April 2009

• Nominations sought for Partnership Health Plan board of directors
• Public Health urges increased vaccinations for local children
• RSVP now for SCMA Wine & Cheese Reception on May 28
• Reminder: Medicare billing seminar in Santa Rosa on April 7
• Sign up for CMA Legislative Day and Leadership Academy
• SCMA Alliance sponsors two fundraisers during May
• Physicians need to comply with identity theft rules by May 1
• CMA files class action suit against WellPoint
• Three health-related propositions on May 19 special election ballot
• Dr. Mark Sloan reads from his new book at Copperfield’s on April 3
• Drs. Rosa and Bernstein named to new posts at Palm Drive
• Volunteers needed for Neighbors in Health
• Medical debts seminar - May 6
• Office equipment for sale
• Free file cabinets
• How to submit an ad

Nominations sought for Partnership Health Plan board of directors

Partnership HealthPlan of California (PHC), a CountyOrganized Health System charged with operating the Managed Medi-Cal program inSolano, Napa and Yolo counties, is scheduled to begin operating in SonomaCounty this October. At that time, PHC will assume care management responsibilityfor almost 50,000 Medi-Cal beneficiaries in the county.

For the past three years, PHC has been working with aPlanning Group appointed by the Sonoma County Department of Health Services toimplement Managed Medi-Cal in the county. The SCMA representative on thePlanning Group is Dr. Kirk Pappas.

As part of the implementation plan for Sonoma County, PHCwill soon expand its board of directors to 22 members and provide Sonoma Countywith seven board seats. The PlanningGroup has requested that SCMA identify a physician for consideration as anominee to the PHC board. This is a very important position, as the directorwill represent all Sonoma County physicians on the board that will control howthe Medi-Cal Managed Care program is administered.

The nominee will be submitted for consideration to RitaScardaci, director of the Sonoma County Department of Health Services. She willsubmit the final recommendations to the Sonoma County Board of Supervisors forapproval.

Important considerations for identifying candidates includethe ability to:

* Travel to Fairfield for board meetings on a monthly basis(evenings, fourth Wednesday of the month).

* Carry out the fiduciary responsibilities of the board inmeeting the health care needs of Medi-Cal recipients in all counties served byPHC.

The SCMA board of directors is hereby requesting nominationsfor the PHC board position. Applicantsshould submit a letter of interest and a CV to SCMA by April 30. Applicantsshould also indicate if they are interested in participating in a PHC boardsubcommittee. For more information about PHC, visit www.partnershiphp.org.

Applications should be submitted by mail, fax or e-mail toSCMA Executive Director Cynthia Melody at the address below. For questions,call her at 525-4359.

Cynthia Melody
SCMA
3033 Cleveland Ave. #104
Santa Rosa, CA 95403
Fax 525-4328
cmelody@scma.org

Public Health urges increased vaccinations for local children

Sonoma County’s childhood vaccination rates, already among the lowest in California, have become front-page news. Recent reports indicate that vaccination rates in some local private schools are as low as 24%, with certain public districts reporting rates as low as 54%.

A major cause of the low rates appears to be the “personal belief exemptions” (PBEs) that parents can sign to exempt their children from vaccinations. Many parents are signing PBEs because they fear vaccines can cause autism—a theory that has long since been discredited.

“Vaccines are safe and they don’t cause autism,” said Deputy Public Health Director Dr. Mark Netherda. He urged local physicians to present the facts about vaccines, along with this stark reminder: “The diseases that these vaccines prevent can kill your child.”

Childhood vaccines are used to prevent more than a dozen once-common contagious diseases, including measles and pertussis.

Netherda, who has an article about the county’s low vaccination rates in the current issue of Sonoma Medicine, said the situation is becoming more acute. “We are seeing these diseases in Northern California,” he noted. “They are on the rise because people aren’t vaccinating.”

Public Health is developing a plan to improve immunization rates and will probably hold a stakeholder meeting on the topic later this spring. Patient-education materials about vaccines are available from the CDC at www.cdc.gov and from the American Academy of Pediatrics at www.aap.org.

RSVP now for SCMA Wine & Cheese Reception on May 28

All SCMA members and their spouses or guests are invited toSCMA’s annual Wine & Cheese Reception on Thursday evening, May 28. Thisyear’s reception will be hosted by Dr. Richard and Julie Andolsen at theirprivate vineyard near Healdsburg. The event offers a wonderful opportunity togather with colleagues in a relaxed, convivial setting.

In addition to cheese and Andolsen Vineyard wines, thereception includes an informal alfresco dinner. There is no cost for SCMAmembers and their spouses or guests; the cost for nonmembers is $35 per person.

Reminder: Medicare billing seminar in Santa Rosa on April 7

Registration is still open forthe Palmetto GBA Medicare billing seminar in Santa Rosa on April 7. All staffinvolved with Medicare billing are urged to attend.

The seminar will run from 8:30a.m. to 12:30 p.m. on Tuesday, April 7, in the Vesalius Room at the SutterMedical Center of Santa Rosa. The address is 3325 Chanate Rd.

To register, visit www.PalmettoGBA.com/J1B and click on the“Learning and Education” tab. Please note that registration for the seminarmust be completed through Palmetto, not SCMA.

Sign up for CMA Legislative Day and Leadership Academy

There’s still time to sign up for CMA’s Legislative Day on April 14, and for their Leadership Academy on April 24-26. Both events help get physicians more involved in the all-important political process.

On Legislative Day, physicians from across the state will gather in Sacramento to hear Attorney General Jerry Brown and others discuss health care policy in a series of morning and luncheon briefings. During the afternoon, SCMA members will be able to meet face-to-face with legislators from Sonoma County.

CMA provides all Legislative Day meals and conference materials free of charge. To RSVP, contact Rachel Pandolfi at 525-4375 or rpandolfi@scma.org. SCMA is coordinating carpools.

The Leadership Academy, which offers 17.5 hours of CME, will be held April 24-26 at the Disneyland Hotel in Anaheim.

Topics include health system reform in a new era of Washington politics; the “medical home” and other emerging models for delivering quality care; the promises and perils of hospital EHR initiatives; and health disparities.

The cost is just $745 for SCMA members or $1,045 for nonmembers. Reduced rates are available for staff and for single-day tickets. To register, call 800-795-2262 or visit www.caleadershipacademy.com. 

SCMA Alliance sponsors two fundraisers during May

The SCMA Alliance will be busy raising funds for local nonprofits during May.

On May 9, Team Alliance will participate in the annual Human Race, which raised more than $1 million for charity last year. Funds raised by Team Alliance will fund breast cancer awareness, safety for school-aged children, and health promotion programs.

Physicians and staff can support Team Alliance by signing up to participate in the race or helping at the Team Alliance booth. To sign up, contact Ann Hurd at 537-1031 or annhurd08@comcast.net or Kathleen Cortez at 483-4953 or kkcortez@sonic.net.

For the less athletically inclined, the Alliance is also sponsoring their annual Garden Tour in Sonoma on May 15 and 16. Participants can take self-guided tours of five spectacular private gardens, enroll in gardening workshops, and participate in a raffle whose prizes includes dinners at Cyrus or the Farmhouse Inn.

Tickets for the Garden Tour are just $40; an optional lunch at Meritage Restaurant is $22. To purchase tickets, visit www.scmaa.org or call Janet Shane at 578-4537.

Physicians need to comply with identity theft rules by May 1

Despite objections from organized medicine, the FederalTrade Commission has ruled that physicians who regularly bill their patientsfor services (including copayments and coinsurance) are considered “creditors”and must develop and implement written identity theft prevention programs fortheir practices by May 1. The so-called Red Flag Rules are required for allfinancial institutions and creditors.

CMA has argued that the Red Flag Rules impose an unnecessaryburden on physician practices, which often operate under strained conditions.CMA also notes that HIPAA already imposes strict requirements to safeguardpatient information. Until further notice, however, physicians should begin toplan their Red Flag compliance programs.

CMA will be hosting alive webinar on April 16 from 12:30 to 1 p.m. to help members understand andcomply with the Red Flag Rules. To register, visit www.cmanet.org/calendar.CMA will also be posting a toolkit on www.cmanet.org to help physicians developand implement identity theft detection programs. 

CMA files class action suit against WellPoint

CMA has joined with other state medical groups and the AMA to file a class action lawsuit against WellPoint. The lawsuit alleges that WellPoint colluded with United Health Group on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care.

“Health insurers are data manipulating to set rates artificially low, forcing patients to pay more than they bargained for when they go to a doctor of their choice,” said Dr. Dev GnanaDev, CMA president.

WellPoint, which operates as Blue Cross in California, is legally bound to pay the “usual and customary rates” (UCR) for care provided to their enrollees by an out-of-network physician. To determine UCR rates, WellPoint uses a database run by Ingenix, a company owned and operated by United Health Group.

A recent investigation by New York Attorney General Andrew Cuomo concluded that the Ingenix data is intentionally manipulated to allow health plans to shortchange reimbursements on medical bills. WellPoint agreed to pay $10 million to help fund a new database run by an independent nonprofit organization to replace Ingenix. The company also agreed to quit feeding data into Ingenix and use the new system once it is up and running.

The class action suit has been filed because the settlement with Cuomo did not seek redress for patients and doctors. ”CMA,” said Dr. GnanaDev, “will continue fighting to obtain relief for patients and physicians who were harmed by the systemic flaws of the conflict-ridden Ingenix database.” 

Three health-related propositions on May 19 special election ballot

Election-weary Californians haveyet another set of ballot propositions to wade through, thanks to the state’shistoric budget agreement earlier this year. A special election set for May 19will include six budget measures, three of which are related to health care.

Proposition 1A would direct the state to spend any excess revenueon education, the Budget Stabilization Fund, and paying off debt, in thatorder. Because health care funding is unprotected, the proposal could result infurther cuts to Medi-Cal and Healthy Families.

Proposition 1D would redirect cigarette tax funds from First 5commissions to the state’s general fund. The proposal could hamper local First5 programs for children’s services but might benefit state-level programs.

Proposition 1E would redirect taxes on the wealthy from an accounttargeted for mental health programs to the general fund. As with Proposition1D, the results are likely to be mixed, with some mental health programsbenefitting and others not.

Dr. Mark Sloan reads from his new book at Copperfield’s on April 3

Dr. Mark Sloan, a pediatrician at Kaiser Santa Rosa, willread from his newly published book, BirthDay, at Copperfield’s Books in Santa Rosa’s Montgomery Village at 7 p.m. onFriday, April 3. The subtitle of the book gives a good idea of its contents: “Apediatrician explores the science, the history, and the wonder of childbirth.”

A longtime member of the SCMA Editorial Board, Dr. Sloan haswritten many articles and editorials for SonomaMedicine, including the editorial for the current issue on children’shealth.

Drs. Rosa and Bernstein named to new posts at Palm Drive

Drs. Greg Rosa and Allan Bernstein are assuming new dutiesat Palm Drive Hospital. Dr. Rosa, a veteran family physician, is directing thehospital’s new medical center, which will offer primary care to west countyresidents. Dr. Bernstein, former co-chief of neurology at Kaiser Santa Rosa, willdirect a headache clinic for Palm Drive.

Volunteers needed for Neighbors in Health

Last year, more than 500 children participated in Neighborsin Health, a day-long event that provides medical care, immunizations, wellchecks and dental exams to uninsured and underinsured children. Organizers hopeto serve even more children at this year’s event, scheduled for August 2. Tovolunteer, visit www.unitedwaywinecountry.org/nih.

Medical debts seminar - May 6

Office equipment for sale

Free file cabinets

How to submit an ad

March 2009

• National physician leader Dr. Palmer to speak in Santa Rosa on March 4
• SCMA members to receive patient-feedback postcards for Doctors Day
• Jerry Brown to speak at CMA Legislative Day on April 14
• Nominations needed for SCMA elections
• Health Action takes first steps with iWalk program
• Redwood Regional to spend $2 million on new equipment and offices
• PFMC grant deadline is April 1
• Stimulus plan includes $19 billion for electronic health records
• Medi-Cal giveth and taketh away
• Pfizer to disclose payments to physicians
• Joint Commission requires collection of physician performance data
• CME: Sign up now for 2009 CMA Leadership Academy discount
• March CME presentations at SDC: anxiety disorders and kidney disease
• IMQ needs family physicians and internists as paid consultants
• CMA to host webinar on effective physician leaders
• CME: Primary care conference at Yosemite Lodge on April 3 and 4
• Medical office equipment for sale

National physician leader Dr. Palmer to speak in Santa Rosa on March 4

Dr. Elissa J. Palmer, president of the Association of Family Medicine Residency Directors, will be in Santa Rosa on March 4 to speak on the future of primary care. Her speech begins at 6 p.m. in the Carston Cabaret Room at the Wells Fargo Center.

Dr. Palmer will discuss innovative models of patient-centered primary care and characteristics of successful primary care practices. Her speech, sponsored by the Sonoma Health Access Coalition, is free and open to the public, but reservations are requested. To RSVP, contact Donna Paul at dpaul@rchc.net or 547-7242, ext. 32.

For additional information about Dr. Palmer and the Sonoma Health Access Coalition, visit sohac.blogspot.com.

SCMA members to receive patient-feedback postcards for Doctors Day

March 30 is National Doctors Day, and SCMA and the SCMA Alliance are marking the occasion by distributing colorful patient-feedback postcards to the offices of SCMA members. Patients can use the postcards to comment on what makes their doctors special. The cards can be left at the doctor’s office or mailed to the SCMA Alliance, which will gather the comments and share them with individual doctors.

Each year, Doctors Day gives patients a chance to show gratitude to their physicians. The first celebration was held in Georgia in 1933, and Congress officially designated March 30 as National Doctors Day in 1990.

Jerry Brown to speak at CMA Legislative Day on April 14

Attorney General Jerry Brown heads the list of speakers at CMA’s annual Legislative Day in Sacramento on April 14. Hundreds of physicians from across the state are expected to gather in the capital that day to hear Brown and others discuss healthcare policy in a series of morning and luncheon briefings. During the afternoon, SCMA members will be able to meet face-to-face with legislators from Sonoma County.

All SCMA members are encouraged to attend this annual free event. CMA provides all meals and conference materials free of charge. To RSVP, contact Rachel Pandolfi at 525-4375 or rpandolfi@scma.org. SCMA will coordinate carpools.

Nominations needed for SCMA elections

Nominations for the following SCMA positions are due by March 20:

*     SCMA president-elect

*     Individual SCMA board representatives from Healdsburg (1), Petaluma (1), and Santa Rosa (2)

*     Two CMA delegates

*     Two CMA alternate delegates

All positions require a three-year commitment, beginning July 1. Nominations can be e-mailed to cmelody@scma.org, faxed to 525-4328, or mailed to SCMA, 3033 Cleveland Ave. #104, Santa Rosa, CA 95403. Each nomination should include a brief statement about the nominee's qualifications.

For more details, contact Cynthia Melody at cmelody@scma.org or 525-4359.

Health Action takes first steps with iWalk program

Hard on the heels of the iPod and the iPhone, the local Health Action council is stepping out with iWalk, a coordinated effort to promote walking in Sonoma County. The council, which includes SCMA members Dr. Mary Maddux-González and Dr. Bo Greaves, will soon launch a media campaign to encourage bipedal locomotion throughout the county.

Among the many aspects of the campaign will be efforts to improve the walkability of communities and support existing walking groups. For more information, visit www.sonomahealthaction.org.

Redwood Regional to spend $2 million on new equipment and offices

Despite the foundering economy, Redwood Regional Medical Group plans to spend roughly $2 million over the next few months to purchase equipment and renovate its offices. About half the money will go for new equipment, including two digital mammography machines. The remaining funds will be used to remodel RRMG facilities in Santa Rosa and Petaluma.

The plans were announced by interim CEO Wayne Fairchild, who joined RRMG last fall. The privately owned group has 10 campuses throughout the North Bay and several dozen physicians on staff.

PFMC grant deadline is April 1

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 1. For application materials, contact Marilyn Flowers at 800-548-7677, Ext. 120, or mflowers@rhs.org. For more information, visit www.pfmc.org.

Stimulus plan includes $19 billion for electronic health records

The economic stimulus package recently signed by President Obama provides approximately $19 billion for electronic health records over the next five years, including bonus payments upwards of $40,000 for each Medicare provider who demonstrates “meaningful use” of an EHR system.

Physicians with significant Medi-Cal patient loads (20% or more for pediatricians, 30% or more for other specialties) may be eligible for additional bonuses paid through state Medicaid programs. As eligibility is based on usage, even physicians who already use EHR systems may be eligible. While the bill does include Medicare payment reductions (starting at 1%) for physicians who do not implement EHR systems, these do not take effect until 2015, and there are exceptions for significant hardship cases.

Medi-Cal giveth and taketh away

California’s recent budget agreement eliminates optional benefits in Medi-Cal for adult dental, acupuncture, audiology, chiropractic, optometry, podiatry, psychology and incontinence treatments. Although there are no reductions for physicians beyond the previously scheduled 1% cut on March 1, reimbursements to public hospitals will be reduced by 10%.

These and other spending cuts may be averted, however, if California takes advantage of the increased federal matching funds available via the federal government’s economic stimulus plan. Under that legislation, a state’s eligibility and renewal procedures for the Medicaid program (Medi-Cal in California) cannot be more limiting than they were on July 1, 2008.

As part of the budget deal enacted last September, California moved from annual to semi-annual reporting for children in Medi-Cal. If that provision is lifted, California will receive $3.7 billion in additional Medi-Cal funds this year, and $11.2 billion total over the next three years.

In Sonoma County, the Partnership Health Plan Managed Medi-Cal implementation is expected to begin on Oct. 1. Details of that plan will be rolled out later this year.

Pfizer to disclose payments to physicians

Beginning in 2010, Pfizer will disclose on its website all payments to physicians or other prescribers that exceed $500 in a year. A handful of other drugmakers, including Merck and Eli Lilly, have also announced plans to disclose payments to physicians who serve as speakers and consultants for the company.

The drugmakers’ actions come on the heels of proposed federal legislation to require such disclosures. So far, Pfizer is the only drugmaker to include in its disclosures payments to doctors who work on clinical studies and write up reports for medical journals.

The Physician Payments Sunshine Act of 2009 would require makers of drugs and medical devices to report annually all payments to doctors over $100 to the U.S. Department of Health and Human Services. The bill includes penalties of up to $1 million for knowingly failing to report such information.

The Sunshine Act is consistent with CMA policy, which supports mandatory disclosure of financial relationships between physicians and drug companies, with the exception of pharmaceutical samples for patients and meals in conjunction with educational meetings.

Joint Commission requires collection of physician performance data

The Joint Commission has begun requiring medical staffs to collect physician-specific performance data on a regular basis, in addition to the every two-year credentialing cycle. The goal for this “ongoing professional practice evaluation” (OPPE) is to ensure that all physicians with medical staff privileges are monitored routinely and regularly—regardless of whether there are specific performance issues—to find problems in a timelier manner and take appropriate steps to improve quality.

The specific data to be collected will be determined by individual medical staffs, but it could include procedures performed and their outcomes, pharmaceutical usage, diagnostic tests ordered, length of stay patterns, and morbidity and mortality data.

More information on the Joint Commission’s OPPE standard is available in CMA ON-CALL Document #1498, “Ongoing Professional Practice Evaluation.” 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.

For more details, contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org.

CME: Sign up now for 2009 CMA Leadership Academy discount

SCMA members who sign up for CMA’s annual Leadership Academy by March 24 will receive a $100 discount on the registration fee. The conference, which offers 17.5 hours of CME, will be held April 24-26 at the Disneyland Hotel in Anaheim.

Topics include health system reform in a new era of Washington politics; the “medical home” and other emerging models for delivering quality care; the promises and perils of hospital EHR initiatives; and health disparities.

Attendees can also select from 14 breakout workshops on topics ranging from survival strategies for practicing in a turbulent economy, to mitigating malpractice risk and developing leadership skills.

Early bird registration by March 24 (including the $100 discount) is just $645 for members, $945 for nonmembers, and $245 for allied health professionals. Tuition for practice managers and other non-MD staff is $295 for CAMGMA members and $395 for nonmembers. SCMA members should register by contacting Cynthia Melody at cmelody@scma.org or 525-4359.

For more details, including the conference brochure, visit the Physician Resources page at www.scma.org.

March CME presentations at SDC: anxiety disorders and kidney disease

The Sonoma Developmental Center will host two CME events in March. Both are scheduled for McDougall Hall from 1 to 2 p.m.

On March 5, Dr. Lorrin Koran will discuss management of anxiety disorders, and on March 12, Dr. Gopa Green will present case studies of chronic kidney disease. For details, call JoAnne Rawles at 938-6419.

IMQ needs family physicians and internists as paid consultants

The Institute for Medical Quality is seeking board-certified family physicians or internists to serve on judicial review committees for the California Department of Corrections and Rehabilitation (CDCR). The review committees hear evidence regarding the quality of care provided by CDCR physicians.

Interested physicians must be available to serve for five consecutive days, once or twice per year. Physicians will be paid on an hourly basis for their time and reimbursed travel expenses.

For more information, visit www.imq.org/imqdoc.cfm/9 or contact Leslie Anne Iacopi at 415-882-5167 or liacopi@imq.org.

CMA to host webinar on effective physician leaders

CMA is hosting a March 5 evening webinar on success factors for becoming an effective physician leader. The webinar runs from 8 to 8:45 p.m. To register, visit www.cmanet.org/calendar.

Dr. Susan Reynolds, president and CEO of the Institute for Medical Leadership, will discuss the UCLA Physician Leader Success Factor Study. Webinar registrants will receive a leadership assessment to help them understand their own leadership styles and how they can maximize their leadership effectiveness.

CME: Primary care conference at Yosemite Lodge on April 3 and 4

A postgraduate institute for primary care physicians will be held at Yosemite Lodge on April 3 and 4. Topics include psychiatric challenges, the biology of aging, and cardiovascular diseases. Includes 16 hours of CME credit. To register, contact the Fresno Madera Medical Society at info@fmms.org or 559-224-4224.

Medical office equipment for sale

Several items, including electric exam tables, scales, copier, exam stools, desk, chairs, etc. Excellent condition. Call Marie Johantgen, 707-799-7457, or e-mail rmrs100@sonic.net.

February 2009

• Recommendations for Use of Influenza Antiviral Medications
• SCMA Board Reaffirms Position Statement on Sutter Proposal
• Physician Directory Set for Delivery
• Volunteer Needed for SCMA Health Careers Scholarship Committee
• Nominations Needed for SCMA Elections
• Local Health Groups Can Apply for PFMC Community Grants
• Meetings on Health Care Reform Set for Feb. 11 and 21
• Obama Community Discussion Group Recommends Finance Reform
• BBR Needs Blood Donations
• Medi-Cal Claims with Patient SSNs Will Be Denied as of Feb. 1
• Physicians Urged to Complete Balance Billing Survey on CMA Website
• CME Events at Sonoma Developmental Center

Recommendations for Use of Influenza Antiviral Medications

By Dep. Health Officer Mark Netherda, MD

Although influenza activity is low in Sonoma County andthroughout the United States to date, preliminary data from a limited number ofstates indicate that the prevalence of influenza A subtype (H1N1) virusresistant to the antiviral medication oseltamivir (Tamiflu) is high. Therefore,CDC is issuing interim recommendations for antiviral treatment andchemoprophylaxis of influenza during the current flu season.

When influenza A (H1N1) virus infection or exposure issuspected, zanamivir (Relenza) or a combination of oseltamivir and rimantadineare more appropriate options than oseltamivir alone. Most labs in SonomaCounty, including the Public Health Department, do not differentiate betweenspecific subtypes of Type A influenza virus (e.g., H1N1 vs. H3N2). The CDC willupdate their recommendations as more information is gained through furthertesting of more viral isolates across the United States.

Both (1) people providing medical care for patients with suspectedinfluenza and (2) people who are candidates for chemoprophylaxis againstinfluenza should consider the following:

Consider use of influenza tests that can distinguishinfluenza A from influenza B.

Patients testing positive for influenza B may be giveneither oseltamivir or zanamivir (no preference) if treatment is indicated.

People who are candidates for chemoprophylaxis should beprovided with medications most likely to be effective against the influenzavirus that is the cause of the outbreak, if known. Respiratory specimens fromill patients during institutional outbreaks should be obtained and sent fortesting to determine the type and subtype of influenza A viruses associatedwith the outbreak and to guide antiviral therapy decisions.

Zanamivir should be used when people requirechemoprophylaxis due to exposure to influenza A (H1N1) virus and considered foruse when subtyping of Influenza A is unavailable and local/regional data suggesta prevalence of H1N1 activity. Rimantadine can be used if zanamivir use iscontraindicated. People whose need for chemoprophylaxis is due to potentialexposure to a person with laboratory-confirmed influenza A (H3N2) or influenzaB should receive oseltamivir or zanamivir (no preference).

For complete recommendations, visitwww.cdc.gov/flu/professionals/antivirals/index.htm.

SCMA Board Reaffirms Position Statement on Sutter Proposal

In response to Sutter’s latest proposal to build a newhospital in Santa Rosa, the SCMA board of directors has reaffirmed an earlierposition statement that emphasizes access to care, support for community healthdirectives, and availability of physicians.

The statement says, in part, that SCMA’s paramount concernis to “ensure that patients will continue to have access to care and to theirphysicians. We continue to express concerns that short-term capacity needs willbe insufficient.”

SCMA’s position statement is among many comments that thecounty’s Department of Health Services is analyzing in response to Sutter’sproposal, including those received at public hearings on Jan. 13 and 14. DHSofficials are expected to report their findings to the Board of Supervisors inthe spring.

Physician Directory Set for Delivery

The annual Sonoma County Physician Directory published bySCMA is back from the printer and will be delivered to all members free ofcharge in the first week of February. This year’s directory includes detailedspecialty and contact information for SCMA members, along with alphabeticallistings and specialty indexes for virtually all physicians in Sonoma County.

Additional copies are $30 for members ($40 for nonmembers)and can be ordered at www.scma.org or by contacting Rachel Pandolfi at 525-4375or rpandolfi@scma.org.

Several dozen physicians have joined SCMA during the pastyear, bringing the latest membership count to 666, about two-thirds of thepracticing physicians in Sonoma County. For more information on joining SCMA,visit www.scma.org.

Volunteer Needed for SCMA Health Careers Scholarship Committee

SCMA needs a physician volunteer for its Health CareersScholarship Committee, which recommends recipients for scholarships and studentloans. The committee meets only twice a year at lunchtime.

Interested physicians should contact Cynthia Melody at525-4359 or cmelody@scma.org.

Nominations Needed for SCMA Elections

Nominations for the following SCMA positions are due by March 20:

*     SCMA president-elect

*     Individual SCMA board representatives from Healdsburg (1), Petaluma (1), and Santa Rosa (2)

*     Two CMA delegates

*     Two CMA alternate delegates

All positions require a three-year commitment, beginning July 1. Nominations can be e-mailed to cmelody@scma.org, faxed to 525-4328, or mailed to SCMA, 3033 Cleveland Ave. #104, Santa Rosa, CA 95403. Each nomination should include a brief statement about the nominee's qualifications.

For more details, contact Cynthia Melody at cmelody@scma.org or 525-4359.

Local Health Groups Can Apply for PFMC Community Grants

Nonprofit health organizationsin Sonoma County are encouraged to apply for Community Grants from the PacificFoundation for Medical Care. The grants, generally in the $10,000 range, areawarded twice a year by the nonprofit foundation to support local projects thatenhance health services.

The application deadline for thenext round of grants is April 1. For application materials, contact MarilynFlowers at 800-548-7677, Ext. 120, or mflowers@rhs.org. For more information,visit www.pfmc.org.

Meetings on Health Care Reform Set for Feb. 11 and 21

At least two meetings on healthcare reform will be held in Santa Rosa during February.

Newly elected county supervisorsShirlee Zane and Efren Carrillo will host a Feb. 11 forum on the role of countygovernment in health care delivery. The forum will be held from 6 to 8 p.m. atthe Veterans Building, 1351 Maple Ave. To RSVP, contactSonomaSolutions@seiu1021.info.

On Feb. 21, Dr. John Shearerwill moderate a discussion of single-payer plans from 3 to 4:30 p.m. at theGlaser Center, 547 Mendocino Ave. Panelists include Drs. Richard Quint andClaudia Chaufan. No RSVPs are required.

Obama Community Discussion Group Recommends Finance Reform

On Dec. 30, nearly 50 localphysicians and other health care leaders attended a Health Care CommunityDiscussion in Santa Rosa sponsored by the Obama-Biden Transition Project.According to a summary of the meeting provided by RCHC and Health Action, thegroup identified financing as the biggest problem in the health system.

“The health care financing modelis the underlying problem in the system,” the group concluded, “because it iswasteful, does not provide equal access to care, and does not reflect a valueof health care as a civil right equal to education and public safety.”

The group also recommendeduniversal coverage, medical homes, and increased emphasis on preventive care.Their recommendations, along with those from similar groups around the country,will be considered as part of a health care reform package to be unveiled bythe Obama Administration later this year.

BBR Needs Blood Donations

Blood Bank of the Redwoods’blood supply is being depleted by limited donations. They are in great need ofblood donors for all blood types.

Blood may be donated at the BBRoffice, 2324 Bethards Dr., Santa Rosa. The office is open from noon to 7 p.m.Monday to Thursday and 9 a.m. to 3 p.m. on Friday and Saturday.

Medi-Cal Claims with Patient SSNs Will Be Denied as of Feb. 1

Beginning on Feb. 1, physicianscan no longer bill Medi-Cal or the Child Health and Disability PreventionProgram using patients’ Social Security numbers as identifiers. All providersmust use the 14-character Medi-Cal identification number from recipients’Benefits Identification Cards (BIC) or paper ID cards when submitting claims.The ID number is located on the front of the card and consists of a 9-digitclient index number, a check digit, and a 4-digit issue date. (The issue dateis used to deactivate cards that have been reported as lost or stolen.)

The only exemption to this ruleis for Medicare crossover claims. Physicians may continue to bill Medicarecrossover claims using the recipient’s SSN/Medicare number as it appears on beneficiaries’Medicare identification cards.

Physicians are also urged to useMedi-Cal identification numbers when verifying eligibility or submittingtreatment authorization requests. In an emergency or in the event a Medi-Calpatient does not bring his or her BIC to an appointment, physicians may (withthe patient’s permission) use a SSN to verify eligibility via the Medi-CalEligibility Verification System.

Physicians Urged to Complete Balance Billing Survey on CMA Website

CMA is conducting a survey togauge the impact of the recent ban on balance billing by the California SupremeCourt and by the Department of Managed Health Care’s regulation definingbalance billing as an “unfair billing pattern.” CMA also is gathering evidenceconcerning other, broader industry practices by health insurers to underpay forout-of-network services.

The survey is located on thehome page of the CMA website at www.cmanet.org. Physicians are urged tocomplete the survey as fully as possible. The information will be used by CMAin its advocacy efforts and will not be used in a manner that reveals anyphysician’s identity.

To request a paper copy of thesurvey, contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org.

CME Events at Sonoma Developmental Center

Two CME events will be held atthe Sonoma Developmental Center in February. Both are scheduled for McDougallHall from 1 to 2 p.m.

On Feb. 5, Drs. Ken Christensenand David Gray will discuss ICD-9 coding. On Feb. 26, Dr. Gopa Green willdiscuss renal osteodystrophy. For details, call JoAnne Rawles at 938-6419.

Charles Amezcua, MD
Anatomic & Clinical Pathology
401 Bicentennial Way
Santa Rosa 95403
393-4684 Fax 393-4291
Univ Southern California 1993

Santiago Centurion, MD
Dermatology
106 Lynch Creek Way #8
Petaluma 94954
763-6816 Fax 763-1730
New Jersey Med Sch 1999

Julie Clark, MD
Obstetrics & Gynecology*
1550A Professional Dr. #100
Petaluma 94954
792-2229 Fax 792-1072
Cornell Univ 2001

Randall Hrabko, MD
Dermatology*
6880 Palm Ave.
Sebastopol 95472
823-7628 Fax 823-1521
Univ Miami 1976

Daciana Iancu, MD
Internal Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4104 Fax 393-4146
Univ North Carolina 1997

Francesca Manfredi, DO
Family Medicine
144 Stony Point Rd.
Santa Rosa 95401
521-4635 Fax 544-4626
Western Univ 2000

Margaret Marquez, MD
Internal Medicine*
Geriatric Medicine*
3559 Round Barn Blvd.
Santa Rosa 95403
571-3953 Fax 571-3941
UC Davis 1994

David Pastran, MD
Family Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4300 Fax 393-4558
Univ Colorado 2003

Carina Quezada, MD
Pediatrics
3925 Old Redwood Hwy.
Santa Rosa 95403
393-4000 Fax 566-5292
Univ Southern California 1994

Mitchell Savitsky, MD
Emergency Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4000 Fax 393-4741
George Washington Univ 1978

Regina Sullivan, MD
Obstetrics & Gynecology*
401 Bicentennial Way
Santa Rosa 95403
393-4696 Fax 393-4299
New Jersey Med Sch 1994

Michael Tsao, MD
Pediatrics
3925 Old Redwood Hwy.
Santa Rosa 95403
393-4000 Fax 566-5929
Northwestern Univ 2003

Jamie Weinstein, MD
Family Medicine
5900 State Farm Dr.
Rohnert Park 94928
206-3000 Fax 206-3042
Oregon Health Sciences Univ 2000

January 2009

• Additional Palmetto Medicare Billing Seminar at SCMA on Jan. 30
• Physicians Invited to Health Care Community Discussion on Dec. 30
• Winter Issue of Sonoma Medicine Examines Children’s Health
• Physician Directory Scheduled for Delivery Later This Month
• County To Hold Public Meetings on Sutter Hospital Proposal
• Physicians Mentors Needed for Students in Health Care Program
• North County Healthcare Foundation Sets Sights on Physician Recruitment
• Medicare Participation Deadline is Dec. 31
• New CME Reporting Requirements
• Neonatal Resuscitation Renewal Program on Jan. 23
• Primary Care Conference at Yosemite Lodge on April 3 and 4
• Marsh Offers Health Insurance Assistance

Additional Palmetto Medicare Billing Seminar at SCMA on Jan. 30

Because of high demand, SCMA will host an additional free seminar on Medicare billing from noon to 2 p.m. on Friday, Jan. 30. Attendees need to bring their own lunch. The first seminar, scheduled for Jan. 26, is completely full.

The Jan. 30 seminar, to be held in SCMA’s office at 3033 Cleveland Ave. in Santa Rosa, will be conducted by Sandra Siddall, a provider outreach consultant for Palmetto GBA, the new Medicare administrator for California. She will address any Medicare billing topics of concern to attendees.

To reserve a spot and suggest topics, contact Rachel Pandolfi at rpandolfi@scma.org or 525-4375. Space is limited, so early reservations are recommended.

Physicians Invited to Health Care Community Discussion on Dec. 30

All local physicians are invited to attend a Health Care Community Discussion on Dec. 30 sponsored by President-elect Obama’s Healthcare Transition Team. The discussion will be held from noon to 2 p.m. in the Sonoma Community Room at the Redwood Credit Union, 3033 Cleveland Ave., Santa Rosa.

Space is limited, so RSVPs are required. Please RSVP by 9 a.m. on Dec. 30 to Donna Paul of the Redwood Community Health Coalition at dpaul@rchc.net or 542-7242.

A Participant Guide for the discussion is available on the SCMA website at www.scma.org/resources/. The guide includes an overview of health care problems, key points of Obama’s health care plan, questions to address at the discussion, and a participant survey.

For more information on the Obama health care plan, visit www.change.gov.

Winter Issue of Sonoma Medicine Examines Children’s Health

The Winter 2009 issue of Sonoma Medicine, due for mailingnext week, features several articles on children’s health by localpediatricians, family physicians and a child psychiatrist. Topics includeimmunizations, nutrition, mental health, autism and the recent Community NeedsAssessment on children’s health.

Physicians interested in submitting article proposals forfuture issues should contact the editor, Steve Osborn, at sosborn@scma.org or525-4325.

Physician Directory Scheduled for Delivery Later This Month

The 2009 edition of the SCMA Physician Directory, one of themost heavily used reference tools in local medical offices, is scheduled fordelivery later this month. This year’s directory includes a new section withdetailed information on SCMA members, along with specialty indexes that listalmost every physician in Sonoma County.

Each SCMA member receives one free copy of the directory.Additional copies cost $30 for SCMA members, $40 for nonmember physicians, and$55 for the general public. To purchase, contact Rachel Pandolfi at 525-4375 orrpandolfi@scma.org.

County To Hold Public Meetings on Sutter Hospital Proposal

Three public meetings onSutter’s proposal for a new hospital next to the Wells Fargo Center will beheld on Jan. 13 and 14. The meetings, conducted by the  Sonoma County Department of HealthServices, will include presentation of the proposal by Sutter officials,followed by public comments. The proposal has been posted to the SCMA websiteat www.scma.org/resources/.

All three meetings will be heldin the DHS Rotunda at 3313 Chanate Road in Santa Rosa. Meetings are scheduledfor:

Jan. 13: 3 to 5 p.m.

Jan. 14: 8 to 10 a.m.

Jan. 14: 3 to 5 p.m.

For more information, contactLynn Scuri, DHS administrative services officer, at 565-4417. 

Physicians Mentors Needed for Students in Health Care Program

Physician mentors are needed for students in the HealthcareWorkforce Development Program at Santa Rosa Junior College. This competitiveprogram enrolls bright bilingual students who are pursuing careers in healthcare. Physicians can help these students by offering:

Internships. Studentscan volunteer in physicians’ office for at least 20 hours per semester.

Mentoring.Establish one-on-one relationships with students to help them explore medicalcareers.

Job Shadowing. Allowstudents to shadow you as you work.

North County Healthcare Foundation Sets Sights on Physician Recruitment

The Healthcare Foundation ofNorthern Sonoma County, a nonprofit group associated with Healdsburg DistrictHospital, has prepared a strategic plan that calls for more physicianrecruitment, improved IT services at the hospital and physicians’ offices, andpurchase of digital mammography and radiology equipment.

The ambitious plan follows asuccessful fundraising drive that began in 2005 and has raised $14.2 million todate. Funds have been used to upgrade the emergency department, ICU and strokecenter at Healdsburg Hospital.

A public meeting on the planwill be held at the Healdsburg City Council chambers at 5 p.m. on Jan. 7.

Medicare Participation Deadline is Dec. 31

Physicians who wish to change their Medicare participation status for 2009 must do so by this Wednesday, Dec. 31. There are three choices: 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 percent of participating physician fees. If you choose not to accept assignment, you can charge the patient 9.25 percent 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. Once you opt out, you cannot opt back in for two years.

For more information, see CMA ON-CALL document #0151, “Medicare Participation (and Nonparticipation) Options,” available at www.cmanet.org/. You can also contact Michele Kelly at 916-551-2862 or mkelly@cmanet.org.

New CME Reporting Requirements

New CME reporting requirementstake effect in 2009. Physicians will now be required to complete 50 CME hours duringevery two-year licensure period, rather than 100 hours every four years. CMEwill also be calculated based on the physician’s personal license renewal date(the last day of the month of your birthday), not the calendar year.

CMA’s Institute for MedicalQuality’s CME Certification Program, now in its 32nd year, documents andverifies physician participation in approved postgraduate education and otherCME activities. IMQ has modified its processes to adapt to the new reportingrequirements. Reporting forms will now be mailed quarterly to physicians withlicense expiration dates in the following quarter.

Once a completed form has beenreceived by IMQ, the physician’s self-reported CME will be verified forcompliance with medical board requirements.

IMQ’s CME certification is $29for members, $49 for nonmembers. Physicians also can request that their CMEcertification information be other agencies for credentialing or membershiprenewal purposes, without additional charge.

For details, contact Paulette Richardsonat 415-882-3387 or prichardson@imq.org.

Neonatal Resuscitation Renewal Program on Jan. 23

A renewal program for neonatalresuscitation (NRP) will be held at Sutter Santa Rosa on Jan. 23. Allparticipants need to complete an online NRP evaluation at www.aap.org/nrp/before attending the class. The program counts for 3 hours of CME credit. Formore details, contact Karen Mack at mackkl@sutterhealth.org.

Primary Care Conference at Yosemite Lodge on April 3 and 4

A postgraduate institute forprimary care physicians will be held at Yosemite Lodge on April 3 and 4. Topicsinclude psychiatric challenges, the biology of aging, and cardiovasculardiseases. Includes 16 hours of CME credit. To register, contact the FresnoMadera Medical Society at info@fmmms.org or 559-224-4224.

Marsh Offers Health Insurance Assistance

Marsh, the endorsed healthinsurance broker and consultant for SCMA, offers several resources for members,including:

* No-obligation review of yourcurrent health plan.

* Access to a variety of healthplans from multiple insurers.

* Health savings accounts.

* Tools to help you stay currenton health and benefit issues.

For details, contact a Marshrepresentative at 800-842-3761.

Space to Sublet
Sublet space in small medical office near Memorial Hospital. Call 707-396-4763.

Medical Office Santa Rosa
Office in class "A" medical building at 1111 Sonoma Ave., Santa Rosa. Approx. 100 sq. ft., with sink. $795/mo., including utilities. Access to shared waiting room, reception area, kitchen, private restrooms. Handicap accessible. Ample parking. Contact Judy at 707-528-0911.

Wanted: Vintage Doctor’s Bag
Looking for a vintage doctor’s bag as a gift for my medical student son. If you have one that is in fairly good condition and you are willing to sell it, contact Cynthia Melody at cmelody@scma.org or 707-525-4359.

How to Submit an Ad
To submit a classified ad for News Briefs or Sonoma Medicine, contact Nan Perrott at nperrott@rhscommunications.com or 707-525-4226. The cost is one dollar per word.