December 2010 December 1, 2010 SCMA News Briefs December 2010 0 Five physicians honored at SCMA awards dinnerDr. Bob Schultz to retire in AprilStill time to update your Directory listingCongress begins negotiations to stop Medicare SGR cuts in 2011Time to declare Medicare participation for 2011AMA survey finds preauthorization policies impact patient careMedicare claims will not be paid if provider is not in PECOS by Jan. 3VOLUNTEERS NEEDEDPEOPLEHOSPITAL/CLINIC UPDATESRESOURCESAPPLICANTSCLASSIFIEDSABOUT SCMAFive physicians honored at SCMA awards dinner More than 100 SCMA members, spouses and guests crowded into the Vintner’s Inn in Santa Rosa on Dec. 1 to honor five local physicians for their exceptional careers. In her opening remarks, SCMA President Dr. Catherine Gutfreund set the tone for occasion by noting, “We’re not providers—we’re physicians.” The subsequent awards made this distinction clear by highlighting the preeminent role of physicians in health care delivery. The first to be honored was former SCMA President Dr. Leonard Klay, who received the Frederick Plessner Award from the California Medical Association in recognition of his decades of service to the patients of Sonoma County and his advocacy or organized medicine. The presentation included a video produced by CMA about Klay’s long career, including his public health work in El Salvador, his Army service in Germany, his long association with Dr. John Renfree, and his many contributions to Sonoma County medicine since arriving in Santa Rosa in 1971. These range from his work at the family planning clinic and the residency program to anti-tobacco campaigns and the successful RICO lawsuit against health insurance companies. The Plessner Award is presented each year to the CMA member who best exemplifies the ethics and practice of a rural country practitioner. Upon receiving the award, Klay wryly observed, “All of us are still country doctors in the eyes of Medicare.” He explained that Sonoma County was definitely rural when he arrived but has become increasingly urban, even though Medicare still pays the county’s physicians at the lower rural rates. All the subsequent award winners praised Klay, who has touched many lives during his lengthy career. First up was Dr. Bo Greaves, who received the Outstanding Contribution to Sonoma County Medicine award for his work with Health Action to make primary care more accessible by establishing patient-centered medical homes. He noted that the project has had success but also some failures. “We can do better,” he said. “We are trying to change the history of American health care.” The Outstanding Contribution to SCMA award went to former SCMA President Dr. Richard Andolsen, who has served the medical association in many capacities for several decades. He advised his colleagues to “Enjoy the profession. It’s still a privilege and a joy for me to go to work.” The evening closed with awards presentations to two physician writers. Dr. Stacey Kerr received the Outstanding Contribution to the Community award for her monthly column in the Press Democrat and her book “Homebirth in the Hospital.” Even though she has closed her practice, she continues to help patients through her writing. “I like to take complex medical issues and turn them into understandable prose,” she explained. Dr. Matt Joseph received the Article of the Year award for Why Poetry?, a collection of poems published in the most recent issue of Sonoma Medicine. He noted that poetry and other arts can help doctors achieve balance in their careers, adding, “Whatever we can do to keep our other passions alive will help with our work.”Dr. Bob Schultz to retire in April Former SCMA President Dr. Bob Schultz, physician-in-chief at Kaiser Santa Rosa since 1995, will be retiring next April. Born in Fresno in 1947, Schultz attended UC Davis and began working at Kaiser Santa Rosa in 1981. He headed the ob/gyn department for several years before becoming physician-in-chief. In an e-mail, Schultz said that the key accomplishments of his leadership at Kaiser included recruiting “an outstanding medical staff” and increasing Kaiser’s contributions to the community. “We are blessed to have a wonderful team of smart and dedicated professionals,” he wrote. “I will miss them dearly.” Schultz served as president of SCMA from 2001 to 2002, at a time when the medical association was reorganizing. Drawing on his background in engineering, he created a user-friendly physician database that is still in constant use at SCMA. In 2002, he received the association’s Outstanding Contribution to the Community award in appreciation of “his steadfast interest, participation, and commitment to community activities.” After retirement, Schultz plans to spend the summer at his farm in upstate New York before returning to Santa Rosa to “think about what I want to do with the rest of my life.” His successor will be named in mid-January.Still time to update your Directory listing SCMA is still accepting updates for the 2011 Sonoma County Physician Directory. The directory features photographs and detailed listings for all SCMA members, including their specialty(s), special medical interest and medical training. Basic information for nonmember physicians is included as well. Physicians can update their listings by returning the verification form that was mailed in October. If you need a copy of the form, contact Rachel Pandolfi at rachel@scma.org or 707-525-4375. Along with their verification forms, SCMA members received dues invoices for next year. Members who pay their dues by Jan. 15, 2011, qualify for a 5% discount. Payments need to be at SCMA by Jan. 15; there is no grace period. Installment payments can be arranged. Nonmember physicians can complete a simple online membership application at www.scma.org/join.asp. Congress begins negotiations to stop Medicare SGR cuts in 2011 By CMA Vice President Elizabeth McNeil The House of Representatives passed HR 5712, the Physician Payment and Therapy Relief Act of 2010, by a voice vote to stop the 23% Medicare physician payment cut before it was scheduled to take effect on Dec. 1. The Senate passed the bill by unanimous consent prior to Thanksgiving. The bill will be signed into law by the President immediately. Congress will remain in session until the Christmas holidays working on a legislative package that includes an extension of the Bush tax cuts and a plan to stop the 25% Medicare SGR cut that is scheduled to take effect on Jan. 1. Both Republican and Democratic leadership met with President Obama at the White House to begin bipartisan negotiations on the package. Both sides appear committed to passing a bill that stops the SGR cuts through 2011 and provides an update. The 12-month SGR proposal costs approximately $17 billion, and the committee staff are engaged in final negotiations on the funding offsets to cover the costs. The talks look promising at this point. CMA continues to work closely with California AARP, which recently approved radio and print ads in California to help with the SGR campaign. CMA urges all physician leaders to continue to call, write and meet with their members of Congress if you have not already done so. CMA is also working to include a Medicare payment locality update in the SGR package. Senators Boxer and Feinstein are talking to Senators Reid and Baucus and urging its inclusion. The House leaders have already committed to the California GPCI fix.Time to declare Medicare participation for 2011 It's that time of year again–time for physicians to decide about their participation in Medicare. Physicians have until Dec. 31 to make changes to their status for 2011. Participation decisions are binding for one year, unless you choose to opt out entirely. Once you opt out, you cannot opt back in for two years. As always, physicians have three choices regarding Medicare: be a participating provider; be a nonparticipating provider; or opt out of Medicare entirely. A participating provider must accept Medicare allowed charges as payment in full for all Medicare patients. A nonparticipating provider can choose to accept or not accept assignment on Medicare claims on a claim-by-claim basis. Nonparticipating physician fees are 95% of participating physician fees. If you choose not to accept assignment, you can charge the patient 9.25% more than the amounts allowed in the participating physician fee schedule. Physicians who opt out of Medicare are bound only by their private contracts with their patients. Medicare's limiting charges do not apply to these contracts, but Medicare does specify that these contracts contain certain terms. When a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract. For more information on physicians' Medicare participation options, see CMA On-Call document #0151, “Medicare Participation (and Nonparticipation) Options.” On-Call documents are free to members at www.cmanet.org/member. Nonmembers can purchase the documents for $2 per page at www.cmanet.org/bookstore.AMA survey finds preauthorization policies impact patient care Policies that require physicians to ask permission from a patient’s insurance company before performing a treatment negatively impact patient care, according to a new AMA survey. The survey of 2,400 physicians was the first to quantify the burden of insurers’ preauthorization requirements for a growing list of routine tests, procedures and drugs. Results indicate that such requirements delay or interrupt patient care, consume significant amounts of time, and complicate medical decisions. Among the findings: • More than one-third of physicians experience a 20% rejection rate from insurers on first-time preauthorization requests for tests and procedures. • Nearly half of physicians experience difficulty obtaining approval from insurers on 25% or more of preauthorization requests for tests and procedures. • Nearly two-thirds of physicians typically wait several days to receive preauthorization from an insurer for tests and procedures, while one in eight wait more than a week. • Nearly two-thirds of physicians report it is difficult to determine which test and procedures require preauthorization by insurers. "Nearly all physicians surveyed said that streamlining the preauthorization process is important and 75% believe an automated process would increase efficiency,” said AMA Immediate Past President Dr. James Rohack. “The AMA is urging health insurers to automate and streamline the current cumbersome preauthorization process so physicians can manage patient care more efficiently.”Medicare claims will not be paid if provider is not in PECOS by Jan. 3 Medicare claims received on or after Jan. 3, 2011, will not be paid if the ordering or referring provider is not enrolled in PECOS (Provider Enrollment, Chain and Ownership System). Physicians should also be aware that PECOS enrollment is required to receive federal EHR incentives under the Medicare program. Beginning in 2011, Medicare providers who demonstrate “meaningful use” of an EHR stand to receive up to $44,000 in incentive payments over five years. Palmetto GBA, California’s Medicare carrier, recently identified 3,500 California providers (physicians and other practitioners who order services) who still do not have a record in PECOS. Over the next several weeks, these providers will receive letters from Palmetto notifying them of the need to enroll. Physicians are urged to complete the application process as soon as possible. Applications are generally processed within 60 days, but can take longer if the application is incomplete or additional information is needed. Physicians who wish to take advantage of the incentive payments available for electronic prescribing, PQRI, and electronic health record program must be enrolled in PECOS. CMA has also developed a step-by-step guide to walk physicians through the process, from determining if they are already in PECOS to helping them navigate the Internet-based PECOS enrollment system. This guide is available at www.cmanet.org/member. CMA also hosted a PECOS enrollment webinar with Palmetto. The previously recorded webinar is available for on-demand viewing at www.cmanet.org/member. Physicians who need help with the enrollment process can contact CMA’s Member Service Center at 800-786-4262 or memberservice@cmanet.org.VOLUNTEERS NEEDED The Sonoma County Office of Education needs physician volunteers to judge entries in the Science Fair on Feb. 8. This annual event attracts about 100 entries from local students in grades 6-12. Entry categories include health and human biology. Volunteers are also needed for the Science Olympiad on April 30, and donations to fund both events are requested as well. To volunteer or to make a donation, contact Mike Roa at mroa@scoe.org or 522-3253. The American Cancer Society is seeking retired physicians who can serve as ambassadors to legislators and the media on cancer prevention and treatment issues. Orientation is provided by the cancer society. For details, contact Laura Moss at laura.moss@cancer.org or 545-6728.PEOPLE Dr. Nicole Faro and Dr. Laurie Salameh, both pediatricians, have joined Kaiser Santa Rosa. Faro graduated from UC Davis and Salameh from Touro University. Dr. Vu Tran, a pulmonologist and sleep medicine specialist, has joined the Sutter Pacific Medical Foundation. His new office is at 95 Montgomery Dr. in Santa Rosa. He previously worked for Kaiser Santa Rosa.HOSPITAL/CLINIC UPDATES Planned Parenthood has opened a new clinic in Santa Rosa. The facility, located at 1140 Sonoma Ave., offers family planning services, cancer screening and testing for STDs. Abortion services will be added at a later date. The clinic serves uninsured patients and those with private insurance or Medi-Cal coverage. Phone is 527-7656. Vista Family Health Center, the newest member of the Santa Rosa Community Health Centers network, has opened at 3569 Round Barn Circle in Santa Rosa. The 42,500 square foot facility houses 150 staff members and 56 exam rooms and will expand the network’s capacity by at least 10,000 patients. The new center, which also houses the Santa Rosa Family Medicine Residency Program, offers a full range of primary care services, including obstetrics, HIV treatment and mental health services. Santa Rosa Memorial and Healdsburg District hospitals have joined forces to recruit physicians and develop integrated clinical systems. Both hospitals have signed an affiliation agreement that preserves their separate identities but allows them to collaborate on certain projects. The agreement comes in the wake of Sutter’s groundbreaking for a new hospital in northern Santa Rosa. West County Health Centers will soon be opening a clinic in Forestville, bringing its network to seven offices in Sebastopol, Guerneville and other west county locations. They will also be expanding their Sebastopol clinic by 5,500 square feet next year. Total staff numbers are expected to rise from 75 to 95 FTEs during 2011. Santa Rosa Memorial Hospital has been certified as a Primary Stroke Center by JCAHO. “We are very pleased to be recognized for the excellent stroke care we provide our patients,” said Dr. Smriti Wagle, the stroke center’s medical director. Memorial is the third facility in Sonoma County to receive the designation, following Kaiser Santa Rosa and Palm Drive. Oaks Alzheimer’s & Dementia, a skilled nursing facility in Petaluma, offers a medication and behavior management program for patients with agitated and aggressive behaviors. For admissions, call 778-8686.RESOURCES Docsite is a commercial online service that helps physicians access their Medicare Physician Quality Reporting Initiative bonuses, which can average about $3,400 per physician. For details, visit www.docsite.com. CMA has published a free guidebook for members on how to obtain federal funding for electronic health records. The guidebook, available at www.cmanet.org/member, explains the “meaningful use” measures needed to qualify for federal EHR funding. Physicians who use the guidebook can begin reporting on meaningful use as early as January 2011. The Alameda-Contra Costa Medical Association is offering a free webinar on medical record documentation from 12:30 to 1:45 p.m. on Tuesday, Dec. 7. Topics include protective progress notes, medication management, and informed consent. To register, visit www.accma.org and click on the Seminars & Webinars link. CMA is hosting a members-only webinar on ICD-10 coding from 12:15 to 1:15 p.m. on Wednesday, Dec. 8. Instruction will include a guide for implementation steps, planning and staff training. Content includes analysis of HIPAA-related transaction standards, new coding characteristics and changes in timeframes. Coding books are not required for webinar. To register, visit www.cmanet.org/calendar at least two hours before the start time. CMA On-Call is a repository of thousands of pages of medical, legal, regulatory, and reimbursement guidance. All documents are available free to CMA members on the members-only website at www.cmanet.org/member. Topic headings parallel the chapters of CMA’s California Physician’s Legal Handbook, such as “Managed Care,” “Medical Board,” and other familiar medical-legal terms. To see a list of documents by topic, simply select that topic.APPLICANTS Jason Bacharach, MD, Ophthalmology*, Glaucoma, 104 Lynch Creek Way #15, Petaluma 94954, 762-3573, Fax 762-6873, jbacharach@northbayeye.com, Hahnemann Univ 1988 William Bartlett, MD, Ophthalmology*, 380 Tesconi Ct., Santa Rosa 95401, 544-3375, Fax 544-0808, Ohio State Univ 1989 Emily Conway, MD, Cardiovascular Disease*, Internal Medicine*, 500 Doyle Park Dr. #205, Santa Rosa 95405, 527-8444, Fax 578-7863, econway@srcmg.com, Brown Univ 2003 Rachel Friedman, MD, Family Medicine, 3569 Round Barn Cir. #200, Santa Rosa 95403, 547-2220, Fax 303-3318, friedmr@sutterhealth.org, Yale Univ 2008 John Gray, MD, Orthopaedic Surgery*, Spine Scoliosis, 525 Doyle Park Dr. #102, Santa Rosa 95405, 535-0838, Fax 535-0839, neagray@comcast.net, Univ Kansas 1969 Rachel Mayorga, MD, Internal Medicine*, Geriatric Medicine*, 1312 Prentice Dr., Healdsburg 95448, 433-3383, Fax 433-7210, Univ Utah 1999 Robert Park, MD, Weight Management, 715 Southpoint Blvd. #C, Petaluma 94954, 778-6019, Fax 778-6068, Instituteforhealthmgmt@gmail.com, Yale Univ 1971 Janet Pulskamp, MD, Obstetrics & Gynecology*, 401 Bicentennial Way, Santa Rosa 95403, 393-4490, Fax 393-3011, janet.h.pulskamp@kp.org, Yale Univ 1988 * board certifiedCLASSIFIEDS Office Space Small suite for lease. Reception, 3 rooms, Summerfield Rd., Santa Rosa. Contact Connie, 707-525-0211. How to submit a classified ad To submit a classified ad for SCMA News Briefs or Sonoma Medicine, contact Erika Goodwin at erika@scma.org or 707-548-6491. The cost is one dollar per word.ABOUT SCMA The Sonoma County Medical Association, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. Founded in 1858, SCMA is affiliated with the California Medical Association and the American Medical Association. © SCMA 2010 2901 Cleveland Ave. #202 Santa Rosa, CA 95403 Comments are closed.
