October 2008 October 1, 2008 SCMA News Briefs October 2008 0 Don't miss SCMA's 150th Anniversary Celebration!SCMA Task Force Devises Solutions for Specialty AccessStill Time to Submit Photos for SCMA Physician DirectoryDistrict 10 Endorses Resolution to Mandate Smoke-Free CasinosImproved SCMA Website Readied for LaunchOb-Gyn Medical Group Closing in NovemberMore Doctors Working for Health CentersDec. 6 is “Flu Shot Saturday”Palmetto Medicare Payment Problems PersistCMA Takes Legal Action to Stop Prohibition on Balance BillingGovernor Signs Bill to Close Insurance Fee LoopholeTransgender Health Conference in Rohnert Park Oct. 10-11Life-Sustaining Treatment Orders Available OnlineFree Screening for Arterial Disease and AneurysmsDrug Abuse Institute Launches Physician WebsiteDon't miss SCMA's 150th Anniversary Celebration! All SCMA members are encouraged to attend the association’s 150th Anniversary Celebration on Tuesday evening, Nov. 11, at the Vintner’s Inn, 4350 Barnes Rd., Santa Rosa. Tickets, which include dinner, are FREE to active SCMA members. To help defray costs, SCMA is actively seeking sponsors for the event, such as medical groups, hospitals, and pharmaceutical companies. Potential sponsors should contact Cynthia Melody at 525-4359 or cmelody@scma.org. See the attached sponsor flyer for more details. SCMA members should RSVP for the event as soon as possible, either by e-mailing scma@scma.org or calling 525-4359. Credit card payments can be accepted over the phone. See you at the Celebration! book SCMA Task Force Devises Solutions for Specialty Access Plans to improve access to orthopedic and endocrinology services for underserved patients were presented at the Sept. 10 meeting of SCMA’s Specialty Access Task Force. Dr. Jeff Sugarman, leader of the orthopedics subgroup, reported that a referral algorithm has been developed, and that the group is trying to establish an “ortho hub,” probably at the Southwest Community Health Center (SCHC). An e-mail describing the access problem and the “ortho hub” was recently sent to all the orthopedic surgeons in Sonoma County. The endocrinology group leader, Dr. Gerald Eliaser, reported that about two-thirds of the county’s safety net referrals to the SCHC Chanate Family Practice Center’s endocrinology clinic, attended by Dr. Yuichiro Nakai, are referred for thyroid issues. Residency physicians, led by Dr. David Schneider, will be taking over management of thyroid patients, freeing Dr. Nakai and several other local endocrinologists to deal with non-thyroid problems for the safety net. The next meeting of the Task Force, which is co-sponsored by the Redwood Community Health Coalition, is scheduled for Nov. 5. Physicians interested in attending the meeting or assisting the task force should contact Cynthia Melody at cmelody@scma.org or 525-4359. book Still Time to Submit Photos for SCMA Physician Directory The deadline for submitting photos for the 2009 SCMA Physician Directory is Oct. 31, so there’s still time to get your picture taken, even if you missed previous photo sessions. Your photo is the most prominent element of your Directory listing, and a recent color portrait is strongly recommended. Members can use any local photographer or even submit their own high-resolution photo to sosborn@scma.org. Duncan Garrett, a photographer whose work often appears in Sonoma Medicine, can take portraits at his Santa Rosa studio for just $50, a significant savings over standard rates. He can be contacted at 578-8192 or duncan@duncangarrettphoto.com. His studio address is 3565 Airway Drive, Santa Rosa. book District 10 Endorses Resolution to Mandate Smoke-Free Casinos CMA’s District 10 delegation, which includes SCMA, has endorsed a resolution by Dr. Brad Drexler to ban smoking in tribal gaming venues. Such venues are currently exempt from the statewide ban on smoking in indoors public spaces. The resolution will be presented at CMA’s annual House of Delegates meeting in October. If enacted, CMA will support legislation to ban smoking at tribal casinos. The National Council of Legislators from Gaming States is already considering similar recommendations. book Improved SCMA Website Readied for Launch The first phase of an improved version of the SCMA website will soon go online, thanks to a grant from the Pacific Foundation for Medical Care. The revised site will not only include Sonoma Medicine, but also the Physician Directory, SCMA News Briefs, and a wealth of resources for local physicians. The site will be fully searchable, using the latest database technology. book Ob-Gyn Medical Group Closing in NovemberSanta Rosa Ob-Gyn, one of the longest-running medical groupsin Sonoma County, will close on Nov. 21. Dr. Cheryl Kellert, the seniorpartner, will move to Bellingham, Wash., and Dr. Garland Herron will relocateto the East Coast.“Private practice for small groups is impossible,” saidKellert. “I would love to stay, but the reality of cost makes it impossible.”She estimated that 75% of the group’s income goes to overhead. In addition, thegroup hasn’t been paid by Medicare all year because of bureaucratic delays.Kellert joined Santa Rosa Ob-Gyn in 1985. Over the years,several prominent local ob-gyns worked for the group, including former SCMApresidents Drs. John Bodle and Thomas Garrett. Another longtime partner, Dr.Thomas McCarthy, left the group last year for health reasons. book More Doctors Working for Health Centers The number of doctors working full- or part-time at local health centers continues to increase. As of September, 65 local physicians were on staff at health centers affiliated with the Redwood Community Health Coalition (RCHC), including facilities in Alexander Valley, Guerneville, Healdsburg, Occidental, Petaluma, Roseland, Sonoma and Santa Rosa, as well as Indian Health. That represents a 44% increase from 2005, when only 45 physicians were on staff at those facilities. An additional 36 physicians enrolled in the Santa Rosa Family Medicine Residency work at the Chanate Family Practice Center, which is also affiliated with RCHC. book Dec. 6 is “Flu Shot Saturday”This year’s “Flu Shot Saturday”will occur on Saturday morning, Dec. 6. During that time, anyone can get a flushot for a suggested donation of $10 at locations throughout Sonoma County.Children under 18 must be accompanied by a parent or guardian, and no one willbe turned away due to inability to pay.For information about times andlocations, call 565-4477 or visit www.sonoma-county.org/flu. book Palmetto Medicare Payment Problems PersistThe transition in Medicareadministration from NHIC to Palmetto GBA is causing serious payment problemsfor many California physicians. CMA continues to receive a high number ofcomplaints from members who have not received payment for claims submitted bothprior to and after the transition. Several members have been forced to accesscredit lines to meet payroll and business expenses, and some are fearful thatthe situation may cost them their practice. While CMA has been successful ingetting resolution for physicians who contact CMA’s Center for EconomicServices, doctors who are going directly to Palmetto are finding it impossibleto get through on their phone lines. Practices that do get through are facingwait times of as much as three hours.CMA has compiled a list of common problems and fixes and posted itonline at www.cmanet.org/palmetto. Physicians who are still experiencingpayment problems are encouraged to review this list to see if their issues areaddressed. If after doing so you still have questions or problems, contact CMA’sReimbursement Help Line at 888-401-5911. book CMA Takes Legal Action to Stop Prohibition on Balance Billing In late September, CMA and a coalition of health care providers filed a petition with the Superior Court in Sacramento seeking an injunction against a regulation recently finalized by the Department of Managed Health Care (DMHC). The regulation expands the definition of “unfair billing pattern” to include a practice commonly known as “balance billing.” DMHC asserts that the new regulation gives them the authority to bring enforcement actions against physicians who balance bill. “Balance billing” occurs when insurers refuse to pay in full for emergency services provided to their policyholders by doctors or hospitals with whom the insurers do not contract. Faced with the insurers’ refusal to pay their bills in full, physicians often bill policyholders for the remaining balance. The DMHC regulation is scheduled to take effect on Oct. 15. CMA anticipates that the court will not act upon the injunction request until November. To help physicians in the interim, CMA will shortly post a “provider toolkit” on this topic at www.cmanet.org. For more details, contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org. book Governor Signs Bill to Close Insurance Fee Loophole Gov. Schwarzenegger has signed SB 1379, which closes a loophole that allowed health insurance companies to use fines imposed by the state to offset their fees to the Department of Managed Health Care. Instead, the bill directs the fines to a loan repayment program and the state’s high-risk insurance pool. In contrast, the governor vetoed AB 1945, which would have required insurance companies to get approval from state regulators prior to rescinding a health insurance policy. book Transgender Health Conference in Rohnert Park Oct. 10-11A conference on providingmedical care to transgender people will be held at Sonoma Mountain Village inRohnert Park on Friday afternoon, Oct. 10, and Saturday, Oct. 11. Theconference includes 11.5 hours of Category 1 credit. Online registration is availableat www.scafem.org, or contact Danielle Jones at 527-6223 orscafem@scafem.org. book Life-Sustaining Treatment Orders Available OnlineA new end-of-life form, thePhysician Orders for Life-Sustaining Treatment (POLST), is now available atwww.finalchoices.org. This voluntary form, which was recently approvedby the Legislature, helps patients and physicians develop and honor plans forlife-sustaining treatment. The form complements but does not replace AdvanceDirectives. book Free Screening for Arterial Disease and AneurysmsRedwood Regional MedicalGroup is offering free screenings for peripheral arterial disease and abdominalaortic aneurysms from 9 a.m. to noon on Saturday, Oct. 18. The screenings, tobe held at 121 Sotoyome St. in Santa Rosa, include an ankle blood pressuretest, an ultrasound and a short consultation with a vascular surgeon.Appointments are required. Patients should phone 525-6161 to reserve a time. book Drug Abuse Institute Launches Physician Website The National Institute on Drug Abuse has created a new website, www.nida.nih.gov/medstaff.html, intended to help physicians stay current with prevention and treatment of drug abuse. The site includes the latest clinical trials and detailed information on drugs of abuse. book Susan Dehnad, MDObstetrics & Gynecology3317 Chanate Rd. #2CSanta Rosa 95404570-1130 Fax 571-2478Mercer Univ 2003Robin Knuttel, MDDermatology*181 Andrieux St. #103Sonoma 95476938-9880 Fax 938-9879sonomaskin@aol.comTufts Univ 1986Timothy Regan, MDFamily Medicine*401 Bicentennial WaySanta Rosa 95403Univ Minnesota 1980Kyle Rhodes, MDOphthalmology104 Lynch Creek Way #15Petaluma CA 94954762-3573 Fax 762-6873Baylor Med Coll 2003Thomas Schlesinger, MDOphthalmology*3536 Mendocino Ave. #380Santa Rosa 95403575-5353 Fax 523-7729Univ Southern CaliforniaAshley Smith, MDDermatology*990 Sonoma Ave. #2BSanta Rosa 95404 579-4239 Fax 579-0459St. Louis Univ 2003Zunairah Syed, MDFamily Medicine5900 State Farm Dr. Rohnert Park 94928206-3036 Fax 206-3041Dow Med Coll 2001* board certified book For Lease. Primemedical/dental office suite near Memorial Hospital. 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