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50 Volume 54

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Winter 2015

Published by The Indiana Association of Osteopathic Physicians and Surgeons, Inc.

Greetings. I am hopeful you had an enjoyable holiday season.

I pray you have a prosperous and healthy new year.

I am sure you have seen the news that the Obama Administration approved Indiana’s Healthy Indiana Plan (HIP) 2.0. As of February 1, 2015, HIP 2.0 Adrian L. Carter, D.O. will provide access to IOA President healthcare for 350,000 uninsured Indiana citizens by giving them the ability to contribute and take charge of their health and health plans. This is good news for providers as well. HIP 2.0 will reimburse physicians at Medicare rates, making it affordable to treat those needing care the most. For further information, please visit the websites referenced in the Family and Social Services Administration (FSSA) press released published later in the Hoosier D.O. In December, Erin Wernert and I met with the Medicaid Director at FSSA, Joe Mosier, to discuss osteopathic manipulative medicine (OMM) codes not being reimbursed under HIP 1.0 or 2.0. We had a productive conversation, and educated FSSA on the benefits of OMM and how it improves the health of our patients. In January, Mr. Moser toured the Marian University College of Osteopathic Medicine (MUCOM) to watch our students in action during OMM class. In early February, we learned our OMM CPT codes were accepted and will now be reimbursed under HIP 2.0. Thank you to Mr. Mosier and FSSA for their speedy response and being open to this beneficial treatment unique to osteopathic medicine.

As you are aware, I attended the Indiana State Medical Association (ISMA) House of Delegates (HOD) meeting last July. I am hoping to meet with ISMA leadership and staff to discuss the Indiana Osteopathic Association (IOA) gaining voting (continued on page 12)

PRESIDENT’S MESSAGE

HIP 2.0 COVERING OMM

As of February 1, 2015, OMM CPT codes will be reimbursed under HIP 2.0. Thank you to those physicians who communicated this problem to FSSA on behalf of the IOA. FSSA, the state government agency responsible for administering Medicaid and HIP was quick to respond and rectify this problem.

INDIANA WINS APPROVAL OF PLAN TO COVER UNINSURED GOVERNOR PENCE PRAISES HEALTHY INDIANA PLAN AS “PROVEN MODEL FOR MEDICAID REFORM.” On January 28, 2015, the State of Indiana received approval from the federal government to use an updated version of the consumer-driven Healthy Indiana Plan known as HIP 2.0 instead of Medicaid to offer access to quality health care to (continued on page 3) IN THIS THIS ISSUE IN ISSUE Member Concerns……………………………………..…3 33rd Annual Winter Update…………………………...….4 Tips From Our Consultant……………..………………..5 WMD Update……..………….…………..………….…..10 AIOA News……………….……………………….…….12 Dean’s Update…………………………………………..13 OMF Financial Assistance…………………………….14 Coming Events………………………………………….15 Practice Opportunities………………………………….16

Winter 2015 Fall 2014

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IN MEMORIAM The IOA has learned that member of the AIOA, Jane Eichorst, of South Bend, died on September 18, 2013.

Memorial contributions may be made to the Motyka Dannin Foundation.

INDIANA WINS APPROVAL OF PLAN TO COVER UNINSURED (continued from page 1)

350,000 uninsured Hoosiers. The Family and Social Services Administration (FSSA) began taking applications immediately and coverage began on February 1. “Since the beginning of my administration, we have worked hard to ensure that low-income Hoosiers have access to a health care plan that empowers them to take charge of their health and prepares them to move to private insurance as they improve their lives.” said Governor Pence. This has been long process, but real reform takes work.” HIP 2.0 participants are required to contribute to a POWER account, which they manage like a health savings account and are rewarded for using preventive care.

Consequences for non-payment range from mandatory copays for services to loss of coverage. In addition, the plan includes a co-pay for emergency room use, designed to encourage appropriate use of the emergency room. The plan also offers low-income Hoosiers an option to receive assistance in purchasing private-market insurance through their employers, called HIP Link. The use of a health savings account as part of a premium assistance program is the first of its kind in the nation. The plan also refers applicants to job training and job search programs offered by the State of Indiana. With this approval, Indiana will end traditional Medicaid for all non-disabled Hoosiers between 19 and 64 and will continue to offer the first-ever consumer-driven health care plan for a low-income population.

In addition, the State will reform its traditional Medicaid program by increasing reimbursement for healthcare providers, which will improve access to care. The State negotiated the rate increase as part of its agreement with the Indiana Hospitals Association, which will help fund the Healthy Indiana Plan so it can be offered at no additional cost to taxpayers. “The expanded and updated HIP 2.0 is based on a program that has been serving 60,000 low-income Hoosiers in our state for seven years,” said Governor Pence. “It is a proven model for Medicaid reform across the nation.”

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For information on how to enroll in the Healthy Indiana Plan, visit www.HIP.IN.gov or call 1-877GETHIP-9.

Questions can be emailed to HIP2.0@fssa.in.gov.

Other bulletins and news items for Indiana Health Coverage Programs providers can be found at http://provider.indianamedicaid.com. To download a HIP communications kit, go to http://in.gov/fssa/hip/2472.htm.

EARN CME ONLINE Not able to attend the IOA's 33rd Annual Winter Update held December 5 - 7, 2014, at the Hyatt Regency, in downtown Indianapolis? Lectures were recorded and 15 hours of category 1-B CME credit have been posted on our website. If you are in need of credits, please visit www.inosteo.org and click on CME Online under the Continuing Medical Education tab.

MEMBER CONCERNS REMEMBER IN PRAYER John P. Eichorst, D.O., of South Bend, on the death of his wife, Jane, on September 18, 2013.

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33RD ANNUAL WINTER UPDATE The Continuing Medical Education (CME) Committee once again built on previous success by assembling a well-received and well-attended program.

On Friday through Sunday, 223 physicians attended the 25 hour category 1-A CME program. On Thursday, the Indiana Academy of Osteopathy provided a highly successful optional pre-conference OMT workshop. 22 physicians attended this 8 hour category 1-A CME program.

Without exhibitors, grantors, and other in kind supporters, the CME Committee would not be able to offer the variety and quality of topics they do. 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.

EXHIBITORS AbbVie Amgen Astra Zeneca Boston Heart Diagnostics Butler University CardioDx Cepheid Eli Lilly Elite Seat Genova Diagnostics Indiana Air National Guard Indiana Professional Licensing Agency Indiana State Department of Health Janssen Marian University College of Osteopathic Medicine Merck Miller Care Group Novo Nordisk Otsuka Plews Shadley Racher & Braun Precision Compounding Pharmacy ProAssurance Purdue Pharma Ranac Sanofi-Aventis Suburban Health Organization Takeda Union Springs US Army Valeritas Vivus

GRANTORS Osteopathic Medical Foundation of Michiana The France Foundation IN KIND SUPPORTERS American College of Osteopathic Family Physicians Boston Heart Diagnostics Hall Render Killian Heath & Lyman Indiana Family and Social Services Administration Indiana State Department of Health Marian University College of Osteopathic Medicine Midwest AIDS Training + Education Center Newby Consulting Plews Shadley Racher & Braun The Doctors Company VEI/Indianapolis Medical Management

SPECIAL RECOGNITION OF INDUSTRY SUPPORTER The IOA has recognized one company for outstanding support of the 33rd Annual Winter Update.

This company played a significant role in making this year’s program a success. This company is: The France Foundation The CME Committee and the Board of Trustees of the IOA recommend that you express special thanks to this company. The France Foundation’s help, along with that of other grantors, in kind supporters, and exhibitors allows our association to offer excellent CME programs yet keep the cost to you as practicing physicians as low as possible.

Winter 2015

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TIPS FROM OUR CONSULTANT By: Joy Newby, LPN, CPC, PCS Newby Consulting

In the CY 2015 Final Rule, the Centers for Medicare & Medicaid Services (CMS) again acknowledged its support for primary care physicians and other qualified healthcare professionals.

As we [CMS] discussed in the CY 2013 PFS final rule with comment period, we [CMS] are committed to supporting primary care and we [CMS] have increasingly recognized care management as one of the critical components of primary care that contributes to better health for individuals and reduced expenditure growth (77 FR 68978).

Effective with dates of service 1/1/2015, Medicare began paying for Chronic Care Management Services (CCM).

Based on how long it took CMS to develop educational materials explaining Transitional Care Management (TCM) Services, NCI believes it will be several months before CMS issues a transmittal detailing all the coverage and coding requirements for CCM. Recognizing that not all physicians monitor the Federal Register and/or read the entire (or even portions of) Medicare Final Rule that details the changes for the following year, we decided to write this article to provide some of the highpoints about coverage for CCM. Information in this article has been researched and checked for validity, accuracy, and completeness based on the information available. Newby Consulting Inc. (NCI) uses reasonable efforts to provide accurate and up-to-date information; however, NCI accepts no responsibility or liability with regard to errors, omissions, misuse, or misinterpretations in the content of this article. NCI does not make any warranties or representations as to the accuracy or completeness of such information. The User's use thereof shall constitute an agreement by the User to release NCI and its employees from any liability for the content of this article, or for the consequences of any actions taken on the basis of the information provided.

The information included in this article should not be construed as an official source that includes all the details and criteria for reporting CCM services. This article is based on the following three (3) references: •

• •

Federal Register 11/13/2014 – Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015 Final Rule Federal Register 12/10/2013 – Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014 – Final Rule American Medical Association’s CPT and RBRVS 2015 Annual Symposium – 11/19/2014 – Presentation

by Kathy Bryant, Director, Division of Practitioner Services, CMS

Physicians participating in one of the following CMS models/demonstration programs cannot bill CCM services for Medicare beneficiaries participating in the program; however, when appropriate, the practice can bill CCM services provided to Medicare beneficiaries who chose not to participate in the program.

• •

Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration Comprehensive Primary Care (CPC).

We believe it is important to note that although there are two sets of codes for chronic care management in CPT® 2015, Medicare will only reimburse CCM services reported with CPT code 99490.

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Chronic Care Management Services 99490 Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following elements:  multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient;  chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline;  comprehensive care plan established, implemented, revised, or monitored  Chronic care management services of less than 20 minutes duration, in a calendar month, are not reported separately Complex Chronic Care Management Services – Bundled by Medicare 99487 Complex chronic care management services, with the following requirements:  multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient;  chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline;  establishment or significant revision of a comprehensive care plan  moderate or high complexity medical decision making;  60 minutes of clinical staff time directed by a physician or other qualified health care professional per calendar month  Complex chronic care management services of less than 60 minutes duration, in a calendar month, are not separately reported 99489 each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure [99487] Do not report 99489 for care management services of less than 30 minutes additional to the first 60 minutes of complex chronic care management services during a calendar month month.

CPT coding notes clearly state that providers cannot report both TCM and CCM for the same calendar “If care management resumes after a discharge during a new month, start a new period or report transitional care management. If discharge occurs in the same month, continue the reporting period or report TCM.” The CY 2015 Final Rule includes: We [CMS] believe that the new CPT code 99490 appropriately describes CCM services for Medicare beneficiaries.

At this time, we [CMS] believe that Medicare beneficiaries with two or more chronic conditions as defined under the CCM code can benefit from care management and want to make this service available to all such beneficiaries.

Like all services, we [CMS] recognize that some beneficiaries will need more services and some less, and thus we [CMS] pay based upon the typical service. However all scope of service elements apply for delivery of CCM services to any eligible Medicare beneficiary. We [CMS] will evaluate the utilization of this service to evaluate what types of beneficiaries receive the service described by this CPT code, what types of practitioners are reporting it, and consider any changes in payment that may be warranted in the coming years.

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We [CMS] are maintaining the status indicator “B” (Bundled) for CY 2015 for the complex care coordination codes, CPT codes 99487 and 99489.

Based on the above information, which Ms. Bryant confirmed during the CPT Symposium, the appropriate code for reporting CCM to Medicare is 99490.

Reporting 99487 with or without 99489 will result in the charges being denied as bundled even if no other services are reported on the same date of service.

As with all bundled services, physicians cannot execute a Medicare Advance Beneficiary Notice of Noncoverage (ABN) and bill the codes for the more intensive Complex Chronic Care Management Services and hold the patient financially responsible for the charge for the complex CCM service.

We appreciated Ms. Bryant’s clarification that CCM is not a “per beneficiary/per month payment.” This type of payment typically means the physician automatically receives the payment regardless of whether services were provided during the calendar month. The difference with CCM is that physicians/ other qualified healthcare professional must bill CCM using 99490 when the practice meets CCM billing requirements.

Thus, when CCM criteria are met for a given month, the practice must report CPT code 99490. The 2015 Indiana Medicare Fee Schedule for 99490 for dates of service 1/1/2015 through 3/31/2015 is $40.70!

Ms. Bryant explained that when the criteria for reporting 99490 is met (at least 20 minutes of clinical staff time during the calendar month), the CCM code should be reported using the last day of the calendar month as the date of service, regardless of whether that date falls on a weekend or holiday.

Ms. Bryant presented a synopsis of the requirements for reporting 99490 • • • • •

•

Beneficiary must have two (2) or more chronic problems Based on clinical staff time – must be at least 20 minutes or more per calendar month Not a per beneficiary / per month payment Coinsurance applies In order to bill  Practitioner must inform beneficiary  Obtain written agreement  Must provide beneficiary a copy of the plan of care  Only one practitioner can bill CCM – Elements of scope of service  The practice must be able to demonstrate the use of written protocols by staff participating in the furnishing of CCM services that describe:  The methods and expected ‘‘norms’’ for furnishing each component of chronic care management services furnished by the practice.  The strategies for systematically furnishing health risk assessments to identify all beneficiaries eligible and who may be willing to participate in the chronic care management services.  Guidelines for communicating common and anticipated clinical and non-clinical issues to beneficiaries  The procedures for informing eligible beneficiaries about chronic care management services and obtaining their consent  The steps for monitoring the medical, functional and social needs of all beneficiaries receiving chronic care management services  System based approaches to ensure timely furnishing of all recommended preventive care services to beneficiaries  CMS recommends, but does not require, the provider to perform the Welcome to Medicare Visit and/or the Annual Wellness Visits

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

Contacting beneficiaries post-discharge from an emergency department or other institutional health care setting, to assist beneficiaries with follow up visits with clinical and other suppliers or providers, and in managing any changes in their medications.  A systematic approach to communicate and electronically exchange clinical information with and coordinate care among all service providers involved in the ongoing care of a beneficiary receiving chronic care management services.  A systematic approach for linking the practice and a beneficiary receiving chronic care management services with long-term services and supports including home and community-based services.  A systematic approach to the care management of vulnerable beneficiary populations such as racial and ethnic minorities and people with disabilities.  Patient education to assist the beneficiary to self-manage a chronic condition that is considered one of his/her chronic conditions.  These protocols must be reviewed and updated as is appropriate based on the best available clinical information at least annually.

Patient access, 24 hours a day, 7 days a week Continuity of care with specified member of team Care management for chronic conditions Management of transitions, including referrals Coordination with home and community based clinical service providers required to support a patient’s psychosocial needs & functional deficits Enhanced opportunities for patient communicate, including through secure messaging, Internet, etc.



     

•

Use EHR [electronic health record] that is acceptable for the EHR Incentive Programs as of December 31st prior to each PFS [Physician Fee Schedule] payment year NCI Comments: Ms. Bryant verbally explained that this means the practice must be using a certified EHR meeting meaningful use criteria for the previous year. For example, if your practice adopted a certified EHR and attested for the incentive payment in 2013, on December 31, 2014, Stage 1 meaningful use criteria were applicable. Thus, for 2015 CCM services, you must be using a certified EHR that meets Stage 1 Meaningful Use. If you adopted and attested for the incentive payment in 2011, on December 31, 2014, Stage 2 meaningful use criteria were applicable. For 2015 CCM services, you must be using a certified EHR and meeting Meaningful Use Stage 2 requirements. Ms. Bryant explained if the physician met and applied for the very narrow EHR Stage 2 Hardship Exception and Stage 1 requirements were applicable on December 31, 2014, the exception is sufficient for CCM services during 2015.

Record certain core portions of the patient's medical record (demographics, problem list, medications and medication allergies and creation of clinical summaries informing care transitions).

Document informed patient consent, provision of the care plan to patient, and communication with home and community based providers.

One exception, for CY 2015, the practice can use any electronic tool (other than fax) to create the care plan; make the care plan available 24/7 within the billing practice; share the care plan with other providers; and transmit clinical summaries in managing care transitions

•

CMS will allow “incident to” billing for CCM with “general supervision” when services are performed by clinical staff  Due to the requirement of 24/7 patient access, CMS created a narrow exception to the direct supervision requirement

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Also applies to non-face-to-face for TCM All other incident to regulations apply Reference CRT 410.26

Payment for CCM does not include a face-to-face component. Physicians will separately report any evaluation and management (E/M) services using the appropriate level of care code to describe any face-to-face encounter that occurs during the calendar month. ‘ Caveat: You cannot count the clinical staff’s time related to the face-to-face E/M when determining whether at least 20 minutes of CCM was provided to the Medicare beneficiary.

We realize this is a very brief overview of CCM services, but hopefully it will begin your process for meeting the criteria for reporting CCM. **CPT codes and two-digit modifiers are copyright 2014, American Medical Association

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Winter 2015

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WMD UPDATE

By: Colonel Charles A. Holt, D.O. This year the Los Angeles Times had an article, carried in the Stars and Stripes, about the (now 3Y) Syrian Civil War and its effluent of death/destruction/disease. It has laid to waste schools/homes/clinics/hospitals/food/ medicines/utilities/immunizations and now polio is back with a vengeance, crippling children there for the first time in 14Y. OMG (oh, my gosh) will the evil in this world never end.

The AP reported that on 14 DEC 2013 that more than a dozen polio vaccination workers/security police for them had been in killed in Afghanistan. Why? Despite Afghanistan & Pakistan being endemic for polio, militants target the polio workers, labeling them spies and telling parents that the vaccine will sterilize Muslims.

Aside from man-made disasters, a new estimate of yearly worldwide Natural disaster costs...$2B! That could buy a lot of sushi! Pharmaceutical shortages continue--last year the FDA recommended NOT disposing of expired auto-injectors of antidotes for organophosphate poisonings (from chemical weapons or insecticides). Constant REtriage/UTD algorithms/training are key in MASCALs, as are 'disaster' electronic order entry sets for PLX (pharmacy/lab/XRAY).

The stat of NY has rolled out e-FINDS to expedite tracking of hospital/nursing home potential evacuees for the next disaster--Hurricane Sandy showed the previous system inadequate. 38 States have OK'd emergency powers acts for non-profit/for-profit corporations.

Are you good at synonyms? Try these. Then, try to think of what disease they are referring to...the answer is somewhere in my notes. Aleppo boil. Jericho buttons.

Oriental sore. Pian bois. Biskra button. Uta. Lahore sore. Chiclero. Baghdad boil. Delhi boil. Kandahar sore.

Have you heard about the new "game" consisting of vandalizing security cameras worldwide? It is part of the growing distrust of increasing government surveillance. The name of the game is 'CamOver.' You will be hearing a lot more if it continues to grow.

3M Central venous catheters are inserted QY. 23,000 Infections result. What to do? Read the new Joint Commission's prevention toolkit.

Newspapers report that the VA sponsored a study that shows increased risk of PTSD in TBI vets from Iraq & Afghanistan. Other reported links to TBI are issues with suicide/weight control/libido. Guess what? Government contractors to the military, in the recent war zones, get similar rates of PTSD/depression/alcohol abuse. Most are veterans, themselves, and in some places outnumbered the troops.

And you thought flu vaccine allergies were due to egg allergies...whoa!, hold your marshmallows and Gummi-Bears. It appears, according to some researchers, that the #1 cause is gelatin allergy.

Check out Medscape/CDC/Children's Hospital of Philadelphia websites for more info. Cutaneous leishmaniasis, from sandfly bites, is seeing a resurgence in the wake of the Syrian Civil War--the answer to my first ? Speaking of war and Jihad--Google Terry Lee Loewen/worker at the Wichita Airport/December 2013 very scary attempt. Also check out Foodsafety.gov's website 'Recipes for Disaster;' all about food poisoning & allergies.

Because many of us travel overseas to 3rd World countries, for various reasons, it behooves us to be familiar with their diseases.

As well, international travel increasingly brings the 3rd World to us. In my overseas military deployments I frequently am surrounded with workers on bases who hail from India, Bangladesh and Sri Lanka. Obviously, Ebola has made it painfully clear that we live in a cosmopolitan world and must be cognizant of it at all times.

Leishmaniasis is a common affliction and there are various strains of the parasite--each of which may cause various disease patterns and have many names, ex Kalaazar. Wikipedia has a great spread on this disease. The cutaneous, and especially the mucocutaneous forms, can be quite disfiguring and difficult to treat. The meds have serious potential side-effects and poor response. PCR is the diagnostic tool of choice in Western medicine. Refer all cases to a geographical/tropical medicine specialist-esp. be on the lookout for this disease among service members and travelers returning from Afghanistan/Africa/Latin America & the Middle East. For more info, read the 5 June 2013 article by Peter Hotez entitled "Aleppo Evil" at: www.blogs.plos.org. Also, check out: www.uk.answers@yahoo.com re anthroponotic diseases.

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ADDRESSING HEALTH CARE WORKPLACE VIOLENCE By: Laurette Salzman, MBA, CPHRM; ProAssurance Senior Risk Management Consultant

Violence in health care settings is very real and hospitals are especially vulnerable. According to a study by the Emergency Nurses Association, the overall frequency of physical violence and verbal abuse for an ED nurse working 36.9 hours in a seven-day period is 54 percent.1 Nurses affected were most often involved in triaging a patient, performing an invasive procedure, or restraining/subduing a patient; patients were the main perpetrators in all incidents.

The study also found physical violence rates increase as population density increases (9.1% rural vs. 14.1% large urban areas). The following tactics were found to decrease the odds of violence and verbal abuse: • Use of panic buttons/silent alarms • Enclosed nursing stations • Locked or coded ED entries • Security signs • Well-lit areas It’s also important to have a system-wide program in place to address workplace violence. The Joint Commission requires accredited hospitals to assess their risk of violence, develop written plans, and implement security measures.2 Risks may vary by facility and department, underscoring the importance of individualized analysis.

A whitepaper on workplace violence in health care, published by ASIS International (an organization of security professionals with 35,000 members worldwide), recommends workplace violence teams adopt a multidisciplinary approach that includes: security, first responders, clinical staff, risk management, legal, human resources, administration, and other key stakeholders.3 They cite the following five components of an effective workplace violence program: 1.

Management commitment and employee involvement 2.

Worksite analysis (including evaluating the physical environment) 3.

Hazard reduction and response 4.

Training 5.

Recordkeeping and program evaluation The ASIS white paper also includes a sample threat assessment checklist, a workplace violence policy, a list of common warning signs, and an assessment outline.

Additional training may also be necessary for employees in high-risk areas. These areas typically include emergency departments, ICUs, behavioral health, and operating rooms. The 2013 Workplace Safety & Patient Care Standards for Nursing Professionals (posted on rn.com) recommends that health care professionals, when confronted with potentially violent situations, should: • avoid confrontation and retreat to a safe place, if possible; • not approach or attempt to disarm an individual with a weapon; • summon security or a behavioral response team, or call 911; • remain calm—refrain from agitating or threatening a violent person; and • isolate the individual—lock doors, direct traffic away from the area, and evacuate if possible.4 1

Emergency department violence surveillance study. Emergency Nurses Association Institute for Emergency Nursing Research. http://www.ena.org/IENR/Documents/ENAEDVSReportNovember2011.pdf. November 2011. Accessed May 21, 2013.

2

Preventing violence in the health care setting. The Joint Commission website. http://www.jointcommission.org/assets/1/18/SEA_45.pdf. June 3, 2010. Accessed May 15, 2013.

3 Managing disruptive behavior and workplace violence in health care. ASIS International Healthcare Security Council website. http://www.g4s.us//media/files/usa/pdf-articles/hospitals and health care/council_healthcare_workplaceviolence.ashx December 2010. Accessed May 21, 2013.

4

2013 Workplace safety & patient care standards for nursing professionals. rn.com AMN Healthcare Education http://www.rn.com/getpdf.php/1842.pdf?Main_Session=d558ee540531925802a30ae14d49cb51. January 2013. Accessed May 21, 2013.

This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical conduct.

Copyright © 2014 ProAssurance Corporation.

Services.

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AIOA NEWS

PRESIDENT’S MESSAGE (continued from page 1)

seats at the HOD so that our voice can be better heard on topics involving osteopathic medicine in Indiana. Being involved in the process has been a positive experience for me, and I would like to see more osteopathic physicians involved in the delegation. It is important we keep our unique identity as D.O.s, however, participate in these important policy making activities with likeminded individuals. This would help bolster our voice amongst the medical and political community in Indiana.

The IOA’s next CME program is planned for June 5 - 7, 2014, at the Crowne Plaza Union Station, in downtown Indianapolis.

The Continuing Medical Education Committee has met and this will be another quality program sponsored by your state osteopathic association. Please consider attending this program. Since we are in the third year of a CME cycle, you might be in need of CME credits, and it is also a wonderful opportunity to meet with colleagues and friends from around the state.

All D.O.s in the state should have received a 2015 dues statement. As you recall, we have changed our fiscal year to the calendar year. Dues statements will come in January from now on.

We thank you for your membership and support. If you know of any D.O.s who are not members of the IOA, please have them call the IOA office at (317) 926-3009 with any questions or they may join online. Remember, you can now pay your dues online too. Please visit www.inosteo.org.

Lastly, I want to remind everyone that we will have our first set of third year medical students from the MUCOM starting their rotations this summer. Any physician who is interested in preceptoring a student, please call (317) 955-6000 and ask for the MUCOM Dean’s office. Thank you to all who are contributing to our medical students in many different ways. Thank you to our staff, Erin Wernert and Debbie Coyle, for all the work they do both center stage and behind the scenes.

Adrian L. Carter, D.O. IOA President

It was good to see everyone last December. I am looking forward to visiting with all of you at the 118th Annual Spring Update to be held June 5 – 7, 2015, at the Crowne Plaza Union Station, in downtown Indianapolis.

At our Board of Trustees meeting in April, we will discuss plan for the Advocates to the Indiana Osteopathic Association (AIOA) program during the 34th Annual Winter Update to be held December 4 – 6, 2015, at the Sheraton Hotel at Keystone Crossing, in Indianapolis.

Lastly, please thoughtfully consider joining the Advocates to the Indiana Osteopathic Association (AIOA).

You may contact Debbie Coyle at the IOA office to receive an application or you also may download an application at www.inosteo.org by clicking on Advocates to the IOA under the Related Organizations tab.

Take care and I hope to see you in December.

Mike Coyle AIOA President

IOAPAC THANKS DONORS Thank you to the following IOA members who contributed in 2014 to the IOAPAC, the political action committee for the Indiana Osteopathic Association. Your participation in the political process is appreciated and aids the IOA in ensuring elected officials who support osteopathic physicians remain in the state legislature.

Shalin Arnett, D.O. Christina Cabott, D.O. Mark Cantieri, D.O. Judy Davis, D.O. Claude Foreit, D.O. David Koronkiewicz, D.O. Thomas Ringenberg, D.O. As a reminder you can add an IOAPAC contribution to your dues payment when you make it. If you pay your dues by check, however, your IOAPAC contribution must be in the form of a separate check (made payable to IOAPAC) and is not tax deductible. The IOAPAC is a state political action committee and is able to receive gifts from non-members and individuals or businesses. Federal PACs, such as the Osteopathic Political Action Committee of the American Osteopathic Information Association, may only solicit members and receive personal checks.

Winter 2015

DEAN’S UPDATE

By: Paul Evans, D.O., FAAFP, FACOFP Vice President and Dean Marian University College of Osteopathic Medicine The Marian University College of Osteopathic Medicine (MUCOM) is now preparing our charter class for two milestones in their careers: the first--sitting for Level 1 of the COMLEX USA licensing board exam, and the second--the start of clinical education in hospitals and clinics as new third year students.

COMLEX preparation begins with our “Boards Boot Camp” program beginning in February led by an external company that specializes in this review process.

The program has directed readings, practice exam questions, “high-yield” study guides, and practice tests all designed to have students peak at the exact time of taking the exam in late May and early June.

Clinical clerkship preparations are two-fold: first, students will be trained to successfully work in the hospital environment with attending physicians as part of the medical team.

Specific medical information, case presentation skills, team skills, and medical procedure basics are part of this course work. Simulation and standardized patients as well as task training will take place before they start their hospital experiences in July.

They will also learn about how hospitals work, navigating the continuum of care from admission to discharge with after care and follow up.

ACCREDITATION. Our AOA-Commission on Osteopathic College Accreditation (COCA) inspection occurred January28 – 30, 2015. The inspection team did a full review per requirements for provisional schools. The final report will be published after testimony in April in Chicago. Presently Marian has met all requirements and is at the highest level possible for a new school. If all goes as planned, full accreditation will be achieved upon graduation of our first class in May 2017.

HOSPITAL PARTNERSHIP OUTREACH. Our priority project for this year continues to be setting up our third year clinical education clerkships. St. Vincent Health and Community Health have committed to 90 and 60 slots per month respectively for Marian students.

Students have received their hospital assignments, and each hospital is now finalizing the details of which physician will take which student in July. We also have 26 other hospitals or systems who have committed to taking students. The devil is in the details for setting up this complicated network of monthly rotations with almost 150 students changing rotations every month. Our clinical dean, Charles E. Henley, D.O., and his chairs for specialty care, Patrick A. Woodman, D.O., and primary care, Richard A. Schuster, D.O., are finalizing the details and the assignments together with the educational objectives

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for these rotations. We have some excess capacity built-in to cover any last minute withdrawals or changes. We have improved our specific assignments with Dr. Mary Abernathy at St. Vincent Health and Dr. Kathy Zoppi at Community Health. Our clerkship coordinators are onboard and the details are pulling together nicely.

COMMUNITY RELATIONS. We are working on a state legislative initiative through the Indiana Hospital Association (IHA), to expand Graduate Medical Education by 500 slots statewide for all medical students in Indiana.

The bill is sponsored by Representative Tim Brown, MD, a family physician who is chair of the House Ways and Means Committee. There is strong support of this bill by many health related groups to include the IHA, ISMA, IOA, IAFP, AHEC, Rural Health Association, Primary Care Association, and of course the IU School of Medicine. There are many hurdles for this legislation to get over. We will be monitoring the bill’s progress as the session moves forward.

ADMISSIONS. We now have over 4,100 applicants for our 162 seats, an increase of about 14% over last year and 30% over year 1. The quality as measured by GPA and MCAT scores appears to be even better. The average GPA is 3.65 with an MCAT score of 28 for our deposited students. We have now interviewed over 400 students and have 102 seat deposits (30% higher than last year). We will have about 150 more interviews this cycle.

We are thankful for all physicians who have helped us in selecting our next generation of osteopathic physicians.

Marian is grateful for the support of the IOA physicians and staff. We are especially grateful for the excellent teaching offers and the quality consultation assistance we have received. We hope to be a very positive addition to improving the number of D.O. physicians in Indiana, working with existing physicians in improving the health of the state and the region.

Winter 2015

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OSTEOPATHIC MEDICAL FOUNDATION FINANCIAL ASSISTANCE In 2003, the Osteopathic Medical Foundation, Inc. (OMF) of Michiana established the OMF Forgivable Loan Program. This program provides financial assistance via forgivable loans of $10,000 per year to osteopathic medical students who are in the FIRST through FOURTH years of study at one of our nation’s osteopathic medical schools and who desire to return to the Michiana area to practice medicine. In exchange for practicing within a 60 miles radius of South Bend, 25% of their loan will be forgiven for each year they are in practice. Please note the following eligibility requirements: An applicant must: 1. be at least a half time student in an osteopathic medical school accredited by the AOA; 2. demonstrate an interest in returning to the northwestern Indiana or southwestern Michigan “area” (“area” is defined as being within a 60 mile radius of South Bend, Indiana. Indiana counties include Saint Joseph, Marshall, Elkhart, Kosciusko, Starke and LaPorte. Michigan counties include Berrien, Cass and Saint Joseph) to practice osteopathic medicine upon graduation; 3. demonstrate financial need; 4. be of good moral character; 5. demonstrate good motivation toward the practice of osteopathic medicine; and 6. be available for a personal interview, if requested, by the Osteopathic Medical Foundation.

In 2007, the OMF Resident Recruitment Grant Program was established to provide financial assistance to new physicians or small practices interested in recruiting a new physician to enter their practice. This program provides a one-time grant of $10,000 to a new physician to assist in the repayment of student loans. Please note the following eligibility requirements: An applicant must: 1. be a graduate of an osteopathic medical school accredited by the AOA; 2. start up or join a practice located in the northwestern Indiana or southwestern Michigan “area” (“area” is defined as being within a 60 mile radius of South Bend, Indiana. Indiana counties include Saint Joseph, Marshall, Elkhart, Kosciusko, Starke and LaPorte. Michigan counties include Berrien, Cass and Saint Joseph).

3.

4.

remain in the Michiana area for two years, and serve one year on the OMF Board of Directors.

Visit the OMF’s website at www.omfmichiana.org to download an application for either of these programs. The deadline for submitting applications is May 15, 2015.

The Osteopathic Medical Foundation appreciates your help in perpetuating the practice of osteopathic medicine in the northwestern Indiana and southwestern Michigan area via financial contributions to the OMF and is grateful for our generosity.

Winter 2015

COMING EVENTS...

Key Elements in Effective Osteopathic Practice February 20 – 22, 2015 16 - 20 hours category 1-A credit anticipated, pending approval by AOA CCME Sheraton Portland Airport Hotel, Portland OR Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com A Sutural Approach to Osteopathy in the Cranial Field February 20 – 22, 2015 20 hours category 1-A credit anticipated, pending approval by AOA CCME Sheraton Portland Airport Hotel, Portland OR Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com 5th Annual Conference April 10 – 12, 2015 12 hours category 1-A credit anticipated, pending approval by AOA CCME The Greenbrier, White Sulphur Springs, WV Sponsor: Scioto County Medical Society and OUHCOM Contact: Scioto County Medical Society, www.sciotocountymedicalsociety.com

MARK YOUR CALENDARS

NOW AND PLAN TO ATTEND THE IOA 118TH ANNUAL SPRING UPDATE JUNE 5 - 7, 2015 CROWN PLAZA UNION STATION DOWNTOWN INDIANAPOLIS, IN

National Osteopathic Medicine Week April 19 – 25, 2015

Annual Convocation March 11 – 15, 2015 Marriott Hotel, Downtown Louisville, KY Sponsor: American Academy of Osteopathy Contact: AAO, (317) 879-1881 or www.academyofosteopahy.org Preconference OMT Workshop: “Counterstrain for the Upper Half of the Body” June 4, 2015 8 hours category 1-A credit anticipated, pending approval by AOA CCME Crowne Plaza Union Station, Downtown Indianapolis, IN Sponsor: Indiana Academy of Osteopathy Contact: IAO, (317) 926-3009 or www.inosteo.org 118th Annual Spring Update June 5 – 7, 2015 25 hours category 1-A credit anticipated, pending approval by AOA CCME Crowne Plaza Union Station, Downtown Indianapolis, IN Sponsor: Indiana Osteopathic Association Contact: IOA, (317) 926-3009 or www.inosteo.org Introductory Course: Osteopathy in the Cranial Field June 13-17, 2015 40 hours category 1-A credit anticipated, pending approval by AOA CCME Naples Grande Resort, Naples, Florida Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com Annual Conference: Traumatic Brain Injury, Neuroscience and Osteopathy June 18 – 21, 2015 Naples Grande Resort, Naples, Florida 20.75 hours category 1-A credit anticipated, pending approval by AOA CCME Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com

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AOA Convention October 17 – 24, 2015 Orange County Convention Center, Orlando, FL Sponsor: American Osteopathic Association Contact: AOA, (312) 202-8014 or www.osteopathic.org

The Neurology of Posture – Maxillofacial Influences: Teeth, Eyes, Ears, Vertebrae April 17 - 19, 2015 21 hours category 1-A credit anticipated, pending approval by AOA CCME Embassy Suites Hotel, Alexandria, VA Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com

Annual Convention March 12 – 15, 2015 The Cosmopolitan Hotel, Las Vegas, Nevada Sponsor: American College of Osteopathic Family Physicians Contact: ACOFP, (800) 323-0794 or www.acofp.org

HOOSIER D.O.

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Winter 2015

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PRACTICE OPPORTUNITIES AVAILABLE IN INDIANA IOA Serves as an Informal Clearinghouse for physicians seeking practice locations.

2014 - 2015 OFFICERS Adrian L. Carter, D.O. President Mark S. Cantieri, D.O. First Vice President Gaston Dana, D.O. Second Vice President Terry A. Iwasko, D.O. Secretary Patrick J. Woodman, D.O. Treasurer Angela B. Wagner, D.O. Immediate Past President TRUSTEES Brian H. Black, D.O. Mary Burden, D.O. Steven J. DeLee, D.O. Chris A. Lowery, D.O. Stephanie M. Overmars, D.O. Rachel A. Shockley, D.O. DISTRICT VICE PRESIDENTS Brian H. Black, D.O., District I Vacant, District II Vacant, District III Vacant, District IV Bruce C. Brink, Jr., D.O., District V Dan C. Galloway, D.O., District VI A.O.A. DELEGATES Thurman V. Alvey, III, D.O. Mark S. Cantieri, D.O. David L. Coil, D.O. Dan C. Galloway, D.O. David C. Koronkiewicz, D.O. Susan M. Moore Riesbeck, D.O. Angela B. Wagner, D.O. A.O.A. ALTERNATE DELEGATES Adrian L. Carter, D.O. Max E. Helman, D.O. Ben D. Huang, 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 www.inosteo.org

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 (317) 926-3009.

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 (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.

PREMIER INDIANAPOLIS AREA FAMILY MEDICINE OPPORTUNITES AVAILABLE. Our practices are growing, and you can be busy right away. You’ll enjoy a collaborative environment with administration and your fellow physicians. Experience the benefits of practicing in a small town environment without sacrificing any big city amenities. Our hospitals offer: supportive cultures, competitive salaries, comprehensive benefits, rapidly growing communities, full and part time options, skilled support staff at each practice and accessible specialty and subspecialty medicine. Hospital owners: Hancock Regional Hospital, Hendricks Regional Health, Henry County Hospital, Johnson Memorial Hospital, Major Hospital, Riverview Health and Witham Health Services. Contact Suburban Health Organization, (317) 295-5279 or send an e-mail message to laurenc@suburbanhealth.com.

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 inhouse 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 c.hurtbfp@mw.twcbc.com or contact Erin Wernert or Debbie Coyle, IOA, at (317) 926-3009.