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J u ly | Au g u s t | S e p t e m b e r | 2011

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PRESIDENT’S MESSAGE P r e s id e n t Ta r r a n ’ s I n a u g u r a l A dd r e s s

The first thing I want to mention is that Mike (Dr. Cornelison) and I both had tickets to last night’s U2 concert in Oakland, and, of course, we had to give up those tickets, so in honor of the new Immediate Past President, I’d like to subtext my remarks with three familiar themes: 1. We still haven’t found what we’re looking for; 2. Sometimes you can’t make it on your own; and of course number 3. In the name of love – what more in the name of love? Friends, colleagues, distinguished past presidents, board members, APMA family, members of the house, brothers and sisters, like the 99 or so before me I stand here today in great humility as I am truly humbled to become the 2011-2012 President of our organization, the CPMA. You have trusted me to help lead this organization and profession into the next exciting chapter. As we evolve into the next century of this great institution we find ourselves stronger, more focused, more nimble and more able to carry out its mission as never imagined at its inception 100 years ago when Rod Farley was...how old?

never have to work a day in your life. ” To put it more elementary, we want to be happy in doing what we’re doing for a living; we want job satisfaction. You want to get up in the morning - that might be enough for Rod Farley, but for the rest of us - and look forward to going to work. It’s really that simple, and it’s not too much of a stretch to say that the CPMA shoulders some of the responsibility for your fiscal and psychological well being. Why? Because we are constantly working to make your working conditions better an your practice life more satisfying; gain you the respect you deserve from hospitals, insurers, the government and patients; and increase your comfort level in all areas of practice so that you can maintain or increase your ability to earn a great living by giving you the tools and information you need to practice successfully.

So what are we looking for? Well, as Steve Wan’s friend and confidant Confucius used to say, “Find a job you love, and you will

See PRESIDENT’S MESSAGE on Page 6

Western Wows Record Crowds The nearly 1,100 attendees of The 2011 Western Foot and Ankle Conference (The Western) were enthusiastic, enthralled and excited by the vast variety of fresh, new dynamic lectures, innovative instructional courses, cutting-edge hands-on workshops, and the world class exhibit hall that featured 140 vendors displaying the latest technologies, tools and techniques in surgery, medicine and management. Being at “The Happiest Place on Earth, ” Western conference attendees also received deep discounts on Disneyland and Disney’s California Adventure theme park passes. While attendees’ days were filled with numerous educational and networking opportunities, there was time in the afternoon and evening for fun with family

- In This Issue -

and friends to stroll, shop and dine at the Disneyland Resort’s vibrant Downtown Disney district, or head over to Disneyland and Disney’s California Adventure parks to check out the latest rides and entertainment. Plans are well underway for next year’s Western (June 7-10, 2012), which will coincide with the California Podiatric Medical Association’s (CPMA) Centennial Celebration, the completion of the Disneyland Resort’s multi-million dollar hotel renovation and upgrade (featuring a new three tier pool), and planned grand opening of the much anticipated Cars Land (based on the 2006 Disney-Pixar film) in Disney’s California Adventure. So mark your calendar and plan to attend the podiatric surgery, medicine and management meeting of the year June 7–10, 2012.

and Surgeon 31 Listening to the Customer 34 Annual Health Policy Report/ Update 4 Physician 39 Medicare T D B , PMAC T P , DPM, MS Certificate Shield Issues CPMA Apology 41 Blue J A. H , DPM, MBA F K , DPM ina

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2011 western pictorial edition J u ly | Au g u s t | S e p t e m b e r | 2011

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Tarran Tapped to Carry CPMA Presidential Torch William Tarran, DPM of Pacifica, California became the 99th president of the California Podiatric Medical Association (CPMA) during the organization’s 2011 House of Delegates in Anaheim, California this past June. In his address to the more than 100 podiatric physicians and surgeons in attendance Dr. Tarran praised CPMA’s efforts to protect the patients and the practice of the specialty of podiatric

in Daly City, California; and has surgical privileges at Physicians Surgery Center in Daly City, California. A Diplomate of the American Board of Podiatric Orthopedics

medicine, noting that California has often led the way in

and Primary Podiatric Medicine (ABPOPPM), Dr. Tarran is a past

advancing and promoting the profession.

president of the San Francisco/San Mateo Podiatric Medical

Dr. Tarran received his Bachelor of Arts Degree in Political

Society. He has served on a number of CPMA committees and

Science from George Washington University in Washington, D.C.,

task forces, as well as being an elected California representative

where he was an honors student. He received his medical training

to the American Podiatric Medical Association (APMA) House of

and Doctor of Podiatric Medicine (DPM) degree from the California

Delegates and Leadership Conference. Dr. Tarran was elected to

College of Podiatric Medicine (CCPM) in San Francisco, and

the CPMA Board of Directors in 2006 and quickly moved through

completed his surgical residency at Frankfort Hospital in

the chairs, serving first as a Director-at-Large, then as Secretary/

Philadelphia, Pennsylvania.

Treasurer, Vice President, and President-Elect before being elected

Dr. Tarran practices in the Serramonte Podiatry Group in Daly City, California, and is on active staff at Mills-Peninsula Hospitals in San Mateo and Burlingame, California; Seton Medical Center

as President for the 2011-2012 term. Dr. Tarran and his spouse Deborah reside in Pacifica with their two sons.

100th CPMA House of Delegates will convene Wednesday, June 6, 2012 Disneyland Hotel • Anaheim, CA

CPMA Past President Michael Cornelison, DPM (l) passes the gavel to 2011-2012 President William Tarran, DPM J u ly | Au g u s t | S e p t e m b e r | 2011

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Physician and Surgeon Certificate In case you missed the “big news,” the California Podiatric Medical Association, the California Medical Association, and the California Orthopaedic Association have issued a public news release announcing a collaborative effort to convene a task force for the purpose of reviewing the training and education of podiatric physicians. This task force is to determine whether there are ways to transition podiatric medical schools so that future graduates will have a pathway for becoming licensed physicians and surgeons. Barry Block, DPM, JD, editor of Podiatry Management, stated in a recent AMA News interview, “This is the biggest story to happen in podiatry in 50 years.” The outcome of this collaborative effort amongst associations which have been on opposing sides of scope battles for the past 50 years will have a positive impact on our collective futures. Before discussing a few of the issues involved and the process going forward, it is important that you review the text in this joint public statement released by CMA on June 6, 2011:

FOR IMMEDIATE RELEASE: Monday, June 6, 2011

CALIFORNIA’S PHYSICIANS, ORTHOPAEDIC SURGEONS AND PODIATRISTS REACH HISTORIC AGREEMENT ON NEW TASK FORCE Joint effort will review Podiatric Training to determine if there are ways to transition Podiatric Schools so Graduates could become Licensed Physicians and Surgeons SACRAMENTO, June 6, 2011 – Today, the California Medical Association (CMA), California Orthopaedic Association (COA), and the California Podiatric Medical Association (CPMA) announced an historic task force between the three organizations to begin the process of reviewing the education, curriculum and training of California’s podiatric medical schools with the ultimate goal of achieving accreditation as full-fledged allopathic medical schools and enabling their graduates to become licensed physicians and surgeons. It is the first agreement of its kind anywhere in the nation. Joint Statement of CMA Chief Executive Officer Dustin Corcoran, CPMA Executive Director Jon A. Hultman & COA Executive Director Diane Przepiorski “The California Medical Association (CMA), the California Orthopaedic Association (COA), and the California Podiatric Medical Association (CPMA) have together agreed to launch a joint task force to evaluate the education and training of future graduates of California podiatric schools – with the goal of preparing these students to have the education, training, and certification to allow them to be licensed as physicians and surgeons in California.  The agreement includes an understanding that the California podiatric schools would be expected to be accredited by the Liaison Committee on Medical Education (LCME). ‘We’re excited to be a part of this unprecedented partnership, ’ CMA Chief Executive Officer Dustin Corcoran said. ‘The licensure requirements of podiatrists have increased in California in recent years, and the time has come to evaluate their training programs in this context. The California Medical Association is looking forward to working with the COA and the CPMA to fully evaluate the 4|

education and training of podiatrists to identify and remove any remaining deficiencies so that future podiatric medical graduates would simply be medical school graduates.’ ‘This Joint Task Force is the first effort nationwide to perform a critical review of the current podiatric medical school standards and curriculum with the goal of creating podiatric training programs that are equivalent to that of a medical school for physicians and surgeons,’ said COA Executive Director Diane Przepiorski. ‘If we can accomplish this goal, podiatrists will receive the education, training, and certification which will allow them to be licensed as a physician and surgeon in California.  We are pleased to be part of this historic and collaborative effort.’ ‘The California Medical Association, the California Orthopaedic Association, and the California Podiatric Medical Association have been working collaboratively on healthcare issues focused on the attainment of the highest quality patient care in California,’ said CPMA Executive Director Jon Hultman. ‘Throughout this process, CPMA has made the strong case that the education and training of doctors of podiatric medicine have evolved and become increasingly similar to that of medical doctors. Based on this awareness, our respective organizations have agreed to form a joint task force for the purpose of evaluating the training, education, and certification of podiatric students with the goal of preparing them to be licensed as physicians and surgeons in California.’ ‘I am proud to be working with the CMA and COA in achieving this important goal, especially given that our organizations have put aside political differences in order to work together in achieving two common goals of healthcare reform in California: quality patient care and wider access to that care,’ Hultman concluded.” This “physician and surgeons” news was released nationally on June 27, 2011, the subject of an AMA News article. This article began as follows: “California physicians and podiatrists pursue collaboration on education. They are forming a task force to evaluate podiatric education in the state, an effort that could see podiatrists licensed as physicians.” In this article, Dustin Corcoran, CEO of the California Medical Association, was quoted, stating, “The CMA is excited to be part of this ‘unprecedented partnership.’ The licensure requirements of podiatrists have increased in California in recent years, and the time has come to evaluate their training programs in this context.” Though formation of this joint task force (a process begun seven years ago) represents a culmination of sorts, this is not an end point, but rather, a new beginning. The goal is to achieve parity with MDs and DOs. This is recognition that DPMs have earned, based on the education and training provided by today’s podiatric medical schools and comprehensive residency programs. There has been some confusion, mis-information, and even some fear amongst DPMs regarding our goal and the ultimate outcome that could result from this collaborative effort. Interestingly, some DPMs fear what might happen if we are not successful, while others actually fear what might happen if we are. Parity has been a goal of DPMs over my forty year career and has been a primary focus for CPMA throughout my tenure as executive director. I feel that the positives of this process far outweigh any negatives. This is the time

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to get involved, rally behind our association, and help to accelerate the forward momentum that we have already established. For those who have sat on the sidelines, uninvolved and thinking that this is “just another dream that will never happen,” know that CPMA’s momentum is already past the “point of no return.” We have a board of directors fully committed to Gene Kranz’s Apollo 13 motto that, “Failure is not an option.” The following are some of the key issues to be addressed by this task force:

Degree Versus Licensure DPMs have long been debating the merits of a degree change from DPM to MD or DO. Everyone is still debating this issue, with little progress having been made. When I began my education at CCPM in 1966 and was touring the college I was given the impression that the DPM and MD curriculums were quite similar, with the primary difference being that DPMs specialized sooner. At that time, we trained for four years, and MDs trained for five. Today, with comprehensive three-year residency programs becoming the norm, the minimum training for DPMs and MDs is now seven years. In California, a two-year residency is required in order for a DPM to receive a “limited” license, while only one year is required for an MD to receive an “unrestricted” Table One Physicians and Surgeons Certificate. The goal that CPMA is working towards is to Degree Independent   Dx and Rx retain the DPM degree while receiving the same   Office Physicians and Surgeons Certificate as MDs and x DPM DOs - with the same rights, privileges, and scope. If this is achieved, DPM = MD = DO for purposes of MD x every statue. A podiatric physician would be treated DO x no differently than any other specialty of medicine. Hospital privileges would be based on training and education, the same as for any other specialty of medicine. Currently, even if a DPM were the undisputed expert in the world on wound care, s/he would have to change the law in order to treat a wound on the leg in California, with this denial of privileges being based on his/her degree rather than on his/her education and training. For those who fear that the DPM education may not be equivalent to that of MDs, please review the side-by-side comparison of current MD courses required for licensure with those received by DPMs. The last time MD and DPM curricula were compared was in the 1993 “Nelson-Medio Report” commissioned by the Medical Board of California. This report recommended that podiatric medical schools add emergency room rotations, increase training in pediatrics, neurology, and women���s health, and add psychiatry to their curriculum. These recommendations have since been implemented.

Physician Versus Non-Physician State medical organizations currently classify podiatrists, along with all other non-MD/DO healthcare providers, as “non-physicians,” and AMA works nationally to assist these organizations in battling all attempts by any “non-physicians” to increase scope. Many of these battles are justified, and CPMA has even fought these battles

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when other providers have sought a scope increase for which we did not believe they had the necessary training and education. Similarly, medical organizations base their opposition to scope increases on training and education; however, the leaders of these organization have little understanding of the current training and education of DPMs. We have been working diligently to inform them. The challenge we have now put forth to these organizations is to live up their words and base their decisions regarding scope on training and education. Comparing the actual education and practice of MDs, DPMs, and DOs (Table One), demonstrates that they are virtually indistinguishable. DPMs complete four years of professional school, three year residencies, independently diagnose and treat, admit to hospitals, perform admitting H&Ps, have full drug and x-ray licensure, and have privileges as first assistant on any type of surgery. The gap between DPMs and the next closest “nonphysician” is vast, while in comparison, the gap between DPMs and physicians is almost imperceptible.

Four Years Professional School

Three Year Residency Minimum

2 year residency requirement for CA Lic

x x x

x x x

x    

Independent SX Privileges Dx and Rx W/Hospital Hospital

x x x

x x x

Admitting H&P Privileges

Full Rx License

1st SX Assist

x x x

x x x

x x x

Accreditation and Testing Medical schools are accredited by the Liaison Committee on Medical Education (LCME) while podiatric medical schools are accredited by the Council of Podiatric Medical Education (CPME). MDs take the USMLE, DOs take the COMLEX, and DPMs take the NBPME (transitioning to the USPMLE). The plan is to have podiatric medical schools meet the standards of the LCME and, ideally, to be accredited by them. The CPME process is rigorous, and part of the joint task force process will be to see how “equivalent” the standards of the CPME and LCME are. The USMLE is already accepted for licensure in California by the Board of Podiatric Medicine. The “sticking point” is that many DPMs believe podiatric specific questions need to be included in the exam to assure podiatric competency. The rest argue that board certification based on the USMLE as it is would give the necessary assurance of podiatric competency and that the licensing exam would not need to include podiatric specific material. This can be an emotional issue. It is significant to note that many practicing MDs believe that if you pass the USMLE exam, you are “one of them.” Obviously, there should be no room for “politics” or “emotion” in this process. Over the past seven years, CPMA, CMA, and COA have See certificate on Page 13

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PRESIDENT’S MESSAGE from Page 1

By the way let me be very clear that membership in the CPMA is for all licensees, residents and students in the state regardless of how they practice, whether they are board qualified, certified or not boarded at all, or whether they belong to ASPS, ACFAS, ACFAOM or for that matter Act-Up (that’s CPMA’s version of Act-Up, you might know it as “Frank Kase”), CPMA along with APMA serves as your umbrella organization that is committed to improving practice life by way of passing along timely information, influencing those that make decisions, supporting or not supporting legislation or maybe creating legislation, providing you with the tools you need to practice our brand of medicine in this rapidly changing world of health care, and about to become a class five rapids under the Patient Protection and Affordable Care Act. We also recognize the fact that change, much to our dismay, does not necessarily translate into simplification yet I and this board are committed to the task of attempting to simplify and demystify the complexities that lie ahead when it comes to the delivery and practice of our highly respected profession. We wish to continue to bring great value to our members such that not being a member of the CPMA would surely be a considered a detriment. We might not always succeed at first at everything we do, but as I’ve learned from serving on this board, it’s not from a lack of effort. We’re all too familiar and acknowledge the Sisyphean efforts of the past in regards to things like Medicare r1/r3, Medi-Cal and Title XIX, the SGR and so forth, but sometimes, quite frankly, there are things that are beyond our control - like the reality of State and Federal budget shortfalls and powerful interest groups that might not care to have our best interest, or for that matter, the public’s interest at heart, and thus as demonstrated in the past this partisanship or disturbing lack of vision often led to setbacks, but let today’s events illustrate what a determined, inspired and concerted effort can do - what openness, reason, and trust can achieve. I stand before you today knowing that we stand on the precipice of political change and an overall increase in the positive attitude and perception by health professionals and the general public towards our profession. This week, with the joint announcement and agreement, you’ve witnessed what I expect to be looked upon as a watershed moment in the history of podiatric medicine. Who would have thought just ten years ago we would hear, “Hi, I’m from the CMA and I’m from the COA and we’re here to help”, but yet there they are willing to help steer us towards Physician and Surgeon status without expecting much in return - or perhaps with the expectation that patients will truly be receiving the best foot and ankle care. Altruistic? Perhaps; I like to think so. As we approach our 100th anniversary as a State association, the Freedom Riders, those brave African American and white activist who rode buses to the Deep South in the name of ending segregation and seeking justice, celebrate their fiftieth anniversary. I’m proud to say we’ve been lucky enough to have our share of brave freedom riders: folks who had the gumption and political courage and the know-how to put themselves on the line and take the

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freedom ride so that one day podiatric medicine would no longer live under policies that emulate separate and unequal, but instead seek to integrate into the house of medicine as equal partners in the treatment of foot and ankle disorders. Those freedom riders don’t just include our own familiar names like Hultman, Kase, Wan, Harkless, Mazza and DeSantis, my predecessor, Mike Cornelison, and others but the likes of COA Executive Director Diane Przepiorski and of course, Dustin Corcoran. Others have help pushed that metaphorical rock up that large, intimidating hill or have flattened out that hill to make our mission a greater possibility. We must all be grateful for their commitment to change and for doing what has been the most requested ask of membership over the last 40 years - attaining Physician and Surgeon status. I know this is only the beginning of our ask and our quest, and I know we’ll be running into our share of problems in the proverbial Deep South - and I’m not referring to the LA County Society - but I’m an optimist, and I can tell you it’s easier to be an optimist when you have leaders who are not only capable, but passionate enough to see this towards completion. I for one can say we have those leaders at the CPMA level, the APMA level, and at our educational and post-graduate institutions. Sometimes ideas that are floated around on K Street in Sacramento take flight and land on the renowned K Street in Washington, DC, and into the landscape of national politics affecting our practice life. Politics, that if handled judiciously, pursued passionately and performed with integrity, will ease this profession into its rightful place in 21st century medicine. We can only hope that if all goes as planned and we continue to educate properly about our profession and what we do, and exemplify the talents of our well trained podiatrists, moments of enlightenment to the allopathic and osteopathic community will become moments of sobriety to third party payers, hospital boardrooms, and the halls of state capitols everywhere recognizing podiatrists as the premier practitioners in the care of the lower extremity, and thus hopefully ending the days of creatively gerrymandering the status of podiatrist out of hospital committees, as full participants in ACOs, regulatory policy, scope of practice, reimbursement criteria and so forth so that we can practice in the world of physician specialists and all that goes with it. I envision a future where podiatrists form a brotherhood with orthopedic foot and ankle surgeons such that the relationship moves fully away from adversarial to supportive and partnership in regards to caring for patients with foot and ankle pathology, such that we conference on cases, share advocacy and such that the lecture halls and workshops at the Western Foot and Ankle Conference include orthopedists or other allopathic specialists who wish to broaden their knowledge of foot and ankle care for the benefit of the patients we both serve. Delegates, I mentioned the Freedom Riders. I also have a dream that one day a podiatrist will be judged not by the letters in their degree, but by their knowledge, character, and by the merits of their ability to render care within their allowed scope of practice.

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The end of the subjugation of the podiatric physician has taken a great leap forward with the announcement of the joint task force this week, but with that, in the words of Peter Parker, “comes great responsibility” - the responsibility of staying true to ourselves and maintaining our independence when it comes to making decisions on health policy legislation. Although our relationship with other professional medical organizations is at its historical best and benefits greatly from collaboration, we must avoid reflexively supporting every piece of legislation they support, remembering that legislation should be judged not solely on what’s best for our practice lives, but what’s best for the patient and what’s best for those that don’t become patients because they do not have access to affordable health care. Fortunately and perhaps not coincidentally, I find that what’s good for podiatric medicine is usually good for our patients and public health and that makes me very comfortable to be in this position. The CPMA, APMA and the schools of podiatric medicine have the responsibility to attract the most qualified students to enter the field of podiatric medicine and the responsibility to incorporate coursework that moves us towards our goal of parity without sacrificing any of the core academic necessities that make us unique as podiatric practitioners, responsibility to take innovative steps and maybe create board examinations that will fairly represent a broad scope of medicine, but also test for expertise in podiatric medicine and surgery. We have the responsibility to create equivalent 3-year residency positions so that all students of podiatric medicine and surgery are given the opportunity to practice and become comfortable in the science and art of podiatric medicine and surgery and be given the opportunity of paying off tremendous financial debt encumbered during years of study and the responsibility to give these resident graduates a fair deal when they enter the practice environment. I haven’t really addressed my priorities for the coming year, so allow me to briefly summarize, and I only hope my actions will speak louder than my intentions: • My priorities this year include ways to use our union affiliation to our advantage via public relations and perhaps even website linkage to increase patient traffic in your offices; • They include ending pay discrimination in cases like Multiplan; • Getting us back into Medi-Cal as Physicians and Surgeons now that we have Thomson-Reuters, favorable interpretations of Title XIX by Donald Berwick and the Teamsters in our corner; • Getting members up to date information be it written, faxed, “webinared” or in a Town Hall format so we can be a little less jittery and more certain as to how to better navigate the future of health care;

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• Getting meetings with important decision makers like the State Secretary of Health, Diana Dooley and Speaker pro-tem, Darrell Steinberg will be part of my goals; and • Establishing personal relationships with personnel associated with UCs to create much needed residency programs and getting these programs funded. • These are laudable goals indeed, but all achievable. Please feel free to help out where you can. I’d like to acknowledge the rest of your team sitting up here today. My fellow board members - Jeff Haupt, our new Treasurer Tom Elardo, Diane Branks, Ami Sheth, our new VP Carolyn McAloon, our President-Elect, Karen Wrubel, and one of the hardest workers I know, Mike Cornelison. The only thing worse than seeing Mike send an email at 3:05 AM was me reading it at 3:09 AM, and Steve Wan who obviously is using his practice in Torrance as a front for a CPMA satellite office, and I mean satellite - a 50 foot dish where he picks up signals regarding everything podiatric. I’m also very much appreciative of the hard work and long hours put in by my predecessor Dan Altchuler, my classmate Tracy Basso, Ernie Hook, and all the leaders in this room who decided at some time in their practice life that something’s not quite right and we’ve got to fix it. Finally, I’d like to acknowledge my family starting with my brothers Jeff and Matt, who decided taking my U2 tickets were more important than being here today, and their families; my cousins Stephanie, Dan and Sam; my mother, Adele and my late father, Alvin, a former leader himself as President of the Long Island Pharmaceutical Society and a humanitarian who was a true stalwart in the community I grew up in on Long Island. Both of my parents instilled in me a sense of righteousness and the spirit of obligation to give back, and I am forever grateful. Thank you to my children whom I adore beyond words, Benjamin and Gabriel, and my very understanding wife and muse, Debbie, for tolerating my seemingly unbalanced life. I look forward to your help and camaraderie in the year to come and want you to reach out to me or any of your board members with your thoughts or concerns. It’s going to be a challenging year, but the pieces are falling into place and we’re ready to go. In the words of Albert Camus, “We must imagine Sisyphus happy. We must imagine ourselves embodying the spirit of medicine in the way it was meant to be and finding contentment in the art and practice of podiatric medicine.” I know sometimes it seems like a 100 years’ war, but with your membership in the CPMA, I can guarantee it will never be a 100 years of solitude. Thank you.

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2011 Awards Podiatric Physician of the Year Franklin Kase, DPM

Executive Director Award Dustin Corcoran

Distinguished Service Award Jerry Brant, DPM

Excellence in Education Award Jonathan Labovitz, DPM

Vision Award Jon Hultman, DPM, MBA

Humanitarian Award Bruce Lehnert, DPM and the Vietnam Mission Project

Meritorious Service Award Irma Walker-Adame, MS Society President of the Year Harvey Danciger, DPM President’s Award Roderick Farley, DPM and Nedra Farley

Communications Awards Gold Award Los Angeles County Podiatric Medical Society Silver Award Orange County Podiatric Medical Society Bronze Award San Diego Podiatric Medical Society 8|

Volunteer of the Year Award Harry Harbison, DPM Step-Up Award Rochelle Bomar, DPM Service Above Self Award Michael Cornelison, DPM

CalPPAC Awards Society with Highest Total Contribution Los Angeles County Podiatric Medical Society Society with Highest Number of Members Contributing Alameda/Contra Costa Podiatric Medical Society Society with Highest Contribution per Member Los Angeles County Podiatric Medical Society Honorable Mention San Diego Podiatric Medical Society C PM A | C a l ifo r n ia Podiat r ic M e dica l A s s ociat io n


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awards!

CPMA Executive Director Jon Hultman, DPM, MBA ( r) presents the Association’s 2011 Distinguished Service Award to Jerry Brant, DPM

CPMA Past President Stephen Wan, DPM ( r) presents the 2011 Local Society President of the Year Award to Coachella Valley Podiatric Medical Society President Harvey Danciger, DPM

David Mullens, DPM (l) presents the 2011 Alumni and Associates Gary P. Bianchi, DPM award to Randall Sarte, DPM

CPMA Director Ami Sheth, DPM (r) presents CSPM Associate Dean Irma Walker-Adame with the Association’s 2011 Meritorious Service Award

CPMA President William Tarran, DPM (l) presents the Association’s 2011 Service Above Self Award to Immediate Past President Michael Cornelison, DPM

CSPM Student Representative Jenny Sarmiento accepts CPMA’s 2011 Humanitarian Award from CPMA Secretary-Treasurer Thomas Elardo, DPM on behalf of Bruce Lehnert, DPM and the Vietnam Mission Project | 9

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CPMA Executive Director Jon A. Hultman, DPM (l) receives the Association’s 2011 Vision Award from President Michael Cornelison, DPM

Samuel Merritt University President Sharon Diaz accepts CPMA’s 2011 Meritorious Service Award from CPMA Director Ami Sheth on behalf of Irma Walker-Adame

President Cornelison (r) presents the 2011 President’s Award to CPMA Past President and Parliamentarian Roderick Farley, DPM and Recording Secretary Nedra Farley

CPMA Past Presidents (left to right) Michael Cornelison, DPM; Roderick Farley, DPM and Stephen Wan, DPM

CPMA President Michael Cornelison, DPM (l) is joined by Lawrence Harkless, DPM, Dean, Western University’s College of Podiatric Medicine (r) in presenting Jonathan Labovitz, DPM (c) with CPMA’s 2011 Excellence in Education Award 10 |

CPMA Executive Director Jon Hultman, DPM (r) presents the 2011 Executive Director Award to CMA Chief Executive Officer Dustin Corcoran

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CPMA Vice President Carolyn McAloon, DPM presents Rochelle Bomar, DPM with the Association’s 2011 Step-Up Award

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President Cornelison (l) and CPMA Executive Director Jon Hultman, DPM (r) present Franklin Kase, DPM with CPMA’s 2011 Podiatric Physician of the Year Award

CalPPAC Chair Derick Ball, DPM (2nd from right) and Co-Chair Robert Abrams, DPM (c) present the 2011 CalPPAC Awards to Vladimir Zeetser, DPM, President, Los Angeles County Podiatric Medical Society (r); Jerry Fabrikant, DPM, President, San Diego Podiatric Medical Society (l), and Jason Hiatt, DPM, President, Alameda/Contra Costa County Podiatric Medical Society (2nd from left)

President Cornelison (r) presents to the 2011 CPMA Communication Awards to Los County Podiatric Medical Society President Vladimir Zeetser, DPM (2nd from right); Devon Glazer, DPM, President, Orange County Podiatric Medical Society (2nd from left), and Jerry Fabrikant, DPM, President, San Diego Podiatric Medical Society (l) J u ly | Au g u s t | S e p t e m b e r | 2011

CPMA President-Elect Karen Wrubel, DPM presents Harry Harbison, DPM with the 2011 Volunteer of the Year Award. | 11


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Diamond CrocsRx

Wright Medical Technology, Inc.

GOLD Advanced BioHealing Formula 3

Integra LifeSciences Corporation Small Bone Innovations (SBI)

SILVER BioMedix

(Educational Grant is provided by BioMedix through the APMA Regional Lecture Series Program)

BioMedix

DePuy Stryker Orthopaedics Tornier

Bronze Arthrex Bako Podiatric Pathology Services BioMimetic Therapeutics BioPro, Inc. CryoProbe KCI

OsteoMed, LP Pamlab, LLC ProLab Orthotics/USA SureFit Synthes Tekscan, Inc.

Program Sponsors American College of Foot & Ankle Surgeons – Division One ArthroCare Sports Medicine OrthoHelix Surgical Designs, Inc.

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Performance Materials Corporation Podiatry Insurance Company of America (PICA) Present Podiatry

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certificate from Page 5

dealt with these political and, sometimes, emotional issues. The leaders of the CMA and COA have taken a significant risk in supporting this effort, even “going public” with their support. There is currently a high degree of trust amongst our three organizations, which helps those involved in this process address problems as they are encountered and jointly solved along the way. Even on the national level, the American Orthopaedic Foot & Ankle Society has issued a statement about the California effort through its president, Keith L. Wapner, MD, stating, “The AOFAS supports any initiative that can improve patient safety and the quality of care for patients.” With the most difficult political and emotional issues behind us, this process will now move to the medical and podiatric educators, consultants, and observers who will form the joint task force.

This academic body will be able to conduct its work knowing in advance that the “political organizations” are going to back off and support the outcome of their work. If, as a result of this process, the task force members detect any “deficiencies” in the podiatric curriculum, we know that as soon as these are addressed, the CMA and COA will support any steps necessary for DPMs to attain the Physicians and Surgeons Certificate. While the rest of the country is still debating degree, with some state societies still locked in heated battle with their state medical and orthopedic associations, CPMA leaders have moved from debating to taking collaborative action. Now is the time for every DPM practicing in California to find his/her voice and support us in this effort.

Rogers Runs for Congress Our own Lee Rogers, DPM is running for Congress from the 25th Congressional District in California. After redistricting, this once mostly Republican district is now more evenly distributed. Lee is running as a Democrat, and so far he is the only Democrat registered with the FEC. Two Republicans, including incumbent Buck McKeon, have entered the primary. According to political insiders, the 72 year-old staunch Republican is vulnerable. Lee considers himself a “politically moderate problem solver”. Dr. Rogers has hired a top-notch campaign consulting group who has experience running physicians for Congress and overall has an excellent track record. The California congressional primary is June 5, 2012, and the general election is on November 6, 2012. Primaries in California are now nonpartisan, so the top 2 move on to the general election as a runoff. This means it is possible to have two candidates from the same party be candidates in the general election. We have never had a podiatric physician in elected national office. I’m sure you understand what this could mean for the profession. Can Lee do it? Can we do it? Can we help raise money for Lee Rogers to be the first podiatric physician in the US Congress? I think we can! Consider this an investment in our future. Please contribute what you can by going to Lee’s website www.LeeRogers2012.com. Thank you. Bill Tarran, DPM President, CPMA

Left to right: Joseph Caporusso, DPM, APMA President-Elect; Lawrence Harkless, DPM, Dean, College of Podiatric Medicine at Western University, and CPMA President William Tarran, DPM

Are you reading yours? J u ly | Au g u s t | S e p t e m b e r | 2011

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NeuraVite

™

Nerve Revitalizing Supplement


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Uy Steps Up to CPMA Directorship Jonathan Uy, DPM, of Benicia, California, was elected as a Director-at-Large to the Board of Directors of the California Podiatric Medical Association (CPMA) during the organization’s 99th Annual House of Delegates, which took place in Anaheim this past June. A Fellow of the American Professional Wound Care Association (FAPWCA), Uy is Board Certified in wound care, primary podiatric care, and diabetic foot wounds. He served as President of the San Francisco/San Mateo Podiatric Medical Society, for which he received CPMA’s Society President of the Year. Uy is active in the podiatric medical community having served and volunteered in a number of capacities including the Baja Crippled Children’s Project in Mexico.

medical training and Doctor of Podiatric Medicine (DPM) degree from Barry University School of Podiatric Medicine in Miami Shores, Florida, where he was also an honors student.

Uy received his Bachelors of Science in biomedical engineering from Boston University’s College School of Engineering, Boston Massachusetts where he was an honor student. He received his

Dr. Uy is a private practitioner with offices in Hercules and San Bruno, California.

Dr. Uy’s postgraduate training includes a podiatric surgical residency at MedPremises Surgery Center in San Diego, California; a diabetic foot fellowship at the California College of Podiatric Medicine (CCPM) and a primary podiatric medicine residency at BUSPM/Columbia Cedars Medical Center in Miami, Florida.

www.calpma.org One of the many excellent benefits of membership in the California Podiatric Medical Association (CPMA) is access to its comprehensive Web site. This rich resource enables CPMA members to search hundreds of documents in minutes, which just a few years ago would have taken weeks to retrieve,if they could have been found at all. At your fingertips are state laws affecting podiatric medicine, current and archived issues of CPMA publications, meeting information and registration forms, third-party payer information and so much more. Perhaps the most popular resource on the public site is the Find-a-Podiatrist member locator, prominently featured on all the public site pages. This resource allows potential patients to find CPMA member podiatrists in their area. The public can search for a member doctor by last name, city, or within 5 to 50 miles from a designated zip code. In addition, the Find-a-Podiatrist site allows CPMA members to post a practice profile page - at no charge. Members can list their specialty, education, office hours, hospital affiliations, insurance accepted, as well as a second office location and information. It’s a valuable service for the public and a rich source of new patients for members. CPMA members also have access to the member’s only area of the national APMA website www.apma.org, as well a being listed on the national Find-a-Podiatrist search engine. Stay on your toes at www.calpma.org. J u ly | Au g u s t | S e p t e m b e r | 2011

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house of

DELEGATES Oliver S. Foster, DPM

Jon Hultman, DPM, MBA

Addressing the House

Past Presidents at the House (l to r): Franklin Kase, DPM; Lyman Wilson, DPM; David Mazza, DPM; Ronald Jensen, DPM; Barry Scurran, DPM; Ernest Hook, DPM; Eric Hubbard, DPM; Randall Sarte, DPM; Jack Bois, DPM; Daniel Altchuler, DPM, and Stephen Wan, DPM

Melvin Barton, DPM

Michael Cornelison, DPM, 2010-2011 CPMA President 16 |

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Q and A

Foundation for Excellence in Podiatric Education Chair Randall J. Sarte, DPM (l) and CAFFE Director Melvin Barton, DPM (r) present CSPM Dean John Venson, DPM (c ) with check for podiatric scholars in the amount of $42,000

CPMA Past President Stephen Wan, DPM (l) with Western University’s College of Podiatric Medicine Dean, Lawrence Harkless, DPM

Orange County delegates Devon Glazer, DPM (at mic) and Michael Heaslet, DPM

(l to r) APMA President Michael King, DPM; APMA Executive Director Glenn Gastwirth, DPM and CPMA Past President Jack Bois, DPM

Jim Rathlesberger, MS, Executive Officer, Board of Podiatric Medicine J u ly | Au g u s t | S e p t e m b e r | 2011

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Harry Goldsmith, DPM

CPMA Director Diane Branks, DPM (2nd from left) with San Diego Delegates Kenneth Charp, DPM, (2nd from right), John Chisholm, DPM (r) and Jerry Fabrikant, DPM (l)

Lyman Wilson, DPM

CSPM Student Representatives Jenny Lynn Sarmiento and Nathan Hansen

Past President Stephen Wan, DPM

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Sharon Diaz, President, Samuel Merritt University

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Derick Ball, DPM, CalPPAC Chair

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2011-2012 CPMA Board of Directors: Vice President Carolyn McAloon, DPM; Director Jeffrey Haupt, DPM; President-Elect Karen Wrubel, DPM; Executive Director Jon Hultman, DPM, MBA; Director Ami Sheth, DPM; Director Rebecca Moellmer, DPM; Director Diane Branks, DPM; Director Jonathan Uy, DPM; Secretary-Treasurer Thomas Elardo, DPM; Immediate Past President Michael Cornelison, DPM, and President William Tarran, DPM

Checking in at House Credentialling

William Tarran, DPM (r) and Thomas Elardo, DPM

Neil Mansdorf, DPM

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Jim Gross, Esq., CPMA Legislative Consultant

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Checking out the goodies during the House break Dustin Corcoran, CMA Chief Executive Officer

Lawrence Harkless, DPM, Dean, College of Podiatric Medicine at Western University of Health Sciences CPMA Director Rebecca Moellmer, DPM (l) with LA Delegate Arnold Serkin, DPM

Franklin Kase, DPM (l) and Jon Hultman, DPM, MBA 20 |

Preparing to vote

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APMA President Michael King, DPM

APMA Executive Director Glenn Gastwirth, DPM

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John Venson, DPM, Dean, California School of Podiatric Medicine at Samuel Merritt University

CPMA Past President Franklin Kase, DPM, Chair, Health Policy Committee

Members of Orange County Podiatric Medical Society Delegation

CPMA Past Presidents Jack Bois, DPM (l) and Ronald Jensen, DPM

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2011-2012 CPMA Board of Direc tors

William Tarran, DPM, President

Karen Wrubel, DPM, President-Elect

Carolyn McAloon, DPM, Vice President

Michael Cornelison, DPM, Immediate Past President

Thomas Elardo, DPM, Secretary/Treasurer

Diane Branks, DPM, Director

D. Jeffrey Haupt, DPM, Director

Rebecca Moellmer, DPM, Director

Ami Sheth, DPM , Director

Jonathan Uy, DPM, Director

Roderick Farley, DPM, JD, Parliamentarian

Jon Hultman, DPM, MBA, Executive Director

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99th CPMA House Sets Goals and Selects Leadership for Coming Year

Over 100 leaders of California’s podiatric medical profession gathered at the Disneyland Hotel in Anaheim this past June for the California Podiatric Medical Association’s (CPMA) 99th Annual House of Delegates (HOD). Delegates and alternates representing CPMA’s eighteen (18) local component societies (stretching from the Oregon to Mexican borders) received in-depth briefing on legislative affairs, health policy issues, podiatric medical education, and legal matters. The delegates unanimously passed the resolution which continues the current CPMA dues for the 2011-2012 year.

Elections The delegates of 2011 CPMA House were also tasked with choosing the Association’s Board of Directors for the coming year. The 2011-2012 Board of Directors as voted by the 99th CPMA House of Delegates are as follows: William Tarran, DPM (Daly City) was elected President. Karen Wrubel, DPM (Hawthorne) was elected President-Elect; Carolyn McAloon, DPM (Castro Valley) was elected Vice President, and Thomas Elardo, DPM (Los Gatos) was elected Secretary/Treasurer. Directors-at-Large Rebecca Moellmer, DPM (Ontario) and Ami Sheth, DPM (Los Gatos) were both reelected to two-year terms, and Jonathan Uy, DPM (Hercules) was elected to a one-year term as Director-at-Large. The 2011 House also selected the delegation that would represent California at the 2012 American J u ly | Au g u s t | S e p t e m b e r | 2011

Podiatric Medical Association (APMA) House of Delegates next spring in Washington, D. C. Stephen C. Wan, DPM was elected to the four-year delegate position joining CPMA’s three other four-year delegates Franklin Kase, DPM; Eric Hubbard, DPM; and Jon Hultman, DPM, MBA. Those elected as one-year delegates and alternates to the 2012 APMA House of Delegates are: Tracy L. Basso, DPM; Michael J. Cornelison, DPM; Ronald Jensen, DPM; David Mazza, DPM; Carolyn McAloon, DPM; William Tarran, DPM; and Karen Wrubel, DPM. The three elected alternates are Daniel L. Altchuler, DPM; Oliver S. Foster, DPM; and Jonathan Labovitz, DPM.

Awards During the meeting, the HOD honored a number of members of the podiatric medical community for their efforts to advance the profession. Award recipients included: CPMA Past President and Health Policy Committee Chair Franklin Kase, DPM who was named California’s 2011 Podiatric Physician of the Year and Jerry Brant, DPM who received CPMA’s 2011 Distinguished Service Award. The 2011 Meritorious Service Award was presented to Irma Walker-Adame, MS. Jonathan Labovitz, DPM received the Association’s 2011 Excellence in Education Award, and CPMA Past President and Executive Director Jon A. Hultman, DPM, MBA, was awarded CPMA’s 2011 Vision Award. | 23


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Past Presidents Stephen Wan, DPM (l) and Jon Hultman, DPM, MBA making toast at Presidents’ Dinner

CPMA Immediate Past President Michael Cornelison, DPM with spouse Nancy and family

Left to right: Franklin Kase, DPM; Jon Hultman, DPM; Dustin Corcoran, Stephen Wan, DPM and Eric Hubbard, DPM

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Gathering of CPMA Presidents: front row (l to r): David Mazza, DPM; Daniel Altchuler, DPM; Noreen Oswell, DPM; William Tarran, DPM; Lyman Wilson, DPM; Roderick Farley, DPM; Michael Cornelison, DPM. Back row (l to r) Ronald Jensen, DPM; Fred Youngswick, DPM; Barry Scurran, DPM; Franklin Kase, DPM; Oliver Foster, DPM; Jeffrey DeSantis, DPM; James LaRose, DPM; Richard Viehe, DPM; Ernest Hook, DPM; Eric Hubbard, DPM; Stephen Wan, DPM; Jack Bois, DPM; Jon Hultman, DPM and Tracy Basso, DPM

(l to r) CPMA Director Diane Branks, DPM, Patti Hultman, Vice President Carolyn McAloon, DPM and President-Elect Karen Wrubel, DPM

CPMA Past President Daniel Altchuler, DPM (l) with newly elected President William Tarran, DPM J u ly | Au g u s t | S e p t e m b e r | 2011

Past President Barry Scurran, DPM | 25


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out

& about

CPMA Executive Director Jon Hultman, DPM, MBA with spouse Patti and son Luke

Past Presidents Lyman Wilson, DPM; Ronald Jensen, DPM and Oliver Foster, DPM sharing a laugh

Past Presidents Franklin Kase, DPM (l) and Roderick Farley, DPM

Past President Barry Scurran, DPM with friends Staci Labovitz (l) and Nanette Wan (r) 26 |

Having fun with Goofy

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CPMA Executive Director Jon Hultman, DPM, MBA and Patti Hultman with CMA Chief Executive Officer Dustin Corcoran

Enjoying a snack during session break.

Say cheese

Western Chair Jonathan Labovitz, DPM with spouse Staci

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out & about

CPMA President-Elect Karen Wrubel, DPM and spouse Derick Ball, DPM, Chair, CalPPAC

Barry Surran, DPM chatting with Shelley Jensen

Paul Scherer, DPM and Laurie Waters 28 |

The new 3-tier pool at the Disneyland Resort is a HIT

Catching up

Thomas Elardo, DPM with his spouse Mai

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President Tarran with proud mom Mrs. Tarran

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CPMA Past President Stephen Wan, DPM (l) and Joseph Hughes, DPM

Daniel Fulmer, DPM (l) chatting with Colleague

CalPPAC Chair Derick Ball, DPM (l) and Western Chair Jonathan Labovitz, DPM

CPMA Past Presidents Eric Hubbard, DPM (l) and Oliver Foster, DPM

(l to r) Meg Heim; Diane Branks, DPM; Roderick Farley, DPM and Nedra Farley.

J u ly | Au g u s t | S e p t e m b e r | 2011

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MEMBERSHIP Has its Benefits

CPMA is the only organization that can lobby on behalf of the podiatric profession in California’s capitol. In addition to realizing the accomplishments that only strong organization and representation can achieve, there are a number of immediate and tangible benefits only members of CPMA, APMA, and the IBT Union can access and receive. CPMA membership gives you access to the following:

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

• Significant discounts for educational conferences and courses, including The Western, which provides 25 CMEs including units to meet California Radiology requirements • Discount on malpractice insurance premiums • E-subscription to the DPMemo, CPMA’s monthly email newsletter plus eAlerts as news you need to know arises • Free subscription to the California Podiatric Physician and JAPMA • Free and discounted legal advice and support • Representation to CMS and insurance carriers via 20+ committees • Webinars with CMEs available 24/7 • Access to tools for managing and marketing your practice online

• Networking and knowledge-sharing opportunities with other DPMs • Regional support through State and Local activities • Convenient automatic monthly payment option • Online Radiologic Manual, required by the State of California • Discounts on wireless service • Car rental, travel, and entertainment discounts • Vacation tours savings to destinations across the globe • Theme park discounts • Loan and mortgage programs • Health program savings – save on vision and dental care and more • Plus many more discounts and opportunities for your professional and personal benefit!

A pp l i ca t i o n f o r M e m b e r s h i p First Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M.I . . . . . . . . .

Professional Licensure

Last Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Podiatric Medical Licenses

Previous Last Name (if changed due to marriage, divorce, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . .

Birth Date . . . . / . . . . / . . . . Sex:  Male  Female Practice Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Owner  Employee Home Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Principal Office/Residency Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................................................................. Phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-Mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . . Year . . . . . . . . . . . . State . . . . . . . . . Number . . . . . . . . . . . . . . . Have you ever had a license to practice podiatric medicine suspended or revoked in any state?  yes  no If yes, please explain on a separate sheet. Are you currently, or have you ever been, on probation suspension, or investigation by any licensure authority, state or federal agency?  yes  no If yes, please explain on a separate sheet.

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

Podiatric Medical Education Podiatric Medical Degree

 yes  no

Podiatric Medical College . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...................................................... Year of Graduation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

For more information on membership, please contact the California Podiatric Medical Association at (800) 794-8988 or jsteed@calpma.org.


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Listening to the Voice of the Customer Being in a people service business I am always looking for ways to improve the quality of service to our customers, which in my case and yours, happen to be patients. Recently I had the opportunity to attend the Medicare POE-AG face-to-face meeting and had the opportunity to listen to an excellent lecture given by Harry Feliciano, MD, MPH, who works with Medicare. It was interesting to hear things from the other side, as we are healthcare providers and they are third-party payers who pay physicians for their services to their beneficiaries. During his lecture he talked about the need to listen to the “voice of our customers” (VOC) to be able to improve the quality of our service.

time was wasted on the paperwork going back and forth with hospital personnel. They looked at what did not have value and cut it out. They found that the patient paperwork could only take 7 minutes, and they had an RN meet each patient as they came in the door who took them back right away. The Nurses had the training and could not only get the information they needed from the patients quicker, but they could triage the problems and get the patient in to a physician to be treated faster.

Dr. Feliciano told a true story of a hospital Emergency Room that was losing patients because the patients were willing to take the risk and drive an additional 20 minutes to go to an ER in a neighboring town for better care. When the hospital realized this they began asking questions as to why this was happening and how they could get patients back to their hospital. They found out that patients were not coming to them because they were able to receive better service quicker at the neighboring hospital. They took the time to find out what the people really wanted from an ER and came up with just these three things: 1. The patients wanted to see the doctor sooner; 2. They wanted to have their family in the waiting room informed of what was happening; and 3. The patients wanted to be treated with respect.

The hospital mapped the patient experiences, then the processes and value. They were able to take their dysfunctional ER and make it a No Wait ER because they were willing to listen to the voice of the customer (VOC). However, the real change came because after they listened, they just didn’t talk about what needed to change, they actually did it!

The hospital began mapping the patient experience in the ER and found out that the average person took 47 minutes just to get the paperwork filled out correctly before being able to be seen, but out of the 47 minutes only 7 really had any value. The rest of the

This really made me think about our practice and how we need to put on our stethoscope and take a good listen to the heart of our business, which is the VOC (voice of our customers), to make sure we are keeping up with their needs, because without them, we have no pulse. Take time to map your customers’ experience with your practice to see if there is something you can do to improve the quality and service you give them. “Quality in a service or product is not what you put into it. It is what the client or customer gets out of it.” - Peter Drucker

CPMA, Your Professional Lifeguard for 100 years! Joining The California Podiatric Medical Association (CPMA) is like hiring a powerful professional staff to watch out for regulatory, legal and legislative actions that would negatively impact your ability to practice medicine – for pennies a day. Your CPMA membership allows you to focus on your patients while CPMA looks out for you.

2430 K Street, Suite 200 • Sacramento, CA 95816 916-448-0248 • 800-794-8988 • Fax 916-448-0258 cpma@calpma.org • www.calpma.org J u ly | Au g u s t | S e p t e m b e r | 2011

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Electronic Health Records Manual

Logon to www.poggiodpm.com to preview and download this valuable asset to ease the transition to your EHR system. This manual is only available as a download. Considering converting to an Electronic Health Records system in your office? Confused? Heard other horror stories?

There are links to CMS and other websites to get more information and clarification.

Meaningful use? This critical process is explained so that you can meet all the requirements and collect your INCENTIVE MONEY!!!!.

This manual has all the information you will need located in one convenient location. Transitioning to an EHR process is outlined in a step-by-step, easy to follow along fashion.

Send orders to: Anthony Poggio DPM, 2059 Clinton Avenue, Alameda, CA 94501 Or via fax to 510-521-9610 First Name

Last Name

Mailing Address City/State/Zip Email Address

Payment Information Check payable to California Podiatric Medical Association or ■ Visa ■ M/C ■ Amex Card Number Exp. Date (mm/yy)

CVV Code

Cardholder’s Name

Date

Cardholder’s Signature


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What Has CPMA Ever Done For Me? For 100 years, the California Podiatric Medical Association (CPMA) has blazed the way for virtually every step of progress made by California’s podiatric medical profession – moving it from a peripheral medical skill to mainstream medicine and enhanced standing in California healthcare system. Here are just a few of CPMA’s hard fought victories on your behalf: • The right to perform independent H & Ps • The right to perform amputations ��� The ability to assist an MD or DO in surgery outside scope of practice • The right for podiatric physicians to perform surgery within scope of practice • The right for limited license podiatric x-ray technicians to take digital x-rays • The right for a podiatric physician acting within his or her scope of licensure to prescribe orthotic or prosthetic devices covered by the patients health plan • The right to prescribe prescription medications • The right to administer local anesthetics • JCAHO recognition of podiatric physicians as qualified members of hospital staff • The right to perform, read and interpret x-rays • The Veterans Administration inclusion of podiatry in the division of medicine and surgery. • Establishment of podiatric residency programs • The availability of state funds for podiatric medical students • Clarification of language guaranteeing DPMs’ right to surgically treat ankles • Surgery center privileges for DPMs • The right to form MD/DPM partnerships • The right to supervise PAs within the scope of licensure • The right for DPMs to expand the names they may use for their practices For nearly 100 years, CPMA has been the difference between success and failure, literally the life or death of California’s podiatric medical profession. Join CPMA and help us in our ongoing efforts to help you!

Call (800) 794-8988.

Now, ask yourself honestly, where would you be without the efforts and advancements made by CPMA?

CPMA Alerts are you getting AND reading yours? “Thank You CPMA for the alerts regarding CMS unannounced office audits/visits regarding DME. Because of the Alerts my office was prepared, even though I was out of the office when the inspectors dropped by unannounced. Everything went smoothly and we passed with flying colors. Thank you again.” CPMA Member CPMA utilizes blast emails and blastfaxes to get important, breaking and time sensitive information to members as quickly as possible on issues regarding your patients, practice and profession, like CMS’ surprise DME inspections. Be sure to read yours.

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ANNUAL HEALTH POLICY This is our Annual Health Policy Report from our committee for which I am Chair for the years 2010 to 2011. In this report, I will briefly discuss some of the issues occurring with regard to specific insurance companies but will devote the majority of this report to Accountable Care Organizations, a new entity formed by the Patient Protection Act of 2010 and recent events that occurred in the American Podiatric Medical Association House of Delegates in March of 2011. We will discuss, however, some specific issues regarding specific insurance companies as we have done in years past.

Also, an issue that we had with Blue Shield was that they were requesting invoices when a podiatric physician would supply a durable medical equipment (DME) product. We have been successful in eliminating the requirement that a podiatric physician, or any other physician for that matter, submit an invoice when providing their patients with a DME that has a reimbursable value under CMS HCPCS coding.

BLUE CROSS OF CALIFORNIA:

As I have indicated in previous reports, I am still a member of the Department of Workers’ Compensation Medical Evidence Evaluation Advisory Committee and have been told that I will have the responsibility of formulating new guidelines for evaluation and treatment of foot and ankle occupational injuries and disorders. Unfortunately, since Governor Brown became governor in November of 2010, our committee has not reconvened due to budgetary constraints. It is anticipated that in the near future we will have another meeting at which time we should discuss, along with other issues, when we will be able to start reforming the present foot and ankle disorder treatment guidelines under ACOEM and ODG’s present guidelines, which are clearly outdated. Until then we need to be aware of foot and ankle evaluation and treatment guidelines for occupationally related disorders under ACOEM and ODG.

As I indicated in my report last year, we have been enjoying a very cordial, collegial relationship with Blue Cross of California. There are few of our members that are on medical review by Blue Cross because they have continuously billed outside the recognized and accepted guidelines of Blue Cross and as billed by their peers. It is important to note that if you are billing high level evaluation and management codes on a regular basis, because of the complicated medical problems that you encounter on a regular basis due to the populations you treat, then you need to have clear documentation in the medical record to support such billing high level evaluation and management codes. In those rare instances, it is indeed appropriate to bill at that high level coding and you may request a “peer-to-peer review” with a medical reviewer at Blue Cross to explain why you bill at a higher level of coding than your peers. In addition, it is important to review Blue Cross’s policies regarding certain surgical and medical procedures, which are clearly delineated on their website. One of the issues that have continuously come up is billing for a subtalar joint arthroereisis, which is considered by Blue Cross and many other insurance companies to be experimental and investigational. It is recommended that prior to performing such a procedure that you get authorization from Blue Cross to be reimbursed for that procedure. In most instances I can tell you that you will not be reimbursed for such a procedure and it will be the responsibility of the patient to pay you upfront provided that you have given them adequate disclosure that this procedure is not payable by Blue Cross and many other insurance companies following those guidelines. It is also important to note that extracorporeal shockwave is also considered experimental and investigational and will not be paid by Blue Cross nor most other insurance companies of which I am aware.

BLUE SHIELD: We have also enjoyed a good relationship with Blue Shield. However, from time to time we notice that they do not pay podiatric physicians as they do medical physicians for certain procedures that they consider “outside of our scope”. Some of the procedures that have come into question are the use of synthetic skin grafts, which is clearly within our scope. On these occasions, we have to educate Blue Shield that a podiatric physician can perform any and all procedures on the foot, ankle and lower leg as all such procedures are clearly within our scope of practice in the treatment of any foot, ankle and lower leg disorder. On most occasions, Blue Shield has rescinded their egregious policies and have issued payment to the podiatric physician provider. 34 |

WORKERS’ COMPENSATION:

UNITED HEALTHCARE: In general, we have not had much difficulty dealing with United Healthcare in California. One issue, however, that has come up in California and nationally has been the failure of United Healthcare to pay a podiatric physician and other physicians for evaluation and management services which are performed at the same time as a minor surgical procedure. An example of this would be payment for a nail avulsion or nail matricectomy but not paying for a new or established patient office visit at the same time. We have discussed this at length with the medical directors at United Healthcare and I have personally spoken to several medical directors at United Healthcare to rectify this situation. It has now become a national policy of United Healthcare that with proper documentation in the medical record, United Healthcare will pay with a -25 modifier appended to the evaluation and management coding, both a minor surgical procedure as well as the evaluation and management service provided that there is medical documentation and medical necessity. This is a major win for podiatric medicine as well as general medicine.

MULTIPLAN: Another issue of great contention in California and nationally has been the issue of MultiPlan’s reimbursement formula. I will be discussing the issue of MultiPlan further in my talk during the Billing and Coding Workshop at the Western Podiatric Medical Congress. I do want to say, however, that MultiPlan has been one of the only insurance plans in California that clearly discriminated against podiatric physicians. It is important to inform all podiatric physicians in the state of California and nationally that MultiPlan does not consider podiatric physicians as doctors. Under MultiPlan’s definitions of first level providers who are only defined as MD and C PM A | C a l ifo r n ia Podiat r ic M e dica l A s s ociat io n


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REPORT 2010-2011 DO providers, and mid-level providers such as optometrists, audiologists, chiropractors, social workers, psychologists, etc., podiatric physicians are considered mid-level providers. Therefore, they are paid significantly less than our first tier providers, i.e. MDs and DOs. Despite the fact that we have educated MultiPlan and have repeatedly sent letters to their medical directors indicating that podiatric physician training is analogous to medical physician and osteopathic medical physician training, they are still stating that until California has a law that clearly prevents them from discriminating against podiatric physicians, they are going to continue to elect to pay podiatric physicians at a lower rate than they do medical and osteopathic medical doctors. While I cannot tell any podiatric physician what to do with regard to signing such an egregious contract, it is important that you are informed of this fact, that you read your contract thoroughly, and make an informed decision as to whether you want to participate in a program that clearly does not consider you a doctor and is going to pay you less than they are your medical and osteopathic medical colleagues that render the same service for foot and ankle evaluation and treatment. More will be discussed with regard to this at the Billing and Coding Workshop at the Western Podiatric Medical Congress.

AMERICAN PODIATRIC MEDICAL ASSOCIATION INVOLVEMENT: Once again, I have been appointed by our new APMA President, Mike King, DPM, to the Health Systems Committee of the APMA. It is the charge of this committee to improve the working relationship between podiatric physicians and the health care world, health insurance and health plan administrators by fostering mutual understanding through education, explanation and sometimes forceful intervention. Our committee has been very successful in ameliorating working conditions for podiatric physicians in their relationship with various health insurance carriers throughout the United States. One of the issues that I had been working on was determining whether or not Aetna was singling out podiatric physicians for decrease in payment for assistant surgeons. I have found that they are merely following Medicare guidelines and are paying assistant surgeons for coding of surgical procedures that Medicare deems applicable for the need of an assistant surgeon and are then paying the assistant surgeon at 16% for the first procedure, and 8% for the second procedure and subsequent procedures. This is compatible with Medicare guidelines in payment for assistant surgeons. In addition, as you may or may not remember, in 2003 the APMA passed a Resolution to eliminate “a separate podiatry benefit” in any health insurance plan. As part of that Resolution, APMA was supposed to send out notices to the effect that they were endorsing such a Resolution and were recommending to all insurance carriers as well as all APMA members that there should be no “separate podiatry benefit” in any health insurance plan or policy. Unfortunately, APMA never sent out such letters and I have now obtained legal counsel from APMA’s attorney that is indeed applicable and appropriate to send out such notice. What such notice will say is J u ly | Au g u s t | S e p t e m b e r | 2011

that the APMA endorses a policy of no “separate podiatry benefit” of any kind in any health plan but a Foot and Ankle benefit (carve out) that includes ALL types of physicians rendering foot and ankle services, and where a certain fee schedule would be reimbursed to ALL those providers, would be acceptable as it would be a benefit that focuses on the type of service rendered rather than the provider rendering that service. At the next Health Systems Committee meeting which is in May of 2011, I have put this issue on the Agenda and will be discussing it in great detail. When I leave the meeting, I expect that APMA will begin the process of sending out such an endorsed letter to all health plans, all APMA members and all health care providers. This is a major step in eliminating ALL discrimination against podiatric physicians in the United States.

NATIONAL HEALTH CARE REFORM AND THE INSTITUTION OF ACCOUNTABLE CARE ORGANIZATIONS: As part of the National Health Care Reform Act, otherwise known as the Patient Protection Act of 2010 (PPACA), there was a provision in the Act that mandated that the Secretary of the Department of Health and Human Services establish an entity called an Accountable Care Organization (ACO) for the purpose of providing cost efficient quality care to Medicare Fee for Service beneficiaries. As part of this new entity, it was determined that the ACO would be comprised of hospitals, medical networks, medical groups and ACO professionals. ACO professionals were defined as medical physicians and osteopathic medical physicians as designated in the Medicare Statute, otherwise known as Title 18 of the Social Security Act of 1968, as R-1 physicians. Podiatric physicians were so designated as R-3 physicians under the Medicare Statute of Title 18 of the Social Security Act of 1968, and were not included as ACO professionals. Added to the definition of ACO professionals were health care practitioners such as social workers, psychologists, physician assistants, nurse practitioners, and certified nurse anesthetists. This is of importance to podiatric physicians as according to the original formation of an Accountable Care Organization, there was a question as to whether or not a podiatric physician as a non-ACO professional, could participate in ACO governance, founding member status, and possibly shared savings of the ACO. As podiatric physicians were not defined as ACO professionals under the PPACA, I submitted a Resolution to the American Podiatric Medical Association House of Delegates which recommended that APMA form an ACO task force to determine the impact of podiatric physicians not being defined as ACO professionals on both the ACO entity as well as other health entities that may arise as a result of the Patient Protection Act of 2010. In addition, in my Resolution, I recommended that APMA seek audience with the Department of Health and Human Services and specifically the Secretary, Kathleen See POLICY REPORT on Page 36

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Sebellius, to educate the Department about a podiatric physician’s present education, training and experience and the value that podiatric medicine and surgery brings to the health care system. It should be noted that the Resolution I presented passed the House of Delegates with overwhelming support. Since that time, Dr. Jeff DeSantis and I have been appointed to be members of the newly formed Accountable Care Organization Task Force, and we are presently discussing a strategy on how to make a podiatric physician more valuable to the Accountable Care entities that are being formed. In addition, we are discussing strategy as to how to make contact with the Department of Health and Human Services. It should also be noted that since our Resolution was introduced at the APMA House of Delegates, new ACO regulations have come out which indicate that a podiatric physician is now considered an ACO provider and ACO participant but are still not considered to be ACO professionals. Information about this specific area can be found on the Patient Protection Act of 2010 website. It is also important to note that the original idea of the ACO has undergone great change since its first discussion. Originally, it was thought that there would be many independent medical physicians that would be interested in starting such an ACO. Now it has come to the attention of the entire medical community that any person participating in the ACO would be subject to rewards as well as possible losses should the cost exceed any monies that are saved by the ACO in a very complicated formula. Of interest also is my wife, Beth Kase, who is the Chair of the L.A. County Bar Health Care Section and has become an expert in ACOs, recently convened a joint meeting with the President of the L.A. County Medical Association about Accountable Care Organizations. At that meeting, there was standing room only and there was a very lively discussion about what the impact on physicians would be by the forming of ACOs. It was concluded that it was most probable the only people to benefit from an ACO being formed would be attorneys and possibly already integrated medical groups such as Kaiser or HealthCare Partners. There has not been full shakeout as to what the end result is going to be about ACOs, but stay tuned. There is more to come.

APMA AND AMA RELATIONSHIP: Another great interest to our membership is the fact that the California Podiatric Medical Association has continued a great relationship with the California Medical Association as well as the California Orthopedic Association. As you may remember, the relationship began when I was President of the California Podiatric Medical Association in 2003. At that time, with the support of the California Medical Association and the neutrality of the California Orthopedic Association, we passed AB932, which for all intents and purposes expanded the scope of practice for podiatric physicians in the state of California to include amputations, assisting at all types of surgery on the human body, and mandated that a minimum requirement of a two year residency program was necessary for licensure in the state of California.

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Since that time, we have maintained and progressed in our relationship with both the California Medical Association and the California Orthopedic Association. To that end, we are presently involved in co-sponsorship of state legislation to allow for the employment of physical therapists by medical corporations and podiatric medical corporations. This is being opposed by the California Physical Therapy Association. This is just one example of extreme cooperation that has developed because of such a positive relationship between the California Podiatric Medical Association and the California Medical Association. Having said that, we are now attempting to “take that relationship on the road” and develop a similar relationship with the American Medical Association. In that regard, Dr. Jeff DeSantis and I met with the Trustee of the American Medical Association who is addressing the APMA House of Delegates, Dr. Joseph Annis, prior his address to the House of Delegates in Washington, D.C. We had drinks with Dr. Annis and in a two hour unscripted meeting, we educated Dr. Annis about our training, our education, and why the American Medical Association should be interested in furthering a relationship with the American Podiatric Medical Association. One of the reasons we discussed for the furtherance of our relationship is so that ultimately we will be able to speak with one voice when it comes to issues of commonality that affect all medical practitioners, including podiatric medical physicians. Dr. Annis was extremely impressed with our presentation and stated that he was extremely surprised at the information he received, and he was going to take it back to the American Medical Association Board of Trustees. Presently, Dr. DeSantis and I are in contact in with Dr. Annis, and we are continuing to maintain that relationship. Hopefully by the start of our House of Delegates here in California, I will be able to give you an update as to where that relationship is going. It is very exciting, however, to see for the first time that the American Medical Association may have a true interest in developing a more cooperative, collegial relationship with the American Podiatric Medical Association. It should also be known that Dr. Mike King, at my request, has developed an Interprofessional Relations Committee, similar to the one that we have here in California, and has made Dr. Jeff DeSantis a member of the Board of Trustees of the American Podiatric Medical Association, its Chairman with myself and others as participants. I believe I have covered much information, although be aware that without a payment fix to the sustained growth rate (SGR), we all risk the potential of experiencing a significant Medicare pay cut. We are presently threatened with a more than 20-30% pay cut by CMS Medicare by January 1, 2012, if the SGR is not permanently repaired. Hopefully, Congress will be courageous enough to finally fix this very important issue as it could greatly impact all physicians as well as all United States consumers.

CONCLUSION: These are some of the issues in Health Policy that are occurring in California and nationally. Once again, it has been a very exciting year for the Health Policy Committee of the California Podiatric Medical Association. I am honored to be and remain as your

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2011/2012 board of directors Chairman. As we in the California Podiatric Medical Association work to improve the lives of our members, please contact us if you experience any source of discrimination or unfairness in your dealings with the insurance world or health community. Remember, our goal presently and in the future is to seek parity with our medical colleagues and not be treated any differently, whether it is for benefit or detriment. We strive to be treated completely as equal in ALL arenas of health care. As a final note, I will be giving a talk at the Billing and Coding Workshop at the California Podiatric Medical Association Western Podiatric Medical Congress on appealing claims, what to look for in contracts, and the effect of ACOs on podiatric physicians. Thank you for your attention. Remember, please contact the California Podiatric Medical Association Health Policy Committee for any issues of discrimination of which you become aware. Sincerely, Franklin Kase, DPM, FAAPSM Chairman, Health Policy Committee California Podiatric Medical Association

President William Tarran, DPM Daly City, CA 94015 (650) 757-3338 wtarran@sbcglobal.net

Directors Diane Branks, DPM Baldwin Park, CA 91706 (626) 851-6864 barrydiane@hotmail.com

President-Elect Karen L. Wrubel, DPM Hawthorne, CA 90205 (310) 675-0900 drkw@cox.net

D. Jeffrey Haupt, DPM - Podiatry Orange, CA 92868 (714) 456-7016 drhaupt@aol.com

Vice President Carolyn E. McAloon, DPM Castro Valley, CA 94546 (510) 581-1484 drmcaloon@bayareafootcare.com Immediate Past President Michael Cornelison, DPM Cupertino, CA 95014 (408) 446-5811 drcornelison@sbcglobal.net Secretary/Treasurer Thomas Elardo, DPM Los Gatos, CA 92037 (408) 358-6234 painfulfeet1@gmail.com

ALAMEDA/CONTRA COSTA COUNTY Jason Hiatt, DPM Walnut Creek, CA 94596 (925) 934-3536 jason.hiatt@chw.edu

INLAND Jarrod Shapiro, DPM Pomona, CA 91766 (909) 706-3877 jshapiro@westernu.edu LOS ANGELES COUNTY Valdmir Zeetser, DPM Encino, CA 91316 (818) 907-6100 drzeetser@gmail.com MID-STATE Paul Mayo, DPM Visalia, CA 92391 (559)627-2849 Foot-hog@hotmail.com

The Western

June 7 - 10, 2012 J u ly | Au g u s t | S e p t e m b e r | 2011

Ami Sheth, DPM Los Gatos, CA 95032 (408) 358-6234 amishethdpm@gmail.com Jonathan Uy, DPM Hercules, CA 94547 (510) 724-4674 flipdpm@sbcglobal.net Executive Director Jon A. Hultman, DPM 2430 K Street, Ste. 200 Sacramento, CA 95816 O: (916) 448-0248/ (800) 794-8988 Fax: (916) 448-0258 jhultmaned@calpma.org

Binoy Sheth (WesternU) bsheth@westernu.edu General Counsel C. Keith Greer, Esq., San Diego, CA 92128 (858) 613-6677 greerkeith@aol.com Governmental Representative Barry Broad, Esq. Sacramento, CA 95814 (916) 442-5999 broad@bglaw.org Parliamentarian/ Recording Sec. Roderick D. Farley, DPM Nedra L. Farley New Mexico 87122  rodnedrafarley@aol.com

2011/2012 COMPONENT SOCIETY PRESIDENTS

COACHELLA VALLEY Harvey Danciger, DPM Palm Desert, CA  92260 (760) 568-0108 docofeet@hotmail.com

2012

Rebecca Moellmer DPM Ontario, CA 91762 (909) 984-5614 rebeccamoellmer@hotmail.com

Student Representatives Jenny Sarmiento (CSPM) jenny.sarmiento@samuelmerritt.edu jennylynn.sarmiento@gmail.com

MONTEREY BAY AREA Bobby Yee, DPM Monterey, CA 93940 (831) 646-8242 yeedoc@comcast.net

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

Central Valley David Wells, DPM Stockton, CA 95219 (209) 529-0560 buniondr1@att.net

ORANGE COUNTY Devon Glazer, DPM Lake Forest, CA 92630 (949) 272-0006 drdev01@yahoo.com

SAN LUIS OBISPO/ SANTA BARBARA Faridi Sherieff, DPM Lompoc, CA 93436 (805) 736-8818 valleypod@msn.com

REDWOOD EMPIRE Paul Weiner, DPM Vallejo, CA  94590 (707) 643-3687 mdweiner@scrserv.com SACRAMENTO VALLEY Mark Warford, DPM Fair Oaks, CA 95628 (916) 548-0218 markwarforddpm@att.net SAN DIEGO/IMPERIAL Kenneth Charp, DPM Carlsbad, CA 92007 (760) 931-9353 zfootdr@roadrunner.com SAN FRANCISCO/SAN MATEO David Tran, DPM San Francisco, CA 94127 (415) 681-2022 DTran@samuelmerritt.edu

SANTA CLARA VALLEY Douglas Robinson, DPM Campbell, CA 95008 (408) 370-3338 feetdoc@earthlink.net SHASTA REGION Gordon Shumate, DPM Redding, CA 96001 (530) 246-4800 g.shumate.dpm@frontiernet.net SOUTHERN CALIFORNIA HMO Anthony Cannizzaro, DPM Pasadena, CA 91188 (626) 405-5478 anthony.x.cannizzaro@kp.org VENTURA COUNTY Donald Kuzyk., DPM Oxnard, CA  93030 (805) 499-3287 dkuzyk@verizon.net

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

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Medicare to Require Revalidation of Provider Enrollment Information Physicians who enrolled in the Medicare program prior to March 25, 2011, will be required to revalidate their enrollment by March 25, 2013, under new risk screening criteria required by the federal health reform legislation. The revalidation requirement is required for new screening criteria that were implemented this last March. Newly enrolling and revalidating providers and suppliers will be placed in one of three screening categories representing the level of risk to the Medicare program. The level of risk will determine the degree of screening to be performed when processing the enrollment application. California’s Medicare contractor, Palmetto GBA, will begin notifying physicians via mail of this requirement in September. Suppliers and other providers will also be required to revalidate their enrollment. The notices will contain instructions for the revalidation process. Palmetto’s plan is to first notify physicians and other organizations that are enrolled in Medicare, but do not yet have complete profiles in Medicare’s online enrollment system, PECOS (Provider Enrollment, Chain and Ownership System). Other physicians and providers will receive notices over the next 19 months, in an order still to be determined. Upon receipt of the revalidation notice, physicians and organizations will have 60 days to respond. Failure to respond may result in deactivation of your Medicare billing number. Do not do anything until you get a letter instructing you to revalidate. (This is very important in order to ensure an orderly enrollment process.) Physicians who are making changes (moving, closing practice, etc.) should continue to submit their changes as usual. Institutional providers will be required to pay an application fee of $505 to enroll or revalidate. This does not apply to physicians or physician groups. HOWEVER, physicians or other providers enrolling as suppliers of durable medical equipment, prosthetics, orthotics and supplies must submit the required application fee.     For more information, see the CMS website    (Source:  CMAnet.org, August 19, 2011)

Durable Medical Equipment KB and 99 Modifiers - More Than Four Modifiers Effective November 1, 2011, if modifiers KB or 99 are used incorrectly, i.e., used with three or fewer modifiers, claims will be rejected as unprocessable and suppliers will need to resubmit. When a supplier uses more than four modifiers, the KB or 99 must be added as the fourth modifier to the HCPCS code. On paper claims, the remainder of the modifiers must be listed in Item 19 with an indicator as to which line the modifiers apply. On electronic claims, the

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remainder should be entered in the NTE segment, the 2400 loop. It is only appropriate to use the modifier KB or 99 when there is a need to use more than four modifiers on the claim line.  KB Beneficiary requested upgrade for ABN, more than four modifiers identified on claim. 99 Modifier overflow The KB modifier only applies to beneficiary upgraded claims for DMEPOS where the supplier obtained an Advance Beneficiary Notice of Noncoverage (ABN) and there are more than four modifiers on the claim line. The 99 modifier is used in any other situation when a claim line has more than four modifiers. (Source:  Tony Poggio, DPM, Chair Medicare Committee)

Medicare Denial of Ultrasound/Nerve Conduction Codes 76881/76882 CPMA Medicare Chair Dr. Tony Poggio is requesting that members fax Medicare claim denials for codes 76881/76882 (including ICN number) be faxed to the CPMA office for research and review. Please fax to 916-448-0258.

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CONTRIBUTION TO THE PHYSICIAN AND SURGEON JOINT TASK FORCE Foundation for Foot and Ankle Education 2430 K Street, Suite 200 Sacramento, CA 95816 (800) 794-8988/(916) 448-0258 www.calpma.org Foundation Tax ID # 94-3174315

Contributor Name: Amount: $_________________________ ($25 minimum for credit card contributions) Phone: ___________________________ Email:

Payment Method:

 Check (enclosed)

 Visa/MasterCard/Discover

 American Express

Please make checks out to Foundation for Foot and Ankle Education with “P&S Task Force” in the memo field.

Credit Card #: Ex. Date (mm/yy): ______________ CVV Code: ______________ Signature: Billing Address: City, State Zip:

On behalf of the profession, thank you for your support. FAX: (916) 448-0258 MAIL: CPMA - 2430 K Street, Suite 200 Sacramento, CA 95816 PHONE: (800) 794-8988 (credit card contributions only) EMAIL: acarrick@calpma.org 40 |

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Hultman Receives Vision Award During the 2011 California Podiatric Medical Association’s annual House of Delegates, CPMA Executive Director Jon A. Hultman, DPM, MBA was presented with the Association’s 2011 Vision Award. A graduate of Loyola University, Los Angeles and a cum laude graduate of the California College of Podiatric Medicine (CCPM), Dr. Hultman served his medical/surgical residency at Vancouver General Hospital in British Columbia, Canada. He received his Masters of Business Administration (MBA) from UCLA’s Anderson Graduate School of Management, with honors. A doubly board certified podiatric physician, Dr. Hultman is certified by both the American Board of Podiatric Surgery (ABPS) and the American Board of Podiatric Orthopedics. He is also a Fellow of the American Board of Foot and Ankle Surgeons (ACFAS), as well as a Fellow of the American College of Foot Orthopedists. Having practiced podiatric medicine and surgery for over 25 years, Dr. Hultman now devotes his expertise, skills and time to advancing the specialty of podiatric medicine and assisting other physicians in improving the performances of their practices. A highly sought after speaker and consultant, Dr. Hultman is a Past President of the California Podiatric Medical Association (CPMA) and the California College of Podiatric Medicine (CCPM). He has served as the current Executive Director of the California Podiatric Medical Association nearly a decade, during which time has help to guide the organization and the profession to important advancements in practice rights for California’s podiatric physicians.

CPMA,

Your Profession’s Insurance

Jon Hultman, DPM, MBA (l) with CPMA President Michael Cornelison, DPM The 2011 Vision Award joins Dr. Hultman’s extensive collection of awards and honors including CPMA’s California Podiatric Physician of the Year Award; Podiatry Management’s Lifetime Achievement “Hall of Fame” Award; the American Podiatric Medical Association’s Award of Excellence, to name just a few.

Blue Shield issues apology to CPMA CPMA Health Policy Chair Dr. Franklin Kase has notified the Association that the Chief Medical Officer of Blue Shield, Dr. Meredith Mathews, has offered an apology regarding the denial of DPM claims for CPT and HCPCS codes using the statement ‘providers of this classification are not allowed to perform this service.’ This is for such codes pertaining to wound care, surgery, injections and dispensing DME products such as surgical shoes. In the apology Dr. Meredith notes that “Blue Shield has identified and corrected an error in our claims edit program which resulted in scope of licensure denials for podiatrists.  This edit has been turned off and adjustments are being processed. I apologize for the inconvenience caused by this error.  We are actively evaluating all claims edits to insure that no other errors are present.” Dr. Kase urges CPMA members who have received denials of reimbursement from Blue Shield due to scope of practice issues, to resubmit any such denials along with a brief letter of appeal, if they do not receive a corrected EOB and payment from Blue Shield within 30 days.

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Thomas Chang, DPM (l) and Jonathan Labovitz, DPM

Jerry Brant, DPM

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Keith Greer, Esq., with Gary Dockery, DPM (l)

Real hands-on learning

Mary Crawford, DPM

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Keith Greer, Esq.

Hands-on use of the latest technology

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Nancy Diaz, RT, PMAC

Lectures were well attended

Using the latest tools and technologies

Alexander Reyzelman, DPM

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CPMA Past President Ernie Hook, DPM having a good time in the workshops C PM A | C a l ifo r n ia Podiat r ic M e dica l A s s ociat io n


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Joseph Treadwell, DPM

Thomas Chang, DPM (seated) and Ernie Hook, DPM smile for the camera

Standing room only

Lee Rogers, DPM

Daniel Fulmer, DPM

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education

Carolyn McAloon, DPM

John Hollander, DPM demonstrating proper casting technique

Poster Session entry

Tina Del Bouno, PMAC

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John Hollander, DPM (back); Tina Del Bouno, PMAC (2nd from right), Jesus Vazquez, PMAC (l) and the assistants’ teaching team

Workshop leader Neil Mansdorf, DPM checks out CPMA Past Presidents Eric Hubbard, DPM (l) and Lyman Wilson’s (r) handiwork

Megan Jennings, DPM

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Teamwork

Brad Bakotic, DPM

Poster symposium

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Now Available -- for you! And for you, a special rate. Free! Please e-mail Kia-Maria Zamora -Kia-Maria.Zamora@dca.ca.gov -- with your request of up to 25 copies each of these BPM brochures: 

DPMs -- Highly trained specialists keep Americans on the move

Orthotics Can Help -- You don’t have to live with foot pain

Las órtesis pueden ayudarlo

Diabetics -- Keep an eye on your feet

Diabéticos: Preste atención a sus pies

Step into a Rewarding Career in Podiatric Medicine

California Board of Podiatric Medicine 2005 Evergreen Street, Suite 1300 Sacramento, CA 95815 www.bpm.ca.gov 916-263-2651 fax 916.263.2647

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In Rare Repeat, Kase Again Named California’s Podiatric Physician of the Year In 2004, in an unprecedented move, the California Podiatric Medical Association (CPMA) bestowed its highest honor, Podiatric Physician of the Year, on then sitting President Dr. Franklin Kase, DPM, FACFAS. In doing so CPMA Past President and Executive Director Jon A Hultman, DPM, MBA said, “It is unprecedented. No sitting President has ever received the Association’s highest honor before.” Dr. Kase has once again joined a very select club in becoming only the second previous recipient of CPMA’s Podiatric Physician of the Year Award to have the award bestowed upon him for a second time. In presenting the Award, CPMA Past President Michael Cornelison noted, “No matter how the Committee looked at it, Frank’s name was always at the top of the list of nominees. His hard work, positive attitude, bulldogged determination, never give up, never surrender attitude placed him atop the list again this year.” A member of CPMA for nearly 35 years, Dr. Kase has made substantial contributions to the leadership of the organization. Beginning at the local level where he served as President of the Los Angeles County Podiatric Medical Society before becoming a member of the CPMA Board where he served as Director-atLarge, Treasurer, Vice President, President-Elect, and President. He has chaired a number of CPMA Committees, most notably the Association’s Health Policy Committee for a number of years. Under his leadership CPMA was able to make significant advances in eliminating discriminatory practices against California’s podiatric physicians by private insurance companies, indemnity insurance companies and preferred provider organizations.

Franklin Kase, DPM A qualified medical examiner, Dr. Kase has served on the Medical Advisory Board of the Southern California Association of Occupational Health Nurses, an expert witness and Exam Commissioner for the Board of Podiatric Medicine, and a consultant to the Los Angeles Police, Sheriff and Fire departments, actively teaching recruits and officers how to prevent and treat athletic injuries of the lower extremities.

Dr. Kase is a Diplomat of both the American Board of Podiatric Surgery (ABPS) and the American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM). He is a Fellow of the American Academy of Podiatric Sports Medicine, the American College of Foot & Ankle Surgeons, and the American College of Foot and Ankle Orthopedics and Medicine.

A native of New York, Dr. Kase earned his Bachelor of Science degree in zoology (with honors) from George Washington University in Washington, DC, in 1972. He graduated (also with honors) from the California School of Podiatric Medicine (CCPM) in 1976. He has been listed in Who ’s Who in American Colleges and Universities. A frequent media spokesperson, Dr. Kase has written numerous peer-reviewed articles, including a chapter on sports medicine in the textbook Review Text of Podiatric Orthopedics and Primary Podiatric Medicine.

Currently the Chief of Podiatric Surgery at Glendale Memorial Hospital in Glendale, California, Dr. Kase is also on staff at Sherman Oaks Hospital, in Sherman Oaks, California. In the past Dr. Kase has served as chief of podiatric surgery at St. Joseph Medical Center in Burbank, California and as clinical assistant professor at Los Angeles County USC Medical Center, teaching foot and ankle surgery.

Licensed to practice in California, Arizona, and Florida, Dr. Kase has been in private practice in Burbank, California for nearly 40 years .A marathon runner and a Past Vice President of the Seratoma Club in Burbank, California, Dr. Kase is active in community service. He and his wife Beth, a healthcare attorney, have been married for nearly forty years, and they have two accomplished daughters.

october is walk to school month! J u ly | Au g u s t | S e p t e m b e r | 2011

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exhibit

hall!

The Hall was a place of learning‌

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Directors Ami Sheth, DPM and Jonathan Uy, DPM

Dynamic Displays, Demonstrations, HAnds-on instruction, Networking, Shopping, Games, Food and Fun madE the 2011 Western Exhibit Hall the PLACE TO BE!

…and laughter

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exhibit

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Gail Johnson, DPM was the happy winner of an iPad2 in CPMA’s Corporate Member drawing

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Vendors were busy

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Traffic was brisk in the Hall

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2011 western sponsors

Jon Hultman, DPM, MBA; Melanie DeSpain, William Tarran, DPM, Kathy Matule, Jonathan Labovitz, DPM, Rebecca Cook

George Cioe, Jon Hultman, DPM, Paul DiMeglio, William Tarran, DPM, Jennifer Painter, Chelsea Knoop Back Row: Jerry Miles, Brian Penrose, Rick Kuneman, John Yelick, Jonathan Labovitz, DPM

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Jon Hultman, DPM; Brad Katzman, DPM, Sue Mann, William Tarran, DPM; Jonathan Labovitz, DPM

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2011 western sponsors

Jonathan Labovitz, DPM, Bob Newport, William Tarran, DPM; Jon Hultman, DPM

Jonathan Labovitz, DPM, Richard Smith, Susan McNamara, William Tarran, DPM; Jonathan Labovitz, DPM

J u ly | Au g u s t | S e p t e m b e r | 2011

Jonathan Labovitz, DPM; Jon Hultman, DPM; William Tarran, DPM, Kathleen Van DeVoorde, Brad Parker, Michael Nelson, Kurt Kartcher

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2011 western sponsors

Jon Hultman, DPM, Eric Grothe, William Tarran, DPM; Jonathan Labovitz, DPM

Jonathan Labovitz, DPM, Alexandera Rodriquez, Sean Luland, Jon Hultman, DPM; William Tarran, DPM, Greg West

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Jon Hultman, DPM, Linda Hull, William Tarran, DPM; Jonathan Labovitz, DPM, Josh Schicke

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2011 western sponsors

Jon Hultman, DPM; Jerry Brant, DPM; William Tarran, DPM; Jonathan Labovitz, DPM; Ross Taubman, DPM

Support the Companies Who Support You!

Thanks to All of Our Sponsors! Jon Hultman, DPM, Erik Reginald, William Tarran, DPM, Fred Habel, Jonathan Labovitz, DPM

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2011 western sponsors

Jon Hultman, DPM, John Butters, Klyle Frye, Hector Gonzales, Mike Bernal, Jonathan Labovitz, DPM; William Tarran, DPM

William Tarran, DPM; Jonathan Labovitz, DPM; Robert Coe, Jon Hultman, DPM

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Brendan Shook, Jon Hultman, DPM; William Tarran, DPM; Jonathan Labovitz, DPM

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www.picagroup.com www.crocs.com

www.wmt.com

www.sunriseshoes.com

www.drcomfort.com

J u ly | Au g u s t | S e p t e m b e r | 2011

www.totalsmallbone.com

www.blainelabs.com

www.samuelmerritt.edu/podiatric_medicine

www.biomedix.com

pacificadvisors.com/podiatry

Support the Companies Who Support You! www.mmi-usa.com

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California Podiatric Medical Association 2430 K Street Sacramento, CA 95816

June 7 - 10, 2012

Disneyland Hotel & Convention Center Anaheim, California Conference Features: • 25 CE contact hours • 12 radiology CE contact hours • Dynamic lecture tracks • Distinguished faculty • Innovative instructional courses • Hands-on surgical workshops • Billing & Coding updates • PICA presentation • 3-day educational seminar for podiatric medical assistants including radiology credits • 3 days of exhibits • Exceptional room rates at the Disneyland Hotel and Grand Californian Hotel & Spa • Significant savings on Disneyland & California Adventure Park Passes • Unbeatable location at the newly renovated Disneyland Hotel

2012

The Western

CELEBRATING A CENTURY OF SERVICE

Visit www.TheWestern.org For more information or to reserve hotel rooms at incredible rates.

Western Foot and Ankle Conference • 2430 K Street • Suite 200 • Sacramento, CA 95816 • (800) 794-8988


CPMA Jul-Aug-Sept 2011