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The SCMA and MLCMS keep you up to date on the latest news,
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January 2015

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SCMA NEWS

Sonoma County GPCI fix

Since SCMA's Health Care Summit in 2001, this issue has been SCMA's primary focus. Through the years, a handful of Sonoma physicians have met with CMS at its field office in San Francisco and in Washington DC, maintained continued contact with our Representatives in Congress, handled media interviews, spoken at countless Assembly, Senate, Congressional, and House Ways & Means hearings, rallied local public campaigns to educate our communities, written letters, and more. SCMA thanks each of you who supported the various campaigns and stayed informed on the issue in what SCMA has referred to through the years as "The Continuing Saga."

In 2014, during one of the most dysfunctional Congresses in history, CMA won passage of California-only legislation that reformed the outdated California Medicare payment localities and brought substantial payment increases to physicians in 14 counties, including Sonoma County. CMA believes this will maintain and improve access to physicians.

> Over the next decade, more than $1 billion in additional payments will be made to California physicians through Medicare FFS, Medicare Advantage and private contracts tied to the Medicare Fee Schedule. Starting in 2017, the new law phases in the new payment rates moving the current county-based payment localities to a Metropolitan Statistical Area (MSA) system: Medicare pays hospitals this way. Physicians will be paid according to their local costs to provide care, and the payments will be updated annually to reflect the rise in local practice costs.

> Depending on the economy, the new law will increase payments to Sonoma County physicians from 4.1 to 9.1% or more. Thirteen other counties receiving payment increases are included in this legislation (El Dorado, Marin, Monterey, Placer, Riverside, Sacramento, San Benito, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Santa Cruz, and Yolo).

> The legislation establishes a payment floor for rural California physicians set at current levels so when another recession hits, payments will not go down.



We think we've earned your membership

Have you renewed for 2015? Below are some of the reasons we think we've earned your membership. We want you to rejoin, or join, MMS!

> Prop. 46 was defeated (NO: 67% YES: 33%)! CMA-MMS spent $8 million of CMA reserves and raised $52 million to protect MICRA.

> The GPCI inequity for Marin County has been permanently solved. (See story above.)

> CMA held off a 10% Medi-Cal cut for three years, ensuring the cut would not have to be repaid.

> Among many other examples, legislative advocacy kept optometrists from practicing ophthalmology.

Click here to join MMS or to renew your 2015 membership online. Call Rachel Pandolfi at 707-525-4375 if you need a copy of your dues invoice. She can answer your questions, or handle payment over the phone. ::


Update your Sonoma County Physician Directory listing by Feb. 13

SCMA is accepting updates for the 2015 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.

To update your listing, return the directory verification form (mailed Jan. 15-20) to SCMA by Feb. 13. If you need a copy of the form, contact Rachel Pandolfi at 707-525-4375 or rachel@scma.org.


Sonoma Medicine winter issue online now

"The Brain" is the theme of the winter issue of Sonoma Medicine with four feature articles. The issue also includes a special report on Hearts of Sonoma County: A Countywide Hypertension Initiative; a "Mystery Case" presents details of a mysterious case and invites physicians to make the diagnosis; an international medicine article, "Bangon Tacloban" (Philippine relief mission), and more. Mailed in mid-January, it is now available online in PDF and text-only versions at www.scma.org.


Win an iPad through SCMA's "Passport to Participation"

To encourage physician collegiality and the advancement of community health, PASSPORT TO PARTICIPATION acknowledges Sonoma County physicians' active engagement with SCMA, CMA and community activities by awarding points for participation. In addition to recognition for exemplary involvement, an iPad will be awarded to the winner at the end of the fiscal year. Click here to learn more.


Save the date: Legislative Advocacy Day April 14

SCMA members are invited to CMA's annual Legislative Advocacy Day on Tuesday, April 14, at the Sheraton Grand in Sacramento. Attended by several hundred physicians, this conference provides an opportunity to meet with local legislators regarding pressing health care issues after morning speeches by CMA's president, Dr. Luther Cobb, and Dustin Corcoran, CMA CEO. This year's keynote speaker is expected to be Governor Jerry Brown, followed by a political panel discussion and afternoon sessions with local legislators in their offices. For more information, visit www.cmanet.org/events or contact Cynthia Melody at 707-525-4375 or cmelody@scma.org.


PFMC grant proposals due April 2

Nonprofit health organizations in Sonoma County are encouraged to apply for Community Grants from the Pacific Foundation for Medical Care. The grants, generally in the $10,000 range, are awarded twice a year by the nonprofit foundation to support local projects that enhance health services. The application deadline for the next round of grants is April 2. For application materials, contact Kathy Pass at 707-525-4281 or kpass@rhs.org. For more information, visit www.pfmc.org.


Donations to Holiday Greeting Card net record $15,000

Donations to the SCMA/SCMAA health careers scholarship fund's 2014 Holiday Greeting Card set a new record of $15,000 from 150 donors who were acknowledged in the card. This year's card featured the stunning artwork of Dr. Kate Black, a Santa Rosa anesthesiologist and pain medicine physician. The Holiday Greeting Card helps fund scholarships for deserving students who are Sonoma County residents currently enrolled or intending to enroll in a medically related field of study. The program has given scholarships to local students since the 1960s, and several former recipients are currently practicing medicine in Sonoma County. For more information about the scholarship fund and other SCMA Alliance activities, visit www.scmaa.org.


Applicants

Ryan Bradley, MD, Anesthesiology, 401 Bicentennial Way, UC San Francisco 2004

Stanley Cheng, 1st year Medical Student, Touro Univ


LOCAL NEWS

iDo26.2 seeking donations to sustain youth run/walk program

iDo26.2, a walking/running program designed to encourage and facilitate regular physical activity and fitness in our Sonoma County youth as part of a healthy family lifestyle, is seeking donations to support the school-based program. The program costs about $4 per student and over 5,000 students are expected to participate this academic school year. Please consider making a donation. For more information, click here to visit the website, or contact Dr. Joe Clendenin at dcjgc@yahoo.com.


HIV/AIDS Review April 25

The 22nd Annual HIV/AIDS Review, an educational CME seminar and luncheon for physicians, mid-levels and pharmacists who provide care to people with HIV/AIDS will be held on Saturday, April 25, 2015, from 8:30 a.m. to 3:30 p.m., at the Finley Community Center, Santa Rosa. This year's program will include: an HIV and HCV Update; HIV Prevention; Substance Use and Harm Reduction; Interdisciplinary Case Management; and Medication Errors in HIV Care. Speakers include: Kirsten Balano, PharmD; Drs. Marshall Kubota, Ele Lozares-Lewis, and Danny Toub; and Meghan Murphy, MSW. For more information, call The North Coast Area AIDS Education & Training Center at 707-303-8904.


CMA NEWS

2015 new health care laws

The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on scope of practice for allied health professionals, prescription drug abuse, public health issues and health care coverage. The following article from Sonoma Medicine provides summaries of the most significant new health laws of interest to physicians: download PDF or link to online article. ::


Top Stories from CMA ALERT

CMA Alert is a biweekly newsletter for members of the California Medical Association. Read the current issue here. Articles include:

  • CMA files amicus brief to protect patient privacy in Oregon prescription drug database case
  • CMA files brief in Medicaid case to be heard by the U.S. Supreme Court • Insurance commissioner issues emergency regulation requiring health insurers to have sufficient networks
  • Insurance commissioner issues emergency regulation requiring health insurers to have sufficient networks
  • Governor's January budget proposal leaves state's woeful Medi-Cal reimbursement rates untouched
  • • Meet and interact with internationally lauded authors at the 2015 Leadership Academy
  • Disneyland measles outbreak continues to grow; physicians advised to look for signs of the disease in patients
  • How to request an IMQ physician surveyor for your hospital accreditation survey • 100,000 Covered California enrollees being transitioned into Medi-Cal managed care in January
  • U.S. Supreme Court to hear ACA subsidy case on March 4
  • Deadline approaching for physicians wishing to opt out of new United Healthcare Medi-Cal managed care network
  • CMA creates new resource summarizing Medicare incentive and penalty programs
  • CMS to hold Medicare claims for first two weeks of January
  • CCalifornia ACEP publishes safe prescribing handout for patients
 


RESOURCES

CPR: CMA Practice Resources

CPR is a free monthly e-bulletin from CMA's practice management experts that focuses on critical payor and health care industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting-related issues along with information on the latest practice management news. Read the current issue here. Titles include:

  • Be prepared for Covered California changes in 2015
  • Verifying your patients' eligibility and benefits in 2015 may save your practice thousands of dollars
  • Potential Medicare pay cuts coming in 2015; participation selections due Dec. 31
  • CMA creates new resource summarizing Medicare incentive and penalty programs
  • DHCS identifies glitch in UCR web app for CHDP primary care rate increase payments
  • Don't miss out on increased Medi-Cal payments! Deadline to attest is Dec. 31
  • Annual Medicare benefit changes • New Reassignment of Medicare Benefits (855R) enrollment form coming
  • DMHC audit finds Anthem, Blue Shield Covered California directories misleading and violate state law
  • Duals project sees additional setbacks
  • Medi-Cal provider training announced
  • Reminder: Anthem expanding its Medi-Cal managed care network
  • The Coding Corner: CPT 2015: Summary of additions and revisions

Sonoma County immunization clinics and clinical services
A complete listing of community clinics and clinical services in Sonoma County is produced by the Sonoma County Immunization Assistance Program. Download the brochure here, and visit the DHS website here. Immunization questions can be sent to IZNurse@sonoma-county.org.

Wednesdays at Hospice House
Beginning in January and running through June, Hospice of Petaluma and Memorial Hospice will host a series of six programs on Wednesday evenings in Petaluma and Santa Rosa. Topics of interest to physicians and health care providers range from "Making Your Mind Magnificent" (neurological research with Steven Campbell) to "Death On Our Own Terms" (palliative and hospice care options with Dr. Gary Johanson).

The monthly presentations, lectures and performances are provided free of charge to the community by Hospice Services of St. Joseph Health. No reservations are required, and attendees will enjoy refreshments provided by local merchants. For a complete schedule and more information, visit www.SonomaCountyHospice.org or contact Denise Burke at denise.burke@stjoe.org.

Dementia care conference coming in February 2015
The California Partnership to Improve Dementia Care is presenting a one-day conference, Dementia Care California: Sustaining Momentum and Success, in Sacramento on Feb. 23, and in Pasadena on Feb. 25. The program will look at where things are now and how to bridge the gap in transitional care for persons with dementia. Physicians, nurses, nursing home administrators and social workers are encouraged to attend. Continuing education credits will be available for nursing home administrators, nurses and social workers. The featured speaker will be G. Allen Power, MD, clinical associate professor of medicine at the University of Rochester, and author of Dementia Beyond Drugs and Dementia Beyond Disease. For more information or to register for the event, click here.

Childhood Obesity Bay Area Annual Conference
This annual conference-to be held March 6 and 7 at UCSF Medical Center-brings together local stakeholders in childhood obesity prevention to promote innovation and provide insight into work being done on this critical issue. The program features keynote presentations, professional panels, breakout sessions, networking events and a garden tour, plus a locally-catered breakfast, lunch, and wine reception. To get your tickets visit: www.coba2015.eventbrite.com.


CLASSIFIEDS

Seeking sublet to rent
Seeking medical office for sublet in Sebastopol, Santa Rosa, or Petaluma.
Please contact office@marinphysiatry.com or call 415-839-8399.

SCMA members get free classifieds!
SCMA members can place free classified ads in News Briefs or Sonoma Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Susan Gumucio at susan@scma.org or 707-525-0102.


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. ©

2015 SCMA, 2901 Cleveland Ave. #202, Santa Rosa, CA 95403


December 2014

Download PDF Here

Holiday Greeting Card: Be part of a medical tradition

The 2014 SCMA Alliance & Foundation's annual Holiday Greeting Card fundraiser is drawing to a close. This 49th edition features the stunning artwork of Dr. Kate Black. To ensure that your name is included on the holiday card, make your donation by Dec. 7. Not only do you send Season's Greetings to your fellows in the medical community, but you also join in the season of giving by supporting the Health Careers Scholarship Fund, which benefits local students pursuing a health care career. Extend your good wishes to that special person in your life by making your donation "in honor of" or "in memory of" and it will be so noted on the card.

Complete your donation by mail or visit our website, www.scmaa.org, and designate the Holiday Greeting Card as the recipient of your generosity. If you have questions, please contact the Holiday Greeting Card Chair, Barbara Ramsey, at holidaygreetingcard@scmaa.org or 707-953-5603.


Awards Dinner Dec. 2: SOLD OUT

Outstanding Contribution awards for 2014 will be presented to Dr. Joe Clendenin, a retired family physician, Dr. Laurel Warner, an infectious disease physician, and Dr. Charles Elboim, a surgeon with a special interest in breast diseases. The Article of the Year Award will be given to Dr. Robert Woodbury for "Emerging Concepts of Obesity," which appeared in the spring 2014 issue of Sonoma Medicine. Finally, a special Recognition of Achievement will be presented to Ritch Addison, PhD. For details, contact Rachel Pandolfi at 707-525-4375 or rachel@scma.org.


Dr. Peter Bretan honored with AMA award

Peter N. Bretan, Jr., MD, FACS, a urological and transplant surgeon practicing in Sonoma, Marin and Mendocino counties, received the Benjamin Rush Award for Citizenship and Community Service from the American Medical Association (AMA). The award recognizes physicians who have performed beyond expectations and made extraordinary public service contributions. Dr. Bretan received the award during the opening session of the 2014 AMA interim meeting in Dallas, TX, on Nov. 8. It was presented by AMA President Robert M. Wah, MD.

The AMA honors Dr. Bretan for his innovative work as a renal transplant surgeon and urologist as well as his participation in global disaster relief efforts. He is the founder of Life Plant International, a charitable organization that promotes disaster preparedness, organ donation, and early disease screening worldwide. Following the devastation of Hurricane Katrina in New Orleans, LA, in 2005, Dr. Bretan provided free medical care as part of "Team Orleans." Since 2002, he also has made nearly 20 medical mission trips to the Philippines to perform and teach local physicians about kidney transplant and laparoscopic kidney removal operations. More recently, he served as part of a medical mission to the Philippines to provide care to victims of Typhoon Halyan.

View the AMA press release announcing the award to Dr. Bretan.


Operation Access celebrates medical volunteers Dec. 9

Come enjoy craft beer, oysters, artisan pizza, and live music (Bootleg Honeys) at Lagunitas Brewery in Petaluma Tuesday, Dec. 9 from 5:30-8:30 p.m. Please join us as we celebrate the contributions of Operation Access medical volunteers who donate their skills to Bay Area residents without access to specialty care.

This year's awards and honorees include: All Hands On Deck Award: Kaiser Permanente San Rafael/Petaluma Gastroenterology Team, including Drs. Jeff Fox, Jennifer Hewett, Brock MacDonald, James Martin, Jeffrey Rothman, and Andrew Spears; Legacy Award: Abdul Harris, MD; Champion Award: Laura Pak, MD; Unsung Hero Award: Daniel Solomon, MD, and Spirit Award: Mary Rogers, RN.

Click here to buy tickets ($25). Proceeds support the Operation Access program in the North Bay.



Win an iPad through Passport to Participation

To encourage physician collegiality and the advancement of community health, PASSPORT TO PARTICIPATION acknowledges Sonoma County physicians' active engagement with SCMA, CMA and community activities by awarding points for participation. In addition to recognition for exemplary involvement, an iPad will be awarded to the winner at the end of the fiscal year.

Download PDF flier.


Applicants

Giac Consiglieri, MD, Neurological Surgery, 525 Doyle Park Dr. #102, Santa Rosa 95405, Univ Southern
California 2005
Ramzi Deeik, MD, Thoracic & Cardiac Surgery*, Cardiothoracic Surgery, 500 Doyle Park Dr. #G05, Santa Rosa 95405, Creighton Univ
Constance Dougherty, MD, Emegency Medicine, PO Box 2064, Santa Rosa 95405, Med Coll Pennsylvania 1975
Rasha Germain, MD, Neurological Surgery, 525 Doyle Park Dr. #102, Santa Rosa 95405, Univ Southern California 2005
Karen Milman, MD, Public Health & General Preventive Medicine*, 490 Mendocino Ave. #205, Santa Rosa 95403, Univ Maryland 2003
Jaime Molden, MD, Clinical Cardiac Electrophysiology*, 3536 Mendocino Ave. #200, Santa Rosa 95403, Univ Chicago 2002

* = board certified; italics = special medical interest


STATE NEWS

Vote No on 46: VICTORY!!
On Nov. 4, the voters of California spoke loudly and definitively, sending the trial lawyers' Proposition 46 to defeat by a vote of 67 to 33 percent. The message is clear--Californians simply don't want to increase health care costs and reduce health care access so trial attorneys can file more lawsuits.

The efforts of CMA and the county medical associations across the state are a tremendous showing of what we can do for the future of health care, the quality of medicine and the dedication to patients everywhere. Working together to spread the truth about Prop. 46, building coalitions across communities, and standing strong as one united voice are what helped carry us to victory.

This was one of the most contentious and high-stakes ballot fights in California history, and we rose to the occasion. We must use this unity moving forward and showcase to our colleagues the value the California Medical Association brings to our great profession--staying united for whatever comes our way next.

Humboldt physician installed as CMA's 147th president

The California Medical Association (CMA) has installed Humboldt County physician Luther Cobb, MD, as its 147th president. He takes office on the heels of the momentous defeat of Proposition 46, a campaign in which doctors and health care providers across California rallied together to oppose the measure that ultimately failed 33 to 67 percent.

After attending Stanford Medical School, Dr. Cobb went on to his residency at Stanford and did a two-year fellowship to study pancreatic islet transplantation for diabetes. He later joined the Stanford faculty and worked at the affiliated county hospital in Santa Clara County, Santa Clara Valley Medical Center. Dr. Cobb is a former chair of the CMA Council on Legislation and has served on the organization's executive committee since 2006. He is also past president of the Humboldt-Del Norte County Medical Society. Dr. Cobb's term as CMA president will run from November 2014 through October 2015.

CMA needs your feedback by Dec. 4 on how workers' comp reform is working

CMA is asking for physician feedback through a survey on how the workers' compensation reforms implemented last year have impacted their practices.

The reforms were implemented in phases beginning on Jan. 1, 2013, and have incorporated changes to the workers' compensation program, including implementation of an independent medical review process to resolve disputes about the medical treatment of injured employees, an independent bill review process to resolve disputes regarding provider payment issues and a fee schedule based on a resource-based relative value scale (RBRVS) similar to Medicare's. CMA's survey is focused on these key areas.

Feedback from physician members thus far indicates potential problems with workers' compensation reform. CMA is asking physicians to share their experience by responding to a brief survey. The results of the survey will help CMA assess areas of reform that working and those that need improvement so we can focus our efforts accordingly.

Are you interested in joining Anthem's Medi-Cal managed care network?

In an effort to expand its Medi-Cal managed care provider network across the state, Anthem Blue Cross is reaching out to CMA member physicians who are interested in joining the insurer's network. Physicians who would like to learn more about this opportunity are asked to provide CMA with some basic information by filling out this brief form. Anthem will follow up with additional details.


MEDICAL FACILITY NEWS

Kaiser Permanente Santa Rosa welcomes new physician in elder care & palliative care

Kaiser Permanente (KP) Santa Rosa Medical Center welcomes Kumari "Maya" Jayawardena, MD to the SNF/Palliative Care department responsible for managing KP members in contracted Skilled Nursing Facilities (SNF). Dr. Jayawardena transferred to KP Santa Rosa with significant training and experience in Palliative Care after three years at KP Oakland. Dr. Jayawardena is a graduate of University of Colombo Faculty of Medicine in Colombo, Sri Lanka. She completed her residency at St. Joseph Health Care Centers and Hospital in Chicago, IL, and her Fellowship at UC Irvine Medical Center.


PRACTICE MANAGEMENT RESOURCES

CPR is a free monthly e-bulletin from CMA's practice management experts that focuses on critical payor and health care industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting-related issues along with information on the latest practice management news. The November issue includes:

  • Blue Shield announces changes to 2015 exchange/mirror products
  • Are you interested in joining Anthem's Medi-Cal managed care network?
  • Health Net modifying exchange/mirror products
  • Voters resoundingly defeat Proposition 46
  • Anthem to require NDC on claims for certain physician-administered drugs
  • CMA publishes duals project FAQ
  • Don't miss out on increased Medi-Cal payments! Deadline to attest is Dec. 31
  • Blue Shield makes positive changes to reimbursement policy for physicians treating out-of-network exchange PPO patients
  • United issues new Premium Designation physician results
  • United Healthcare to host webinars about its Premium Designation Program for contracted physicians
  • CMA wants to hear from practices experiencing problems with the new prescription drug prior authorization form
  • Counting down to ICD-10 implementation
  • State issues report cards for HMOs, PPOs and large medical groups
  • Ask the Expert: Do I enter a qualifier in box 14 of the claim form if the patient has Medicare prime and a secondary insurance?
    • Meet your CMA Affinity Partner: Union Bank
  • The Coding Corner: Modifier 59 and beyond
  • Workshop for Physician Health Committees

Workshop for Physician Health Committees
California Public Protection & Physician Health (CPPPH) is offering a free workshop on Saturday, Jan. 24 from 9 a.m. to noon in Oakland for those who serve on physician health committees of hospital medical staffs, medical groups, and specialty societies and to those with credentialing and privileging responsibilities. No CME. Advance registration required. Contact Tina Hsu at CPPPHInc@gmail.com.


CLASSIFIEDS

Seeking sublet to rent
Seeking medical office for sublet in Sebastopol, Santa Rosa, or Petaluma.
Please contact office@marinphysiatry.com or call 415-839-8399.

SCMA members get free classifieds!
SCMA members can place free classified ads in News Briefs or Sonoma Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Susan Gumucio at susan@scma.org or 707-525-0102.


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.

© 2014 SCMA, 2901 Cleveland Ave. #202, Santa Rosa, CA 95403

November 2014

Download PDF Here

RSVP now for SCMA Awards Dinner on Dec. 2

All physicians are invited to the Awards Dinner, which runs from 6 to 9 p.m. on Tuesday, Dec. 2 at the Vintner's Inn, 4350 Barnes Rd. in Santa Rosa. Outstanding Contribution awards will be presented to Dr. Joe Clendenin, a retired family physician; Dr. Laurel Warner, an infectious disease physician; and Dr. Charles Elboim, a surgeon with a special interest in breast diseases. The Article of the Year Award will be given to Dr. Robert Woodbury for "Emerging Concepts of Obesity," which appeared in the spring 2014 issue of Sonoma Medicine. Finally, a special Recognition of Achievement will be presented to Ritch Addison, Ph.D.

The evening begins with a social hour at 6 p.m., followed by dinner and the awards presentation. Tickets are free for SCMA members; spouses, guests and nonmembers are $50 each. To RSVP, contact Rachel Pandolfi at 707-525-4375 or rachel@scma.org. Mail orders can be sent to SCMA, 2901 Cleveland Ave. #202, Santa Rosa, CA 95403. For more details, click here to download PDF invitation.


Win an iPad through "Passport to Participation"

To encourage physician collegiality and the advancement of community health, PASSPORT TO PARTICIPATION acknowledges Sonoma County physicians' active engagement with SCMA, CMA and community activities by awarding points for participation. In addition to recognition for exemplary involvement, an iPad will be awarded to the winner at the end of the fiscal year. Click here to learn more.


Applicants

Glen Barrisford, MD, Urology*, Urologic oncology, 401 Bicentennial Way, Santa Rosa 95403, SUNY Syracuse 1998
Kawai Cheung, MD, Internal Medicine, 401 Bicentennial Way, Santa Rosa 95403, Emory Univ 2011
Arlin Chin, MD, Family Medicine*, 401 Bicentennial Way, Santa Rosa 95403. SUNY Syracuse 2011
Shawn Daly, MD, Diagnostic Radiology*, 121 Sotoyome St., Santa Rosa 95405, Univ Arizona 1998
Tashfeen Ekram, MD, Diagnostic Radiology*, 121 Sotoyome St., Santa Rosa 95405, Univ Michigan 2008
Kurt Holt, DO, Pediatrics*, 3925 Old Redwood Hwy, Santa Rosa 95403, Harvard Med Sch 2008
Laurel Imhoff, MD, Surgery*, 401 Bicentennial Way, Santa Rosa 95403, UC San Diego 2006
Andrew Luckett, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ Louisville 2013
Anusuya Mokashi, MD, Diagnostic Radiology*, 121 Sotoyome St., Santa Rosa 95405, New York Med Coll 2007
Sarah Stassi, MD, Diagnostic Radiology*, 121 Sotoyome St., Santa Rosa 95405, Louisianna State Univ 2008
Angela Zarate, MD, Pediatrics*, 3925 Old Redwood Hwy, Santa Rosa 95403, Med Coll Wisconsin 2002

* = board certified; italics = special medical interest


8 DAYS LEFT TO DEFEAT PROP 46

* The Press Democrat has joined with every other major paper in the state by taking a NO position on Prop. 46. Click here to read the article.

* Get the facts at www.Noon46.com.
* Click here to watch the "No on 46" ads.
* Order lab coat cards, "No on 46" buttons, posters, bumper stickers, and brochures in English and Spanish. Click here to order them now - Free Shipping! (Or download Order Form.)
* Coordinate a meeting with your medical group. We guarantee a speaker! Contact Cynthia Melody at 707-525-4375 or cmelody@scma.org.
* Wear your "No on 46" button.
* Put a "Vote No on 46" yard sign in front of your office and at your home. We have crateloads at SCMA and will deliver. Just call us at 707-525-4375.
* A pull-out poster is available in the fall issue of Sonoma Medicine along with articles, charts, the order form and more.
* Talk with your colleagues, patients, friends, family, neighbors, the checkout person at the store, etc. about Prop 46: Increased costs; Losing your Doctor; Threatening your privacy.



State News

DHCS releases duals project toolkit
The California Department of Health Care Services (DHCS) has published a physician toolkit to help providers and their patients understand the Cal MediConnect duals demonstration project. The toolkit includes an overview and several fact sheets that include how to submit crossover claims to Medi-Cal plans, contracting with Cal MediConnect plans, how crossover claims are processed for Medi-Cal managed care patients, continuity of care, and sample patient letters (for contracted and non-contracted physicians).

State issues report cards for HMOs, PPOs and large medical groups
The California Office of the Patient Advocate yesterday released its 14th annual "California Health Care Quality Report Cards" that rate the state's health plans and medical groups on a four-star scale.

The report cards allow consumers to compare the quality of care that more than 16 million commercially insured consumers receive from the state's 10 largest HMOs, six largest PPOs and more than 200 medical groups. Data used is drawn from 2013 claims data and patient surveys. Users can drill-down online to see specific plan performance on topics of greatest interest to them, such as chronic disease management, pediatric care and mental health care. The report cards are available at the Office of the Patient Advocate's website.

Blue Shield makes positive changes to reimbursement policy for physicians treating out-of-network exchange PPO patients
Blue Shield of California recently announced a two-part reimbursement policy change for contracted providers that do not currently participate in the plan's Individual and Family Plan (IFP) PPO product, otherwise known as its exchange/mirror PPO product. Blue Shield's policy change is in response to provider feedback of difficulties collecting from exchange/mirror patients they have seen out-of-network. The policy change also brings its physician payment rules in line with Blue Shield's facility payment policy for PPO exchange/mirror patients who are seen out of network.

CMA believes the policy change will be positive for physicians and commends Blue Shield for their responsiveness to provider concerns. Click here for more information or contact Blue Shield Provider Information & Enrollment at 800-258-3091.


FEDERAL NEWS

New rules on prescribing hydrocodone combo products took effect Oct. 6
Medicines containing hydrocodone were reclassified as Schedule II substances, in line with oxycodone and morphine, effective Oct. 6, 2014. As Schedule II drugs, patients will need a new script each time the medication is filled (prescription could be refilled five times). Physicians will not generally be allowed to call, fax or e-mail in a prescription to a pharmacy, instead patients will have to present a written prescription. Click here for more information, or contact: CMA Legal Information Line, 800-786-4262 or legalinfo@cmanet.org.

CMS launches Open Payments website
The Centers for Medicare & Medicaid Services (CMS) launched its Open Payments website, which allows consumers to see the financial relationships between drug and medical device manufacturers and physicians as reported under the Physician Payments Sunshine Act. To view Open Payments physician payment dataset, click here.

The data published online contains 4.4 million payments made between Aug.1 and Dec. 31, 2013, valued at nearly $3.5 billion and attributable to 546,000 individual physicians and almost 1,360 teaching hospitals. The database is divided into three categories, general payments, research payments and physicians ownership and investments. CMS plans to publish these reports annually and will include a full 12 months of payment data, beginning in June 2015.

The Sunshine Act requires drug and medical device manufacturers and group purchasing organizations to report their financial interactions with licensed physicians-including consulting fees, travel reimbursements, research grants and other gifts.

Physicians have until Dec. 31 to file disputes for any inaccurate information that should be corrected in the next data release. View instructions for doing so on the AMA's Sunshine Act website.


PEOPLE

Peter Bretan, MD

The American Medical Association (AMA) will award Peter Bretan, MD, a Sonoma, Marin, and Mendocino County urologist, with the Benjamin Rush Award for Citizenship and Community Service at its November Interim Meeting of the AMA House of Delegates in Dallas, Texas. The award recognizes a physician who has gone above and beyond the professional call of duty to make an outstanding public service contribution to their local community.



PRACTICE MANAGEMENT RESOURCES

CMA publishes summary of new 2015 health care laws
The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on scope of practice for allied health professionals, prescription drug abuse, public health issues and health care coverage. CMA has published a summary of the most significant new health laws. Click here to read CMA's Significant New California Laws of Interest to Physicians for 2015. Click here to download the PDF of new laws (700 KB).

How much revenue is your practice losing by not working denials?
It's no secret that claim rejections and denials can result in a significant amount of lost revenue. Consider this-a practice submitting 80 claims a day at an average reimbursement rate of $100 per claim should expect to receive $8,000 in daily revenue. If 10 percent of those claims were rejected or denied (eight claims per day at $100 per claim equals $800 per day), and the practice only appealed one out of every 10 rejections or denials ($720 per day loss), the practice could expect to lose as much as $180,720 annually (251 business days at $720 per day in denials or rejections). The numbers are staggering and the loss of income could cover the cost of several full time employees

While it might not be feasible for a solo or small physician group to appeal every single denial or rejection, practices can significantly reduce potential lost revenue by identifying and addressing the three most common reasons for denial or rejection: internal billing error; payor error; or medical necessity denial. Click here for more information.

CPR / CMA Practice Resources
CPR is a free monthly e-bulletin from CMA's practice management experts that focuses on critical payor and health care industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting related issues along with information on the latest practice management news. The October issue includes:

> Are you ready for the new prescription drug prior authorization form required on Oct. 1?
> DHCS releases duals project toolkit
> New rules on prescribing hydrocodone combo products take effect Oct. 6
> How much revenue is your practice losing by not working denials?
> DHCS announces additional delays for some ACA Medi-Cal primary care rate increases
> DHCS announces new continuity of care rules for duals demonstration project
> DHCS revises Cal MediConnect "Choice Forms"
> Medi-Cal audits began in September
> Meet your CMA affinity partners: Staples Advantage
> Updated payor profiles now available
> The Coding Corner: Coding office E/M at the highest level: 99215

Click here to learn about how you can sign up for a free CPR subscription, contact CMA with questions about articles, and download a printable version of the newsletter.


Classifieds

Seeking sublet to rent
Seeking medical office for sublet in Sebastopol, Santa Rosa, or Petaluma.
Please contact office@marinphysiatry.com or call 415-839-8399.

SCMA members get free classifieds!
SCMA members can place free classified ads in News Briefs or Sonoma Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Susan Gumucio at susan@scma.org or 707-525-0102.


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.
Visit us at www.scma.org.

October 2014

Download PDF Here

SCMA NEWS

Fall dinner Oct. 15 features CMA's Elizabeth McNeil

CMA's Elizabeth McNeil is the featured speaker at a special SCMA dinner on Wednesday evening, Oct. 15. Topics include Vote No on 46 campaign and a federal legislative update.

The special dinner will be held at the Fountaingrove Inn in Santa Rosa and is free for SCMA members. Spouses, guests and nonmembers are $40 each. The evening begins with a wine reception at 5:30 p.m., followed by dinner and program at 6. Dinner choices include Ceasar salad, choice of grilled chicken, grilled salmon or pesto penne, and chocolate fudge cake.

To RSVP, contact Rachel Pandolfi at 707-525-4375, rachel@scma.org or download the flier and fax to 707-525-4328.

No on Prop 46


Drs. Clendenin, Warner & Elboim to receive SCMA awards

 SCMA Awards

Three Sonoma physicians will receive Outstanding Contribution awards at the annual SCMA Awards Dinner on Dec. 2. The awards will be presented to:

Dr. Joe Clendenin, a retired family physician, for Outstanding Contribution to the Community.
Dr. Laurel Warner, an infectious disease physician, for Outstanding Contribution to Sonoma County Medicine.
Dr. Charles Elboim, a surgeon with a special interest in breast diseases, for Outstanding Contribution to Sonoma County Medicine.

All physicians are invited to the Awards Dinner, which runs from 6 to 9 p.m. on Tuesday, Dec. 2, at the Vintner's Inn, 4350 Barnes Rd. in Santa Rosa. The evening begins with a social hour at 6 p.m., followed by dinner and the awards presentation. Tickets are free for SCMA members; spouses, guests and nonmembers are $50 each. To RSVP, contact Rachel Pandolfi at 707-525-4375 or rachel@scma.org. Mail orders can be sent to SCMA, 2901 Cleveland Ave. #202, Santa Rosa, CA 95403. To download event flier, click here.


Covered California "Lunch & Learn" #2, Oct. 24

Over 25 medical office personnel attended the July lunchtime presentation in Santa Rosa, and requested a second opportunity to learn more about Covered California 2015 and the impact on physician practices. Join us Friday, Oct. 24, from 12:30-1:30 p.m. for updated 2015 enrollment information and demographics, identifying qualified health plans within the exchange, and practice management tips. To RSVP and reserve your place, download the event flier. For questions or more information, contact Rachel Pandolfi at rachel@scma.org or 707-525-4375.


Win an iPad through "Passport to Participation"

To encourage physician collegiality and the advancement of community health, PASSPORT TO PARTICIPATION acknowledges Sonoma County physicians' active engagement with SCMA, CMA and community activities by awarding points for participation. In addition to recognition for exemplary involvement, an iPad will be awarded to the winner at the end of the fiscal year. Click here to learn more.


Sonoma Medicine focuses on "Medicine & Politics"

"Medicine & Politics" is the theme of the fall issue of Sonoma Medicine, with a federal update, a report on Covered California, and the latest on Prop. 46 including a pull-out poster for your office and more. The issue also features special reports on tick-borne infections and the new Sutter Hospital, and articles on electromagnetic hypersensitivity, high-intensity focused ultrasound, and techniques for changing patient behavior.

Watch for the magazine in the mail the second week of October.
It will also be emailed and posted at www.scma.org.



Latino Health Forum Oct. 16

The 22nd annual Latino Health Forum runs from 7:30 a.m. to 4:30 p.m. on Thursday, Oct. 16, at the Flamingo Conference Resort in Santa Rosa. All local physicians, medical professionals, and students interested in medical careers were invited to attend. Registration is now closed, and the forum is sold out. Please visit www.LatinoHealthForum.org to sign up for next year's conference.


APPLICANTS

Alisa Awtry, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC San Diego
Nathalie Boittin, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Perelman Sch Med
Margot Brown, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC San Francisco
Joel Charles, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ Wisconsin
Melissa Coleman, MD, Pediatrics*, 3925 Old Redwood Hwy., Santa Rosa 95403, Harvard Med Sch 2008
Phoebe Mar Devitt, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ Wisconsin
Serena Edwards, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ Iowa
Pirouz Fakhraei, MD, Internal Medicine*, Hospice & Palliative Medicine*, 401 Bicentennial Way, Santa Rosa 95403, Azad Univ 2005
Francheska (Sevy) Gurule, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Univ New Mexico
Laura Kromann, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Texas A&M Med Coll
Kristin Montalvo, MD, Psychiatry*, 3554 Round Barn Blvd., Santa Rosa 95403, Uniformed Services Univ 1999
Edna Prieto, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UC San Francisco
Tania Rezai, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Stanford Univ
Robert Schulman, MD, Physical Medicine & Rehabilitation*, Pain Medicine*, 440 Bohemian Hwy., Freestone 95472
Daniel Whitesides, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, UNC Sch Med
Ellie Wiener, MD, Family Medicine, 3569 Round Barn Cir., Santa Rosa 95403, Icahn Sch Med
Michael Yoo, MD, Internal Medicine*, Pediatrics*, 401 Bicentennial Way, Santa Rosa 95403, Emory Univ 2007

* = board certified


BE PREPARED FOR PROP. 46: VOTE NO

  • Get the facts at www.Noon46.com.
  •  Click here to watch the "No on 46" ads.
  •  Order lab coat cards, "No on 46" buttons, posters, bumper stickers, and brochures in English and Spanish. Click here to order them now--Free Shipping! (Or download Order Form.)
  •  Coordinate a meeting with your medical group. We guarantee a speaker! Contact Cynthia Melody at 707-525-4375 or cmelody@scma.org.
  •  Wear your "No on 46" button.
  •  Put a "Vote No on 46" yard sign in front of your office and at your home. We have crateloads at MMS and will deliver. Just call us at 707-525-4375.
  • A pull-out poster will be in the fall issue of Marin Medicine with articles, charts, the order form and more. Watch for it.
  •  Talk with your colleagues, patients, friends, family, neighbors, the checkout person at the store, etc. about Prop 46: Increased costs; Losing your Doctor; Threatening your privacy.



RESOURCES

Oct. 18
Perspectives on Pediatric Orthopaedics.
Pediatricians, family practice doctors, physician assistants and nurses will meet in Sacramento for a CME seminar hosted by the orthopaedic faculty at Shriners Hospitals for Children-Northern California, located at 2425 Stockton Boulevard, Sacramento. The all-day event runs from 8 a.m. to 3 p.m. and 5 CME credits are available. The cost is $90 for physicians, $60 for nurses and physician assistants. Registration fee includes all conference materials, continental breakfast and lunch. Call 916-453-2191 or send email ncal.education@shrinenet.org.

Oct. 28
Managing Pain Safely Forum.
Partnership HealthPlan of California is hosting an all-day forum offering an opportunity for providers, prescribers, quality leaders and staff to learn how others in our communities are managing to balance the use of opioids for healing while avoiding harm. The forum will be held at the Hyatt Vineyard Creek Hotel from 7:30 a.m. to 4:30 p.m. and topics include opioid overuse as a public health issue, rational and irrational use of opioids, alternatives to opioid treatment, broaching the subject of overuse with patients, and the art and very little science of tapering. The registration fee is $40 and $60. Click here for details and to register.

Oct. 30
IMQ 2014 Medical Staff Conference.
The Institute for Medical Quality is offering physicians leading a medical staff this one-day conference that provides a foundation of knowledge, techniques, and best practices to help them succeed. 6.75 AMA PRA Category 1 Credits available. The location is the Embassy Suites SFO Waterfront Hotel in Burlingame, CA (near San Francisco International Airport). For more information, visit IMQ.org; to register, click here.



MEDICAL ORGANIZATIONS

Sutter Health donates former Warrack Hospital to SAY. Sutter Health announced its donation of the former Warrack Hospital to Social Advocates for Youth (SAY) to advance SAY's mission to provide education and housing for at-risk Sonoma County youth. SAY's newly named Dream Center will operate the former hospital building serving Sonoma County youth with proven counseling, employment, and education services. In addition, the Dream Center will offer up to 63 new units of affordable housing for imminently homeless, former foster youth aged 18-24 years old. In order to transform the campus from hospital to home, an extensive interior remodel is scheduled to begin over the winter months. Operations at the Dream Center are expected to begin in late 2015.

Kaiser Permanente has awarded Community Benefit grants to 27 Sonoma nonprofit organizations. The grants, ranging from $7,500 to $20,000, support efforts to address some of the most crucial health issues in Sonoma County. The 2014 grantees are: California Parenting Institute, Catholic Charities of Diocese of Santa Rosa, Centro Laboral de Graton, Community & Family Service Agency, Community Action Partnership Sonoma County, Community Child Care Council Sonoma County, Community Garden Network of Sonoma County, Community Matters, Council on Aging, County of Sonoma Department Health Services Safe Routes to School Matching Grant, Healthy Community Consortium (HC2), Interfaith Sustainable Food Coalition, Jewish Community Free Clinic, La Luz Center, LifeWorks of Sonoma County, Lomi Psychotherapy Clinic, Mentor Me Petaluma, Northern California Center for Well-Being, PDI Surgery Center, Petaluma People Services Center, Bounty Hunters Community Network, Redwood Community Health, Redwood Empire Food Bank, School Garden Network of Sonoma County, SOS Community Counseling, Valley of the Moon Children's Services, Verity, and YWCA of Sonoma County.


CLASSIFIEDS

Seeking sublet for rent
Seeking medical office for sublet in Sebastopol, Santa Rosa, or Petaluma.
Please contact office@marinphysiatry.com  or call 415-839-8399.

Open house welcomes Dr. Khurram Abbass
The medical community is invited to an open house welcoming Khurram Abbass, MD and his staff to the area on Thursday, Oct. 16, from 6 to 7:30 p.m. at 750 Las Gallinas Ave. Ste. 110 in San Rafael. Dr. Abbass is a board-eligible rheumatologist and board certified in internal medicine. He recently completed his rheumatology fellowship at the University of Minnesota. For more information, contact Dr. Abbass at 415-785-7154, ordrkhurramabbass@gmail.com. Visit his Facebook page at www.facebook.com/drkhurramabbass.

SCMA members get free classifieds!
SCMA members can place free classified ads in News Briefs or Sonoma Medicine. Cost for nonmember physicians and the general public is $1 per word. To place a classified ad, contact Susan Gumucio at susan@scma.org or 707-525-0102.


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.

Visit us at www.scma.org. Check here for the fall issue of Sonoma Medicine magazine, available in early October.


Your Ad Here! Call (707) 525-0102