aide of Senator De Leon; Jodi Hicks, Legislative Counsel; Rebecca Moellmer, DPM, Secretary/Treasurer; Executive Director Jon Hultman, DPM, MBA, CVA

President McAloon with Assemblyman Jimmy Gomez

Derick Ball, DPM, Chair, CalPPAC

CPMA Past President Michael Cornelison, DPM; President-Elect Thomas Elardo, DPM and CPMA Executive Director Jon Hultman, DPM, MBA, CVA A p r i l | m ay | j u n e | 2014

Dustin Corcoran, Executive Officer, California Medical Association

Students checking-out the breakfast buffet | 29

CPMA Storms Capitol Corridors

President McAloon presents Assemblyman Gomez with CPMAâ&#x20AC;&#x2122;s 2014 Legislator of the Year Award

Lawrence Harkless, DPM, Dean, College of Podiatric Medicine at Western University of Health Sciences chatting with student

Thomas Tanaka, DPM, Director

Robert Lee, DPM; Brad Wicklas, Honor Medical; Karen Wrubel, DPM, Immediate Past President

Jodi Hicks, CPMA Legislative Counsel

CPMA Executive Director Jon A. Hultman, DPM, MBA, CVA 30 |

Lt. Governor Gavin Newsom C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Lee Rogers, DPM

(l to r) Immediate Past President Karen Wrubel, DPM; President Carolyn McAloon, DPM; President-Elect Thomas Elardo, DPM; Marjorie Schwartz, Healthcare Consultant for Senate Pro-tem Darryl Steinberg; CPMA Legislative Counsel Jodi Hicks; CPMA Executive Director Jon Hultman DPM, MBA, CVA

Jim Rathlesberger, MA, Executive Officer, Board of Podiatric Medicine with BPM President Neil Mansdorf, DPM

Carolyn McAloon, DPM, President A p r i l | m ay | j u n e | 2014

CPMA Past President William Tarran, DPM with CPMA Director Jonathan Uy, DPM

Assemblyman Scott Wilk is presented the 2014 CPMA Patient Advocate Award by Lee Rogers, DPM

Assemblyman Jimmy Gomez and President McAloon doing the selfie | 31

CPMA Storms Capitol Corridors

Smiling Students Jodi HIcks, Legislative Counsel; Carolyn McAloon, DPM, President; Agnes Lee, Assembly Speaker John Perezâ&#x20AC;&#x2122;s Healthcare Consultant; Karen Wrubel, DPM, Immediate Past President; Thomas Elardo, DPM, President-Elect; Jon Hultman, DPM, MBA, CVA, Executive Director

Mandi McGill, Bako Intergraded Physician Solutions

Students were out in force 32 |

Lawrence Harkless, DPM, Dean (far right) and CPMA Director Rebecca Moellmer, DPM (center) with Western University College of Health Sciences and College of Podiatric Medicine students

Discussing the value of podiatric medicine with legislators C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Seeking support for CPMAâ&#x20AC;&#x2122;s bill AB 1868

A p r i l | m ay | j u n e | 2014

CalPPAC Chair Derick Ball, DPM with Elaine Cartas, Campaign Finance Manager for Lee Rogers, DPM, Candidate for the 25th Congressional District

Jim Rathlesberger, MA, Executive Officer, Board of Podiatric Medicine

Assemblyman Scott Wilk

Brad Wicklas, Honor Medical

Assemblyman Jimmy Gomez, sponsor of AB 1868 legislation to reinstate podiatric medicine in Medi-Cal | 33

“Where have we been, where are we no Where have we been? June, 2003, offered an opportunity for a “new beginning” in CPMA history. At the time, CPMA, CMA, and COA were locked in a bitter scope battle. CPMA had introduced AB 932 – seeking the legal right for DPMs to perform amputations, administer physical exams, perform admitting histories, and function as assistant surgeons on non-podiatric procedures. Throughout the year in which the bill was first introduced, CPMA was unable to secure a sufficient number of committee member votes to move it out of the Assembly Business and Professions Committee. On the verge of defeat, a last minute decision was made to convert it to a two-year bill – a strategy which often prolongs the agony, with little chance of success. At the time, the association was barely able to pay its bills. CPMA had been tapping into its line of credit the first four months of each year, enabling it to stay afloat until dues payments began to arrive. The Sacramento office building was in need of major repairs, office technology was antiquated, there were no CPMA or Western websites, and the Scientific Program had actually lost money the previous year. Non-dues income was basically non-existent. Strategically, the association was moving sideways, with no clear vision or strategy for the future. Each new president brought a fresh agenda with a new direction. Even though the leaders were pursuing laudable goals, there was no consistent momentum directed at advancing the profession. It was clear by June of 2003 that the CPMA Board needed to rethink its strategy. The most immediate changes made were to

hire both a new executive director and a lobbyist. The board was also “reshuffled”, committees restructured, office processes reengineered, the building remodeled, office technology updated, a CPMA website created, new budgeting and financial protocols established, and communication channels amongst board members, committees, local societies, and members, improved. An evolution towards stronger respect for CPMA leadership was underway – both in California and nationally. At CPMA, we believe in the axiom, “You can’t cut your way into prosperity.” Instead of cutting programs and services, the board decided to take a long-term approach to increasing the value of membership and expanding the influence of CPMA leaders – all of this without raising dues. It was in June of 2004 that the association achieved success in passing AB 932. Along with passage of this bill, changes were also made in the Western Foot and Ankle Conference, the scientific program for attendees was improved, and the value for exhibitors and sponsors was enhanced. This is an ongoing process today. Following these advances, staff conceived a new idea – corporate membership. This non-dues source of income has undergone many changes which have increased its value and is expanding under the leadership of president-elect, Tom Elardo, DPM. The board also developed a new strategy at an annual planning retreat whereby, instead of each president taking the association in a new direction, long-term goals would be formulated by the board with each president advancing the association in a consistent direction as far as s/he would be able, with each successive president continuing the momentum by leading the association in the same direction. A major outcome of this new strategy was the board’s recognition of and agreement to the idea that podiatry had evolved to a specialty of medicine and that because DPMs are trained, educated, and have responsibilities equivalent to other physicians, their license should reflect this fact and be the same as that of MDs and DOs. Having transitioned from this concept at a retreat to the creation of a Joint Physician and Surgeons Task Force that includes CMA, COA, and OPSC reflects the ability of the board to progress from the “idea stage” to the implementation and execution of an idea – even when achievement of a specific goal may, at first, appear to be “impossible.” The CPMA board and staff have clearly adopted the same philosophy as the Army Core of Engineers: “The difficult we do immediately. The impossible takes a little longer.” Where are we now? As of June, 2014, CPMA, CMA, and COA are no longer at odds. The Physicians and Surgeons Joint Task Force is a reality. Site visits of California’s two podiatric medical schools and two of its residency programs

34 |

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

w, and where are we going?” have been accomplished (refer to the “P&S Task Force report”). The goal of this task force is for all future graduates to receive a Physician & Surgeons Certificate – the same as that issued to MDs and DOs. Throughout this process, CMA and CPMA have been collaborating on issues they have in common – including AB 1868 (CPMA’s bill to reestablish DPMs in Medi-Cal), the coalition to protect MICRA, scope battles with physical therapists and others, and information sharing. There have also been spinoffs from the Task Force relationship, including a letter of support from CMA for APMA’s HELLPP legislation as well as national “attention” from AMA and state medical associations following (1) the joint press release from CMA, COA and CPMA and (2) CMA’s testimony at the Scope of Practice Partnership – attention that should impact State Medical Associations whose members continue to “fight the old fight” with Podiatric Medical Associations in other states. Financially, 2013 was CPMA’s best year to date. We held a highly successful and profitable Western Foot and Ankle Conference, brought in a total of 31 Corporate members (and growing), and maintained a stable membership. This year, to do its part in increasing the number of highly qualified applicants to the California podiatric medical schools, CPMA is initiating an endowed scholarship at each school. The CPMA office in Sacramento has been fully remodeled, including state-of-the-art technology and a functional website containing valuable resources for members. Not only does CPMA no longer use its line of credit to run the association throughout the first four months of each year, 100% of 2013 staff salaries were paid from non-dues income – enabling the Board of Directors to utilize all dues dollars for member programs and projects. Additionally, even though endowed scholarships are being funded this year and we have asked for no dues increases this past decade, CPMA has also been able to invest funds in the P&S Joint Task Force and in CMA’s coalition to fight MICRA – with a “little bit” “left over” for funding reserves. The association continues to build momentum as it moves forward with a clear strategy. Similar to a football quarterback, each president takes the ball downfield, gaining as many yards as possible and then hands it off to the next president who, in turn, continues the momentum in the same direction. Yards became tougher once we moved into the red zone, but the goal is in sight, and we will continue until we cross that final yard. CPMA has gained the respect of podiatric and non-podiatric organizations both in California and nationally, and this respect – in conjunction with financial stability and strong leadership – has enabled a relatively small organization to accomplish big things. As we enter the 2014 House of Delegates, the executive board can be proud of its achievements this past year, and the House of Delegates can feel lucky to have these leaders as we move forward. Immediate Past-President, Karen Wrubel, challenged the “Duals” initiative at a point in which the board was advised that nothing could be done to alter it. Her persistent efforts to call attention to its potential negative impact on patient access and the quality of care led to a collaborative strategy with the Los Angeles County Medical Society and a slowing of the implementation process. Carolyn McAloon was invited to the CMA House of Delegates and A p r i l | m ay | j u n e | 2014

was acknowledged and “called out” by the president of CMA in his speech. Tom Elardo’s efforts in the area of Corporate Membership and CalPPAC donations garnered at the Northern “One Voice” event have improved the association’s financial ability to run its programs and continue in its achievement of strategic goals as well as strengthen the PAC. Ami Sheth has worked diligently on the Governmental Affairs Committee, one that both reviews bills to protect members from potential harm and introduces Legislation (such as CPMA’s Medi-Cal Bill, AB 1868) to advance the profession. The addition of CPMA’s new lobbyist, Jodi Hicks, has leveraged the ability of this committee to focus its efforts on protecting and advancing the profession. Treasurer, Rebecca Moellmer, has watched over the Association’s resources, resulting in our best financial outcome so far, and she has been “creative” in finding unbudgeted dollars for the association’s initiation of endowed scholarships for California’s two podiatric medical schools. She has also helped maintain dues income by working diligently on the membership committee. In addition to their focus on moving all CPMA strategic initiatives forward, our members-at-large have served as liaisons to committees and local societies, generated new ideas for board consideration, and actively participate in board discussions and decisions. Where are we going? Ultimately, our most significant goals can be stated in two words – parity and influence. We demand parity in reimbursement and licensure because of our education and training which are equivalent to that of MDs and DOs and because of the fact that we are held to the same level of patient responsibility. We have influence because our integrity, opinions, and ideas are respected by others. This will need to continue after we achieve parity because we will continue to have good ideas that we want to implement. Translating these ideas into reality will require that we be able to educate legislators, payers, and both state and national healthcare leaders. Influence, in combination with a strong association, will continue to be necessary for protecting and advancing the profession. Collaboration with other associations such as CMA will enable us to leverage our value to our members through the opportunity that this affords us to tap into information, analysis, and resources that are available only through such large organizations. Healthcare delivery and the medical profession are changing. So too are reimbursement methods, practice models, and technology. Adapting to all of these changes requires that CPMA and its members have access to relevant data and information. There is a light at the end of what was once a very long tunnel, and looking ahead to the next five to ten years, CPMA fully expects to have achieved its most significant goals. Even after this is accomplished, we plan to remain relevant to the needs of all podiatric practitioners, whether they are in private practice (single specialty or multi-specialty), or are employed by medical groups, HMOs, or hospitals. | 35

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Hiring the Right Person for the Job the First Time In my experience working with numerous practices as a consultant, the hiring process is one of the most daunting and critical tasks. It is often not given the focus, time and value that it deserves. Reviewing resumes and interviewing prospective candidates can be overwhelming, especially when you have limited time to devote to it. If you have ever done this you know how difficult and time consuming it can be. Weeding out candidates because their resumes do not have what you are looking for needs to be done and can take a lot of time when 100’s of applicants are applying for the job. You will want to have specific criteria that the position requires to help you pick out those that do not have the skills for which you are looking. After the selection has been narrowed down, it is time for the first interview, which usually is over the phone. The interviewer must have the natural ability to keep the candidate talking either about their prior jobs or accomplishments or themselves. The more you can get them to talk, the more personal information you will be able to find out about them. Getting the candidate to open up and relax while talking to you on the phone will make for a better faceto-face interview if he or she is chosen. Once finished with the phone interviews pick your top 5 candidates to do face-to-face interviews with and then have a back-up selection of 5 others. If you pick too many to interview it can become quite draining, and you may not give your all to each candidate when they come in, which would be unfortunate. If none of the face-to-face interviewees click as possible hires, then go to your second group selection. In the first face-to-face interview pay close attention to the candidate’s appearance, communication skills, verbal and non-verbal, and how you personally connect with him or her. Communicate clearly to the candidates about when you will be making a selection for the second interview; this way, if the time passes and they did not get called back, they will know not to expect a call.

feel like they are special and we value them?” Coming up with great questions that allow you to see who the candidates really are and if they have thought about what it will take to do the job takes thought. You never want to ask questions that will make your candidates feel like you are interrogating them. It is important to help bring out the best of who they are so that you can see if they are the right people for the position you are looking to fill. One of the most critical steps that must be done once you find your final 1-2 candidates is to complete a good background check on them. It is amazing what things people will put on their resumes thinking that no one will ever check them out. Recently Jay Henderson of DPMHiring.com wrote an excellent article in his newsletter about checking employee references. He has given me permission to share this important information with you. Real Talent Warning Tobacco companies are required to print warnings on each pack of cigarettes they sell. This is a scare tactic, but from a good source – the one trying to protect you. Since people are doing whatever they can to get a job I came up the following: REAL TALENT WARNING: Hiring is a High Risk Activity and When Done Wrong Will Likely Cause a Loss of the Following: Customers, Revenue, Profit, Motivation, Time, Energy, Happiness, and Your See talent on Page 39

When you bring the final candidates back for the second interview spend time talking about the things that you have learned about them personally, like sports teams they like, their hobbies, or their family lives. Once you have them relaxed lead into information and questions about the job they are applying for and make sure you have good questions to ask them that will make them think, be challenged, and bring out the best in them, for example, when hiring for a front office medical receptionist, ask “How will you greet our patients when they come in so that they A p r i l | m ay | j u n e | 2014

| 37

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General Well Being. You Will Also Likely Experience Frustration, Aggravation, A Strong Possibility of Violence, Potential Migraines, and a General Sense of Malaise. Right? It’s crazy out there! Here are just 5 reasons why you need to be on the lookout when hiring: Reason 1: You can now BUY a job reference. For those who are applying for a job but lack sufficient references, there is now Career Excuse, a professional reference provider. For a mere $50 a month, this online company allows individuals to purchase fake job references, including a live operator acting as a supervisor’s secretary. They use the client’s script to connect to a bogus live HR operator via their very own toll-free fax number and local phone number, as well as a virtual company website with email addresses on their domain name to make it all look legit. For only $150 you can even create your own company!

Reason 2. The Society for Human Resource Management has found that over 51% of resumes contain false or misleading information. 53% lie about their length of stay at a past job. 51% lie about their salary at a past job. 61% lie about their college educations. Reason 3. People also pay $1,000 to $3,000 dollars to have someone create a well-written resume for them... because they can’t? Reason 4. They also hire coaches to teach them how to handle interviews so they can bluff their way through and get on your payroll. Reason 5. There are books with every interview question they could be asked right along with the ‘perfect’ answers. These are just 5 reasons why I reveal your risk and give you amazing detail about who you’re really getting.

Company founder William Schmidt started the site in 2009 and told DailyDot.com that he started the service after realizing there was a high demand for fake job references.

Objective number one is to block the problems from getting into your life. The second is to know exactly whom you’re hiring so your expectations aren’t blown all out of proportion (a huge factor between boss and employee). The third is accurate and detailed information so you can know how to manage them better. But revealing your RISK is key.

“Yes, there’s a moral issue in fibbing on your résumé to land a job, but that’s for people to deal with themselves,” he reportedly said. “In today’s environment with rampant unemployment, everyone’s looking for an edge. Our service just gets them the interview.”

If you hire the wrong person for the job it will cost you money, time, stress, and lack of ability to run your office efficiently, which ultimately will cause stress for your staff. Take the time to hire the right person for the job.

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SKIN, RIGHT ANTERIOR LOWER LEG, PUNCH BIOPSIES (two): - SPONGIOTIC DERMATITIS, SUBACUTE, MOST CHARACTERISTIC OF NUMMULAR (eczematous) DERMATITIS. - A PERIODIC ACID SCHIFF REACTION FAILS TO DEMONSTRATE FUNGAL ELEMENTS. COMMENT: These histopathologic features may be seen in association with conditions as disparate as acute allergic contact dermatitis, early-evolving nummular (eczematous) dermatitis, and Id reaction. In light of the constellation of both clinical and histopathologic features in this case; one potential therapeutic course for this patient could include the application of a low potency (class 6-7) topical corticosteroid. The therapeutic value of such steroids may be augmented by concomitant use of topical urea.

CLINICAL INFORMATION: Dermatitis. Rule out tinea corporis. Lower leg. GROSS DESCRIPTION: Received in formalin fixative are two 2-mm punch biopsy specimens which are submitted en toto for processing in 2 cassettes. MICROSCOPIC DESCRIPTION: Sections demonstrate a superficial perivascular infiltrate comprised of lymphocytes. There is diffuse spongiosis and an admixed compact and basket-woven stratum corneum with intracorneal serum. Scattered intradermal eosinophils are seen. A PAS stain fails to demonstrate fungal organisms. Final Diagnosis performed by Bradley W. Bakotic DPM,DO. Electronically signed 3/28/2013

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Hultman Adds CVA to Long List of Titles California Podiatric Medical Association (CPMA) Executive Director Jon A. Hultman, DPM, MBA has earned the designation of Certified Valuation Analyst (CVA). Dr. Hultman successfully completed the certification process with the National Association of Certified Valuation Analysts (NACVA), a global professional association that supports the business asset valuation services and financial forensic services, including damages determinations of all kinds and fraud detection and prevention by training and certifying financial professionals in these disciplines. To become accredited by NACVA, Dr. Hultman was required to successfully complete an intensive training and testing process. The rigorous certification process is open only to those who meet the association’s intensive standards of professionalism, expertise, objectivity, and integrity in the field of business valuation, litigation support, and related consulting disciplines. CPMA Executive Director Jon A. Hultman, DPM, MBA, CVA was one of the featured speakers at the prestigious Western Health Care Leadership Academy this past April. The Keynote Speaker of the 2014 Conference was former Secretary of State Senator Hillary Clinton. The conference featured speakers from government, health care organizations and insurance companies.

LESSONS FROM GEESE 1. As each bird flaps its wings, it creates lift for the bird following it. By flying in a Vee formation, the whole flock extends its flying range 71% greater than if each bird flew alone.

The migration of geese is an awesome sight, as they fly south in the Fall and north in the Spring of each year. The remarkable thing in their interdependence in flight, and the following observations are the result of years of study.

(Moral: People who share a common direction and sense of community can get where they are going quicker and easier because they are traveling on the thrust of one another.)

2. Whenever a goose falls out of formation, it suddenly feels the extra drag of ‘going it alone’ and it quickly gets back into the formation to take advantage of the lifting power of the bird immediately in front.

(Moral: If the rest of us had as much sense as a goose, we would stay in formation with those headed where we want to go.)

3. When the head goose at the tip of the Vee gets tired, it rotates back into formation and another goose takes over the lead in the point position. A p r i l | m ay | j u n e | 2014

(Moral: It pays to take turns doing the hard tasks and sharing leadership. People, as with geese, are interdependent with each other.) 4. The geese in formation honk from behind to encourage those up front to keep up their speed.

(Moral: We need to be sure our ‘honking’ from behind is encouraging, not something less helpful.)

5. When a goose gets sick or wounded or shot down, two geese drop out of formation to follow him down, to help and protect him/her. They stay with him/her until he/she is either able to fly again, or dies. They launch out on their own with another formation or catch up with the flock.

(Moral: If we would have as much sense as the geese, we would stand by each other.)

| 41

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NAFTIN Cream, 2% is indicated for the treatment of interdigital tinea pedis, tinea cruris, and tinea corporis caused by the organism Trichophyton rubrum in adult patients ≥18 years of age. ADVERSE REACTIONS In clinical trials with NAFTIN Cream, 2%, the most common adverse reaction (≥1%) was pruritus. WARNINGS AND PRECAUTIONS If redness or irritation develops with the use of NAFTIN Cream, 2%, treatment should be discontinued.

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MEMBERSHIP Has its Benefits CPMA is the only organization that lobbies on behalf of the podiatric profession in California’s capitol. In addition to realizing the accomplishments that only strong organization and representation can achieve, there are a number of immediate and tangible benefits only members of CPMA, APMA, and the IBT Union can access and receive.

Not a Member? Join now! With convenient payment plans and a simple application process, CPMA makes it easy to join. Apply online today at www.calpma.org/membership or complete the form below.

CPMA membership gives you access to the following: • Significant discounts for educational • Regional support through State and Local conferences and courses, including activities The Western, which provides 25 CMEs • Convenient automatic monthly payment including units to meet California Radiology option requirements • Online Radiologic Manual, required by the • Discount on malpractice insurance premiums State of California • E-subscription to the DPMemo, CPMA’s • California Resident-to-Practitioner “how to” monthly email newsletter plus eAlerts as handbook - coming soon news you need to know arises • Discounts on wireless service • Free subscription to the California Podiatric • Car rental, travel, and entertainment Physician and JAPMA discounts • Free and discounted legal advice and • Vacation tours savings to destinations across support the globe • Representation to CMS and insurance carriers • Theme park discounts via 20+ committees • Loan and mortgage programs • Webinars with CMEs available 24/7 • Health program savings – save on vision and • Access to tools for managing and marketing dental care and more your practice online • Plus many more discounts and opportunities • Networking and knowledge-sharing for your professional and personal benefit! opportunities with other DPMs

Application for Membership First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M.I . . . . . . . . . . . . Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous Last Name (if changed due to marriage, divorce, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Birth Date . . . . / . . . . / . . . . Sex:  Male  Female

Professional Licensure Podiatric Medical Licenses Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . . Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . . Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . .

Have you ever had a license to practice podiatric medicine suspended or Practice Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Owner  Employee revoked in any state? Home Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Principal Office/Residency Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................................................................................................................ Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 yes  no If yes, please explain on a separate sheet. Are you currently, or have you ever been, on probation suspension, or investigation by any licensure authority, state or federal agency?  yes  no If yes, please explain on a separate sheet.

E-Mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Professional Medical Practice Secondary Office/Residency Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Original Start of Practice Date (Mandatory) . . . / . . . / . . . Please submit a copy of ALL state licenses with this application. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-Mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unless you are in a residency program, please forward your completed application directly to the California Podiatric Medical Association at 2430 K Street, Suite 200, Sacramento, CA 95816, or fax to (916) 448-0258. If you are applying for resident membership, please forward your application directly to APMA at 9312 Old Georgetown Road, Bethesda, MD 20814.

Podiatric Medical Education

Podiatric Medical Degree  yes  no Podiatric Medical College . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...................................................... Year of Graduation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

For more information on membership, please contact the California Podiatric Medical Association at (800) 794-8988 or jsteed@calpma.org. A p r i l | m ay | j u n e | 2014 | 43

Protecting Your Practice My articles generally address issues involving clear and present danger to members, such as Medicare EHR incentive bonus audits, unannounced site audits by the Radiology Board, trends with third party payor audits, and, of course, ways to protect against malpractice suits and licensing board complaints. There are so many issues causing imminent concern, that often it is difficult to find the time for long term strategic planning, in life and in business. Unfortunately, a lack of strategic planning will eventually lead to clear and present danger. Over the last few years, we have seen a dramatic increase in the sale of medical offices due to members retiring, becoming disabled, and sadly, passing away. We have also seen an increase in practice sales and consolidations due to the changing economic climate of health care. Unfortunately, without proper planning, doctors are forced to deal with these circumstances reactively. This can result in the practices they spent their whole careers developing being sold for pennies on the dollar, or, in some circumstances, simply dissolved, leaving themselves or their heirs in a state of financial hardship. In most cases, a doctor’s practice constitutes a substantial portion of their net worth, along with their primary residence and investments. Although they typically have plans for succession of their real estate and financial investments, they don’t have a plan for maximizing the value of their practices. In this article, I am going to cover general principles and issues relating to estate planning, from residency to retirement. In a series of future articles, I will be covering individual topics in more depth, including the significance of having a trust, ways to legally avoid taxes and fees, and how to prepare your practice for sale or consolidation in order to maximize its value for you and your heirs. We will be adding additional forms to the Legal Resource Center on the CPMA member website which will also be discussed in future articles. As always, if members have any questions or need assistance with the forms, they can call the legal hotline at (800) 794-8988. Programming the ‘GPS’ Properly A good way to think about an estate plan is to liken it to a map or the GPS in your car. Finding your way is always easier when you can clearly see things on a map. A good map gets you to your destination on time, without any wrong turns or backtracking. Without those directions, it’s impossible to know the correct roads to take, and if you miss an exit, you may find yourself unable to turn around and losing valuable time. Fortunately, for most Podiatric Physicians, receiving those ‘directions’ to get their estate to where it needs to be is a fairly straightforward proposition with the right directions. That begins with acknowledging the need for a plan and seeking out proper counsel to help program and guide you through the essentials of estate planning that come with every stage of personal and practice life. This allows you to be properly prepared to meet any need as soon as it arises. Even though you might not think it’s essential right now, estate plans are often called on unexpectedly, so it’s never too early to start looking at a roadmap. 44 |

Young and Starting out in Practice It is unfortunate how many young DPMs pass by important areas of Estate Planning. They think they’re too young, are busy building their practices and feel they’ll have time in the future to get around to it. But this is the time when the critical foundation for effective future planning is laid and the necessities and goals of a solid estate plan should be learned. The foundation of all estate planning involves establishing a Trust. A properly constructed and funded Trust eliminates the potential process of probate, a very long, expensive judicial process that freezes assets, makes everything public, and is a very unpleasant experience. Additionally, young adults should establish a Will, Durable Power of Attorney and Advanced Healthcare Directive so that in the event of an incapacitating accident, someone is able to make legal decisions regarding treatment and health care decisions. Though a chilling topic avoided by many, these documents can be essential to settling familial legal battles, and have often actually saved the lives of clients by allowing the proper medical care to be given, arguing with the health insurance carrier, etc. Married and Growing the Practice Things change when two people become legally bound to one another, and definitely once children enter the scene. At those points in time, everything about life (including Estate Planning) needs to be reevaluated. The two biggest personal changes that clients find after they have started a family are the ownership of property and their considerations for their children’s futures. The Children To protect the children and ensure that they are raised in the best possible way, parents should draft new wills that list the people they would like to have become legal guardians of the children in the event they both die. Without a will specifying the custody of the children, legal battles between families often erupt. Even if both sides are perfectly compliant, the court might give preferential consideration to an individual because of his or her relationship, versus what the parents would wish. Though a court would never knowingly make a decision that might endanger a child, proactive parents should want to select a guardian who will raise their children as they would have. Otherwise, a bureaucratic employee of the State of California will determine who will raise them. Property The other challenge to the estate is the determination of marital property. Though a basic will and intestate guidelines will almost always give large marital property to the surviving spouse, the property may still have to go through probate (the legal process of carrying out a will). In addition, there could be significant tax disadvantages if this is not done properly. It is very important to keep all property as Community Property in the Trust with an automatic right of survivorship. In this case, the marital property is owned by the couple and passes to the survivor outside of probate. This makes the transfer of property essentially C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

and Your Estate instant and saves time and money. This Community Property ownership must be declared for each piece of property, as it is titled, and again, can create some tax advantages if done properly. Maturing Individuals and Practices This is a typical period for significant growth of many medical practices. This is also a time when many are investing and growing their individual estates. A prepared middle-aged couple or individual will definitely benefit from more advanced estate planning. This will often include comprehensive methods of tax saving strategies, wealth accumulation and avoiding estate taxes in the future. There are several options in this area, which is why it is important to meet every few years with a qualified attorney who will help ensure all elements of the Estate Plan are properly addressed: tax planning, financial planning and of course, maintaining the proper legal structures in the necessary documents. Practice-Specific Planning While there are many similarities, each medical practice is uniquely different, just like the individuals who own them. Therefore, it is essential that each physician carefully has their specific practice evaluated, as well as their personal situation, if they are to effectively accomplish their estate planning goals. There will be much more detail on this covered in future issues, but below are just some of the very important questions that are critical to be addressed to be successful at properly planning for your future. See which questions you are able to answer: • Is your practice properly structured to provide the greatest asset protection possible in the case of litigation? Surprisingly, many professionals either do not have the proper corporate structure or have not maintained it effectively to protect them personally in the event of litigation. • Do you have key employees, and if so, what is being done to retain them? Often times, a key employee can make a very positive (or negative) affect on patients and the practice overall. Employee incentive programs may be of significant benefit and can many times be structured in a way that will benefit you personally, as well as the practice. For example, you can put an employee pension plan in place that not only benefits the employees, but allows you and your spouse to participate in it as well, saving the practice tax dollars, adding to your retirement funds and creating some very loyal employees. • Are your financial and business consultants working as a team? We see so many clients where their Estate Planning Attorneys, Financial Advisors (if they even have one) and CPAs aren’t even in communication, much less coordinated. This often creates significant amounts of money that ‘falls through the cracks’, because of taxes or fees. So, in addition A p r i l | m ay | j u n e | 2014

to the proper structuring of an Estate Plan, it is critical to make sure all professionals involved are communicating effectively. • Are your current insurance programs sufficient to protect employees (and your family) in the case of a catastrophic event? Here, too, we have found so many examples of clients that have sufficient liability coverage, but when it comes to health, life or disability insurance, they found out the hard way that they didn’t have the right levels and types of coverage to protect the practice and their families. • What would happen if suddenly you were unable to practice medicine? Too often a very successful practice collapses when the principal physician becomes incapacitated. We have all seen those cases where the doctor’s family tried to keep the practice going without proper advanced planning and the practice eventually fell into disrepair and had to be closed, causing great financial hardship. It is critical to have a formalized plan in place to protect against this contingency. • Do you have an “exit strategy,” and if so, what is it? Let’s face it; most of us would ultimately like to cut back our workloads at some point, but oftentimes we get so busy building and running the practice that the necessary planning and preparation simply doesn’t get done. So when we finally decide to step out of the practice, the structure is not there to sell it or the price received is negatively affected due to the lack of planning. The process of selling a practice should start between three and five years before the projected sale date. Arriving at Your Destination Isn’t it nice your GPS says, “You have arrived at your destination?” Putting together a successful Estate Plan needs to start as early as possible in the trip if you are to arrive at your destination on time. However, regardless of when it is, it’s always better to stop and ask for directions as soon as possible to get back on the right road. Effective estate planning is as much a service to yourself as it is to the loved ones you are providing for. With a little motivation and assistance from qualified consultants, estate planning can be dealt with thoroughly and efficiently. In upcoming articles, we will be addressing the various components of a proper Estate Plan in detail, including the proper legal documentation necessary to make sure the plan is solid. Our goal is by this time next year to have all members ready with a solid plan that protects their practice, themselves and their loved ones. Next article: Maximizing the Value of Your Practice.

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What Has CPMA Ever Done For Me?

For over 100 years, the California Podiatric Medical Association (CPMA) has blazed the way for virtually every step of progress made by California’s podiatric medical profession – moving it from a peripheral medical skill to mainstream medicine and enhanced standing in California healthcare system. Here are just a few of CPMA’s hard fought victories on your behalf: • The right to perform independent H & Ps

• The right for limited license podiatric x-ray technicians to take digital x-rays

• Establishment of podiatric residency programs

• The right for a podiatric physician acting within his or her scope of licensure to prescribe orthotic or prosthetic devices covered by the patients health plan

• The availability of state funds for podiatric medical students

• The right to prescribe prescription medications • The right to administer local anesthetics

• The right to perform amputations

• JCAHO recognition of podiatric physicians as qualified members of hospital staff

• The ability to assist an MD or DO in surgery outside scope of practice

• The right to perform, read and interpret x-rays

• The right for podiatric physicians to perform surgery within scope of practice

• The Veterans Administration inclusion of podiatry in the division of medicine and surgery.

• Clarification of language guaranteeing DPMs’ right to surgically treat ankles • Surgery center privileges for DPMs • The right to form MD/DPM partnerships • The right for DPMs to expand the names they may use for their practices For over 100 years, CPMA has been the difference between success and failure, literally the life or death of California’s podiatric medical profession. Join CPMA and help us in our ongoing efforts to help you! Call (800) 794-8988.

Now, ask yourself honestly, where would you be without the efforts and advancements made by CPMA? A p r i l | m ay | j u n e | 2014

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ANNUAL HEALTH POLICY report Dear Fellow CPMA Members. Once again, I thank you for the opportunity for allowing me to continue as Chair of the Health Policy Committee of the California Podiatric Medical Association. Over the past year, there have been many changes in the healthcare landscape and particularly there have been some changes with regard to specific insurance companies in the way that they deal with us as podiatric physicians. I will attempt to describe some of these specific issues and how we have been dealing with them. As an aside, myself, Dr. Jonathan Labovitz and several other experts will be discussing the changing healthcare landscape and its effect on podiatric physicians at a workshop at The Western Foot and Ankle Conference, June 19-22, Disneyland Hotel and Convention Center, Anaheim, California. It should be very informative and give people strategies and insights about how to deal with the changing healthcare landscape.

a podiatric physician, Blue Shield of California will send me that second appeal for evaluation. I have indicated my willingness to review these potential denials if they should be in fact generated by Blue Shield of California.

Now I will highlight some of the specific issues we are dealing with concerning individual insurance companies. I will then discuss workersâ&#x20AC;&#x2122; compensation issues, healthcare reform issues and strategies for dealing with some of these.

As I have been indicating in many previous annual policy and seasonal health policy reports, Multiplan continues to be one of the only health plan companies that clearly discriminates against podiatric physicians in their reimbursement policy. Up until the past two years, the Medical Director at Multiplan felt that podiatric physicians were not in fact like other MD or DO physicians and therefore should be paid more like nurses, optometrists, and physicians assistants.

Blue Shield of California Blue Shield of California this year has certainly been our most time-consuming health policy project. I say that because for many years we have significantly reduced, and almost effectively eliminated, denials by Blue Shield of California on insurance claims from podiatric physicians for the issue of scope of practice. As historic information, Blue Shield in years past used to deny podiatric physicians for many services they performed for their patients as not being within the scope of practice. Over the years I have been working with Blue Shield to remediate this situation and up until the past one to two years, there were very few of these issues to deal with. Unfortunately, over the past two years, and as Blue Shield changed its claims editing computer software, these issues have once again reared their ugly head. I am in regular contact with the â&#x20AC;&#x153;powers that beâ&#x20AC;? at Blue Shield of California about how podiatric physicians should not be denied any services rendered to their patients that involve treatment on the foot, ankle or muscles and tendons that insert into the foot. Despite all of my efforts, and having included the Board of Podiatric Medicine in my correspondence, up until very recently, I have not succeeded in eradicating this problem. What I would like you all to know is that I wrote a scathing, angry, assertive letter to the Medical Director at Blue Shield of California as well as all the Operations Managers and Directors of Provider Relations at Blue Shield of California. In that letter, I indicated that I was ready to go to the Department of Managed Healthcare, the Department of Insurance, and the press if this situation was not immediately rectified. Since the receipt of that letter, I have been in regular contact with Blue Shield of California Medical Directors who have assured me that once a podiatric physician has appealed a denied claim for services rendered to their patient, before a second appeal is determined to be not in the scope of practice for

I should have you know that in the past three months, we have not received any denials for scope of practice from Blue Shield. So, being the cautious optimist that I am, it appears this egregious, discriminatory policy and poorly written claims data system may have been effectively ameliorated. Stay tuned for further information regarding this. As an aside, if you do receive any denials for scope of practice from Blue Shield of California, or any insurance company for that matter, please immediately forward them to the Health Policy Committee at CPMA. MULTIPLAN

Over the past two years, I have developed a very collegial, respectful relationship with the new Medical Director at Multiplan who resides in Waltham, Massachusetts. After many discussions with him, he fully agrees that podiatric physicians should be treated exactly like any other MD or DO physician and should be paid in that same manner without any deviation of policy, procedure or reimbursement. However, he has indicated to me that although he is in complete support of this change in policy at Multiplan, it is up to Corporate Network Development to implement such a change. I have been advised that in order for Corporate Network Development to institute such a change, there has to be a perceived need for more podiatric physicians to participate in Multiplan. If there is not such a perceived need for more podiatric physicians to participate in the provider lists of Multiplan, then there will be no incentive for Multiplan to change their discriminatory policy. This brings me to a very important point. Again, as I have indicated in previous articles, if we devalue ourselves to the point that we accept contracts that pay us less reimbursement dollars for the same services that are performed by an MD or DO physician who are paid at a higher rate, then we have merely aggravated an already egregious situation. To state it another way, if we sign up for a lower rate than our MD or DO colleagues performing the same service, then unfortunately we deserve what we get. Although I cannot tell you what to do when contracts of this type come across your desk, I can only tell you that I as an individual would refuse to sign any contract where I am paid in a manner different than an MD or DO physician for performing the same service.

Hopefully, in the future, Multiplan will see that there is a need to include more podiatric physicians in their network rolls and the discriminatory and egregious policy that they presently have towards podiatric physicians will be forever changed. Stay tuned for further results. ANTHEM BLUE CROSS OF CALIFORNIA Of late, there have not been many issues specific to Anthem Blue Cross of California. What is important to note, that Anthem Blue Cross of California publishes its policies on their website. I feel it is very important to review those policies so that you know what services are allowed and which services are not. In that vein, you should know that even though Dermagraft has been taken over by Apligraf (Organogenesis), the only biologic grafts that Anthem Blue Cross will cover for a diabetic ulcer is either Apligraf or Dermagraft. All of the other synthetic grafting materials are not covered for diabetic wounds. Integra is covered for burns however. Consider this when applying a biologic graft to a diabetic wounds. I have also been in constant contact with the Reimbursement Coordinators at Anthem Blue Cross to see if we can increase reimbursement for functional foot orthotic devices. At the present time, Anthem Blue Cross of California pays the least amount for functional foot orthotic devices than any other insurance company in California. I have been working with these folks to improve and increase fee reimbursement for orthotics as I have explained to them that their present coverage barely covers the foot orthotic cost. They are looking into improving this fee schedule when their new fee schedule comes out next year. Again, stay tuned. CIGNA AND AETNA Cigna and Aetna also have placed their health policies online at their website. It is important to note that as a strict policy guideline in both of these insurers, foot orthotic devices are not covered for anybody except for those people with diabetic peripheral neuropathy. However, there are cases where a specific employer, that uses Cigna or Aetna insurance, may include a provision in their contract that allows for the payment of foot orthotics. I would state that whether or not you are a provider for Cigna or Aetna, until you receive in writing something from the employer that the patient is covered for foot orthotics, that such persons with these insurance plans should be “CASH”. Otherwise, you will be chasing down payment from these people for foot orthotic devices and will be out of pocket until you receive payment. WORKERS’ COMPENSATION Those of you who treat the injured worker, know that as of January 2014, the workers’ compensation fee schedule and provisions of workers’ compensation law changed. Some of the important provisions of the policy change are: 1. Evaluation and management services are paid at 120% of Medicare. 2. In order to see the injured worker, you need to be part of a Medical Provider Network or MPN. It is important to A p r i l | m ay | j u n e | 2014

understand that in the workers’ compensation world, podiatric physicians are considered physicians as any MD or DO physician. Therefore, all discussion about physicians applies to DPMs as well as MDs and DOs. 3. In order to request treatment for various occupationally related injuries, you must use good quality evidence using the Medical Treatment Utilization Schedule (MTUS), ACOEM Guidelines (American College of Occupational Environmental Medicine), or ODG Guidelines (Official Disability Guidelines). As you may know, I have been reappointed to the Medical Evidence Evaluation Advisory Committee of the Department of Workers’ Compensation in California. This year, I will be attempting to review and re-write ACOEM and ODG Guidelines to be updated so that they may be included in the California Medical Treatment Utilization Schedule as it applies to foot and ankle evaluation and treatment. Unfortunately, I cannot use any persons outside of the actual Committee to assist me in the re-write of such guidelines. I have already reviewed the ACOEM and ODG Guidelines and they actually are very comprehensive in the conditions that they discuss. Unfortunately however, they do not discuss all foot and ankle injuries sustained by workers. Therefore, I am attempting to use some of the guidelines from ACOEM and some of the guidelines for ODG, although this is a challenge in and of itself. I have a meeting on May 8th in Oakland and we will be further discussing these issues. 4. It is now a requirement that a physician has to pay a fee in order to activate or initiate a lien again an employer for services rendered in the treatment of an injured worker. This could become a very costly service and you must determine whether or not it is worthwhile to file liens that you have to pay money up front in order to fight. If you do not receive proper payment from the insurance company, then you almost have no choice but to file a lien and take the chance. But this has to be done by each person on an individual basis. 5. DME supplies. Once of the other issues that we have had to face regarding workers’ compensation is that many review companies request invoices for properly billed DME services such as dispensing equalizer boots and night splints. What is important to understand is that according to Labor Code LC.8 CCR-9789.11(a)(1), it is clear that if there is a fee associated with that DME supply in the CMS DMERC Schedule or in the workers’ compensation OMFS Schedule, then there is no reason for the submission of an invoice when properly providing an injured worker with a DME supply. What I do, and what I recommend be done, is that when requested by a review company to submit an invoice for some supply that See Health policy report on Page 51

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Health policy report from page 49

has a fee published in one of those schedules associated with it, I cite this Code, tell the review company I am not going to submit an invoice, and if they persist in asking me for an invoice and not pay me, I am going to file a complaint with the Department of Workers’ Compensation which I have done on occasion. In almost all instances, we do get paid. Now, having said the above, it is important to understand that if there is not a fee published in the CMS DMERC or in the workers’ compensation OMFS associated with such a DME supply, such as with a trauma shoe or L3260, then it indeed appropriate and necessary to submit an invoice in order to be properly paid. It is very important to distinguish between a supply that has a fee associated with it and a supply that does not have a fee associated with it under DMERC or OMFS. PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) I want to just briefly discuss another issue that has come to fruition this year and that is two effects of the iniciation of the ACA. They are the implementation of ACOs or Accountable Care Organizations and the implementation of the State Insurance Exchanges. While this will not be a comprehensive discussion about these, I just want to give you some highlights of these two entities. These entities will be discussed in greater detail at the Western Podiatric Medical Scientific Seminar workshop about changes in healthcare landscape. ACOs As you may remember out of the ACA came an entity called the Accountable Care Organization. The Accountable Care Organization was designed to foster cost effective, high-quality care for Medicare employees. In its original form, there had to be at least 5,000 Medicare employees that were enrolled in the ACO on a fee for service basis. There was a very complicated formula as to how they were assigned to the ACO but now they can be assigned based on their primary care physician or those physicians that have provided the majority of services for them over a year or more time. What is important for podiatric physicians to understand is that even if they are not part of the ACO, they can still see those patients as they are fee for service and are not restricted in terms of who they can see. Also, some of the potential benefits of an ACO are possible shared savings and the fact that you become enfranchised with a group of primary care physicians that now can refer you these patients, as well as other patients that they treat. This integrates you to a much greater extent into the healthcare community in your area.

For podiatric physicians, there is almost no down-side in joining one or more ACO’s. As a specialist physician, as we are, we can join as many ACOs as we would like. However, a primary care physician is limited to participating in only one ACO. What I also recommend is that if you participate in any ACO, that you become involved in the governance of the ACO or the financial policy committee of the ACO or the quality committee of the ACO. I have always found that it is better to take a leadership role in any entity that you wish to participate in as opposed to just being a mere participant. That way, you can direct, in some part, what your future holds. STATE INSURANCE EXCHANGES Another entity that arose from the ACA was the State Insurance Exchange. This was designed to be an insurance marketplace for employees of business as well for people who were uninsured or not adequately insured. The ACA mandated that certain essential health benefits were incorporated in any insurance plan that would be written throughout the United States. One of the major essential health benefits that affected podiatric physicians is ambulatory care, surgical care and hospital care. There is much more to say about that which again, we will discuss at the Western. What is important for podiatric physicians to understand is, that if they sign up for one of the exchange programs through Blue Cross or Blue Shield PPOs, they have agreed to take a substantially discounted rate. There are other provisions of the contracts associated with the exchanges that are very important to review and I highly recommend that before you sign up with any of these exchange programs, that you or somebody with legal knowledge and expertise, reviews the contract. Otherwise, you could find yourself taking a substantially reduced rate, not only on the patients you see through the exchange, but other patients that you see through a non-exchange plan, but through the same insurance company. There is a lot more to be discussed about this and it will be more thoroughly discussed at the Western workshop. As you may know, I have also been reappointed to the Health Policy and Practice Committee of the American Podiatric Medical Association and will be attending my first health policy meeting in Washington, DC in the next two weeks. I am sure by the time of the Western, there will be a lot more information to share with you. Thank you once again for allowing me to Chair this very important committee of the California Podiatric Medical Association. Remember, we are all here to serve you and if you have any difficulty with any insurance company, do not hesitate in sending such issue to the CPMA Health Policy Committee.

Find Us on Facebook Like our Page: www.facebook.com/calpma Join or Group (CPMA Members Only): www.facebook.com/groups/calpma A p r i l | m ay | j u n e | 2014

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PRESIDENT’S MESSAGE from page 1

of us can contribute that we will ensure that the practice of our specialty continues to be rewarding and fulfilling. So how did we do? 1) Our commitment to provide value in membership for every California podiatrist resulted in an increase in the number of CPMA members. This increase provides additional resources to carry out our mission without increasing our dues. Our increased membership also qualified us for additional delegates, thereby increasing our representation and influence nationally at the APMA House of Delegates. 2) We promoted our members and our specialty with an increase in the quality and quantity of engaging, innovative, and informative media placements and the increased use of social media. 3) We were vigilant in protecting and advancing our specialty by monitoring the incredible volume of healthcare legislation. We were committed to advocating for both our members and the patients we serve. Our legislative leadership conference in Sacramento was our most successful yet with inspiring speakers and high level meetings with our state’s elected leaders which has resulted in increased recognition of our specialty and our Association. 4) We nurtured our corporate relationships and developed new ones to increase our non-dues revenue so that we can provide greater value without our raising dues. 5) We worked to ensure that all Californians, especially the most vulnerable among us, have access to our services by sponsoring

a bill to restore our services in Medi-Cal. We will continue to advocate on behalf of our patients for access and choice. We will also continue to create and provide resources to help members thrive in an environment of an expanded insured population. 6) Our Physician and Surgeon’s Joint Task Force has provided the foundation for increased collaboration between CPMA and CMA as we get ever closer to our goal of parity. CPMA leaders attended the CMA House of Delegates and the Western Health Care Leadership Academy for the first time this year. We are standing together with our physician colleagues to protect MICRA and to restore podiatric services in Medi-Cal. CPMA has the vision to be THE association that serves and enhances the professional life of ALL California podiatrists and we have developed the strategies and aligned the right people to make this vision our reality. We are responsible not only for helping our members cope with the inevitable changes that affect our specialty, but also to set the direction of where those changes will take us. The only way to predict our future in healthcare is to create it ourselves. As every president before me has surely appreciated, you have a duty to do as much as you can with the 12 months that you have been elected to serve and a duty to leave the association in an ever stronger position. We could not be in any better hands than our next president, Tom Elardo, DPM and the dedicated CPMA Board of Directors. Thank you for allowing me to serve our specialty in this incredibly meaningful way.

No Dog Days of Summer at CPMA

Summer typically means reduced work schedules, vacation and relaxation - not at CPMA. Despite often sweltering triple digit temperatures in Sacramento, CPMA’s headquarters continues to operate during its normal hours in order to assist members on a myriad of issues ranging from problems with third-party payers, regulatory issues, licensing, providing continuing medical education, and legislative advocacy. We are here to serve our members. Contact information: 2430 K Street, Suite 200, • Sacramento, California 95816 Phone: (916) 448-0248 or (800) 794-8988 • Fax: (916) 448-0258 • E-mail: cpma@calpma.org • Website: www.calpma.org A p r i l | m ay | j u n e | 2014

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Helping Podiatrists Protect What Matters Disability Insurance Specialist, Wayne Winter, DPM 800-330-3742

podiatry@pacificadvisors.com

www.pacificadvisors.com/podiatry

Luck doesn’t build a successful podiatry practice, but bad luck can destroy one in a heartbeat. You have a lot riding on your practice. We’re here to help you protect your income so you can keep caring for those that matter most to you.

See uS at the WeStern Foot and ankle ConFerenCe Booth #520 | June 19 – 21, 2014

Wayne Winter, DPM*

Wayne Winter’s career and life’s passion was practicing podiatry. Without warning, Dr. Winter was forced to close his practice. With the proceeds of his disability policy, he was able to largely replace his private practice income. Learn how you can protect you and your loved ones.

Inquire About Our Additional Services for Podiatrists: • Financial Organization • Life & Insurance Services • Retirement Strategies

Wayne Winter, CA Insurance License #0C24915 Agent, The Guardian Life Insurance Company of America (Guardian), New York, NY. Pacific Advisors, Inc. is not an affiliate or subsidiary Guardian. Insurance products offered through Pacific Regional Insurance Services, a DBA of Pacific Advisors, Inc. * Not practicing for Guardian or any subsidiaries or affiliates thereof. The Guardian Network™ is a network of independent agencies authorized to offer products of The Guardian Life Insurance Company of America (Guardian) and its subsidiaries, and is not an affiliate or subsidiary of Guardian. GEAR 2014-5041 Exp. 4/16

classifieds PODIATRY PRACTICE FOR SALE

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15 minutes from San Francisco. Grossing 300K and growing. All private, no HMOs. All sports/ surgery. Turnkey opportunity. Call 510-214-8283

8 month old dark room light $35 - ($4850 for all)

All Pro 2010 automatic film processor in good working condition $1000 2 X-ray view boxes 13 1/2 X 24” $100 each 5 X-ray cassettes $35 each

10 Blue fabric waiting room chairs in good condition $50 each - ($350 for all) Oak computer work station with matching hutch, lockable door, and print stand $850

REDUCE OVERHEAD Looking for other Podiatrists in the Santa Monica/ West LA area who are interested in sharing space to cut costs. Open to all ideas. If interested, lets talk! Dan Altchuler 310-451-8045 or email dalt@usa.net

Dr. Fredrick S. Wilson 510-409-2029 CENTRAL CA PRACTICE FOR SALE I will stay for transition. Price and terms negotiable. Serious inquiries only call/txt 209-617-0241 or email sbaileydpm@aol.com

PART-TIME PODIATRY ASSOCIATE (INLAND EMPIRE) Seeking Part-time Podiatry Associate to service skilled nursing and assisted living facilities in the Inland Empire, specifically San Bernardino and Riverside Counties. Staff and supplies will be provided. Independent contractor. Must have: - Valid state license - Valid malpractice insurance - Valid DEA license - Reliable transportation Please send resume with contact information in response. Thank you for your interest, Dr. Pete Carrasco Jr. Carrasco Podiatry Corp. email pcarrasco@pete-melissa.com

Staples welcomes CPMA Members! Staples welcomes CPMA Members!

Access to StaplesLink.com is now available as a benefit of the California Podiatric Medical Association. You can order is supplies Access to StaplesLink.com now available as a benefit electronically for delivery and have immediate of the California Podiatric Medical Association. access to over 30,000 products all with You can order supplies electronically for delivery and negotiated discounts ranging from 2 – 80%.

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Register with Staples as a member now at: discounts ranging from 2–80%. http://linkregistration.stapleslink.com/c/s? Register with Staples as a member now on the Bember Benefits RegFormId=631185

page at CalPMA.org.

News You NEED to know delivered to your in box each month. Don’t miss it! Be sure CPMA has your correct email on file. A p r i l | m ay | j u n e | 2014

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on your toes Dear CPMA Members: Finally, the mass adjustment for claims that were improperly denied for routine foot care in October 2013 during the Noridian transition are being processed. Some checks have already been issued and the remainder should be in the mail very soon. Thank you for your patience as we worked with Noridian to correct this matter. Tony Poggio, DPM Chair, Medicare Committee CPMA Engaged in Epic Battle over MICRA Ballot Initiative The California Podiatric Medical Association (CPMA) along with a coalition of health care organizations, community and business groups, local governments and unions is in the midst of a critical battle over a ballot measure that would have what many are calling a catastrophic impact on the state’s health care system – impacting both providers and patients. At issue is the Medical Injury Compensation Reform Act, or MICRA, signed by Gov. Jerry Brown in 1975, which put a cap on pain-and-suffering awards (speculative, noneconomic damages) of $250,000 in medical malpractice cases. Economic damages, such as lost wages and future medical costs, are unlimited. During the 1970s California was in the midst of a medical malpractice insurance crisis as high noneconomic damage awards lead to skyrocketing professional liability premiums. The passage of MICRA ensured that injured patients would receive fair compensation while stabilizing liability costs, which MICRA successfully did. The ballot measure, put forth by California trial lawyers would more than quadruple MICRA’s cap on non-economic damages, raising it to $1.1 million. This would have devastating effects on California’s health care system, increasing costs by billions of dollars annually and reducing access to care while allowing for the encouragement of meritless lawsuits and increased attorney fees. An analysis by the state’s independent Legislative Analyst says the measure could also increase costs by “hundreds of millions of dollars annually” for the state and local governments. Titled “The Troy and Alana Pack Patient Safety Act,” the initiative contains additional provisions regarding drug testing of doctors; as well a monitoring doctors prescribing practices that would place infeasible requirements on the state’s prescription drug database, which proponents of the measure have admitted were added because they polled well with the public. “It’s very important for podiatric physicians to oppose this initiative which is slated to appear on the November ballot,” said CPMA President Carolyn McAloon, DPM. “The measure is being pitched to the public as a patient safety issue, when in reality the primary purpose is to raise the noneconomic damage cap in medical malpractice cases. CPMA has been told that passage of the measure could lead to a tripling or quadrupling of professional liability insurance rates California’s podiatric physicians.” For more on MICRA and how you can help please see page 74. 56 |

California’s Duals Demonstration Project Begins in Ernest After numerous delays, California’s Dual Demonstration Project officially launched on April 1 in five counties, according to officials from the Department of Health Care Services, which is overseeing the project. Part of the California’s Coordinated Care Initiative (CCI), the project—known as Cal MediConnect—was authorized by the state in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state’s dual eligible beneficiaries (aka Medi-Medi) transition to managed care plans. The project will impact approximately 450,000 duals in eight counties – Alameda, Los Angeles, Orange, Riverside, San Diego, San Mateo, San Bernardino, and Santa Clara. On April 1 San Mateo County began the automatic process – known as passive enrollment. On May 1 passive enrollment began in Riverside, San Bernardino and San Diego counties. Los Angeles County is slated to start passive enrollment in July, though LA Care, one of the larger providers in the county, will not passively enroll dual eligibles until January 2015. LA Care passed its CMS readiness review so the insurer is able to accept dual eligibles who voluntarily enroll, but LA Care’s low marks in the CMS star rating system will prevent it from automatic enrollment till 2015. The other LA County providers include HealthNet, Caremore, Care 1st and Molina. Three other counties -- Alameda, Orange and Santa Clara -- are scheduled to participate in the project starting in January 2015. See official timeline in CPMA’s Duals Resource Center. Affected patients have been notified by the California Department of Health Care Services 90, 60 and 30 days prior to their passive enrollment date. If patients do nothing, they will automatically be enrolled in a Cal MediConnect managed care plan that will combine both their Medi-Cal and Medicare treatment and services. HOWEVER, patients have the right to opt out of the integrated program. While patients must choose a Medi-Cal managed care plan for their Medi-Cal benefits, they have the right to remain with their current fee-for-service Medicare plan. If patients wish to continue their current fee-for-service Medicare plan they must choose a straight Medi-Cal plan. Again, if patients do not act they will be enrolled in one on the integrated Cal MediConnect plans. CPMA along with a number of other healthcare organizations strongly objected to the state employing passive enrollment with such a vulnerable patient population. The Association also requested that a simple, easy to read opt-out option be available for patients, rather than the confusing manner in which the options are currently presented. Unfortunately, the state refused both requests. To help members navigate the process and educate their dual eligible patients as to their rights and options, CPMA created the Duals Resource Center on the Association’s website calpma.org. There CPMA members will find letters they can use to inform their patients of their rights and options, as well as county transition timelines and project news and updates. C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Doctors Targeted in Tax Refund Fraud CPMA has become aware of a tax scam directed at doctors. Initially, the fraud was reported by practitioners in other states, but it now seems that the scheme has made its way to California. Reports indicate that upon filing a legitimate tax return, the doctor is informed by the IRS that a return has already been filed, most likely by an identity thief. Affected doctors may also learn of the scam by receiving a 5071C letter from the IRS alerting them of possible fraud. The United States Secret Service and the IRS are investigating how the identity thieves obtained the practitioner data needed to file fraudulent returns. While some speculate that the fraud may be related to a recent Medicare report that listed practitioners’ NPI numbers, it is still unclear how the fraudsters obtained the sensitive information.

provisions are requirements of Covered California, CPMA has concerns with certain provisions that appear to be beyond the scope of regulatory requirements. One provision of significant concern is language that removes a participating doctor’s ability to opt out of the individual/exchange product without affecting the underlying Prudent Buyer contract, as is allowed currently. Effective July 1, the only option for doctors who wish to opt out of the individual/exchange product is to terminate the underlying Prudent Buyer PPO agreement. Doctors do have the right to opt out of the Anthem exchange product without affecting the underlying Prudent Buyer PPO

If you learn that your identity has been compromised in this way, act quickly and consider the following steps. • Alert the IRS Identity Theft Protection Unit at 800.908.4490, complete Form 14039 and submit it to the IRS with any supporting documentation. More information is available at IRS.gov • Contact the Office of the California Attorney General to register the identity theft at www.oag.ca.gov/idtheft • Contact the Federal Trade Commission at 877.438.4338 and create an Identity Theft Report at www.consumer.ftc.gov/ • Place a fraud alert on your credit report with the three consumer reporting agencies (Equifax: 800.525.6285, Experian: 888.397.3742 and TransUnion: 800.680.7289). • File a report with local law enforcement in the jurisdiction where you reside. Bring with you all documentation available, including the state and federal complaints you filed. • Call the Social Security Administration’s fraud hotline at (800) 269-0271 to report fraudulent use of your Social Security Number. In case your number is being used for fraudulent employment, you can also request your Personal Earning and Benefits Estimate Statement from the Social Security Administration ssa.gov or call (800) 772-1213. Make sure to check the report for accuracy. • Consult the Department of Justice (DOJ) website at www. justice.gov for additional information. doctors Who Wish to Opt out of Blue Cross Exchange Network Must do so by June 30 Doctors who do not wish to participate in Anthem Blue Cross’ individual/exchange network have until June 30, 2014, to opt out. Anthem Blue Cross recently notified over 11,000 practices that are currently participating in its individual/exchange network of a contract addendum that will become effective July 1, 2014. The amendment only applies to providers who are currently participating in the Anthem Blue Cross individual/exchange network. According to the notice, which was mailed on March 31, the addendum contains new regulatory requirements. While many A p r i l | m ay | j u n e | 2014

See On Your Toes on Page 59

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CENTENNIAL GALA PLANNING COMMITTEE  Tracy L. Basso, DPM ‘88 Andrea Carrick Thomas Chang, DPM

Samuel Merritt University and the California School of Podiatric Medicine cordially invite you to the CCPM/CSPM

Centennial Gala Celebrating 100 Years of Educating Doctors of Podiatric Medicine

Sharon C. Diaz, PhD (hc) Timothy Dutra, DPM ‘85 Thomas J. Elardo, DPM ‘96 Daniel C. Fulmer, DPM ‘76B Donald R. Green, DPM ‘72 C. Keith Greer, Hon. D.Sc. ‘01 Eric R. Hubbard, DPM ‘68 Millie Hubbard Jon A. Hultman, DPM ‘70

Friday, June 20, 2014

6:00 p.m. Wine and Hors D’oeuvres 7:00 p.m. Dinner, Program and Dancing The Disneyland Hotel 1150 West Magic Way Magic Kingdom Ballroom 1 and 4 Anaheim, California $250 per person*

(Sponsorship Opportunities Also Available)

For more information or to purchase tickets online go to http://www.samuelmerritt.edu/cspm_gala or call (510) 869-6618 or (510) 869-8628.

Ronald D. Jensen, DPM ‘84 Gail R. Johnson, DPM ‘90 Franklin Kase, DPM ‘76 Kevin A. Kirby, DPM ‘83 Neil B. Mansdorf, DPM ‘97 Carolyn F. McAloon, DPM ‘97 Alexander Reyzelman, DPM ‘95 Carla R. Ross Ami A. Sheth, DPM ‘02 James W. Stavosky, DPM ‘83 William Tarran, DPM ‘88 Betsy Taubman Ross E. Taubman, DPM ‘83 David D.Q. Tran, DPM ‘98

ONLY A FEW SEATS STILL AVAILABLE! ~ RESERVE YOURS TODAY!

Jonathan J. Uy, DPM Sue Valencia John N. Venson, DPM Irma Walker-Adamè

*$140 OF THE $250 PER PERSON PRICE IS TAX DEDUCTIBLE AND WILL BENEFIT THE PODIATRIC MEDICINE SCHOLARSHIP FUND.

Reservations will be held at the door. Fair market value for each ticket is $110.

On Your Toes from Page 57

contract if Anthem receives notice before the effective date of the addendum, July 1, 2014. The notice must be received by Anthem by June 30. If you do not wish to participate in the individual/exchange product, you can opt out by providing written notice, which should be sent via certified mail with return receipt, to: Anthem Blue Cross Prudent Buyer Plan Contract Processing Attn: Individual/Exchange Contract Processing Mail Station 8A P.O. Box 4330 Woodland Hills, CA, 91365-4330 Doctors are reminded that even if they opt out, their PPO patients may still have some out of network benefits. Patients with EPO products will likely not have any out of network benefits. However, be aware that Blue Cross and Blue Shield refuse to honor assignment of benefits and will send any out of network payments to the patient. Therefore, it is recommended that doctors collect payment at the time of service for Blue Cross or Blue Shield patients they see out of network. Doctors who decide to opt out are also encouraged to notify affected patients. Passage of Temporary Medicare Payment Patch Puts Permanent Repeal of SGR and Designation of Doctors of Podiatric Medicine in Medicaid as Physician and Surgeons Legislation on Life Support On Tuesday, April 1 President Obama signed into law the Protecting Access to Medicare Act of 2014 (H.R. 4302), which prevented the 24% cut in Medicare reimbursement rates to health care providers that was scheduled to go into effect on April 1. In addition, the act: 1) Delays implementation of ICD-10, which was set to go into effect October 1, 2014, to October 2015; 2) Delays enforcement of the two-midnight rule in hospital for reimbursement at Medicare B rates to March 2015 3) Extends the current suspension of recovery audits (RACs) of “medically unnecessary and improper” healthcare claims which were set to be reinstated in the fall of 2014 through March 31, 2015, and 4) Overhauls of the cost-of-living classifications that are used to calculate Medicare payments.

Adjustments to tie Medicare payments to the cost of living were implemented in California in 1989. Under that original classification San Diego County has been considered a “rural” county since that time, even though it is now the eighth most populated city in the U.S. As a result, physicians in that region have received about 5% to 10% less in Medicare reimbursement payments than physicians in areas such as Los Angeles and San Francisco. Because private insurers often base their payments on Medicare reimbursement rates, rural designation costs San Diego County providers $100 million per year overall, or an average of $14,300 per physician. (California Heathline, April 7, 2014).

A p r i l | m ay | j u n e | 2014

Despite the addition of the above last minute “sweeteners” in what many believe to have been an effort to prevent opposition from doctors, HR 4302 was strongly opposed by national organized medical groups including the American Medical Association, the American College of Surgeons, and the American Podiatric Medical Association, whose HELLPP (Helping Ensure Life and Limb-Saving Access to Podiatric Physicians)Act, which would recognize doctors of podiatric medicine as physicians and surgeons under Medicaid (Medi-Cal), had been included in the Senate version of the SGR repeal legislation. This year doctors wanted permanent repeal of the SGR, and repeal seemed on the horizon with bipartisan support in both the Senate and the House of Representatives. The major sticking point was how to pay for repeal, which the Congressional Budget Office (CBO) had projected would cost approximately $180 billion over 10 years.(FierceHealth, April 3, 2014) Unfortunately partisan politics again reared its head when the House of Representatives introduced an amendment to the House bill to repeal the SGR that would delay the implementation of the Affordable Care Act’s mandate requiring all individuals to obtain health care by five years, essentially killing the measure since it was highly unlikely to pass in the Senate, and even if it had passed, would have been vetoed by the President. With time running out before the April 1 cuts were to kick in, leaders of the House and Senate crafted the new bill HR 4302. Passage of the measure has been likened to something out of an episode of the television series “House of Cards,” a show about intrigue, double dealing and back stabbing in the nation’s capital. On morning of Thursday, March 27, in the face of mounting opposition to the legislation, House GOP leaders fearing the bill’s defeat pulled it from the floor, after which the House leadership called a recess, which sent most members back to their offices to await word on the schedule for the day. During the recess Republican and Democratic leaders huddled behind closed doors. Then, in a surprise move, while many representatives were still in their offices, HR4302 was brought back to the floor. (CNNPolitics March 27, 2014) Arranged under special rules that provided for no amendments and limited debates, HR 4302 was rushed through the House of Representatives in 25 seconds with no debate on an unrecorded voice vote. (Healthleaders, Media, March 31, 2014) Members of the House were caught off guard when they returned to the House floor and learned the bill had passed. Physician groups were outraged by the maneuver. “Congressional leadership had to resort to trickery to pass an SGR patch that was opposed by physicians,” said American Medical Association Ardis Dee Hoven, MD. (AMA Wire March 27, 2014) On Monday March 31, HR 4302 moved to the Senate. Senate Finance Committee Chairman Ron Wyden tried to get the Senate to consider a permanent fix for Medicare’s sustainable growthrate formula for reimbursing physicians only to face immediate See On Your Toes on Page 61

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On Your Toes from Page 59

objection from Republicans, essentially killing the effort. (Modern Healthcare March 31, 2014).

Covered California’s Big 3 Provide Guidance for Providers

Late Monday night, with essentially no time to spare, the Senate passed the temporary “doc fix” on a vote of 64 to 35, making it the 17th time a “temporary fix” has been employed since the enactment of the SGR in 1997.

Three major managed care payors offering coverage through Covered California have provided additional information to their contracted providers on their exchange/mirror products. Together, these three payors – Health Net, Anthem Blue Cross and Blue Shield of California – account for approximately 75 percent of enrollment in Covered California products to date.

So, where does this leave the permanent repeal and designation of doctors of podiatric medicine as physicians and surgeons in Medicaid? While the repeal legislation is still technically “alive” until the end of the year, the truth of the matter is that the 2014 mid-terms are just around the corner, and few believe that such a contentious matter will be revisited before the November elections. With the announced retirement of a number of senior legislatures, and what is believed to be a number of highly contested seats across the country, and that many political pundits believe the Republicans will take control of the Senate, giving them a majority in both houses and opposed to a Democratic Whitehouse, Washington will remain in gridlock. And little, if anything will get done. CMS Announces Addition to EHR Program Hardship Exemptions Available to Eligible Providers The Centers for Medicare & Medicaid Services (CMS) recently announced an addition to its hardship exemptions available to physicians who are unable demonstrate meaningful use of electronic health records (EHR). A few grounds for hardship exemptions now are available, including: • The doctor’s software vendor is unable to achieve 2014 Edition certification, the most recently added hardship exemption • The doctor can’t get sufficient Internet access or faces other infrastructure barriers • The doctor is newly practicing and has not had enough time to establish meaningful use, in which case the physician can apply for a two-year exception • The doctor is practicing at multiple locations and has no control over the availability of certified EHR technology for more than one-half of patient encounters • A natural disaster or other unforeseeable circumstance occurs • A doctor hasn’t had enough patient interactions to meet the threshold requirements Some doctors, such as those new to Medicare or those in certain specialties, are exempt from the penalty and do not need to apply for a hardship in 2014. Doctors who are not exempt and cannot meet the requirements of the program face penalties beginning next year. Doctors who are unsure whether they will be able to demonstrate meaningful use in 2014 may apply for a hardship exemption. If a physician applies for a hardship exemption but still attests to and meets meaningful use, the hardship exemption acts as a safety net. Learn more about exemptions in a tip sheet from CMS, and get the hardship exemption application. A p r i l | m ay | j u n e | 2014

The notices, sent to providers over the past few weeks, were cobranded with Covered California and contain additional information to help providers navigate the exchange. While the notices were only sent to contracting doctors, the information may also be helpful to non-contracting providers. The Health Net notice, sent on March 7, includes information such as the exchange/mirror products in which the physician is listed as participating, the product types that are offered in different regions and what information is on patient ID cards. Blue Shield sent two notices, one for its EPO and one for its PPO. The notices, sent on March 14, were very comprehensive, containing clarification on “mirror” products, a plan summary that includes copayment, coinsurance and deductible information, sample ID cards, answers to frequently asked questions, a map indicating which product types are offered by county and additional useful tools. Anthem Blue Cross’s notice, sent on March 17, includes answers to frequently asked question, clarifies that it is offering a narrowed network for its exchange/mirror product enrollees, a breakdown of products sold by county, reported provider network size and a helpful plan name guide to assist practices in identifying their exchange/mirror product patients. To help Members navigate the exchange, CPMA has developed the Covered California Exchange Resource Center on the CPMA website www.calpma.org, which is available free to members. Windows XP May No Longer Be HIPAA Compliant Doctors’ practices using Windows XP should be aware that Microsoft will no longer provide support for Windows XP after April 8, 2014. This means that updates, bug fixes, security patches and troubleshooting will not be available for systems operating Windows XP, making such systems vulnerable to security risks. These security risks could lead to data breaches that may require your practice to notify patients as well as government officials, and could expose your practice to liability for violating state data security laws. While the HIPAA security rule does not specifically mandate any minimum operating system requirements, practices using Windows XP should be aware that continuing to use an unsupported operating system without the proper maintenance in place to protect electronic patient health information (PHI) increases their risk of security breaches. See On Your Toes on Page 63

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CPMA Members Get More For Their Money: Get Your $avings On!

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For details visit the Member Benefits page at CalPMA.org 62 |

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

On Your Toes from Page 61

The HIPAA security rule requires a security management process, which means the development and implementation of policies and procedures to prevent, detect, and correct potential risks and vulnerabilities to electronic PHI. An unsupported operating system should be identified as a risk, and practices using Windows XP should conduct a risk assessment to determine the appropriate measures to reduce any risks to electronic PHI, including upgrading to a more current, supported operating system such as Windows 7 or 8. Also be sure to work with your vendors to analyze your risk and determine appropriate actions. Finally, ALL virus and security software-no matter what operating system it is running on-should be up to date. CPMA’s Compliance Center offers Members materials to help ensure their practices are HIPAA complaint. HHS Releases Security Risk Assessment Tool to Help Healthcare Providers with HIPAA Compliance The U.S. Department of Health and Human Services (HHS) has released a new tool to help guide health care providers in small to medium sized practices conduct information security risk assessments of their organizations. The tool, available at www.HealthIT.gov, is the result of a collaborative effort by the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR). It is designed to help practices conduct and document a risk assessment in a thorough, organized fashion at their own pace by allowing them to assess the information security risks in their organizations under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The tool also produces a report that can be provided to auditors. HIPAA requires organizations that handle protected health information to regularly review the administrative, physical and technical safeguards they have in place to protect the security of the information. By conducting these risk assessments, health care providers can uncover potential weaknesses in their security policies, processes and systems. Risk assessments also help providers address vulnerabilities, potentially preventing health data breaches or other adverse security events. A vigorous risk assessment process supports improved security of patient health data. Conducting a security risk assessment is a key requirement of the HIPAA Security Rule and a core requirement for providers seeking payment through the Medicare and Medicaid EHR Incentive Program, commonly known as the Meaningful Use Program. The tool is available for both Windows operating systems and iPad. Download the Windows versionwww.HealthIT.gov. The iPad version is available from the iTunes App Store (search “HHS SRA tool”). Congress Passes Long Overdue California Medicare GPCI Fix After nearly a decade long lobby effort by the California Podiatric Medical Association (CPMA) and other physician organizations, Congress has finally passed legislation to update California’s outdated Medicare localities know as the Geographic Pricing Cost A p r i l | m ay | j u n e | 2014

Index (GPCI). The long overdue fix will update California’s Medicare provider payment regions to the same Metropolitan Statistical Areas (MSA) used to pay hospitals and raise payment levels for urban counties misclassified as rural, while holding remaining rural counties harmless from cuts. The MSAs used to determine payment rates for hospitals are continuously updated, so that reimbursement accurately reflects local costs to deliver care. The physician payment localities, on the other hand, have not been updated in 15 years. As a result, 14 urban California counties are still designated as rural. This has caused many California physicians to be paid up to 13 percent per year below what Medicare says they should be paid if they were in the correct region. Many of these counties are currently experiencing significant access to care problems. About a third to one half of the physician groups and hospitals in these regions report difficulty recruiting doctors to treat seniors because the cost of living and the cost to practice are high, but the Medicare locality payments have not kept pace with real costs. San Diego, for instance, is now the eight largest city in the country, yet under the old Medicare localities, it is still designated as a rural area. San Diego providers and patients alone lose $26 million in Medicare funding each year because of the inaccurate rural designation. It is projected the California GPCI fix will increase payments to physicians in 14 counties by $50 million annually to over $400 million in the next decade. The rate increase begins in 2017 and will be phased in each year until full implementation in 2022. The counties poised to see reimbursement increases are San Benito, Santa Cruz, Marin, Santa Barbara, San Diego, Monterey, Sonoma, Placer, El Dorado, Yolo, Sacramento, San Luis Obispo, Riverside and San Bernardino. Because private health plans in these areas tie their fee schedules to the Medicare fee schedule, this will help access to care for all California patients, not just Medicare seniors. Locality 3 counties of Napa and Solano and Locality 99’s remaining rural counties will be held harmless from cuts. (In other words, their geographic rates will never be lower than their current rates.) Their rates can increase as costs go up but they will never be cut below the current floor. San Francisco, Santa Clara, San Mateo, Alameda, Contra Costa, Orange, Ventura and Los Angeles counties have always been in their own localities and reimbursed at their local costs to provide care. This will continue under the MSA system. (Source: CMANet, April 1, 2014) CMS Publicly Releases Medicare Part B Payment Data On Wednesday, April 9 CMS publicly released Medicare physician payment data for the first time since 1979, showing how the program paid out $77 billion to more than 880,000 health care providers in 2012, The data include information on payments made under Medicare Part B in 2012 to all participating providers. Specifically, the data include: See On Your Toes on Page 65

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On Your Toes from Page 63

• Physicians’ names and addresses; • Summaries of the services provided; and • The amount providers were paid for the services. The data do not include any patient information. Further, CMS will not release any information on providers with fewer than 11 patients who are Medicare beneficiaries. Regulators, insurers and other industry stakeholders are likely to use the information to locate potential sources of waste and fraud in the system, according to the New York Times. The data could offer a “roadmap” for where fraud and waste are occurring in the U.S. health system, Reuters reports. Physician organizations (including CPMA) are concerned that just providing raw data in no real context could result in the misinterpretation of data and lead to confused and uninformed decisions about medical treatment on the part of the general public. “Raw numbers provide no window into the quality of care provided, whether patients benefitted from treatments or if the surgeries and medical services were necessary,” said CPMA President Carolyn McAloon, DPM. In addition Dr. McAloon said that doctors should been given the opportunity to review the data and to correct any mistakes before the information was publicly released.

Although the RAC audits are suspended, automated reviews that do not require additional medical record documentation will continue through June 1. (Source: AMA Wire 3/14/2014) First Year EHR Participants Avoid Penalties, Begin Meaningful Use by July 1 First-time participants in the Medicare and Medicaid meaningful use electronic health records (EHR) program should begin the 90-day reporting period no later than July 1 to avoid payment penalties in 2015. Doctors who attest to meaningful use for the first time by Oct. 1 are eligible for an incentive payment and can avoid payment penalties for the following year. Physicians who miss the Oct. 1 attestation deadline but still attest to meaningful use in 2014 are eligible for an incentive payment, but will be subject to a 1 percent payment adjustment in 2015. Those who begin the meaningful use program after 2014 are not eligible for any incentive payments. Starting in 2014 all physicians, no matter when they began the meaningful use program, must use Version 2014 of certified EHR software, otherwise they face a penalty.

CMS Suspends RAC Audits

Doctors who begin participation in the program this year can earn up to $11,760 if they demonstrate 90 days of Stage 1 meaningful use. Successful demonstration of meaningful use each year, beginning in 2014, could earn a physician up to $23,520, according to the Centers for Medicare & Medicaid Services (CMS).

The Centers for Medicare and Medicaid Services has temporarily halted RAC (Recovery Audit Contractor) audits as it reevaluates its contracts and implements improvements for providers.

CMS offers additional resources on its EHR Incentives Program page at CMS.gov, including an interactive eligibility assessment tool, a Stage 1 attestation calculator and timelines.

The suspension, which is expected to last until sometime in the fall, comes as CMS procures new RAC contracts and transitions down current contracts.

Physician Quality Reporting System (PQRS) Payment Adjustment Information

(Source: California Healthline, April 9, 2014)

Organized medicine (including CPMA) has advocated for changes in the RAC program to help protect doctors against burdensome audits and wrongful determinations. As a result, CMS announced program changes that act as muchneeded safeguards, including: • RACs must wait 30 days before asking a Medicare administrative contractor (MAC) to adjust a claim payment. The delay will allow physicians to discuss the audit with the RAC. Previously, physicians had to choose between initiating a discussion and filing an appeal. • While auditors previously were not required to let physicians know they had received a request for discussion, RACs now must confirm that they have received such requests within three days. • RACs no longer will receive their contingency fee directly following the recoupment of payments they deemed “improper.” Rather, if a physician chooses to appeal an audit, the RAC must wait until the physician has exhausted the second level of appeal.

Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a payment adjustment under PQRS beginning in 2015. The PQRS payment adjustment applies to all of the eligible professional’s Part B covered professional services under the Medicare Physician Fee Schedule (PFS). Accordingly, eligible professionals receiving a payment adjustment in 2015 will be paid 1.5% less than the MPFS amount for that service. For 2016 and subsequent years, the payment adjustment is 2.0%. 2016 PQRS Payment Adjustment In 2014, if an eligible professional or group practice does not satisfactorily report or satisfactorily participate while submitting data on PQRS quality measures, a 2% payment adjustment will apply in 2016. The adjustment (98% of the fee schedule amount that would otherwise apply to such services) applies to covered professional services furnished by an eligible professional or group practice during 2016. See On Your Toes on Page 67

A p r i l | m ay | j u n e | 2014

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C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

On Your Toes from Page 65

If reporting for PQRS through another CMS program (such as the Medicare Shared Savings Program, Comprehensive Primary Care Initiative, Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to earn a PQRS incentive and/or avoid the PQRS payment adjustment. Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, eligible professionals should look to the respective quality program to ensure they satisfy the PQRS, EHR Incentive Program, Value-Based Payment Modifier (VBM), etc. requirements of each of these programs. Avoiding 2016 PQRS Payment Adjustments For Individual Eligible Professionals Eligible professionals can avoid the 2016 payment adjustment by meeting one of the following criteria during the 2014 PQRS program year: 1. Meet the requirements to satisfactorily report or satisfactorily participate for incentive eligibility as defined in the 2014 PQRS measure specifications (same criteria as 2014 PQRS incentive eligibility) 2. Report at least 3 measures covering one NQS domain for at least 50 percent of the eligible professional’s Medicare Part B FFS patients via claims or qualified registry • An eligible professional that reports fewer than 3 measures covering at least 1 NQS domain via claims or qualified registry- reporting will be subject to the Measure-Applicability Validation (MAV) process, which will allow CMS to determine whether additional measures domains should have been reported. 3. Participate via a qualified clinical data registry (QCDR) that selects measures for the eligible professional, of which at least 3 measures covering a minimum of 1 NQS domain AND submits measures for at least 50% of applicable patients seen during the participation period to which the measure applies For Group Practices Group practices participating in the Group Practice Reporting Option (GPRO) can avoid 2016 payment adjustments by meeting one of the following criteria during the 2014 PQRS program year: 1. Meet the requirements for satisfactorily reporting for incentive eligibility as defined in the applicable 2014 PQRS measure specifications 2. Report at least 3 measures covering one NQS domain for at least 50 percent of the group practice’s Medicare Part B FFS patients via qualified registry • Report 1-8 measures covering 1-3 NQS domains for which there is Medicare patient data (subjecting the group practice to the MAV process*), AND report each measure for at least 50% of the group practice’s Medicare Part B FFS patients seen during the reporting period to which the measure applies. *A group practice who reports fewer than 3 measures covering 1 NQS domain via the registry-based reporting mechanism will be A p r i l | m ay | j u n e | 2014

subject to the MAV process, which would allow CMS to determine whether a group practice should have reported on additional measures. Payment Adjustment Resources can be found on the CMS website at CMS.gov. Insurer Claim Edits to Come Into the Light Expensive claim denials and unexpected payment adjustments that stem from the hundreds of proprietary claim edits individual health insurers create behind closed doors could become a thing of the past in a few short years, thanks to an initiative underway in Colorado. By early next year, a draft set of standardized payment rules and claim edits will be released for full public review. The rules are in the final stages of development by the Colorado Clean Claims Task Force, a multi-stakeholder group established in 2010 by the state’s Medical Clean Claims Transparency and Uniformity Act. All health insurers in the state will be required to adhere to these rules beginning Jan. 1, 2017. That means doctors will have access to payment rules and claim edits, and they’ll know what to expect across all insurers when they submit claims. Right now, payer-specific edits account for 61 percent of all claim denials. The average price to rework a denied claim is $25, according to MGMA. These costs really add up, considering many insurer edits exist in a black box inaccessible to physicians and their billing staff. (Source: AMA Wire 4/25/2014) Stolen EHR Charts Sell for $50 Each on Black Market Doctors can expect criminals to increasingly target their electronic health records (EHRs) for patient information that they can sell on the black market for as much as $50 per chart compared to the $1 that a stolen credit card or Social Security card sells for on the black market, warns the FBI. The agency’s Cyber Division issued a memo in early April forecasting what criminals see a golden opportunity in healthcare information technology. It’s an opportunity born of the mandatory shift to EHRs, laxer safeguards in healthcare compared with those in the retail and financial sectors, and “a higher financial pay-out for medical records in the black market,” according to the FBI. The proliferation of EHR systems coupled with more and more medical devices connected to the Internet, the FBI said, “is generating a rich new environment for cyber criminals to exploit.” The federal program to encourage “meaningful use” of EHRs with bonuses and penalties has contributed to this state of vulnerability, said Steven Waldren, MD, an information technology expert and senior strategist with the American Academy of Family Physicians (AAFP). The meaningful-use program may have pushed some medical practices to implementation EHRs even though they weren’t exactly ready to. See On Your Toes on Page 69

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2013/2014 board of directors President Carolyn E. McAloon, DPM Castro Valley, CA 94546 P: (510) 581-1484 drmcaloon@bayareafootcare.com President-Elect Thomas J. Elardo, DPM Los Gatos, CA 95032 P: (408) 358-6234 painfulfeet1@gmail.com Vice President Ami A. Sheth, DPM Los Gatos, CA 95032 P: (408) 358-6234 amishethdpm@gmail.com Immediate Past President Karen L. Wrubel, DPM Hawthorne, CA 90205 P: (310) 675-0900 drkw@cox.net Secretary-Treasurer Rebecca A. Moellmer, DPM San Bernardino, CA 92404 P: (909) 886-3668 rebeccamoellmer@hotmail.com

Directors John A. Chisholm, DPM 345 F Street, Suite 100 Chula Vista, CA. 91910 P: (619) 427-3481 F: (619) 420-7807 dr_triguy@yahoo.com Devon Glazer, DPM Newport Beach, CA 92660 P: (949) 272-0007 drdev01@yahoo.com Thomas J. Tanaka, DPM Ontario, CA 91761 P: (909) 724-5052 drtanaka@doctor.com Jonathan J. Uy, DPM Hercules, CA 94547 P: (510) 724-4674 flipdpm@sbcglobal.net Mark A. Warford, DPM Fair Oaks, CA 95628 P: (916) 548-0218 markwarforddpm@att.net

Executive Director Jon A. Hultman, DPM 2430 K St Ste 200 Sacramento, CA 95816 P: (916) 448-0248 (800) 794-8988 jhultman@calpma.org jonhultman@gmail.com General Counsel C. Keith Greer, Esq. San Diego, CA 92128 P: (858) 613-6677 greerkeith@aol.com Governmental Representative Jodi Hicks Sacramento, CA 95814

2014 CPMA House of Delegates will convene

Wednesday, June 18, 2014 Disneyland Hotel Anaheim, CA

Parliamentarian/ Recording Secretary Roderick Farley, DPM/ Nedra L. Farley Albuquerque, NM 87122 drrodfarley@gmail.com

Student Representatives Kevin Grenier (CSPM) Oakland CA 94601 Kevin.grenier@samuelmerritt.edu Dayna Chang (Western U) Walnut CA, 91789 changd@westernued.org

2013/2014 COMPONENT SOCIETY PRESIDENTs ALAMEDA/CONTRA COSTA COUNTY Timothy Dutra, DPM P: (510) 869-6511 x7564 tdutra@samuelmerritt.edu docpod85@yahoo.com CENTRAL VALLEY Matthew Takeuchi, DPM Stockton, CA 95204 P: (209) 948-3333 mjtakeuchi@gmail.com COACHELLA VALLEY Harvey Danciger, DPM Palm Desert, CA 92260 P: (760) 568-0108 docofeet@gmail.com INLAND Diane Koshimune, DPM Pomona, CA 91766 P: (909) 706-3778 ISCPMA@gmail.com LOS ANGELES COUNTY Gabriel Halperin, DPM Los Angeles, CA 90063 P: (323) 264-6157 ghalp@earthlink.net MID-STATE Richard Motos, DPM Visalia, CA 93291 P: (559) 734-1171 moetoes@hotmail.com

MONTEREY BAY AREA Vittorio Lagana, DPM Monterey, CA 93940 P: (831) 375-5634 vlagana@gmail.com

SAN FRANCISCO/SAN MATEO Bill Metaxas, DPM San Francisco, CA 94108 P: (415) 433-3668 bjm@faisf.com

NORTHERN CALIFORNIA KAISER Thomas DaSilva, DPM Walnut Creek, CA 94596 P: (925) 295-7099 thomasdasilva@hotmail.com

SAN LUIS OBISPO/SANTA BARBARA David Sterling, DPM Santa Maria, CA 93455 P: (805) 928-5645 sterlingfamily4@gmail.com

ORANGE COUNTY Gregory Eirich, DPM Tustin, CA 9 92780 P: (714) 669-1780 eirichdpm@sbcglobal.net REDWOOD EMPIRE Paul Weiner, DPM Vallejo, CA 94590 P: (707) 643-3687 mdweiner@scrserv.com SACRAMENTO VALLEY Mark Warford, DPM (liaison) Fair Oaks, CA 95825 P: (916) 488-8750 markwarforddpm@att.net SAN DIEGO/IMPERIAL Nicholas DeSantis, DPM San Diego, CA 92101 P: (619) 239-3286 footdoc5@pacbell.net

SANTA CLARA VALLEY Adam Howard, DPM Cupertino, CA 95014 P: (408) 446-5811 footdoc4u@gmail.com SHASTA REGION Gordon Shumate, DPM Redding, CA 96001 P: (530) 246-4800 g.shumate.dpm@frontiernet.net SOUTHERN CALIFORNIA HMO Anthony Cannizzaro, DPM South Pasadena, CA 91031 P: (323) 857-2000) anthony.x.cannizzaro@kp.org doctoracann@aol.com VENTURA COUNTY Heather McGuire, DPM Ventura, CA 93003 P: (805) 648-2016 drhmcguire@me.com

The California Podiatric Physician is the official publication of the California Podiatric Medical Association. CPMA and the California Podiatric Physician assume no responsibility for the statements, opinions and/ or treatments appearing in the articles under an authorsâ&#x20AC;&#x2122;s name. For editorial or business information and advertising, contact California Podiatric Medical Association, 2430 K Street, Suite 200, Sacramento, California 95816; telephone, (916) 448-0248; facsimile; (916) 448-0258; e-mail; calpma.org.

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June 25-28, 2015

TheWestern.Org

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

On Your Toes from Page 67

The organizations most vulnerable to hackers and identity thieves are small physician practices and small community hospitals with scarcely any money to make the investments in data security that large hospital systems do. Doable Defenses Doctors aren’t helpless in the face of data thieves. Some protective measures that are doable even in a solo practice include: • Keeping software up-to-date and installing all security “patches” offered by the vendor. • Install only those applications on office computers that are needed to operate the practice. • Likewise, restrict the kinds of Web sites that can visit on company computers. Some sleazy sites are engineered to let hackers enter the practice’s system. • Talk to your EHR and billing software vendors about encrypting data on laptops, smartphones, and other mobile devices. • Don’t forget to establish rules for physically securing mobile devices as well. A laptop sitting on the backseat of a car invites a break-in. • Also ask your software vendors about the best practices that they recommend for customers. What’s their advice on operating a wireless network in the office, for example? • If you have an EHR that runs on a client-server network in your office, consider switching to an online, cloud-based system. “Having the server in the office pushes security requirements to the end user. Because the remote server of a cloud-based EHR system stores patient data from multiple medical practices, it may appear to be a more tempting target for hackers, but a large vendor has more resources to protect those assets than a single medical practice tending an office server. (Robert Lowes, Medscape Medical News, April 28, 2014) United Healthcare to Begin Rolling out Premium Provider Designation Program in California United Healthcare recently announced it would begin implementation of its Premium Designation program in California in the coming months. Under the program, physicians will be ranked on both national and specialty-specific measures for quality and various cost-efficiency benchmarks. United expects to fully implement the program by the end of 2014. An introductory announcement was recently mailed to physicians advising of the program’s inception and directing physicians to the UnitedHealthcareOnline.com website for more information about the program. Under the program, providers achieving United’s criteria for quality and cost thresholds will receive a Premium Designation on their physician profile, marketed to United members through the United online physician directory. In addition, employers may choose to offer health benefit programs (e.g., reduced cost-sharing or tiered A p r i l | m ay | j u n e | 2014

benefit programs) that provide benefit incentives for members to use only those doctors with the United Healthcare Premium Designation. CERT/Therapeutic Shoes for Persons with Diabetes April 2014 The Comprehensive Error Rate Testing (CERT) Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), performs medical review audits for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) provided to Medicare beneficiaries to determine the paid claims error rate for Medicare contractors and providers. Medicare covers therapeutic shoes and inserts for persons with diabetes as established by the Social Security Act §1861(s) (12). You may access the Therapeutic Shoes for Persons with Diabetes (TSPD) LCD and Related Policy Article on the CMS website under the Medicare Coverage Database. In order for your patient to qualify for these shoes and inserts, Medicare statute mandates specific coverage and documentation requirements that must be met. The most common CERT errors center on missing documentation from the certifying physician of the patient having diabetes, the existence of one or more of the conditions for coverage and the therapeutic plan of care. Three criteria are critical to coverage and form the majority of physician-related CERT errors: 1. Documenting your management of the beneficiary’s diabetes. You are considered the “Certifying Physician” and there is no substitute for this documentation requirement. The Certifying Physician, by statute, must be an M.D. or D.O. and not a nurse practitioner, physician assistant or clinical nurse specialist; 2. Documenting a qualifying foot condition. As opposed to the criteria above regarding documentation of the beneficiary’s diabetes management, the documentation of the qualifying foot condition may come from your records or by your indication of agreement (signified by initialing and dating) with information from the medical records of an in-person visit with a podiatrist, another M.D or D.O., physician assistant, nurse practitioner, or clinical nurse specialist that is within 6 months prior to delivery of the shoes/inserts. 3. Failure of the records to substantiate that an in-person visit occurred within 6 months prior to the delivery of the shoes or inserts. It is important to note that even though you may complete and sign a form attesting that all of the coverage requirements from the policy have been met, there also must be documentation in your records to indicate that you are managing the patient’s diabetes and records from either your chart or that of another practitioner documenting a qualifying foot condition. Please refer to the Local Coverage Determination (LCD) on Therapeutic Shoes for Persons with Diabetes (TSPD), the related Policy Article and the Supplier Manual for additional information about coverage, billing and documentation requirements. Thank you for your assistance in reducing the CERT error rate. (Source; Tony Poggio, DPM) See On Your Toes on Page 71

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On Your Toes from Page 69

Correct Coding & #65533; Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Revised Joint DME MAC Publication As part of the 2014 HCPCS update codes were created describing certain off-the-shelf (OTS) orthotics. Some of these codes parallel codes for custom fitted versions of the same items. Refer to the appropriate Local Coverage Determination (LCD) for a list of codes. When providing these items suppliers must: & #65533;Provide the product that is specified by the ordering physician, i.e. (1) type of orthosis and (2) method of fitting (OTS or custom fitted) & #65533;Be sure that the medical record justifies the need for the type of product and method of fitting & #65533;Be sure only to use the code that accurately reflects both the type of orthosis and the appropriate level of fitting & #65533;Have detailed documentation that justifies the code selected for custom fitted versus OTS codes) The following definitions will be used for correct coding of these items. Off-the-shelf (OTS) orthotics are: & #65533; Items that are prefabricated & #65533; They may or may not be supplied as a kit that requires some assembly. Assembly of the item and/or installation of add-on components and/or the use of some basic materials in preparation of the item does not change classification from OTS to custom fitted & #65533;OTS items require minimal self-adjustment for fitting at the time of delivery for appropriate use and do not require expertise in trimming, bending, molding, assembling, or customizing to fit an individual & #65533;This fitting does not require expertise of a certified orthotist or an individual who has equivalent specialized training in the provision of orthoses to fit the item to the individual beneficiary The term & #65533; minimal self-adjustment & #65533; is defined at 42 CFR & #65533; 414.402 as an adjustment the beneficiary, caretaker for the beneficiary, or supplier of the device can perform and that does not require the services of a certified orthotist (that is, an individual who is certified by the American Board for Certification in Orthotics and Prosthetics, Inc., or by the Board for Orthotist/Prosthetist Certification) or an individual who has specialized training. For example, adjustment of straps and closures, bending or trimming for final fit or comfort (not allinclusive) fall into this category. Fabrication of an orthosis using CAD/CAM or similar technology without the creation of a positive model with minimal self-adjustment at delivery is considered as OTS. Custom fitted orthotics are: & #65533;Devices that are prefabricated & #65533;They may or may not be supplied as a kit that requires some assembly. Assembly of the item and/or installation of add-on components and/or the use of some basic materials in preparation of the item does not change classification from A p r i l | m ay | j u n e | 2014

OTS to custom fitted & #65533;Classification as custom fitted requires substantial modification for fitting at the time of delivery in order to provide an individualized fit, i.e., the item must be trimmed, bent, molded (with or without heat), or otherwise modified resulting in alterations beyond minimal self-adjustment & #65533;This fitting at delivery does require expertise of a certified orthotist or an individual who has equivalent specialized training in the provision of orthosis to fit the item to the individual beneficiary Substantial modification is defined as changes made to achieve an individualized fit of the item that requires the expertise of a certified orthotist or an individual who has equivalent specialized training in the provision of orthotics such as a physician, treating practitioner, an occupational therapist, or physical therapist in compliance with all applicable Federal and State licensure and regulatory requirements. A certified orthotist is defined as an individual who is certified by the American Board for Certification in Orthotics and Prosthetics, Inc., or by the Board for Orthotist/ Prosthetist Certification. Use of CAD/CAM or similar technology to create an orthosis without a positive model of the patient may be considered as custom fitted if the final fitting upon delivery to the patient requires substantial modification requiring expertise as described in this section. A certified orthotist is defined as an individual who is certified by the American Board for Certification in Orthotics and Prosthetics, Inc., or by the Board for Orthotist/Prosthetist Certification. Kits are: & #65533;A collection of components, materials and parts that require further assembly before delivery of the final product & #65533;The elements of a kit may be packaged and complete from a single source or may be an assemblage of separate components from multiple sources by the supplier A summary classification algorithm is included at the end of this document to assist in determinations about the type of product and correct code selection. Refer to the Contractor Supplier Manual, applicable Local Coverage Determination and related Policy Article for additional information about other coverage, coding and documentation requirements. For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form located on the PDAC website: https://www.dmepdac.com/ This link takes you to an external website. Classification Algorithm & #65533; Overview of Criteria Determining Proper Coding of Prefabricated Orthotics The following question and answer relates to whether a prefabricated orthotic is properly billed using a code for a custom fitted orthotic versus one furnished off-the-shelf and does not See On Your Toes on Page 73

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CPMA, Your Professional Lifeguard for over 100 years! Corporate Member

TESTIMONIAL

“CPMA Corporate Membership is by far the best marketing decision I have ever made.

C PMA

The purchase of disability insurance is an important commitment that can last over 35 years. It is vital that a podiatrist has complete faith in me, the people I represent and the products I recommend. Since becoming involved with CPMA’s Corporate Member Program it has been easier to earn this trust. My sponsorship obviously holds weight with the membership and this weight continues to grow each year.

Joining The California Podiatric Medical Association (CPMA) is like hiring a powerful professional staff to watch out for regulatory, legal and legislative actions that would negatively impact your ability to practice medicine – for pennies a day. Your CPMA membership allows you to focus on your patients while CPMA looks out for you.

2430 K Street, Suite 200 • Sacramento, CA 95816 916-448-0248 • 800-794-8988 • Fax 916-448-0258 cpma@calpma.org • www.calpma.org

The CPMA leadership appreciates my commitment and many of them have gone out of their way to help me achieve my goals.” Thanks again, Wayne Winter, DPM Pacific Advisors Guardian Disability Insurance

Count on It’s Time to Rethink Varicose Veins

to help heal fractures*. Visit exogen.com for additional information. * Summary of Indications for Use: The EXOGEN Ultrasound Bone Healing System is indicated for the non-invasive treatment of established non unions† excluding skull and vertebra. In addition, EXOGEN is indicated for accelerating the time to a healed fracture for fresh, closed, posteriorly displaced distal radius fractures and fresh, closed or Grade I open tibial diaphysis fractures in skeletally mature individuals when these fractures are orthopaedically managed by closed reduction and cast immobilization. There are no known contraindications for the EXOGEN device. Safety and effectiveness have not been established for individuals lacking skeletal maturity, pregnant or nursing women, patients with cardiac pacemakers, on fractures due to bone cancer, or on patients with poor blood circulation or clotting problems. Some patients may be sensitive to the ultrasound gel. Full prescribing information can be found in product labeling, at www.exogen.com, or by calling customer service at 1-800-836-4080. † A non-union is considered to be established when the fracture site shows no visibly progressive signs of healing. © 2014 Bioventus LLC EXOGEN is a registered trademark of Bioventus LLC. Bioventus and the Bioventus logo are trademarks of Bioventus LLC.

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More than 30 million Americans suffer from venous disease, including varicose veins and chronic venous insufficiency, yet only 1.9 million seek treatment each year.* Visit Covidien at the WFAC to learn how the Rethink Varicose Veins campaign can help you educate your patients about venous disease and the importance of seeking proper diagnosis and treatment. www.RethinkVaricoseVeins.com

* US Markets for Varicose Vein Treatment Devices 2011, Millennium Research Group. 2011. Rethink Varicose Veins is a trademark of Covidien company © 2014 Covidien. Trademarks of their respective owners.

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

On Your Toes from Page 71

address medical necessity for the item. The descriptors for the HCPCS codes for custom fitted orthotics include the following nomenclature: & #65533;Off-the-shelf (OTS) - Prefabricated item that requires minimal self-adjustment such as being trimmed, bent, molded, assembled, or otherwise adjusted to fit the beneficiary. Minimal self-adjustment does not require the expertise of a certified orthotist or an individual with equivalent expertise. & #65533;Custom fitted - Prefabricated item that requires substantial modification e.g., has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by certified orthotist or an individual with equivalent expertise. Question: Is the prefabricated orthotic furnished with custom fitting that is and can only be provided by an individual with expertise or furnished off-the-shelf (OTS)? Answer: Classification depends on (1) what must be done at final fitting and (2) who must do it. Expertise of a qualified practitioner and substantial modification at the time of delivery qualify the items for classification as custom fitted. Fail either one of these criteria and the item is classified as off-the-shelf. How to Decide What Code Type for Prefabricated Orthotic Flowchart: Prefabricated, Fit requires substantial modification? if no, OTS. If Yes, Modification requires expertise, Custom Fitted. (See 2014 January/February/March California Podiatric Physician pg 27.) (Source: Toney Poggio, DPM) Survey Finds Wide Confusion Over California Covered Contracting Plans The California Medical Association (CMA) recently surveyed doctors about their contracting experience with Covered California plans. Eighty percent of respondents reported that they were confused about their participation status in a Covered California plan and that this has negatively impacted patient care. CMA reports that the survey resulted in an unprecedented response from over 2,300 physicians in less than two days, and showed that health plan contracting practices, such as all products clauses, vague and confusing contractual language and silent amendments, is the primary contributors to the current state of network confusion for providers. Survey respondents also report that the confusion has negatively impacted patient care in their practice and has led to the loss of patients. With roughly 1.4 million Californians newly enrolled in Covered California products since January, it has been difficult for both doctors and patients to find out who is in and out of the narrow provider networks offered by Anthem Blue Cross and Blue Shield of California. Much of the uncertainty over whether a provider is in a Covered California panel or not has been caused by intentionally vague “all products clauses” in provider contracts that bind them to participating in unspecified current and future products offered by the health plans. Also contributing to the confusion, is a loophole in California’s law, which gives health plans the ability to make unilateral changes A p r i l | m ay | j u n e | 2014

to providers PPO contracts and consider a provider’s lack of response as acceptance of the changes, also known as a “silent amendment.” This is unlike the laws governing health maintenance organizations (HMOs), which require any change to a contract to first be negotiated and agreed to by the provider. With the rollout of Covered California, some health plans have used the PPO loophole to push many physicians unknowingly into additional product networks without their knowledge. The result has been that many doctors do not realize they have been added to lists of Covered California providers – this has caused mass confusion for both patients and physicians about participation status in the new product. It is important to remember that a plan purchased on the Covered California Exchange is private insurance offered through one of these standalone health plans. Policies purchased may be HMOs, PPOs or EPOs. Despite being purchased on the Exchange these plans operate functionally just like any other commercial health plan. If and when a patient contacts your office with a plan purchased on the Covered California exchange (or they may call it “Obamacare”), CPMA strongly recommends that your office verifies participation status with the plan. CPMA Members can check their status on various exchange plans on the Covered California Resource Center on the CPMA website at calpma.org If a doctor is not already part of the network for this plan, the office should find out what the reimbursement rates would be for services provided by an out-of-network provider. By design, out-of-network provider reimbursements are exceptionally limited through these plans. If a doctor is interested in becoming part of an Exchange plan’s network, the office should ask the plan for the specific contractual terms of its Exchange product, including the specific fee schedule used for reimbursement under this product and the number of new patients the office should expect to see with this plan. It should not be assumed that the plan would reimburse network providers at the same rate as for services provided under other policies offered by that plan. While these Exchange plans function like other commercial insurance products, these are new policies likely sold to new patients who may not have a great deal of experience with health care coverage and may not have focused on the benefits included in the policy when they purchased it. It will be important for podiatric physicians’ offices to communicate directly and clearly with the patient as well as the patient’s plan before treatment begins. Noridian Begins Next Round of Medicare Revalidation Process As called for under the Affordable Care Act (ACA), Medicare Administrative Contractors (MACs) have been requiring physicians to revalidate their Medicare enrollments. Between now and March 23, 2015, MACs will continue reaching out to physicians on a regular basis, notifying them if they need to revalidate. Noridian, California’s MAC, recently sent another round of revalidation letters. See On Your Toes on Page 82

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Contributions to CPMA: MICRA FAQ FOR CONTRIBUTORS How much can I contribute? Contributions to ballot measure committees, including Patients, Providers and Healthcare Insurers to Protect Access and Contain Health Costs (the “Committee”) are not limited. Donations to the Committee are not deductible as charitable contributions for federal income tax purposes. Who can contribute? Contributions can be accepted from individuals, corporations, other business entities, non-profit organizations (other than private foundations), and political committees. Contributions cannot be accepted from foreign nationals. All contributions of $100 or more will be disclosed on the Committee’s campaign reports.

How can my contribution be spent? Contributions received by the Committee can be used for expenditures to support the Committee’s purposes, including engaging in a campaign to defeat the proposed ballot measure to quadruple MICRA’s $250,000 cap on noneconomic damages to $1.1 million that would increase lawsuits against doctors and healthcare providers, increase health care costs for consumers and reduce patient access to care. How do I contribute to the campaign? Please send your check made payable to California Podiatric Medical Association with “MICRA” in the memo field.

Alternatively, you may make a contribution by credit card; please complete the Contribution Form and send it to the same address, or by email or fax. How has the Committee been formed? Patients, Providers and Healthcare Insurers to Protect Access and Contain Health Costs (FPPC ID No. 1359222) is a California non-profit corporation and is exempt from taxation under Section 501(c)(4) of the Internal Revenue Code. The Committee has been primarily formed to oppose Initiative 13-0016 (Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute.)

MICRA CONTRIBUTION FORM Please send your contribution directly to CPMA for processing. CPMA will send one total contribution to Patients and Providers to Protect Access and Contain Health Costs. Your donation is not tax deductible. Name of Donor: _______________________________________________________________ CPMA #__________________________ Address: _____________________________________________________________________________________________________ City/State/Zip: _________________________________________________________________________________________________ Daytime Phone: __________________________________________ Email: ________________________________________________ Amount of Contribution: $_________________________

Payment Information o Check enclosed - Please make checks payable to CPMA with “MICRA” in the memo field Credit Card: o Visa o MasterCard o Discover o American Express

________________________________________________ _________________________________ _______________ Credit Card Number Exp. Date (mm/yy) Security Code

_________________________________________ _______________________________________ ________________ Cardholder’s Name Cardholder’s Signature Date

___________________________________________________________________________________________________ Credit Card Billing Address including Zip Code

California Podiatric Medical Association • 2430 K St, Ste 200 Sacramento, CA 95816 Contact us: Phone 800.794.8988/916.448.0248 • Fax 916.448.0258 • calpma.org • jsteed@calpma.org

It Pays tO be a CPMA Member Discounts on registration for CPMA sponsored meetings including The Western Foot and Ankle Conference – one of the premier podiatric medicine, management and exhibitions in the country. Up to 15% off PICA professional liability insurance Being listed on the statewide CPMA and nationwide APMA Find-a-Podiatrist search sites for patients seeking a podiatric physician A micro-practice website hosted by CPMA CPMA membership dues are tax deductible Peace-of-Mind in having CPMA’s professional team there for support when a payor is engaging in discriminatory practices or improper reimbursement practices, when scope of practice rights are denied are challenged, or when there’s the unexpected knock from a regulatory inspector at the door.

PRICELESS!

Who Will Do It? Once upon a time there were four podiatric physicians named Everybody, Somebody, Anybody and Nobody. They were involved in an important California podiatric medicine campaign. Everybody was asked to contribute. Everybody was sure Somebody would do it. Anybody could have done it, but Nobody did. Somebody got angry because it was Everybody ’s job. Everybody realized that Anybody could do it, but Nobody realized that Everybody would do it. So, Everybody blamed Somebody, when Nobody did what Anybody could have done. To help ensure that the job does get done, please send your contribution today to CalPPAC, a non-profit, nonpolitically-aligned organization run for California’s doctors of podiatric medicine for the betterment of California’s doctors of podiatric medicine. Mail your supporting contribution to: CalPPAC 2430 K Street, Suite 200 Sacramento, CA, 95816 To use your VISA, MasterCard or AmEx call (800) 794-8988.

Help CalPPAC in its ongoing efforts to help YOU! A p r i l | m ay | j u n e | 2014

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Trade Payroll and HR Pressures for Peace of Mind Most business owners dread one word on a regular basis – payroll. It’s a big burden with little reward, especially if you think you’re saving time and money doing it yourself. Paychex simplifies payroll processing. Submit your payroll online, call your dedicated Paychex payroll specialist, or fax it in . . . and you’re done! We also offer other services to help manage your employees and benefits administration.

• Payroll packages include tax payments, mobile access, reports, state unemployment claims management, and more. • Add a time and attendance system or human resource services to free up even more time for your business. • Retirement plans can be set up to fit the needs of your business and those of your employees.

California Podiatric Medical Association members receive 15% off select Paychex payroll packages and HR setup fees!

2/14

Call 800-729-2439 today (mention code 5830).

go to the western from Page 1

encourages attendees to register for this important course to learn all they can and to not wait for later opportunities. Get Set for Business Podiatric physicians can opt to register for Track II: How to Build Your Successful Practice, joining podiatric medical assistants in a separate session on Friday afternoon for lectures on the ACA, valuebased care, and practice marketing at no additional cost. Specialist Rem Jackson will present topics on how to make doctors’ practices stand out in the marketplace. Go to the Best in the West Hosted by the Disneyland Hotel and Convention Center June 19 – 22, 2014 The Western provides an exhilarating environment for registrants to learn from superlative lecturers and network with peers and vendors. Podiatric physicians and medical assistants make it a tradition to convene annually not only to keep their skills sharp and learn new techniques, but also to bring their colleagues, family, and friends together to make memories. The Western’s esteemed faculty and range of topics promise an outstanding educational experience – one that many come back for year after year, but after soaking in a day of education, attendees can soak in some Southern California sunshine. Just outside the conference center are excellent restaurants and lounges like the one-of-a kind Trader Sam’s Enchanted Tiki Bar. Attendees can put their feet up and relax in the pools and spas, recline by the outdoor fireplace, or network in the Downtown Disney® District, which offers even more dining and entertainment choices. Plus, Western attendees can purchase specially-priced tickets to the two Disneyland® Resort Theme Parks.

Need more reasons to attend The Western this year? Check these out! • Economically-conscious registration rates • Support of your Association • 3 full days of exhibits just steps away from the lecture hall • Complimentary refreshments • Podiatric medical assistant radiology course • Free guest passes to the exhibit hall • Exciting raffle prizes • Helpful and friendly staff • Up to 15% discount on your PICA renewal premium • AAA Four Diamond Award accommodations at the Disneyland Hotel • A myriad of dining and entertainment options • Significantly reduced prices on theme park tickets See you there!

Full Registration Brochure starts on page 7.

You’ve Got Mail CPMA is increasingly utilizing Email and the Association’s website (CalPMA. org) to get important information to members in a rapid, efficient and costeffective manner. To make sure that CPMA has your correct email please go to CalPMA.org and log-in. Once you are logged in, click on Physicians’ Desk and then on Member Directory. Put in your name and view your contact information. If the Association does not have your email, or if it or any of your information is incorrect call 800-794-8988 or email jsteed@calpma.org. Members are also encouraged to check the CPMA website regularly. A p r i l | m ay | j u n e | 2014

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Let Magic Begin! the

Thrilling news rides, exciting attractions, dazzling shows and special events await the 2014 Western Attendees at Disneyland and Disneyâ&#x20AC;&#x2122;s California Adventure.

World of Color The nighttime water spectacular weaves water, color, fire and light into a kaleidoscope of fantasy and imagination. More than 1,000 jets of water form incredible shapes in time to the music as Disney characters come to life on a shimmering veil of mist.

Take a heart-pounding thrill ride on Tower of Terror

Jedi Academy Where younglings learn to defend the galaxy from the Darkside

Captian Jack Sparrow Awaits riders of The Pirates of the Caribbean 78 |

C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Aladdin Live Night skies come alive with the nightly display of Disney’s dazzlingly fireworks

Continues to thrill audiences at Disney’s California Adventure’s spectacular Hyperion Theater.

Fantasmic!

Dumbo

Fantasmic! a nighttime extravaganza featuring music, pyrotechnics, water screens , lasers and much more!

You’ll believe an elephant can fly on this family favorite, which captures the magic of Disney’s Dumbo the Elephant

Haunted Mansion Hitch Hiking

Buzz Lightyear Astro Blasters Help save the galaxy when Buzz Lightyear recruits you as a Space Ranger to thwart the Evil Emporer Zurg! Spin, twist and turn as you shoot lasers at Zurg’s bad robots to keep them from carrying out his evil plan to steal the batteries from good toys everywhere. A p r i l | m ay | j u n e | 2014

Paradise Pier

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Cars Land

It’s a Small World Everyone’s favorite! Try to spot your favorite Disney characters!

Ca-Chow!

Indiana Jones Temple of the Forbidden Eye Soarin’ Over California Fly away on a gentle breeze of music and inspiration! Soarin’ Over California is an exhilarating simulated hang-glider flight over California’s famous natural and manmade wonders.

Carsland at Disney California Adventure

King Triton’s Whimsical Carousel 80 |

Dinosaurs at Disneyland C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

Big Thunder Mountain Train Race along the railroad tracks in a runaway mine carâ&#x20AC;&#x201D;and watch for new surprises along the way! This classic Disneyland attraction is back, and better than ever before.

Suit up at the Iron Man Tech Exhibit

Tea Cups

Grizzly Peak Ride A thrilling whitewater raft adventure that takes you roaring down a California river in the Sierra Nevada mountains.

Finding Nemo Submarine Voyage

Sleeping Beautyâ&#x20AC;&#x2122;s Castle A p r i l | m ay | j u n e | 2014

Dive into the Tomorrowland Lagoon and discover the world of Finding Nemo! As your whimsical Australian submarine sinks into the vibrant waters, explore the undersea curiosities and follow Marlin as he searches for Nemo through the perils that dwell in the ocean deeps. | 81

On Your Toes from Page 73

This revalidation effort applies to providers and suppliers that were enrolled prior to March 25, 2011.

process.) Doctors who are making changes (moving, closing practice, etc.) should continue to submit their changes as usual.

The revalidation requirement is necessitated by new screening criteria called for under the ACA. Newly enrolling and revalidating providers will be placed in one of three screening categories representing the level of risk to the Medicare program. The level of risk will determine the degree of screening to be performed when processing the enrollment application.

A change of procedure in this and future rounds of revalidation requests is a requirement to submit an Electronic Funds Transfer form (CMS 588), even if you are already receiving funds electronically from Medicare.

Doctors who receive a request for revalidation must respond to that request within 60 days or face the possibility of being deactivated. Do not do anything until you get a letter instructing you to revalidate. (This is very important to ensure an orderly enrollment

The Centers for Medicare and Medicaid Services (CMS) publishes a list of providers who have been sent revalidation requests, broken down by the month in which the revalidation request was mailed. CMS will add lists on a bimonthly basis. The list can be found on the CMS website www.cmas.org. If you are listed, and have not received the request, please contact Noridian at (855) 609-9960.

M CP A R

CO P

E TE M

www.bakopathology.com www.merzusa.com

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C PMA | C a l i f o r n i a P o d i at r i c M e d i c a l Ass o c i at i o n

HHS Sets ICD-10 Compliance Date of Oct. 1, 2015 The ICD-10 transition has been delayed for one year. HHS expects to release an interim final rule that would require the use of ICD-10 beginning on October 1, 2015. As noted in the March 2014 issue of CPMAâ&#x20AC;&#x2122;s electronic newsletter DPMemo the Protecting Access to Medicare Act of 2014 stated that the Secretary of HHS may not adopt ICD-10 prior to October 1, 2015. This interim final rule would also require HIPAA-covered entities to use ICD-9-CM through September 30, 2015. CMSâ&#x20AC;&#x2122; plans to conduct ICD-10 end-to-end testing in July with providers, MACs, and the Common Electronic Data

Interchange (CEDI) contractors have been canceled due to the delay. However, additional opportunities to participate in end-to-end testing will be available next year. Health-care providers should continue to prepare for the ICD-10 transition despite the year-long delay. The 2014 Western Foot and Ankle Conference is offering a ICD-10 checkup to help podiatric physicians see where they are currently in the transition and what they need to do in the next 18 months to be compliant.

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www.picagroup.com | 83

California Podiatric Medical Association 2430 K Street Sacramento, CA 95816

western foot and ankle conference june 19 – 22, 2014 disneyland hotel & convention center anaheim, california

visit www.TheWestern.org

for more information

get more for your money: • Economically conscious registration rates • 25 CE contact hours • 10 radiology CE contact hours • Dynamic lecture tracks • Distinguished faculty • Innovative instructional courses

• Hands-on surgical workshops • Billing & Coding updates • PICA presentation • 3-day educational seminar for podiatric medical assistants including radiology credits • 3 days of exhibits

• Exceptional room rates at the Disneyland Hotel and Grand Californian Hotel & Spa • Significant savings on Disneyland & California Adventure Park Passes • Optimal location near shopping, dining, entertainment and more!

2430 k street • suite 200 • sacramento, ca 95816 • (800) 794-8988