July 2011 Partnership HealthPlan begins serving Medi-Cal patients in MarinReminder: Adolescents need Tdap booster before school begins in fallDr. Lee Lipsenthal to speak at MMS Fall DinnerResolution requiring “opt in” for prescribing data advances to CMA HouseNew MMS officers elected for 2011-12 fiscal yearStudy finds inequities in Medicare's geographic payment formulaHealth Information conference in Santa Rosa July 14-15MEDICAL FACILITIESRESOURCESCLASSIFIEDSABOUT MMSPartnership HealthPlan begins serving Medi-Cal patients in Marin About two-thirds of the 15,000 Medi-Cal patients in Marin County became Partnership HealthPlan members as of July 1. The nonprofit health plan offers a managed-care version of Medi-Cal that links patients to primary care physicians. All the hospitals in Marin County are participating in the Partnership plan, along with a network of specialty physicians and ancillary providers. Medi-Cal patients who aren’t enrolled in Partnership will remain in the traditional fee-for-service program. Physicians can determine patient eligibility for Partnership by calling 800-557-5471 (available 24/7) or 707-863-4120 (normal business hours). Most Partnership members will have an assigned primary care physician who will authorize referrals for specialty care. Procedures provided by specialists or ancillary providers will need an approved Treatment Authorization Request from Partnership. Questions about the new Partnership plan should be directed to Daniel Santos at dsantos@partnershiphp.org or 707-419-7941, or to the main Provider Relations Line at 707-863-4100.Reminder: Adolescents need Tdap booster before school begins in fall Physicians are reminded that a new state law requires all adolescents to have a Tdap booster for pertussis before school begins this fall. Pertussis is widespread in California, and more than 1 million of the state’s adolescents may not yet have received a Tdap booster. Doctors should keep track of which patients have or haven’t received Tdap and should send patient reminders now. All adolescents will need clear documentation of Tdap immunization to enroll in school this fall. For more information, visit www.shotsforschool.org.Dr. Lee Lipsenthal to speak at MMS Fall Dinner Dr. Lee Lipsenthal, author of Finding Balance in a Medical Life, is the featured speaker at the MMS Fall Dinner on Oct. 12. He will discuss his forthcoming book, Enjoy Every Sandwich: Living Each Day As If It Were Your Last, which shows how to grow the sense of meaning and purpose in your life while enhancing the quality of your work. The event, to be held at Jason’s Restaurant in Greenbrae, begins with a social hour at 6 p.m., followed by dinner and program at 7. Dinner choices include salmon, ribeye steak, brandy chicken or vegetarian gnocchi. To RSVP and indicate your dinner choice, contact Rachel Pandolfi at 415-924-3891 or rachel@marinmedicalsociety.org. Resolution requiring “opt in” for prescribing data advances to CMA House In response to the recent Supreme Court ruling allowing pharmaceutical wholesalers to sell physician prescribing data to drug companies, delegates at the June 24 CMA District 10 caucus, which includes MMS, approved a resolution that would require physicians to “opt in” to any program that sells their prescribing data. The resolution, by Healdsburg ob-gyn Dr. Brad Drexler, notes that use of the current “opt out” option has been negligible, and that drug companies are denying samples to physicians who do opt out. The “opt in” resolution will advance to the CMA House this fall, along with several other resolutions approved by District 10. One resolution, by MMS President Dr. Peter Bretan, asks CMA to design a template for organizing physician volunteers to help with disaster preparedness and in delivering care to the indigent and uninsured. Another, by Santa Rosa pediatrician Dr. David Smith, would require that medical marijuana be dispensed in child-proof containers.New MMS officers elected for 2011-12 fiscal year Dr. Peter Bretan has been re-elected president of MMS for the 2011-12 fiscal year. Other newly elected officers include Dr. Irina deFischer (president-elect), Dr. Georgianna Farren (secretary/treasurer), Dr. Lori Selleck (past president) and Dr. Anne Cummings (CMA alternate delegate). They are joined on the MMS board of directors by Drs. Larry Bedard, Scott Levy and Barbara Nylund, who were elected or appointed in previous years. Membership in MMS has been increasing recently and now stands at more than 300 active members.Study finds inequities in Medicare's geographic payment formula The data that Medicare relies on to adjust for geographic variation in costs to pay physicians and hospitals is flawed and leads to inaccurate payments, according to a report recently released by the Institute of Medicine (IOM). The finding represents a huge victory for CMA and will go a long way toward ensuring that California physicians are reimbursed accurately for the differences in geographic practice costs. CMA has for years been urging Congress to reform the flawed and outdated geographic payment regions. CMA testified before the IOM last fall, showing that the costs of running a physician's practice differ substantially across the country. Failing to take that variance into account in Medicare payments is a big mistake that harms senior citizens’ access to care, CMA said in its testimony. Geographic adjustments to Medicare payments are intended to cover regional variations in wages, rents and other costs incurred by physicians and hospitals. The IOM study found, however, that almost 40% of hospitals have been granted exceptions to how their adjustments are calculated, strongly suggesting that the mechanisms underlying the adjustments are inadequate. The IOM study concluded that the rationale for fine-tuning Medicare payments based on geographic variations in expenses is sound and should be continued. However, the report urges fundamental changes to the data sources and methods used to calculate the adjustments and increase the accuracy of the payments. One such change recommended by the study would be to place physicians and hospitals into the same Metropolitan Statistical Areas (MSAs), which reflect regional costs more accurately than the outdated payment localities that are currently used to determine reimbursement. In California, for example, the physician payment localities haven't been updated in more than 12 years, leaving many recently urbanized counties inappropriately grouped into payment localities with lower-cost rural counties.Health Information conference in Santa Rosa July 14-15 The fifth annual “Connecting California to Improve Patient Care” conference will be held at the Hyatt Vineyard Creek Hotel in Santa Rosa on July 14 and 15. The conference, which is organized by the nonprofit Redwood MedNet, will focus on clinical informatics and electronic health information exchanges. Conference presenters include physicians and other experts in medical information technology. The conference begins on the afternoon of July 14 with workshops on health information privacy and security. The cost of the workshops is $75. The Friday session begins with a keynote address by Dr. Carol Diamond, followed by a full day of presentations. Cost for the full day is $250. To register, and for more details, visit www.redwoodmednet.org.MEDICAL FACILITIES Researchers at the Buck Institute in Novato have found use of lithium with mice prevents the aggregation of toxic proteins and cell loss associated with Parkinson’s disease (PD). “This is the first time lithium has been tested in an animal model of PD,” said lead author Dr. Julie Anderson, noting that the institute plans to conduct clinical studies of lithium in humans in conjunction with standard PD therapy. “The fact that lithium’s safety profile in humans is well understood greatly reduces trial risk,” she said. Women in Marin County without private insurance will continue to receive maternity services, thanks to a new partnership between Marin General Hospital, Prima Medical Foundation, Marin Community Clinics and the County of Marin. The county, which had been running an ob-gyn program in partnership with Marin General, had to reduce funding by 40%, potentially leaving several hundred women without prenatal care. Under the new agreement, Marin Community Clinics will offer prenatal care with assistance from physicians in Prima, and women will be able to deliver at Marin General regardless of insurance status.RESOURCES Two one-hour CMA webinars are scheduled for July. “Collections--Get Paid Now,” begins at 12:15 p.m. on July 6, and “Writing Effective Appeals,” begins at 12:15 p.m. on July 20. The webinars are free for MMS members; cost for nonmembers is $99. To register, visit www.cmanet.org/calendar.CLASSIFIEDS Shred-It On-site guaranteed service. Office console provided. Stay compliant. Free consultation. Contact Marie Anderson at 415-721-7278 or marie.anderson@shredit.com. How to submit a classified ad To submit a classified ad for MMS News Briefs or Marin Medicine, contact Erika Goodwin at erika@scma.org or 707-548-6491. The cost is one dollar per word.ABOUT MMS The Marin Medical Society, a 501(c)(6) nonprofit association, supports local physicians and their efforts to enhance the health of the community. We are affiliated with the California Medical Association and the American Medical Association. © 2011 MMS, PO Box 246, Corte Madera, CA 94976 July 1, 2011 MMS News Briefs July 2011 0 0 Comment Read More »