MMS News Briefs

February 2010

• Marin foundation gets $10 million from Sutter to improve access to care
• CMA members split on stalled health care legislation
• Beginning April 5, Medicare may reject claims if physician is not in PECOS system
• Registration open for CMA Leadership Academy in San Diego
• CMA files lawsuit against governor over scope-of-practice laws
• Dustin Corcoran named chief executive of CMA
• CVS to open new pharmacy in San Rafael
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Marin foundation gets $10 million from Sutter to improve access to care

Flush with a $10 million grant from Sutter Health, the MarinCommunity Foundation will soon be inviting local nonprofits to submit proposalsfor increasing access to care, purchasing needed equipment, and launchingpreventive health programs. The foundation plans to issue $2 million in grantsper year for the next five years.

"This funding initiative is a significant contributionto the health and well-being of every resident in Marin," said Dr. ThomasPeters, the foundation's president. "We look forward to working closelywith representatives from Sutter, the county health department, communityclinics, and other providers to seek input on the most effective use ofSutter's generous donation."

Dr. Larry Meredith, director of health and human servicesfor Marin County, added, "A vibrant, nonprofit system of accessible healthcare is a critical piece of our county's overall health system, and this isexactly what the Sutter Health initiative will address." He added that theinitiative is likely to reduce the burden on local emergency rooms, which havebecome the providers of last resort for patients without insurance.

Peters indicated that nonprofits will be contacted directlyand invited to submit grant proposals. The first grants are expected to beannounced in May.

CMA members split on stalled health care legislation

While CMA member physicians are unified in their support forhealth reform, they are evenly split (44% to 44%) on whether they favor oroppose the health reform legislation that is currently stalled in Congress.That split was one of the main findings of a survey CMA sent to members in lateJanuary. Of the 407 members who responded, 97% indicated that they favor eitherincremental or fundamental health care reform over no reform.

For the preferred system of health care financing, nearlytwo-thirds of the respondents (66%) favored a mix of government and privatepayers over single-payer (19%) or a free market system without public insurance(13%).

In addition to unified support for the concept of healthreform, CMA members showed support across all demographics for specificprovisions of health reform legislation, including:

·      Protecting MICRA, California’s law limitingnoneconomic damages in medical liability cases (94% favor).

·      Prohibiting insurance companies from denyinghealth coverage because of pre-existing conditions or changes in health status(89% favor).

·      Providing tax credits and subsidies to low-incomefamilies and small employers so they can purchase health insurance (88% favor).

·      Expanding health insurance coverage to 95% ofthe uninsured (82% favor).

·      Providing funding to develop best practices andquality measures for health care providers (76%).

Throughout the health reform debate, CMA has relied onpolicy developed by the democratically elected CMA House of Delegates toformulate its position and priorities for health care reform. The poll wasundertaken at the request of the House of Delegates to ensure that CMA membershad an opportunity to voice their opinions and have an impact on health carereform legislation.

While health reform has been sidetracked by recent events,congressional leaders continue to debate the issue. CMA will use the results ofthis poll to represent the interests of California physicians in that debate.

Beginning April 5, Medicare may reject claims if physician is not in PECOS system

Medicare physicians who have not updated their enrollmentinformation in the past five years may need to fill out another application orface payment problems for ordered or referred services. The new rules, whichtake effect April 5, authorize Medicare to reject claims if an orderingphysician is not identified in Medicare’s PECOS enrollment system.

If you are not sure if you are already in the PECOS system,the Centers for Medicare & Medicaid Services has posted a list of allphysicians enrolled in PECOS on cms.hhs.gov.Be aware that this is an enormous document, containing over 13,000 pages, andas such it will take time to download. To see if you are on the list, go to thesearch tool and enter your type 1 (individual) NPI number, or last name, andhit enter. If you do not appear on the list, you will need to revalidate yourenrollment with Medicare.

If you determine that you need to submit a new enrollmentform, you can do so online using the web-based PECOS system at pecos.cms.hhs.gov or byfilling out the appropriate paper enrollment form(s) (CMS-855I and CMS-855R, ifappropriate) and mailing the forms to Palmetto, which will enter yourinformation into PECOS and process your enrollment application. If you enrollonline, be sure to also mail to Palmetto the signed and dated CertificationStatement within seven days.

MMS president-elect Dr. Peter Bretan serves on CMA’sTechnical Advisory Committee for PECOS. For further information about PECOS fromCMA, contact Michele Kelly at 213-226-0338 or mkelly@cmanet.org.

Registration open for CMA Leadership Academy in San Diego

Registration is now open for CMA's annual Health CareLeadership Academy, scheduled for April 9-11 in San Diego. This year'sconference will assess the status and impact of federal health reform efforts,including provider payment incentives that may change the organizational formsof medical practice.

The 2010 Academy, approved for 18.25 hours of Category 1 CMEcredit, will feature three main breakout tracks: health information technology,leadership skills development, and practice management.

MMS gets a group discount, so you can save $100 if you registerwith MMS by March 9 rather than online. Early bird registration is $645 formembers, $945 for nonmembers, and $295 for allied health professionals.Early-bird tuition for practice managers and other non-MD staff is $295 forCAMGMA members, $395 for nonmembers.

To register, contact Jessica Whittom at 924-3891 or jessica@marinmedicalsociety.org.

CMA files lawsuit against governor over scope-of-practice laws

CMA and the California Society of Anesthesiologists havefiled a lawsuit asking a court to overturn a decision by Gov. Schwarzenegger toopt out of the federal requirement for physician supervision of anesthesia carefor Medicare patients. The governor's decision would enable hospitals to allownurses to administer anesthesia on Medicare patients without physiciansupervision.

Schwarzenegger in June 2009 requested and received anexemption from the federal Medicare requirement that physicians supervise nurseanesthetists. The exemption was requested without input from any professionalmedical organization and with disregard for state law that requires physiciansupervision of nurse anesthetists.

“If the governor had followed the law, he would have seenthat reducing the standards for anesthetists could have a detrimental impact onpatient safety,” says CMA President Brennan Cassidy, MD. “As doctors, our No. 1priority is the health and safety of our patients and that’s why the governoris taking a step in the wrong direction.”

Dustin Corcoran named chief executive of CMA

Dustin Corcoran, CMA's head lobbyist and senior vicepresident, has been named CEO of the association. He replaces Alfred Gilchrist,who resigned unexpectedly in January.

Corcoran joined CMA in 1998 as the membership coordinatorfor its political action committee. He soon began working as a lobbyist underthe late Steve Thompson, guiding bills related to access to care, emergencymedicine, hospitals, tobacco usage, public health and health care systemreform.

After Thompson’s death in 2004, Corcoran took over as CMA’shead lobbyist and went on to become senior vice president. Corcoran was namedthe "most effective lobbyist under 40" in 2005 by "Around theCapitol" and one of the most powerful political brokers in California in2009 by "Capitol Weekly."

CVS to open new pharmacy in San Rafael

Replacing pachyderms with acronyms, CVS plans to open apharmacy in the space formerly occupied by Elephant Pharm in downtown SanRafael. The store was shuttered last year when Elephant Pharm went out ofbusiness. CVS, which has more than 800 stores in California, including seven inMarin, said it would open the new outlet this fall. 

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Medical office spaceto share
Dermatology practice seeks full- or part-time physician to share medicalspace in San Rafael. Office is a beautifully remodeled building in greatlocation. Two exam rooms with exam tables are available and use of additionalrooms is negotiable. Shared restrooms and staff lounge. Contact Kathleen at415-259-0131 or mdermatology@yahoo.com.

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