50 Volume 52
H
4 Number 3
O O S I E
D O
R
Fall 2013
Published by The Indiana Association of Osteopathic Physicians and Surgeons, Inc.
It is hard to believe that there are now 162 osteopathic medical students filling the halls of the Michael A. Evans Center for Health Sciences on the campus of Marian University. This is the culmination of many years of hard work and the financial generosity of many corporations and Angela B. Wagner, D.O. IOA President individuals coupled with a unique partnership between the Indiana Osteopathic Association (IOA) and the Marian University College of Osteopathic Medicine (MUCOM). It really is a dream come true for everyone involved and a key event in the history of medicine in the state of Indiana. I feel very fortunate to have the opportunity to serve as your president during such a monumental and quite honestly exceedingly fun year to do so. I also want thank our immediate past president, Chris A. Lowery, D.O., for his exceptional leadership. During his presidency our membership grew 35%, which is a great accomplishment. Dr. Lowery represented the IOA well and continues to be supportive and involved in both the IOA and the MUCOM. It will not be without challenges as we continue to work together to support our students and grow as a profession and state organization. Our increase in membership has been exciting and appreciated, but we have a long way to go to reach the numbers necessary to make a significant impact in the state of Indiana both in support of medical education of osteopathic medical students and in advocacy for the osteopathic profession. I believe this growth will come as we begin to graduate our first classes at the MUCOM. In the meantime, however, it is going to take the time and resources of dedicated practicing physicians to allow us to offer quality programming to our students when membership numbers remain low and finances are tight. (continued on page 17)
PRESIDENT’S MESSAGE
ANNUAL CONVENTION
During the president’s luncheon at the annual convention on May 3, 2013, Susan Sevensma, D.O., brought greetings from the American Osteopathic Association (AOA) and an update on AOA activities. She also swore in new officers. The IOA recognized Paul Evans, D.O., of Indianapolis, with its highest honor. Dr. Evans received the J.B. Kinsinger plaque for outstanding service to the osteopathic profession and his community. Brian H. Black, D.O., of Greencastle, also was honored. He was named Outstanding Young D.O. of the Year for 2013, an honor which is reserved for physicians who have been in practice less than ten years and who have made significant contributions to the IOA and their communities. See pages 4 and 5 for highlights from other annual convention activities. IN THIS THIS ISSUE IN ISSUE Member Concerns……………………………………..…3 116th Annual Convention…..………………………...….4 32nd Annual Winter Update……………………………..6 Tips From Our Consultant……………..………………..9 AIOA News……………….……………………….…….17 WMD Update……………….…………………….….....17 Dean’s Update…………………………………………..19 Motyka Dannin Foundation……………………………22 Coming Events………………………………………….23 Practice Opportunities………………………………….24
“As physicians, we have so many unknowns coming our way... One thing I am certain about is my malpractice protection.” Medicine is feeling the effects of regulatory and legislative changes, increasing risk, and profitability demands—all contributing to an atmosphere of uncertainty and lack of control. What we do control as physicians: our choice of a liability partner. I selected ProAssurance because they stand behind my good medicine and understand my business decisions. In spite of the maelstrom of change, I am protected, respected, and heard. I believe in fair treatment—and I get it with Claims-Made Plus® for Indiana physicians.
Proudly endorsed by
Professional Liability Insurance & Risk Management Services ProAssurance Group is rated A+ (Superior) by A.M. Best. ProAssurance.com • 800.292.1036
Fall 2013
The following physician was accepted as a new member of the IOA at the Board of Trustees meeting on May 2, 2013: OUHCOM
Page 3
EDITOR TIPS HAT TO
IOA WELCOMES NEW MEMBERS
Chad R. Kauffman, D.O., Ophthalmology, Indianapolis
HOOSIER D.O.
(2003),
NEW LIFE MEMBERS HONORED Congratulations to Lawrence R. Curry, D.O., of Mishawaka, and Dennis L. Streeter, D.O., of Merrillville, on their achievement of life membership in the IOA. They were honored during the president’s luncheon at the 116th Annual Convention.
SCIENCE FAIR AWARDS The IOA again sponsored the Hoosier Science and Engineering Fair, Indiana’s science fair. This year two prizes in the category of human health, biology, or life sciences were awarded. First prize, and a check for $100, was won by Nirupama Devanathan, grade 9, Homestead Senior High School, in Fort Wayne. The project was “Integral Proteins Involved in Tumor Metastasis: Analysis in Pancreatic and Colon Cancer Series.” Second prize, and a check for $50, was won by Austin Hughes, Grade 6, Our Lady of Perpetual School, in New Albany. The project was “Shin Guard Showdown.”
HOUSE OF DELEGATES The osteopathic profession in Indiana was well represented at the AOA House of Delegates meeting in Chicago in July. The IOA delegation included Thurman V. Alvey, III, D.O., Mark S. Cantieri, D.O., David L. Coil, D.O., Dan C. Galloway, D.O., Max E. Helman, D.O., David C. Koronkiewicz, D.O., and Susan M. Moore Riesbeck, D.O. The AOA’s House of Delegates meets annually to set organizational policies and elect new officers. D.O. spokespeople were available before and during the meeting upon request to discuss the policy issues.
Brian H. Black, D.O., of Greencastle, who has received the degree of Fellow from the American Academy of Family Physicians (AAFP). He was one of only five Hoosiers presented with this honor in 2013. Dr. Black also was ranked among top physicians in the nation for 2012. Patients’ Choice announced that Dr. Black was one of few physicians honored with the prestigious 2012 Compassionate Doctor Award. Each year, nearly 100 million patients across the U.S. provide feedback about experiences with their physicians. Only those physicians with outstanding scores, as voted by their patients, are selected for the Compassionate Doctor recognition. Less than 3% of the nation’s over 870,000 physicians ever receive this award. The Compassionate Doctor certificate is part of the Patients’ Choice recognition program. Michael L. Kuchera, D.O., of Greenwood, who was elected to the Board of Governors at the annual business meeting of the American Academy of Osteopathy (AAO) during the AAO Convocation in Orlando, FL, in March. Dr. Kuchera will serve a three year term.
VINN INSTALLED AS PRESIDENT Norman E. Vinn, D.O., an osteopathic family physician from San Clemente, CA, is the 117th president of the American Osteopathic Association (AOA). Dr. Vinn’s exposure to osteopathic medicine began by watching the dedication his father, who was a D.O., had to his patients and to the osteopathic profession. Years later, Dr. Vinn’s own daughter, Vanessa S. Vinn, D.O., followed her father and grandfather into osteopathic medicine. “The osteopathic profession has grown tremendously since the days when my father practiced and osteopathic medicine was still gaining acceptance in many parts of the country. Following in his footsteps, I am proud to lead by fellow D.O.s--including my daughter--as osteopathic medicine continues to grow and receive worldwide recognition,” says Dr. Vinn. “As D.O.s remain committed to delivering a distinct form of medicine that emphasizes prevention and the health of the whole person, we can expect osteopathic medicine to play an everprominent role in the delivery and evolution of health care.” As founder of Housecall Doctors Medical Group, Inc., a home care network that provides on-site clinical services to more than 1,000 homebound elderly in Southern California’s Orange, Los Angeles, Riverside and San Bernardino counties, Dr. Vinn (continued on page 16)
Fall 2013
HOOSIER D.O.
Page 4
116TH ANNUAL CONVENTION The following exhibitors, grantors, and in kind supporters made possible the excellent continuing medical education (CME) program offered during the annual convention, which included a one day ultrasound symposium. A total of 122 physicians attended the 25 hour category 1-A CME credit program on Friday through Sunday. The CME Committee and the Board of Trustees of the IOA encourage you to let representatives of these companies know that you appreciate their support.
GRANTORS Community Westview Hospital Michigan State University College of Osteopathic Medicine Osteopathic Medical Foundation of Michiana IN KIND SUPPORTERS American Osteopathic Association Marian University College of Osteopathic Medicine Newby Consulting VEI
EXHIBITORS AbbVie Amarin Pharma Astellas Boston Scientific Bristol Meyers Squibb Center for Diagnostic Imaging Community Westview Hospital Decatur Vein Clinic Eli Lilly Elite Seat Emcare Grifols Janssen Marian University College of Osteopathic Medicine Med Express Merck MMIC Group Novo Nordisk Otsuka Pfizer Purdue Pharma Sanofi-Aventis South Bend Medical Foundation Takeda Teva Ultrsonix Medical
Outgoing president, Chris Lowery, D.O. (right) presents the Outstanding Young D.O. of the Year award to Brian Black, D.O. Angela Wagner, D.O., and Terry Iwasko, D.O., IOA trustees, are in background.
Fall 2013
HOOSIER D.O.
Page 5
(Left to right) Dan Galloway, D.O., Bruce Brink, Jr., D.O., Terry Iwasko, D.O., Brian Black, D.O., Adrian Carter, D.O., David Coil, D.O., Mary Burden, D.O., and Stephanie Overmars, D.O., are sworn in as members of the IOA’s Board of Trustees. Susan Sevensma, D.O., AOA trustee, provides an update on AOA activities. Mary Burden, D.O., IOA trustee, is in background.
Incoming president, Angela Wagner, D.O. (right) addresses colleagues during the president’s luncheon. Terry Iwasko, D.O., IOA trustee, is in background.
Outgoing president, Chris Lowery, D.O. (right) presents the Jule Warner - Frances Allen award to Christine Galloway. Susan Sevensma, D.O., AOA trustee, is in background.
Fall 2013
HOOSIER D.O.
Page 6
32ND ANNUAL WINTER UPDATE Mark your calendars now and plan to attend the Indiana Osteopathic Association’s 32nd Annual Winter Update to be held December 6 – 8, 2013, at the Hyatt Regency, in downtown Indianapolis. See pages 7 and 8 for the tentative agenda as well as details on making reservations for hotel accommodations and registering.
DOCTORS SAID LAST YEAR... “Speakers were superb.” “I liked all of the speakers’ enthusiasm.” “Very practical.” “Interesting topics and good speakers.” “Program was well organized and skillfully administered.” “All good topics with very useful information presented by very knowledgeable physicians.” “Great lectures.” “I liked all of the lectures. Thanks.” “I liked the variety of topics.” “Very well done and useful.” “Great conference!”
PRE-CONFERENCE WORKSHOP On Thursday, the Indiana Academy of Osteopathy is offering an optional pre-conference workshop for an additional fee. Participation is limited so register early.
ENTERTAINMENT December in Indianapolis offers numerous opportunities for family and grown-up fun. You can enjoy first rate theater, concerts, shopping and dining. The holidays aren’t complete until you’ve treated the family to a performance that has spanned the decades--A Christmas Carol at IRT, the season’s most heartfelt gift. The beloved classic of loss and redemption returns to IR’s snow-covered stage. Dickens’ characters bring new life life every season in this faithful, fanciful and frolicsome adaptation. It’s Indy’s favorite holiday tradition. Tickets on sale now. Go to www.irtlive.com or call (317) 6355252 Monday through Friday, 11:00 am to 6:00 pm.
Indiana’s best holiday tradition for families returns! Ring in the holidays with the magic of top dancing santas, festival carols and largerthan-life puppetry that everyone will love. For the ISO’s annual Duke Energy Yuletide Celebration, one of the most popular hosts of all time—the five-tim e Grammy award-winning vocalist Sandy Patty—will return and share the stage with guest artists, The von Trapps, the four great grandchildren of Captain and Maria von Trapp made famous by The Sound of Music. Tickets on sale now. Go to www.indianapolissymphony.org or call (317) 639-4300 or (800) 366-8457 outside Central Indiana Monday through Friday from 9:00 am to 5:00 pm or Saturday from 12:00 pm to 4:00 pm. A trip to Christmas at the Zoo is unlike any other time of the year. As the sun sets over the White River State Park, enjoy the bright glow of holiday lights, which create a magical nighttime experience. You’ll find yourself eager to celebrate everything the holidays should be… plus animals! Several of the Zoo’s hardiest will stay up late to enjoy the cooler nights, including the sea lions, polar bears, walrus, and brown bears. You and your loved ones can keep warm as you dash between Oceans, the Dolphin Sweet Shop and two campfires. Then grab some hot cocoa and join the fun! The Zoo opens at 12 noon daily, and you can enjoy regular Zoo attractions and the White River Gardens from then until 9:00 p.m., while all the fun holiday activities are available from 5:00 pm to 9:00 pm. Holidays sparkle at the Children's Museum of Indianapolis. Explore Jolly Days Winter Wonderland, visit with Santa Claus, and ride down the Yule Slide. The museum is open Tuesday through Sunday, from 10:00 am to 5:00 pm. The Eiteljorg Museum (Western and Native American arts and crafts), the Indianapolis Art Museum, the American Cabaret Theater, Circle Centre for shopping, and many fine restaurants also are all within a short walk or drive from the hotel.
Fall 2013
TENTATIVE AGENDA
HOOSIER D.O.
Page 7
HOTEL RESERVATIONS
PRECONFERENCE OMT WORKSHOP THURSDAY, DECEMBER 5, 2013 8:00 am - 5:00 pm
Counterstrain to the Lower Half of the Body*
*
This is an optional OMT workshop for an additional fee. (Please indicate attendance on your registration form.)
FRIDAY, DECEMBER 6, 2013 (Exhibits open 8:00 am - 3:30 pm) 7:00 am - 5:30 pm
HBO and Radiation Tissue Necrosis Pituitary and Adrenal Glands Common Orthopedic Injuries Chest Pain Multiple Sclerosis Legislative Update Improving Stroke Prevention in Patients with Atrial Fibrillation OMT Workshop
Indiana Chapter, ACOFP, Reception
6:00 pm
SATURDAY, DECEMBER 7, 2013 7:00 am – 5:30 pm
Throat Cancer Ophthalmologic Emergencies Examining Contemporary Antiplatelet Strategies: The Key Role of Primary Care Hospitalist Medicine Nausea/Vomiting The Magic of Osteopathy ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care Diabetes Research
SUNDAY, DECEMBER 8, 2013 7:00 am - 12:45 pm
Chronic Renal Disease Anemia and New Transfusion Guidelines Dermatology Chronic Head and Neck Pain Coding and Billing Update
(Topics and times subject to change.)
BOOK YOUR ROOM EARLY! The Hyatt’s address is One South Capitol Avenue Indianapolis, IN 46204. Make your reservation via the internet at https://resweb.passkey.com/go/INOS or call (800) 233-1234. Room rates are $174.00 per night single or double occupancy $184.00 per night triple occupancy $194.00 per night quadruple occupancy until November 6. Be sure to mention the IOA Annual Winter Update to receive these rates. Make your reservation now even if you’re not certain you will need a room. If you decide to cancel your reservation, please contact the IOA first.
BRING YOUR LAPTOPS! Participants may download powerpoint presentations on the IOA’s website during CME programs free of charge. For an additional fee of $5, the IOA will have flash drives loaded with all powerpoint presentations provided to us before the start of the annual winter update. (Please indicate if you prefer a flash drive on your registration form.)
Fall 2013
HOOSIER D.O.
Page 8
INDIANA OSTEOPATHIC ASSOCIATION 32ND ANNUAL WINTER UPDATE DECEMBER 6 – 8, 2013 REGISTRATION FORM ____________________________________________________________________________________________________________ Name(indicate first and last for name badges) Degree AOA Member Number ____________________________________________________________________________________________________________ City State Zip Code Mailing Address(indicate office or residence) ____________________________________________________________________________________________________________ Medical College Year of Graduation Telephone Number(indicate office or residence) ____________________________________________________________________________________________________________ E-Mail Address Specialty
REGISTRATION FEES (circle appropriate fee) Non Member Member* Residents/Interns *
Before 11/8/13 $595 $450 $65
After 11/8/13 $645 $500 $65
Member of IOA or respective state association.
I would prefer a flash drive. I have included an additional fee of $5 in my check. I understand that an additional fee of $5 will be charged as indicated below. I will participate in the optional preconference OMT workshop on Thursday, December 5, from 8:00 a.m. until 5:00 p.m. I have included an additional fee of $215 in my check. I understand that an additional fee of $215 will be charged as indicated below. Check (made payable to IOA) enclosed. Charge to: Visa Mastercard Discover American Express ___________________________________________________________________________________________ Card Number Expiration Date CVV Number Authorized Signature
REGISTER ON-LINE FOR AN ADDITIONAL FEE: Go to www.inosteo.org.
CANCELLATIONS & REFUNDS:
The IOA must receive notice of cancellations by November 8, 2013, to grant full refunds. If originally paid by credit card, cancellations are subject to a 5% service fee. If originally paid by credit card on-line, cancellations are subject to an additional 5% service fee. All cancellations received after November 8 are subject to a 15% service fee. After November 29, 2013, all cancellations are subject to a 25% service fee.
MAIL REGISTRATION FORM WITH PAYMENT TO:
Indiana Osteopathic Association, 3200 Cold Spring Road, Evans Center, Suite 107, Indianapolis, IN 46222-1672.
QUESTIONS?
Call (317) 926-3009 or (800) 942-0501.
SPECIAL NEEDS?
Contact the IOA before November 8, 2013, if possible
Fall 2013
HOOSIER D.O.
Page 9
TIPS FROM OUR CONSULTANT By: Joy Newby, LPN, CPC, PCS Newby Consulting
INDIANA CERT EXAMPLES The Centers for Medicare & Medicaid Services (CMS) developed the Comprehensive Error Rate Testing (CERT) program to improve the processing and medical decision making involved with payment of Medicare claims. Under the CERT program, a random sample of claims is selected from each Medicare contractor, and medical records are requested from the providers who submitted the claims. These records are then reviewed to determine if the claim was submitted and paid appropriately. Each practice should have at least two (2) employees sufficiently trained to know how to respond to CERT requests as well as requests for medical records by any Medicare or Medicaid contractor, commercial payers, the Zone Program Integrity Contractor (ZPIC), the Office of Inspector General, etc. Simply not sending the appropriate information can result in a refund demand. Not knowing how to review documentation to ensure the physician’s signature is present and not knowing what to do when the document is not signed will result in a refund demand. We find the vast majority of the documentation deficiencies are simply due to • • •
not responding to the request for medical records (typically one claim) not sending all related documentation supporting the codes submitted on the claim not reviewing the information verifying proper signatures are in place
This is the first in a series of articles that will address some of the problems found during the CERT contractor’s analysis of Indiana claims. These scenarios may reflect the services you provide. The information included below will allow you to perform a self-audit to ensure your documentation and coding does not include these deficiencies. Missing Signatures The physician billed CPT 99215-25. The documentation received was missing a valid provider signature to support the office encounter. The CERT received typed office visit with unacceptable co-signature by an unknown person. The CERT requested additional information and received a duplicate invalid co-signed note. The CERT did not receive any response to its request for a physician signature attestation statement. The physician billed CPT 99222 and 99233. The documentation received was missing signature of the physician who provided the inpatient services for billed dates. The submitted notes for the requested dates of service were not signed and did not include a history or physical exam. The CERT requested valid signed progress notes; and received two notes stating, “not a patient at this facility” with another note stating, “patient was hospitalized on 11/23/11-11/30/11, attached are the records.” The CERT received duplicate records and no attestation statements. Then the CERT received a note stating, “OK send refund request.” Signature Guidelines WPS admonition: “Per the Program Integrity Manual, if there is no signature of the person providing the service the documentation is not considered in the review process.” Medicare Program Integrity Manual, Chapter 3, §3.3.2.4 - Signature Requirements This section is applicable for MACs [Medicare Administrative Contractor], CERT, and ZPICs [Zone Program Integrity]. This section does not apply to Recovery Auditors. For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a handwritten or electronic signature. Stamped signatures are not acceptable.
HOOSIER D.O.
Fall 2013
Page 10
If MAC and CERT reviewers find reasons for denial unrelated to signature requirements, the reviewer need not proceed to signature authentication. If the criteria in the relevant Medicare policy cannot be met but for a key piece of medical documentation that contains a missing or illegible signature, the reviewer shall proceed to the signature assessment. Providers should not add late signatures to the medical record, (beyond the short delay that occurs during the transcription process) but instead should make use of the signature authentication process. The signature authentication process described below should also be used for illegible signatures. Handwritten Signatures A handwritten signature is a mark or sign by an individual on a document signifying knowledge, approval, acceptance or obligation. • • •
If the signature is illegible, MACs, ZPICs and CERT shall consider evidence in a signature log or attestation statement to determine the identity of the author of a medical record entry. If the signature is missing from an order, MACs and CERT shall disregard the order during the review of the claim (e.g., the reviewer will proceed as if the order was not received). If the signature is missing from any other medical documentation (other than an order), MACs and CERT shall accept a signature attestation from the author of the medical record entry.
Electronic Signatures Providers using electronic systems need to recognize that there is a potential for misuse or abuse with alternate signature methods. For example, providers need a system and software products that are protected against modification, etc., and should apply adequate administrative procedures that correspond to recognized standards and laws. The individual whose name is on the alternate signature method and the provider bear the responsibility for the authenticity of the information for which an attestation has been provided. Physicians are encouraged to check with their attorneys and malpractice insurers concerning the use of alternative signature methods. Signatures of Disabled Physicians and Other Providers CMS is permitting use of a rubber stamp for signature in accordance with the Rehabilitation Act of 1973 in the case of an author with a physical disability that can provide proof to a CMS contractor of his/her inability to sign their signature due to their disability. By affixing the rubber stamp, the provider is certifying that they have reviewed the document. Potential Fraud Referrals At any time, suspected fraud shall result in a referral to the ZPIC for development. If MAC, Recovery Auditor or CERT reviewers identify a pattern of missing/illegible signatures, the reviewer shall refer to the appropriate ZPIC for further development. NCI Helpful Hints Remember, no documentation is accepted unless it is personally signed by the physician. The signature can be handwritten or electronically affixed to the document. When using electronic signatures, be sure you have a written Electronic Signature Protocol clearly identifying that your system is password protected and that only the user can use their password to sign a document. Look at the documentation before putting it in the envelope!! If it isn’t signed, DO NOT sign the information! This is altering a medical record.
Fall 2013
HOOSIER D.O.
Page 11
For progress notes and interpretations, although there is no “mandated” language for a Signature Attestation Statement, why “reinvent the wheel?” NCI recommends completing WPS’ example of a Signature Attestation Statement which can be found on the website at http://www.wpsmedicare.com/j8macpartb/forms/_files/2010_0518_attestation_example.pdf. Be sure to complete all the blanks including the date the physician signs the attestation statement! Notice the statement is for one date of service. If you have more than one date of service/document that you are sending to the contractor, complete a separate attestation for each date/document. The signature attestation statement is not applicable for missing signatures on orders for tests, e.g., tests not performed in your office. In this scenario, if the requisition is not personally signed by the physician, the document will not be sufficient to support the charges for the entity performing the test. Diagnostic Tests The physician billed CPT 36415 collection of venous blood by venipuncture. The CERT received documentation that did not include any orders for any laboratory testing that would require the performance of venipuncture on the billed date of service. The submitted documentation included laboratory reports for hemoglobin A1C and TSH. The CERT requested valid orders and documentation to support the medical necessity for the tests. The CERT received a “problem report phone note” signed and dated by the RN who ordered a TSH and hemoglobin A1C, but there was no signature by the ordering provider. The CERT also received an office visit note that supports medical necessity, a test form signed by an RN, and laboratory reports. The CERT did not receive valid signed and dated orders for the diagnostic tests to support billing the venipuncture. The physician billed CPT 80061 lipid panel and 83036 hemoglobin; glycosylated (A1C). The initial information received was missing a current/valid physician signed/dated order and progress notes to support the plan and necessity/reason for ordering the lipid panel and hemoglobin A1C. Upon request, the CERT received an invalid unsigned lab requisition, test results, a progress note that does not include an order for the billed tests, and a physician signature attestation statement for the date of service 4/21/2011, but the date the attestation statement was signed is missing. NCI Comments: Multiple problems are found in this example. The progress note did not include the exact tests to be performed and, even if this information had been documented, the fact that the attestation statement was not dated when it was signed would have made the documentation invalid for both the tests as well as billing the associated visit. Physician billed CPT 85025 blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count. The documentation submitted includes the physician’s order for CBC. The differential was not ordered. The physician submitted the lab results for CBC with differential. Because the order did not include the request for a differential WBC count, the documentation required changing codes from CPT 85025 to 85027 blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count). The physician was asked to refund the different in payment between the two (2) tests. Physician Billed 82947 glucose; quantitative, blood (except reagent strip) performed on 05/11/2011. The CERT received a note dated 05/04/2011 stating the beneficiary is in to follow-up on “...elevated Hgb A1C.” The 05/04/2011 note is electronically signed by the physician. The progress note for 05/11/2011 does not include the result of the glucose test. The CERT requested additional information and received duplicate original documentation, with the addition of blood glucose result and provider’s signature, without notation of a late entry or addendum. This is considered an alteration of a chart and a refund was requested. NCI Helpful Hints Per Medicare regulations, only the “treating physician” or “treating practitioner” (nurse practitioner, clinical nurse specialist or physician assistant) can request that a diagnostic test be performed for a beneficiary.
Fall 2013
HOOSIER D.O.
Page 12
§80.6.1 Chapter 15, Medicare Benefits Policy Manual states that a signed physician’s order is not required for clinical diagnostic tests paid on the basis of the clinical laboratory fee schedule, the physician fee schedule, or for physician pathology services. However, there must be clear documentation by the physician in the medical record (e.g. progress note) of his or her intent that the test be performed. To be considered for Medicare payment, all diagnostic services require a physician order or a progress note which includes the order and documentation supporting the medical necessity for ordering the test. Except for clinical diagnostic tests, an unsigned order or requisition will not be considered during a review. In addition, a signature attestation statement is not acceptable for unsigned orders/requisitions. Payment may not be made for diagnostic tests ordered by ancillary staff, e.g., RN, LPN, medical assistant. When progress notes are used to support intent for ordering diagnostic tests, the specific test(s) being ordered must be clearly documented. It is insufficient to document “will order labs.” Remember, when using the progress note as the order for tests (especially for tests performed in the office setting), if the progress note is unsigned, a signature attestation should be completed by the ordering provider and submitted with the records. WPS has noted lab ordering systems or forms often do not differentiate between a “CBC” and a “CBC w/Differential.” WPS encourages all physicians to review ordering systems and forms to determine if they specifically include both a CBC and a CBC with differential. If the intention is to order a CBC with differential, that distinction must be clearly noted on the order or payment will be adjusted. Recognizing the Meaning of “Standing Orders” http://www.wpsmedicare.com/j8macpartb/departments/cert/recognizing-standing-orders.shtml Medicare will consider payment for appropriately documented covered services that are reasonable and necessary for the beneficiary, given his/her clinical condition. Medical necessity is the driving force for the payment of any Medicare service. If a service is not medically necessary, it cannot be paid by Medicare. Providers need be cognizant of the various meanings represented by use of the term “standing orders.” Some understand this to mean recurring orders specific to the care of an individual patient, while others understand this as routine orders for services delivered to a population of patients. The following can help you understand the various uses of “standing orders.” Routine Orders Routine orders are orders for those services and treatments that are applied to patients who have the same or similar medical condition(s). These frequently called “routine, protocol or standing orders” are based on an assessment of the impact of a given condition in the population of patients with that condition (medical illness or injury) and are widely applied to those patients. Medicare defines any order(s) that does not specifically address an individual patient’s unique illness, injury or medical status, as not reasonable and necessary. As is required by law, Medicare does not accept such “standing orders” as supporting medical necessity for the individual patient. Services related to population-based or condition-based orders are not reimbursable. Recurring Orders For physician services, Medicare may reimburse “standing orders” that are specific to an individual patient’s treatment. For example: the standing order “Evaluate this patient’s decubitus ulcer on a daily basis for signs of infection i.e. drainage, odor, size and staging prior to changing dressing.” Reimbursement of tests or services provided under a standing order for a recurring or serial evaluation is subject to medical necessity review. All such orders must be written for a specific patient, and each instance of the test or service must be necessary. Each result must be reviewed with appropriate action taken by the treating physician, including any appropriate change in the frequency or duration of testing.
Fall 2013
HOOSIER D.O.
Page 13
Treatment Protocols Treatment protocols may be reimbursable since these protocols are individualized to each patient. For example, the use of chemotherapeutic drug protocols, that suggest drugs, dosage ranges, frequency and/or duration specifically ordered for an individual patient. Laboratory Orders In some circumstances, a “standing order” for a recurring lab test that is specific to the needs of an individual patient may be reimbursable. (See requirements below.) Preprinted orders are not covered by Medicare. However, preprinted or electronic lists of potential orders are permitted if the provider individually affirms, defines, or otherwise modifies each component as appropriate for an individual patient’s clinical circumstances. Standing orders for recurring diagnostic tests may be appropriate when all of the following conditions are met: Each ordered test must be appropriate and necessary for the individual patient’s clinical circumstances. • • • •
The frequency and number of repeated testing must not be greater than medically necessary. The diagnosis must be indicated for each test with sufficient clarity to permit accurate ICD-9-CM coding to the highest level of specificity. The treating physician must review each test’s result, making any indicated adjustments in frequency and number of repeated studies. All lab tests must be reviewed and documentation must support that the appropriate clinical action was taken.
Examples of appropriate, recurring diagnostic tests under Medicare include: • •
Repeat cardiac enzymes to rule out acute ischemia. Prothrombin times for a patient on chronic warfarin.
In relation to blood glucose monitoring, CMS has specific instructions in Change Request 5443. Medicare separately pays for a blood glucose test only when the service meets all of the conditions of payment for a test payable under the clinical laboratory fee schedule including that the test must be ordered by the physician who is treating the beneficiary and the physician must use the results in the management of the beneficiary’s specific medical condition. WPS regulation states that for payment to be made for a blood glucose test under Medicare Part B, a physician must certify that each test is medically necessary and that a standing order for many tests over a time period is not sufficient documentation. Payment for hospital and nursing facility glucose monitoring is encompassed under Medicare Part A and other payment methods. Standing Orders for Consultation Standing orders for consultations for Medicare beneficiaries admitted to a hospital, observation unit, or a nursing facility are not allowed. There must be medical necessity for any such consultation. Page Last Updated: Wednesday, 17-Apr-2013 15:24:52 CDT Documentation Timeliness http://www.wpsmedicare.com/j8macpartb/claims/submission/documentation-timelines.shtml Question: I am confused concerning the timeliness of my documentation in connection with the provider signature, submitting the claim to Medicare, and the timely filing rule. Can you provide more information?
Fall 2013
HOOSIER D.O.
Page 14
Answer: There are several provisions that may affect "timeliness" when talking about documentation. The first is that a provider may not submit a claim to Medicare until the documentation is completed. Until the practitioner completes the documentation for a service, including signature, the practitioner cannot submit the service to Medicare. Medicare states if the service was not documented, then it was not done. The second is that practitioners are expected to complete the documentation of services "during or as soon as practicable after it is provided in order to maintain an accurate medical record." This statement is from the Centers for Medicare & Medicare Services (CMS) Internet Only Manual (IOM) Publication 100-04, Chapter 12,Adobe Portable Document Format Section 30.6.1. CMS does not provide any specific period, but a reasonable expectation would be no more than a couple of days away from the service itself. In addition, CMS has a statement in the IOM Publication 100-08, Chapter 3,Adobe Portable Document Format Section 3.3.2.4 discussing the requirements for practitioner signature, "Providers should not add late signatures to the medical record, (beyond the short delay that occurs during the transcription process) The IOM Publication 100-08, Chapter 3Adobe Portable Document Format, Section 3.3.2.5 discussing late entries. A provider should never add a signature to a medical record after the times discussed above. If a practitioner does not affix a signature at the time of the service (also allowing limited delay due to transcription), then the provider may complete an attestation statement. CMS may, occasionally instruct the contractors differently than that stated here due to extenuating circumstances. WPS Medicare will publish information to this affect when we receive notification. The next time discussed is the timely filing limit. This does not apply to the medical record documentation but instead indicates that a practitioner has 1 year from the date of service to file the claim to Medicare. If Medicare does not receive the claim within that year, Medicare does not make payment and the patient is not liable. IS YOUR ADDRESS UP TO DATE? WPS requested we include the following information in this article. Recently SafeGuard Services, a CMS contractor, sent multiple Comparative Billing Reports (CBRs) to those providers across the country with the highest outlier billing for evaluation and management services (E/M). As of today, close to 20 percent have been returned as addresses invalid. WPS Medicare often mails important educational information, requests for medical record documentation and results of claim reviews to providers based on the address listed in their Medicare file. We have noted recent instances where our correspondence is returned as undeliverable because the address on file for the provider is no longer valid. This can result in unnecessary claim denials or missing out on important educational initiatives. We would like to remind providers that changes in practice location must be reported to Medicare within 30 days of the effective date of the change. Failure to comply with this requirement may result in revocation of the provider’s Medicare billing privileges. For more information on Reporting Changes of Information to Medicare, please refer to the article on our Provider Enrollment web page located here: http://www.wpsmedicare.com/j8macpartb/departments/enrollment/breportadd.shtml
Fall 2013
NHSC S2S LRP APPLICATION CYCLE NOW OPEN The National Health Service Corps (NHSC) would like to share some important information with various partners that interact with medical (M.D. and D.O.) students. The 2014 Students to Service (S2S) Loan Repayment Program (LRP) application cycle is now open. To be eligible for the S2S LRP, applicants must currently be enrolled as a full-time student in their last year of an eligible allopathic or osteopathic degree program at a fully accredited school, and planning to complete an accredited primary medical care residency in an NHSCapproved specialty (internal medicine, family practice, pediatrics, obstetrics/gynecology, psychiatry and geriatrics). In addition, applicants should be interested in working with underserved communities in high need areas throughout the U.S. or its Territories. The S2S LRP is expected to be competitive, and applicants are encouraged to begin the application process early. On average it takes approximately 3 weeks to
HOOSIER D.O.
Page 15
complete an application. While several documents will be required to submit a completed application, the NHSC encourages applicants planning to apply to begin obtaining the required loan verification and supplemental documentation, letters of recommendation and an official school transcript. The application and program guidance can be found on the NHSC website at nhsc.hrs.gov and contains all of the requirements and program details. If you any questions, please contact the Customer Care Center at (800) 221-9393, Monday - Friday, 8:00 a.m. to 8:00 p.m., ET (except federal holidays).
Doctors Who Listen Community Westview Hospital, which is a part of Community Health Network, is located at West 38th Street and North Guion Road on Indianapolis’ Westside. Community Westview Physicians is a network of 27 specialty and primary care physician practices owned and operated by the hospital. Community Westview is the state’s only osteopathic hospital. The practice of osteopathic medicine recognizes that the body is inherently capable of healing itself, and doctors of osteopathic medicine (D.O.s) encourage and facilitate this process. Community Westview Hospital offers patients a variety of treatment options to maintain a state of wellness while supporting a century-old osteopathic philosophy of care.
Terry Iwasko, D.O., with patient.
For more information on Community Westview Hospital visit us online at www.communitywestview.org or call (317) 920-VIEW (8439) for more information on our services.
Fall 2013
HOOSIER D.O.
Page 16
VINN INSTALLED AS PRESIDENT (continued from page 3)
is considered a leader in residentialist care, which focuses on the care of homebound or access-challenged patients. “Caring for those who are confined to their homes due to age, illness or other reasons involves analyzing clinical, psychosocial, nutritional and safety issues that factor into care options,” says Dr. Vinn. “Despite these challenges, there is nothing more rewarding than helping a patient receive the best possible quality of healthcare at a time when they are most in need of it.” Dr. Vinn is often recognized for his advocacy for seniors and homebound patients. In 2011, he received the Orange County Senior Care Humanitarian Award. He also was recognized at the 2008 South County Senior Services’ Captain’s Ball Gala. A fellow of the American College of Osteopathic Family Physicians (ACOFP), Dr. Vinn also was honored as Physician of the Year by the ACOFP of California in 2009. That same year he was honored with the Lifetime Achievement Award from the Osteopathic Physicians and Surgeons of California (OPSC). A longtime member of the AOA Board of Trustees, Dr. Vinn has served in many capacities including chair of the Department of Research, Quality and Public Health; chair of the Department of Educational Affairs; and chair of the Strategic Planning Committee. In addition to his involvement with the AOA, Dr. Vinn is a past president of the OPSC and a founding member of the American Osteopathic Association of Medical Informatics. After receiving his undergraduate degree from Tulane University in New Orleans, Dr. Vinn earned his osteopathic medical degree from the Philadelphia College of Osteopathic Medicine. He completed his postdoctoral medical training at what is now Botsford General Hospital in Farmington Hills, MI. He later attended the University of Southern California Marshall School of Business, where he obtained a master of business administration degree.
GROVE NAMED PRESIDENT Jeffrey S. Grove, D.O., FACOFP dist., of Largo, FL, was elected as president of the American College of Osteopathic Family Physicians (ACOFP) for 2013 – 2014 beginning with the March 2013 ACOFP Annual Convention & Exhibition in … Dr. Grove is a graduate of Florida Southern College and earned his osteopathic medical degree from the Nova Southeastern University College of Osteopathic Medicine (NSUCOM) in 1990. He served both his internship and residency at the Sun Coast Hospital in Largo, and then joined Suncoast Family Medical Associates, where he currently practices. Dr. Grove is board certified in family medicine with an added certification in geriatrics. Dr. Grove holds sub-specialty certifications from the American Board of Quality Assurance and Utilization Review Physicians in Case Management, Managed Care and Risk Management. He became a Fellow of the ACOFP in 2002. This honorary designation is bestowed upon those candidates who have contributed outstanding national and local service through teaching, authorship, research, or professional leadership. He is a Fellow of the American Institute for Healthcare Quality. He holds a Distinguished Fellow designation, which recognizes exceptional members of the Conclave of Fellows who have shown exemplary contributions to ACOFP governance and committees, as well as consistent attendance at state and national ACOFP meetings. Throughout his career, Dr. Grove has played an active leadership role in the ACOFP, serving as a member of the Board of Governors, Chair of the Florida Society Delegation to the ACOFP Congress of Delegates, Chair of the Marketing and Public Relations Committee, Chair of the Young Physicians Committee, and Vice Chair of the Membership Committee. In addition to his service with the ACOFP, Dr. Grove held the presidency of the Florida Society of ACOFP and was the 2011 - 2012 President of the Florida Osteopathic Medical Association. A dedicated educator, Dr. Grove is a Clinical Associate Professor in Family Medicine at NSUCOM and serves as Adjunct Clinical Associate Professor of Family Practice/Geriatrics at Lake Erie College of Osteopathic Medicine--Bradenton (LECOM--Bradenton). He holds an appointment as Clinical Instructor in Family Medicine at Kirksville College of Osteopathic Medicine. In addition, Dr. Grove serves as chair of the AOA Council on Continuing Medical Education.
Fall 2013
PRESIDENT’S MESSAGE
HOOSIER D.O.
Page 17
WMD UPDATE
(continued from page 1)
By: Colonel Charles A. Holt, D.O.
I am grateful to the many physician and advocate members who have made contributions to our various fundraising campaigns in support of the MUCOM. During orientation week for the students, the IOA sponsored a welcome luncheon. Thank you to the IOA members and leadership who were able to attend this fun event. On August 11, 2013, the IOA sponsored the white coat ceremony for the MUCOM inaugural class. We had great representation at this ceremony too. Following my induction during the president’s luncheon at our 116th Annual Convention, I declared this “IOA Year of the Student”. It was fitting that I was surrounded by my own mentors from past to present at the luncheon and was able to recognize and thank them. It is my hope that you, too, will take a moment to remember your mentors and what their time and encouragement meant to you and thank them personally. The ultimate thanks will be to return this support by mentoring a student. Our ongoing mentorship of and encouragement to our students in the coming years as they navigate the challenge of being an inaugural class is vital. Those of you who helped interview and select the incoming class know the caliber of students who were admitted. They are up for this challenge and have infectious enthusiasm for the osteopathic profession. I also was supported during my training as an out of state osteopathic medical student by the Motyka Dannin Osteopathic Educational Foundation as well as by the IOA’s leadership and active membership. This support had a huge impact on my ongoing and continued involvement in the IOA. We must provide this same support for both the MUCOM students and the Indiana students at other osteopathic medical schools in order that they will get involved in the IOA early and practice osteopathic medicine in Indiana following completion of their post graduate training. As we move through this unforgettable year in the history of medicine in Indiana, it is essential that we continue to strengthen our membership numbers and involvement in the IOA. Please feel free to contact me with any questions, concerns, or fantastic ideas on how we can make this year truly monumental!
Here are some highlights for the NOT faint at heart. Syphilis continues to be a growing problem in Indy—majority among homosexual men/half are HIV+/disproportionately in blacks/many had it before. Don’t do treponemal IgG in previously infected. Always get the four horsemen when doing STD testing: syphilis/HIV/chlamydia/gonorrhea. Shake and Bake methamphetamine method fiery explosions are leading to closure of burn units around the country d/t most have no insurance/require more and longer care ave. $130,000. Norovirus loves not only cruise ships but airplanes—thank goodness this GE usually “passes” in 3d—to infect another. Hand washing, folks, hand washing. Tornadoes and earthquakes bring to mind the need to have basements/safe rooms/storm cellars/gas water heaters and furnaces California code strapped/alternate family regrouping sites. Check out the CDC App—it is free and has endless info access providing “just in time” internet access. Drug-resistant bacteria kill 100,000 US hospital pts./Y and cost $20B. Two new viruses have been found and causing havoc: SFWTSV (severe fever with thrombocytopenia syndrome virus) in China and the Heartland Virus in Missouri (from tick bites). Mobile Apps are all the rage for emergencies, too. The Nat. Library of Medicine has a list of all of them. Get a car charger for your phone…in case the home power goes out. Want daily info: sign up at MESHintel@meshcoalition.org. Police want you to report ASAP any suspicious package, anywhere—one was recently blown up by local police d/t a threatening note attached to it. Again, neti pots for nasal rinsing can kill you if you don’t use sterile water—see CDC info on PAM (primary amebic meningoencephalitis)—99% fatal!!! Don’t get drunk and eat raw crawfish—some brilliant folks from my home state of Missouri (the birthplace of osteopathy) did this last year. They had the great honor to have lung flukes burrow into their intestines and through their diaphragms into their lungs! OMG! And now, for the martini party trivia to impress your friends with: the lung worms are called Paragonimus kellicotti and about the only thing to kill them with is praziquantel. The Indiana State DOH is looking for help: ESAR-VHP (Emergency System for Advance Registration of Volunteer Health Professionals) and Medical Reserve Corps are seeking volunteers. The CDC continues to investigate the epidural steroid injection-related fungal meningitis outbreaks from last year. Power outages continue to kill persons requiring electrical medical devices—patients must have backup plans coordinated with their utility companies and/or own generators. This brings up another hazard—CO poisoning. It accidentally kills almost 500/Y in the US, alone—most were from generators used in garages/basements. In the same vein— get your furnace/chimneys/flues inspected yearly—one bird nest in your pipe could do you in.
Angela B. Wagner, D.O. IOA President
Fall 2013
HOOSIER D.O.
Page 18
E-MAIL THINK BEFORE YOU HIT “SEND” Submitted By: ProAssurance
Although e-mail is a convenient way to correspond with patients and other physicians, e-mail privacy may be a myth. Despite potential risks, the reality is many physicians use e-mail and its use is predicted to increase. When e-mailing patients we suggest you: • Clarify that e-mail should not be used for urgent messages • Actively discourage use of e-mail as a substitute for a clinical examination • Instruct patients to use a category in the subject line, e.g. “prescription”, “appointment”, “billing question”, etc. • Require patients to respond in acknowledgement of messages containing medical advice; • Consider whether to permit discussion of highly sensitive topics • Include a notice stating the e-mail contains confidential informantion (intended only for the individual named in the address) • Ensure software is designed to send automatic responses indicating you have receive the patients’ messages • Never send e-mails to multiple recipients where the names of the other recipients are visible • Avoid mistaken identity by asking patients to include their full names and patient identification numbers in the body of the message • Watch the “tone” of e-mail messages. The impersonal nature of e-mail may exaggerate real or imagined sarcasm, animosity, etc. records. conduct.
Lastly, e-mail communication between physicians and patients should be included in the patients’ medical This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical Copyright © 2013 ProAssurance Corporation
ProAssurance is a national provider of medical professional liability insurance and risk management services. For more information on the company, visit proassurance.com.
Fall 2013
HOOSIER D.O.
FIGHT RX ABUSE - PLEASE VISIT WWW.IN.GOV/INSPECT
Page 19
Don’t turn a blind eye to prescription drug abuse
inspect@pla.in.gov
Get Registered Today!
Visit www.in.gov/inspect and click “Registration Information” for instructions
13 millions records collected annually Over 16,000 registered users Fulfilling over 6,000 reports daily 44% of eligible osteopathic physicians already registered INSPECT Program: 402 W. Washington Street, Room W072 Indianapolis Indiana 46204
Fall 2013
HOOSIER D.O.
Page 20
DEAN’S UPDATE
By: Paul Evans, D.O., FAAFP, FACOFP Vice President and Dean Marian University College of Osteopathic Medicine The dream has come true! The Marian University College of Osteopathic Medicine (MUCOM) is now operational. WE are now the first osteopathic medical school in our state’s history and only the second medical school in Indiana. Our first class of medical students has started the journey to become osteopathic physicians. It has been a long road and the Indiana Osteopathic Association (IOA) was invaluable in making this happen. The IOA steering committee started the long road a number of years ago, seeking Indiana colleges and universities that could and would have an interest in starting a new osteopathic medical school. After many inquiries and meetings, Marian University was selected and submitted a feasibility study to American Osteopathic Association’s Commission on Osteopathic College Accreditation (COCA). It has been three years since I arrived at Marian University to serve as founding dean of the MUCOM, and the changes have been many. I was the sole employee, and the only evidence of the developing school in September of 2010 was the feasibility study, some big piles of plans, and a big hole in the ground! We set about hiring our COM leadership team, working with our president and board of trustees to obtain financing of bonds and developing community support, and then inventing a brand new way of osteopathic education based on the Carnegie Report (2010) and the Fundamental Osteopathic Medical Competencies (2011) from the National Board of Osteopathic Medical Education (NBOME). The new curriculum stresses an integration of biomedical science knowledge learned through clinical cases, using systems based instruction that involves active learning and the strong influence of physician teachers, even in the first year. A planned emphasis on not just learning OMT but doing OMT is a cornerstone of our instruction. We received our provisional accreditation, and started recruiting our first class by visiting with regional premedical advisors to tell the Marian story. Our faculty is excellent and has a national caliber of talent. Many are award winning medical educators and researchers who strongly believe in our new educational model. Our student recruitment strategy was highly successful. We had 3,352 applicants, did 639 interviews with many community D.O.s and M.D.s assisting in our Multi Mini Interview process, and selected 162 bright new students. The class is 51/49 percent male to female, with 84% from Indiana. The average GPA and MCAT scores are about at the national average for first year osteopathic medical students. Eighty different universities and colleges
and three foreign countries (India, Azerbaijan, and Canada) are represented in the student body. 17% have a physician parent. All students will have planned clinical experiences in year 1. Our IOA mentors have helped this next generation of osteopathic physicians-to-be by supporting their white coat purchases and by serving as a reference point for questions about becoming an osteopathic physician. We are grateful for these mentors. Our students have had many positive experiences through their assistance. The students already have made an impact on the Marian community in their interactions with other students and faculty as well as our staff. They are now hard at work learning the important fundamental materials needed to start a clinical education experience. The attitude is very good! They are maintaining their enthusiasm as they work hard each day. The MUCOM clinical education network under the leadership of Charles E. Henley, D.O, M.P.H. has grown substantially, with 41 affiliated hospitals and over 9,000 teaching beds state-wide to date. Even more clinical sites are in development. Our clinical education team has organized clinical lectures for students from many community physicians, a real plus for students who learn from and have role models of actively practicing physicians. Bryan Larsen, Ph.D. our biomedical sciences dean has started up our research activities in newly renovated labs. He and our founding Ph.D. faculty are developing active collaborations with other universities and colleges in both teaching and in research activities. Our beautiful new home at the Michael A. Evans Center for Health Sciences offers high tech facilities in lecture halls, labs, seminar rooms, and simulation areas. These are shared by the COM and the School of Nursing. We are pleased that the new IOA office is located in our building as well. These relationships will foster sharing of our educational facilities for pre-doctoral, GME, and CME as well as hosting other educational activities at the MUCOM. Keep your eyes open for educational activities hosted here--we would love you to visit our wonderful new building! We anticipate many challenges. However, the new school will bring great opportunities for strengthening medical education generally and the osteopathic community specifically in Indiana. With your help we hope to build a strong foundation from which to provide exceptional osteopathic medical education and expand the presence of our new school and our graduates in Indiana in the years to come.
Fall 2013
IOA ELECTS NEW OFFICERS AND TRUSTEES At the Annual Meeting of Members, May 3, 2013, Angela B. Wagner, D.O., of Indianapolis, was elected president. Adrian L. Carter, D.O., of Evansville, was elected first vice president. Mark S. Cantieri, D.O., of Mishawaka, was elected second vice president. Terry A. Iwasko, D.O., of Indianapolis, was elected secretary. Patrick A. Woodman, D.O., of Indianapolis, was elected treasurer. Dr. Wagner succeeds Chris A. Lowery, D.O., of Indianapolis. Dr. Lowery remains on the Board of Trustees as immediate past president. Serving new three year terms as trustees are Mary Burden, D.O., of Indianapolis, and Stephanie M. Overmars, D.O., of Indianapolis. Dan C. Galloway, of Crown Point, and Susan M. Moore Riesbeck, D.O., of Granger, will serve new three year terms as delegates to the American Osteopathic Association (AOA) House of Delegates. Dr. Wagner will serve a new one year term as an alternate delegate.
ADVOCATES OFFICERS During the Advocates’ annual business meeting, Mike Coyle, of Cumberland, was elected president, for 2013 – 2014. Others elected were: Gloria Krejsa, of Lowell, vice president; Rebecca Brink, of Princeton, recording secretary; David Riesbeck, of Granger, treasurer, and Sharon Helman, of Granger, corresponding secretary.
AIOA NEWS Summer had ended, fall has begun, and plans for the 32nd Annual Winter Update to be held December 6 – 8, 2013, at the Hyatt Regency, in downtown Indianapolis, are in full swing. Although there are no Advocates activities at the annual winter updates, these are still opportunities for us to see and visit with one another. I am looking forward to this. At our Board of Trustees meeting in October, we will discuss plans next year’s annual convention and decide on scheduled morning and afternoon activities for spouses and guests of physicians. As always, I encourage all of you who are not members of the Advocates to the IOA (AIOA) to help us support and promote the osteopathic profession by joining. Please contact Debbie Coyle at the IOA office to receive an application, or download an application at www.inosteo.org by clicking on Advocates to the IOA under the Related Organizations tab.
Mike Coyle AIOA President
HOOSIER D.O.
Page 21
DR. WAGNER APPOINTS 2013 – 2014 COMMITTEES Legislative Committee Rachel Shockley, D.O.,Chair Mark Cantieri, D.O. Adrian Carter, D.O. Patrick Woodman, D.O. Public Health/Hospitals Committee Ben Huang, D.O., Chair Thurman Alvey, D.O. Joshua Dawalt, D.O. Heather Richardson, D.O. David Williams, D.O. Public Relations/Publications Committee Adrian Carter, D.O., Chair Mary Burden, D.O. Paul Evans, D.O. Mark Schmeltz, D.O. Membership Committee Arnold del Pilar, Jr., D.O., Chair Mary Burden, D.O. David Coil, D.O. Dan Galloway, D.O. Terry Iwasko, D.O. David Koronkiewicz, D.O. Medical Economics Committee Terry Iwasko, D.O., Chair Thurman Alvey, D.O. Allan Arkush, D.O. Claude E. Foreit, D.O. Organizational Affairs Committee Susan Moore Riesbeck, D.O., Chair David Coil, D.O. Paul Evans, D.O. Dan Galloway, D.O. Douglas Rex, D.O. Peer Review Committee David Koronkiewicz, D.O., Chair Allan Arkush, D.O. Thomas Akre, D.O. Brian Black, D.O. Mark Cantieri, D.O. Max Helman, D.O. Continuing Medical Education Committee Bruce Brink, Jr., D.O., Chair, Annual Winter Update Gaston Dana, D.O., Chair, Annual Convention Brian Black D.O. Mary Burden, D.O. David Coil, D.O. Charles Henley, D.O. Eugene Justus, D.O. Chris Lowery, D.O. Stephanie Overmars, D.O. Scott Nall, D.O. Lisa Richter, D.O. Motyka Dannin Osteopathic Educational Foundation Committee Brian Black, D.O., Chair Thurman Alvey, D.O. Joshua Dawalt, D.O. Ben Huang, D.O. Angela Wagner, D.O. Students, Interns, and Residents Committee Errin Weisman, D.O., Chair Stephanie Overmars, D.O. Angela Wagner, D.O.
Fall 2013
HOOSIER D.O.
Page 22
REMEMBER THE
MOTYKA DANNIN FOUNDATION
IOA (in memory of Sungshik An, D.O., Donald E. Kotoske, D.O., John E. Mann, D.O., Myrna D. Trowbridge, D.O.) David Riesbeck and Susan M. More Riesbeck, D.O. (in memory of Lois Brink) J. David Spencer, D.O.
As you make your charitable giving plans, think about how you can help Indiana students in colleges of osteopathic medicine. Ask your tax advisor how you can reduce your taxes while giving to the Motyka Dannin Foundation.
ESTATE PLANNING , TOO We also remind you, when you write or revise your will, to remember the Motyka Dannin Foundation. After you have provided for your loved ones, church, alma mater, and favorite charities, perform one last generous act for the future of your profession. Telephone: 317/926-3009 or 800/942-0501 Motyka Dannin Osteopathic Educational Foundation a 501(c)(3) charitable organization
MOTYKA DANNIN FOUNDATION CONTRIBUTORS Advocates to the IOA Mike and Sue Claphan (in memory of Lois Brink) Brandy Dickenson (in memory of Glenn O. Dickenson, D.O. and Lois Brink, and in honor of Richard N. Halstead, D.O. and Jerry L. Like, D.O.) Franciscan St. Anthony Health Christine and Dan C. Galloway, D.O. (in memory of Lois Brink)
On behalf of the future osteopathic physicians who will be helped by your generosity, thank you for your gifts to the Motyka Dannin Osteopathic Educational Foundation, Inc. (Motyka Dannin Foundation). For additional information regarding the Motyka Dannin Foundatoon, contact Erin Wernert, Executive Director, at the IOA office. Contributions can be sent to the Motyka Dannin Foundation, 3200 Cold Spring Road, Evans Center, Suite 107, Indianapolis, IN 46222.
MOTYKA DANNIN FOUNDATION FORGIVABLE LOANS The Advocates to the IOA (AIOA) has established the Motyka Dannin Osteopathic Educational Foundation, Inc. (Motyka Dannin Foundation) to generate funds for loans to Indiana students in osteopathic medical schools accredited by the AOA. These loans are to be forgiven if the student practices in Indiana following completion of his or her training. Details are in the actual loan agreement. For 2013-2014, the Motyka Dannin Foundation intends to award forgivable loans to Indiana students who are in the FIRST or SECOND years of study at one of the 29 osteopathic medical schools with 37 locations. Please note the following eligibility requirements. An applicant must: 1. be an Indiana resident; 2. be a first or second year student in an osteopathic medical school accredited by the AOA; 3. demonstrate an intent to return to Indiana to practice osteopathic medicine; 4. demonstrate financial need; 5. be of good moral character; 6. demonstrate good motivation toward the practice of osteopathic medicine; and 7. be available for a personal interview, if requested, by the Motyka Dannin Foundation. To receive an application, students may call (800) 942-0501 or send an e-mail message to info@insteo.org. The Motyka Dannin Foundation will forward the necessary forms. The deadline for submitting applications is December 31, 2013.
Fall 2013
COMING EVENTS... OMED September 30 – October 4, 2013 40 hours category 1-A credit anticipated, pending approval by AOA CCME Mandalay Bay, Las Vegas, NV Sponsor: American Osteopathic Association Contact: AOA, (312) 202-8014 or www.osteopathic.org Fall Conference: “Practice Transformation & Physician Leadership Skills for the New Healthcare Environment” November 2, 2013 Sheraton Hotel at Keystone Crossing, Indianapolis, IN Sponsor: Indiana Academy of Family Physicians Contact: IAFP, (317) 237-4237 or www.in-afp.org Preconference OMT Workshop: “Counterstrain to the Lower Half of the Body” December 5, 2013 8 hours category 1-A credit anticipated, pending approval by AOA CCME Hyatt Regency Downtown, Indianapolis, IN Sponsor: Indiana Academy of Osteopathy Contact: IAO, (317) 926-3009 or (800) 942-0501 or www.inosteo.org 32nd Annual Winter Update December 6 - 8, 2013 25 hours category 1-A credit anticipated, pending approval by AOA CCME Hyatt Regency Downtown, Indianapolis, IN Sponsor: Indiana Osteopathic Association Contact: IOA, (317) 926-3009 or (800) 942-0501 or www.inosteo.org Introductory Course: “Osteopathy in the Cranial Field” February 15 – 19, 2014 40 hours category 1-A credit anticipated, pending approval by AOA CCME Holiday Inn, Lake Buena Vista, FL Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com “Key Elements in Effective Osteopathic Practice” February 21 – 23, 2014 Holiday Inn, Lake Buena Vista, FL Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com Annual Convention March 13 – 16, 2014 Marriott Downtown, Philadelphia, PA Sponsor: American College of Osteopathy Family Physicians Contact: ACOFP, (800) 323-0794 or www.acofp.org Annual Convocation March 15 – 23, 2014 The Broadmoor, Colorado Springs, CO Sponsor: American Academy of Osteopathy Contact: AAO, (317) 879-1881 or www.academyofosteopathy.org
HOOSIER D.O.
MARK YOUR CALENDARS
NOW AND PLAN TO ATTEND THE IOA 32ND ANNUAL WINTER UPDATE DECEMBER 6 - 8, 2013 HYATT REGENCY DOWNTOWN INDIANAPOLIS, IN
Opportunities in Medicine in Indiana Search for the right job or let employers find you. OMI connects DO’s directly with Indiana employers: not headhunters or third-parties.
• Quick, easy registration • Find Indiana employers • 100% confidential • No advertising or recruiting firms
“Orthopedic Neurology” April 10 – 13, 2014 Holiday Inn, Lake Buena Vista, FL Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com Introductory Course: “Osteopathy in the Cranial Field” June 14 – 18, 2014 40 hours category 1-A credit anticipated, pending approval by AOA CCME Sheraton City Centre, Indianapolis, IN Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com Annual Conference: “Beyond Sutherland’s Minnow—Anatomy, Perception and Treatment” June 19 – 22, 2014 Sheraton City Centre, Indianapolis, IN Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com
Page 23
OMIonline.org | 800-479-1666
Fall 2013
HOOSIER D.O.
HOOSIER 2012 - 2013 OFFICERS Angela B. Wagner, D.O. President Adrian L. Carter, D.O. First Vice President Mark S. Cantieri, D.O. Second Vice President Terry A. Iwasko, D.O. Secretary Patrick J. Woodman, D.O. Treasurer Chris A. Lowery, D.O. Immediate Past President TRUSTEES Brian H. Black, D.O. Mary Burden, D.O. Gaston Dana, D.O. Steven J. DeLee, D.O. Laura L. Helman, D.O. Stephanie M. Overmars, D.O. VICE PRESIDENTS DISTRICT CHAIRS Terry A. Iwasko, D.O., District I Steven J. DeLee, D.O., District II Zachry L. Waterson, D.O., District III Laura L. Helman, D.O., District IV Bruce C. Brink, Jr., D.O., District V Dan C. Galloway, D.O., District VI A.O.A. DELEGATES Mark S. Cantieri, D.O. David L. Coil, D.O. Dan C. Galloway, D.O. Max E. Helman, D.O. David C. Koronkiewicz, D.O. Susan M. Moore Riesbeck, D.O. A.O.A. ALTERNATE DELEGATES Thurman V. Alvey, III, D.O. Ben D. Huang, D.O. Angela B. Wagner, D.O. The Hoosier D.O. is published four times per year in the Winter, Spring, Summer, and Fall by the Indiana Association of Osteopathic Physicians and Surgeons, Inc. dba Indiana Osteopathic Association. Editor: Deborah E. Coyle, CPS IOA Staff: Erin L. Wernert, Executive Director Deborah E. Coyle, Manager of CME Programs and Office Manager The IOA Office is located at: 3200 Cold Spring Road Evans Center, Suite 107 Indianapolis, IN 46222 (317)926-3009 or (800) 942-0501 www.inosteo.org
Page 24
PRACTICE OPPORTUNITIES AVAILABLE IN INDIANA IOA Serves as an Informal Clearinghouse for physicians seeking practice locations. CENTRAL INDIANA. Hensler Weight Loss Services, Inc. in Anderson has an immediate opening for a physician 2 days a week. The weight loss clinic has been in business for 28 years. The practice has a well-established patient base with an experienced well-trained staff and an in house lab. Please visit our website at www.weightlossindiana.com. For more information, contact Judy at (765) 6443626 or judyhensler@gmail.com. FREELANDVILLE INDIANA. The small rural community of Freelandville misses its retired physician and is hoping a new one will come to town. If interested in a solo practice, contact Erin Wernert or Debbie Coyle, IOA, at (800) 942-0501 or (317) 9263009. INDIANAPOLIS PHYSICIAN AVAILABLE FOR FAMILY PRACTICE, OCCUPATIONAL MEDICINE, OR URGENT CARE. Certified in family practice in 1999. For additional information, contact Erin Wernert or Debbie Coyle, IOA, at (800) 942-0501 or (317) 926-3009. NORTHERN INDIANA. Mishawaka Osteopathic Clinic has an immediate opening for a physician to come into the practice. We have a well-established and large patient base. Our experienced, loyal, and well-trained staff attracts many new patients. Currently, we have one full time and one part time D.O., an R.N., multiple medical assistants, fully staffed front office and medical records. Our Clinic has 11 exam rooms, including an office surgery/procedure room, PAP room, conference/lunch room and a large comfortable waiting room. We are a fast paced and patient friendly practice caring for families since 1969. Come join our team of patient care professionals who feel that “our patients matter.” For more information, please contact Mary Behrle, RN Staff Coordinator at (574) 323-3812 or e-mail inquiries along with your CV to mocnurse@yahoo.com. OPPORTUNITY IN INDIANAPOLIS. Community Westview Hospital’s Department of Emergency Medicine is seeking an emergency medicine board certified or eligible physician with good interpersonal skills to work in a lower volume but occasionally high acuity emergency department (ED) in Indianapolis. Volume is less than 10,000 but pay is extremely competitive with other Indianapolis EDs. Work in a collegial environment with other ED board certified or eligible physicians with an excellent hospitalist group and great specialty support as well as superb administrative support. There are some teaching opportunities with our family practice and podiatry residents as well as with medical students. For more details, please contact Ben Huang, D.O., MPH, FACOEP at benhuangdo@gmail.com or call/text (317) 698-1942. SOUTHERN INDIANA. Brink’s Family Practice in Princeton has an immediate opening for a physician to come into the practice. The practice has a well-established patient base with experienced, well-trained staff and an in-house lab. The practice is located in a growing community that still possesses small town friendliness and has access to large city amenities. For more information, please e-mail inquiries along with your CV to B.brinkdo@insightbb.com or contact Erin Wernert or Debbie Coyle, IOA, at (800) 942-0501 or (317) 926-3009.