June 2009

• Dr. Kirk Pappas nominated for Partnership HealthPlan board
• SCMA launches Lunchtime Legal Seminars
• Specialty task force increases access to local specialists
• Cast your vote in the annual SCMA election by June 30
• Latino Health Forum seeks donations for student scholarships
• iWalk strolls into view
• CMA proposes Medicare overhaul
• Court of appeal upholds MICRA
• New Medicare enrollment rules could have costly consequences
• Dr. Elise Sullivan joins SCMA board
• Drs. Severt and Mazur combine forces at new Hand Center in Santa Rosa
• Dr. Tom Crane’s daughter named top Berkeley grad
• Three CMA webinars in June
• June 9 AMA webinar on accessing HIT funding
• June 24 webinar on new asthma guidelines
• Volunteers needed for Jewish Community Free Clinic
• Volunteer for Neighbors in Health
• Regional medical director for Partnership HealthPlan
• Medical transcription
• Medical office space
• How to submit a classified ad
• TO UNSUBSCRIBE

Dr. Kirk Pappas nominated for Partnership HealthPlan board

SCMAPresident Dr. Kirk Pappas has been unanimously nominated by the SCMA board ofdirectors to serve on the board of Partnership HealthPlan, which will beginmanaging care for almost 50,000 Medi-Cal beneficiaries in Sonoma County thisfall.

Thenomination was the result of an open process in which SCMA solicitednominations from its entire membership through News Briefs and personalcontacts. Several applications were received, but Dr. Pappas emerged as thestrongest candidate because of his past service on a Partnership planning groupand his familiarity with the health plan. His nomination will be forwarded tothe Department of Health Services and then to the county board of supervisors.

Meanwhile,Partnership is looking for a part-time regional medical director for SonomaCounty. A job description has been posted at www.partnershiphp.org.

SCMA launches Lunchtime Legal Seminars

Doyou have a legal question related to your practice? Do you have concerns aboutemployment issues and requests for medical records? What about the Red FlagRule?

Answersto these and other questions will be provided by SCMA attorney Larry McLaughlinat a series of free lunchtime seminars this summer. The monthly sessions will runfrom 12:30 to 1:30 p.m. Participants need to bring their own lunch.

OnlySCMA members and their staff are eligible to attend. To RSVP and receive thelocation, contact Rachel Pandolfi at rpandolfi@scma.org or 707-525-4375.

Thefollowing topics are scheduled:

June 25: CMA and SCMA legalservices. CMAlegal resources; SCMA legal services; most common legal questions members pose.

July 23: Employment issues. At-will employment andtermination; disability and leave laws.

August 27: Medical records. Patient access; transmittingrecords between physicians; access for divorced parents.

September 24: The Red FlagRule. Newidentity theft protection requirements that apply to many physicians.

Specialty task force increases access to local specialists

Accessto local specialists is slowly improving, thanks to the efforts of a specialtytask force formed last year by SCMA and the Redwood Community Health Coalition.To date, the task force has focused on orthopedics and endocrinology and hassecured commitments from a significant number of those specialists to providecare to the under- and uninsured.

Specialtyclinics have been established at the Southwest Community Health Center(orthopedics) and the Chanate Family Practice Center (endocrinology). Inaddition, Kaiser has agreed to perform one unfunded orthopedic surgery permonth.

Cast your vote in the annual SCMA election by June 30

Asa member of SCMA, you are entitled to vote for SCMA officers and boardrepresentatives, and for delegates and alternate delegates to the CMA House ofDelegates.

Forthe SCMA board of directors, you are allowed one vote in the district in whichyour primary office is located. (TPMG physicians constitute their owndistrict.)

Forthe CMA House of Delegates, vote for two delegates and two alternate delegates.

Tovote, print out the ballot below, then signand fax to 525-4328 by June 30.

SCMA President-Elect

CatherineGutfreund, MD, family medicine

___Yes         ___No

SCMA Board of Directors (three-year terms, July2009 to June 2012)

Healdsburg District

BradDrexler, MD, ob-gyn

___Yes         ___No

Santa Rosa District

LeonardKlay, MD, ob-gyn

___Yes         ___No

PhyllisSenter, MD, family medicine

___Yes         ___No

The Permanente Medical Group

JoseMorales, MD, pediatrics

___Yes         ___No

CMA Delegation (three-year terms, July2009 to June 2012)

LelaEmad, MD, ob-gyn

___Yes         ___No

CatherineGutfreund, MD, family medicine

___Yes         ___No

LeonardKlay, MD, ob-gyn

___Yes         ___No

PhyllisSenter, MD, family medicine

___Yes         ___No

_________________________________

Latino Health Forum seeks donations for student scholarships

TheLatino Health Forum, now in its 17th year, is seeking donations from localphysicians to help fund student scholarships for this year’s forum, scheduledfor October 8. The scholarships are given to local college and high schoolstudents interested in medical careers.

This year’s forum, organized by the Santa RosaFamily Medicine Residency and the Sonoma County Academic Foundation forExcellence in Medicine (SCAFEM), will focus on healthy communities andnon-medical determinants of health. More than 200 physicians and otherproviders are expected to attend.

iWalk strolls into view

iWalk, a community walking program organized byHealth Action, has taken its first steps by opening a website at iwalksonoma.org and placing ads in local media.

The website offers detailed information about thebenefits of walking, along with a calendar of walking events and a list ofwalking groups. Maps, starter kits and walking tools are included as well.

Health Action has also prepared iWalk “prescriptionpads” that physicians can use to encourage their patients to walk. Plans areafoot to distribute the pads to SCMA members.

CMA proposes Medicare overhaul

As the health care reform battle heats up inCongress, CMA has proposed several changes to Medicare, including:

* Eliminating the SGR (sustainable growth rate)formula.

* Providing physicians with a 10% payment increaseto make up for the last seven years of inadequate updates.

* Establishing a new physician payment system thatallows physicians to select among six payment tracks based on their mode ofpractice.

* Updating the GPCI (geographic practice cost index)formula to accurately reflect practice costs.

Court of appeal upholds MICRA

In late May, a California court of appeal upheld thestate’s longstanding MICRA malpractice statutes in a case that pitted anational law firm against a California surgical group. The surgeons’ lawyers,supported by a CMA amicus brief, successfully argued that a malpractice awardagainst the group should be limited to $250,000, per the MICRA statutes.

In its ruling, the court noted that MICRA benefitsthe state by keeping malpractice insurance rates low. The court furtherobserved that insurance rates uncontrolled by MICRA would pose “seriousproblems for the health care system in California, threatening to curtail theavailability of medical care in some parts of the state.”

New Medicare enrollment rules could have costly consequences

New Medicare enrollment rules that took effect inApril limit physicians’ ability to retroactively collect from Medicare. Therules shorten the time frame during which physicians can bill retroactively forMedicare services after enrolling or otherwise changing their enrollmentstatus. Under the new rules, enrollment will be retroactive to 30 days prior tothe receipt date of a complete application, or for new physicians joiningMedicare, the date the physician saw his first Medicare patient, whichever islatest.

This change could result in physicians not beingpaid for services to Medicare beneficiaries if they do not submit applicationsor other status changes in a timely fashion. For example, if Dr. Jones relocatesher practice on September 1, but does not submit an address change to Medicareuntil December 1, she could lose two months’ worth of Medicare payments.

The new rules also require physicians to alertMedicare of a change in practice location within 30 days, or risk expulsion fromMedicare for up to two years. Physicians are strongly urged to submit newapplications and reportable changes to Medicare accurately and immediately. Toavoid unnecessary delays, physicians should use Medicare’s web-based PECOSenrollment system. 

Dr. Elise Sullivan joins SCMA board

Elise Sullivan, MD, a resident in the Santa RosaFamily Medicine Residency, has been named to the SCMA board of directors torepresent the residency program. She replaces Ian Hoffman, MD, who isgraduating from the residency and moving to Oakland.

Drs. Severt and Mazur combine forces at new Hand Center in Santa Rosa

Dr. Raymond Severt, a Santa Rosa orthopaedic andhand surgeon, has joined the Santa Rosa Orthopaedics group, where he will workwith hand surgeon Dr. Kai Mazur in a new Hand Center scheduled to open on July1. Services at the center, located at 131B Stony Circle in Santa Rosa, willinclude treatment of fractures and injuries, congenital defects, arthritis,tendon disorders and repetitive stress.

Dr. Tom Crane’s daughter named top Berkeley grad

Emma Shaw Crane, the daughter of social worker SusanShaw and Kaiser family physician Dr. Tom Crane, has been named the top graduatein the UC Berkeley class of 2009, which includes 6,800 students. AnInterdisciplinary Studies major, she maintained a perfect 4.0 average at theuniversity while working on a variety of global and community projects. 

Three CMA webinars in June

CMA is sponsoring three one-hour webinars duringJune. The webinars are for CMA membersonly. To register, visit www.cmanet.org/calendar.

June 4, 12:30p.m. Howthe stimulus bill impacts your HIPAA obligations.

June 17, 5:30p.m. Long-termplanning in a recessionary environment.

June 18, 12:30p.m.Medical staff challenges for the future: Are we helping or hurting ourselves?

June 9 AMA webinar on accessing HIT funding

The American Medical Association is sponsoring afree webinar on June 9 to help physicians understand the health informationtechnology provisions in the federal stimulus bill, which includes $19 billionin funds to help physicians purchase and use HIT. To register, visit www.ama-assn.org/go/hit.

June 24 webinar on new asthma guidelines

A webinar on asthma diagnosis and screeningguidelines will be held from noon to 1 p.m. on June 24. Information on thewebinar, part of a new asthma education project in Sonoma County, will soon beposted on www.ggbreath.org. For details, contact Cerissa MacNichols at707-217-5160 or cerissam@ggbreath.org.

Volunteers needed for Jewish Community Free Clinic

Volunteer for Neighbors in Health

Lastyear, more than 500 children participated in Neighbors in Health, a day-longevent that provides medical care, immunizations, well checks and dental examsto uninsured and underinsured youngsters. Organizers hope to serve even morechildren at this year’s event, scheduled for August 2. To volunteer, visit www.unitedwaywinecountry.org/nih.

GregoryAckroyd, MD
Neurology*
Sleep Medicine*
585 W. College Ave. #A
Santa Rosa 95401
525-9616 Fax 526-2358
ackroyd@nbsmi.com
Ross Univ 2000

* board certified

Regional medical director for Partnership HealthPlan

Medical transcription

Medical office space

How to submit a classified ad

TO UNSUBSCRIBE

You are receiving SCMA News Briefs because you are a physician or an affiliated medical professional in Sonoma County. If you wish to unsubscribe, contact Steve Osborn at sosborn@scma.org or 707-525-4325.

© SCMA 2009
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

May 2009

• Guidelines for swine flu testing
• Feds vow to raise Medicare rates in Sonoma County
• Dr Catherine Gutfreund nominated as SCMA president-elect
• RSVP now for SCMA Wine & Cheese Reception on May 28
• Still time to sign up for Human Race or SCMA Alliance Garden Tour
• Delivery of current Sonoma Medicine delayed for some subscribers
• California Supreme Court sides with CMA in peer review case
• Several health-related bills pending before California Legislature
• Urgent Care Medicine conference in San Diego Sept. 23-25
• Marsh offers Workers’ Compensation programs
• Volunteers needed for Neighbors in Health
• NCMA surgeons in Santa Rosa moving to new office on Fourth Street
• Sixteen SCMA physicians receive awards from St. Joseph Health
• Residency program selects 12 top graduates for incoming class
• Free orthopedics seminars in Sonoma
• Medical Office Space
• About SCMA
• To Unsubscribe

Guidelines for swine flu testing

As the swine flu situation continues to evolve, health officials in Sonoma County have asked providers to focus on the following types of patients for testing:

Hospitalized patients with ILI (influenza-like illness) who do not have another diagnosis.

Outpatients with ILI in one or more of the following categories:

* Patient is a contact of a confirmed swine influenza A (H1N1) case.

* Patient is in a high-risk setting for transmission (e.g., school, prison).

* Patient is part of a cluster of people (like a family) with ILI (only one patient needs laboratory confirmation).

* Patient returned from Mexico or another area with a high number of confirmed cases of swine flu within 7 days of illness onset or cared for ill household members with this travel history.

For guidelines on submitting specimens, call the Sonoma County Public Health lab at 565-4711 or visit sonoma-county.org/health/ph/. For the latest official information on swine flu, visit the CDC website at cdc.gov/swineflu or California Public Health at cdph.ca.gov.

Feds vow to raise Medicare rates in Sonoma County

A summit called in mid-April by House Speaker Nancy Pelosiand Rep. Sam Farr to address the long-standing Medicare geographic paymentinequity in Sonoma and 11 other California counties concluded with a commitmentfrom federal officials to tackle the problem this year.

“This is a welcome breakthrough on a problem that hasreduced access to care for years,” said CMA President Dev A. GnanaDev, MD. “Ascosts have risen in places like Santa Barbara and San Diego counties, Medicarereimbursements have not kept up, and that has resulted in fewer doctors beingable to serve those patients.”

The Medicare payment formula includes a geographicadjustment factor (GAF) that adjusts the payment rate for local geographicmarket conditions. The goal is to base physician reimbursement on the cost ofproviding care in a particular geographic region.

The formula calculates a GAF for every California county,and assigns each county to one of nine Medicare regions in the state, calledpayment localities. Because of rapid growth and development in recent years,physicians in some California counties, including Sonoma, have practice coststhat are up to 10% greater than the average costs of other counties in theirpayment localities.

The Medicare summit included members of key House and Senatecommittees, along with representatives from CMA and Medicare. Participantsacknowledged that something must be done about the payment inequities butstopped short of agreeing on a solution.

SCMA and CMA have spent much of the last decade exploringpossible solutions to the Medicare reimbursement problem. Because federal lawrequires that geographic payment changes be budget neutral, CMA will only backa resolution that holds California’s other rural counties harmless.

For more information, contact CMA Vice President ElizabethMcNeil at 415-882-3376 or emcneil@cmanet.org.

Dr Catherine Gutfreund nominated as SCMA president-elect

Dr. Catherine Gutfreund, a family medicine physician atKaiser Santa Rosa, has been nominated by her colleagues as SCMApresident-elect. Nominees for the board of directors include Drs. Brad Drexler,Phyllis Senter, Leonard Klay and Jose Morales. Nominees for the CMA delegationinclude Dr. Lela Emad and Drs. Senter, Klay and Gutfreund.

RSVP now for SCMA Wine & Cheese Reception on May 28

All SCMA members and their spouses or guests are invited to SCMA’s annual Wine & Cheese Reception on Thursday evening, May 28. This year’s reception will be hosted by Dr. Richard and Julie Andolsen at their private vineyard near Healdsburg.

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

Reservations are required. To RSVP (and receive the address), contact Rachel Pandolfi at rpandolfi@scma.org or 525-4375.

Still time to sign up for Human Race or SCMA Alliance Garden Tour

On May 9, a team from the SCMA Alliance will participate inthe annual Human Race, which raised more than $1 million for charity last year.Physicians and staff can support Team Alliance by signing up to participate inthe race or helping at the Team Alliance booth. To sign up, contact Ann Hurd at537-1031 or annhurd08@comcast.net or Kathleen Cortez at 483-4953 orkkcortez@sonic.net.

On May 15 and 16, the Alliance is sponsoring its annualGarden Tour in Sonoma. Participants can take self-guided tours of privategardens, enroll in gardening workshops, and enter a raffle for free dinners atCyrus Restaurant or the Farmhouse Inn.

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

Delivery of current Sonoma Medicine delayed for some subscribers

Because of problems with the post office, delivery of theSpring issue of Sonoma Medicine was delayed to some subscribers. The magazinewas mailed on April 2 and should have been received by mid-April at the latest.

If you still have not received your copy, you can view theonline version at scma.org. If you prefer, contact the editor, Steve Osborn, at525-4325 or sosborn@scma.org, and he will send you a copy via unstoppablefirst-class mail, while supplies last.

California Supreme Court sides with CMA in peer review case

The California Supreme Court has issued a ruling that prevents peer review “hearing officers” from usurping the clinical decisions of the peer review body. In an amicus brief, CMA urged the court to place limits on the authority of hearing officers.

Hearing officers are usually laypeople without the expertise needed to make decisions on medical disciplinary charges. In the case at hand, a hearing officer’s decree to terminate a peer review hearing directly restricted a particular physician’s privileges. The restriction led to the filing of unproven disciplinary reports to state and federal agencies.

By terminating the hearing, the hearing officer essentially made a clinical determination that the physician was medically incompetent to practice at the hospital, thus depriving the physician of a fair hearing before his medical peers.

CMA’s brief argued that the granting of such powers to a hearing officer unlawfully deprives physicians of a fair hearing before their medical peers, and deprives patients of access to their physician of choice.

Several health-related bills pending before California Legislature

Several CMA-sponsored bills arebeing considered by the California Legislature during its session, along withsome bills that CMA opposes. Highlights appear below.

Adequate reimbursement for vaccines (AB 1201). This CMA-sponsoredbill requires health plans to fully reimburse physicians for the costs ofimmunizations, including purchasing the vaccine, storage, supplies and stafftime. The bill also prohibits health plans from applying copays, deductiblesand other cost-sharing mechanisms to immunizations.

Unlawful Health Insurance Cancellation (AB 2). This CMA-sponsoredbill requires insurers to obtain approval from an independent revieworganization before rescinding a patient’s health insurance.

Car-Pool Lane Access for Physicians (AB 497). This CMA-sponsoredbill would allow physicians to use carpool lanes on the freeway when respondingto an emergency. The bill would expand current law, which allows physicians incertain circumstances to exceed speed limits when responding to emergencies.

Nurse Practitioner Scope of Practice (SB 294). CMA is opposing thisbill, which would expand the scope of practice for nurse practitioners,allowing them to admit patients to the hospital and be designated as primarycare providers.

Corporate Medicine Bar (AB 648 and SB 726). These CMA-opposed billswould erode the ban on the corporate practice of medicine in California byallowing certain hospitals to hire physicians. Under current law, hospitals arebarred from hiring physicians as employees.

For more on these and otherbills, visit CMA’s Legislative Hot List at cmanet.org/news/hotlist.asp.

Urgent Care Medicine conference in San Diego Sept. 23-25

The American Academy of UrgentCare Medicine is sponsoring a Sept. 23-25 conference in San Diego. Topicsinclude point-of-care chemistry analysis, back pain and otitis media. Up to 13hours of CME are available. To register, visit www.aaucm.org.

Marsh offers Workers’ Compensation programs

Workers’ Compensation insurancerates may be increasing soon. One rating bureau has recommended a 24% increaseon July 1, and the Department of Insurance is recommending a 5% increase.

The SCMA-sponsored Workers’ Compensationprogram from Marsh offers members a 5% discount (possibly 15%, depending uponwhere you have your group medical coverage). The program is underwritten byEmployers Compensation Insurance Company.

For more information, contactMarsh at 800-842-3761. 

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.

NCMA surgeons in Santa Rosa moving to new office on Fourth Street

The Santa Rosa surgery divisionof Northern California Medical Associates plans to move to a new office inearly May. The address is 1701 Fourth St., Suite 200. Phone (579-2100) and fax(523-0616) remain the same. The surgeons include Drs. Brian Schmidt, RobertWoodbury, Allen Cortez and Abdul Harris.

Sixteen SCMA physicians receive awards from St. Joseph Health

The St. Joseph Health System ofSonoma County recently presented “Excellence in Patient Satisfaction” awards to21 local physicians, including 16 SCMA members. The awards, based on patientsurveys, honor physicians who provide outstanding care and communication.

The SCMA honorees included Drs.Lance Barlas, Tom Degenhardt, Patrick Devlin, Sanjay Dhar, Tom Dunlap, EldanEichbaum, Joel Erickson, Douglas Green, John Grollmus, Robert Khoo, SusanLogan, Kent Matsuda, Jeannie Pflum, Loie Sauer, Jan Sonander and Gary Stein.

Residency program selects 12 top graduates for incoming class

From a pool of 400 applicants,the Santa Rosa Family Medicine Residency has selected 12 top medical schoolgraduates for its incoming class of 2012. The new residents—10 women and twomen—speak a total of 11 languages, and almost all are fluent in Spanish. Theybegin the residency, which has trained 288 physicians since 1938, on July 1.

Sumit Kohli, MD
Gastroenterology*
Internal Medicine*
1210 Sonoma Ave. #B
Santa Rosa 95405
544-5093  Fax 528-8444
skohli@santarosagi.org
Univ Delhi 1996

* board certified

Free orthopedics seminars in Sonoma

Queen of the Valley Medical Center is offering FREE one-hourorthopedic seminars at the Sonoma Community Center during May and June. Thepublic is invited.

* On May 12,beginning at 6:15 p.m., Dr. Daniel Birkbeck will present “Treating HandProblems.”

* On May 20, at6:30 p.m., Dr. Michael Shifflett and Dr. John Diana will present “TreatingArthritis of the Hip and Knee.”

* On June 3, at6:15 p.m., Dr. Stephen Franzino will present “Shoulder Pain: Treatment andRepair.”

For more information on the seminars, call 707-251-3509. TheCommunity Center is located at 276 E. Napa St. in Sonoma.

Medical Office Space

Small suite available for rent. Three exam rooms, southeastSanta Rosa. Call Connie, 707-525-0211.

About SCMA

The Sonoma County Medical Association, a 501(c)(6) nonprofitassociation, supports local physicians and their efforts to enhance the healthof the community. Founded in 1858, SCMA is affiliated with the CaliforniaMedical Association and the American Medical Association.

© SCMA 2009
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

To Unsubscribe

You are receiving SCMA News Briefs because you are aphysician or an affiliated medical professional in Sonoma County. If you wishto unsubscribe, contact Steve Osborn at sosborn@scma.org or 707-525-4325.

April 2009

• Physicians need to comply with identity theft rules by May 1
• ABOUT SCMA
• TO UNSUBSCRIBE

Physicians need to comply with identity theft rules by May 1

Physicians who bill theirpatients for services, including copays, only have until May 1 to comply withthe federal government’s new “Red Flag Rules” for identity theft detection andprevention. According to the FTC, physicians who bill their patients are“creditors” and are thus subject to the new rules.

CMA and SCMA are offering twoimportant resources to help physicians comply with the new rules:

First, CMA has prepared a free26-page Red Flag Rules Toolkit thatincludes recommendations for designing and implementing an identity theftdetection and prevention program. The toolkit is available on the CMA websiteat www.cmanet.org, or you can contact SCMA for a free copy at 525-4375or rpandolfi@scma.org.

The second resource is a CMA Webinar on the Red Flag Rules from12:30 to 1:15 p.m. on Thursday, April 16. The webinar will focus on howphysicians can comply with the new rules. To register, visit cmanet.org.

ABOUT SCMA

The Sonoma County Medical Association, a 501(c)(6) nonprofitassociation, supports local physicians and their efforts to enhance the healthof the community. Founded in 1858, SCMA is affiliated with the CaliforniaMedical Association and the American Medical Association.

© SCMA 2009
3033 Cleveland Ave. #104
Santa Rosa, CA 95403

TO UNSUBSCRIBE

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

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