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SDCMS "News You Can Use" (2009.10.23)

by: San Diego County Medical Society
Published October 24, 2009

SDCMS "News You Can Use"
— October 23, 2009

Have You Taken SDCMS' 2009 Workforce and Compensation Survey?
Executive Director Comment: SDCMS' Workforce and Compensation surveys are critical tools in our discussions with lawmakers and decision makers. We need to explain the workforce issues and the compensation environment, and we need your input to make it accurate. All answers are de-identified, anonymized, and cannot be traced back to individual submitters. We know it only takes five (5) minutes of your time — please pitch in by completing our 2009 Workforce and Compensation survey now: CLICK HERE

Latest Developments on Healthcare Reform

  • Senate Fails to Advance Bill to Repeal Medicare SGR: The U.S. Senate's Oct. 21 vote for cloture on S. 1776, the Medicare Physician Fairness Act of 2009, failed by a vote of 47 to 53. The bill would have permanently repealed the Medicare sustainable growth rate (SGR) and laid the foundation for establishing a new Medicare physician payment system. A cloture vote would have made the bill filibuster-proof and cleared the way for a floor vote. CMA has many serious concerns with the Senate health care legislation, one of the biggest being its failure to address long-term cuts to Medicare payments. Although the House bill does contain a physician payment fix, the Senate bill would increase doctors' payments by 0.5% in 2010, but it would leave doctors facing a 25% cut in 2011. California Senators Dianne Feinstein and Barbara Boxer continue their strong support for physicians and voted in favor of cloture.
  • Stark Statement on Physician Payment (SGR) Reform: Congressman Pete Stark (D-CA), chairman of the powerful Ways and Means Health Subcommittee and one of the Democratic leaders on health reform, put out the following statement lambasting the Senate for the failure to repeal the SGR for physicians: "I am disappointed that the Senate refused to consider legislation to correct a dishonest budgeting formula under current law that threatens the stability of Medicare with massive cuts to physician payments. Those who objected to this effort because it was not paid for do not understand the problem that was created after years of Republican mismanagement. The cuts projected under current law will never happen. CMS actuaries have in the past admitted in their projections that they can't even estimate the effects of the implementation of those cuts. We must quit kicking the can down the road. Adjusting the baseline in conjunction with health reform will allow us to change the physician payment system to more effectively control costs and promote coordinated, accountable care in the future." The House still plans to take up the SGR repeal on the House floor soon, and Senate leaders are working on alternative SGR proposals. We will keep you posted. For more information on the budgeting gimmicks in the current Medicare physician payment formula, click here.
  • Letter From AMA President on Senate's Oct. 21, 2009, Vote on S. 1776: "An overwhelming majority of U.S. senators, Democrats and Republicans alike, are on record stating that the so-called Medicare sustainable growth rate (SGR) is flawed and should be replaced. S. 1776, the Medicare Physician Fair Payment Act, introduced last week by Sen. Debbie Stabenow, D-Mich., would have repealed the SGR, erasing the existing debt and freezing physician payments at current rates for 10 years. Yesterday's Senate vote on S. 1776 was an opportunity for every senator to deliver on their pledge of support for repealing the SGR. Instead the Senate voted 53-47 to block consideration of S. 1776.

    The blame game being spun by some politicians over the outcome of that vote should be seen for what it is-pure political gamesmanship.

    Notwithstanding all of the hard work conducted by physicians who reached out to senators of both parties, this bill was blocked for these basic reasons: 1) There is growing concern on the part of legislators and the public over expanding federal deficits. Therefore, a number of moderate Democrats and Republicans, although concerned about the SGR problem, simply would not vote for a bill they viewed as having negative deficit implications; 2) The Senate Republican leadership cast this as a test vote on Democrats' health reform legislation.

    The problem is that another temporary fix of the SGR formula will merely exacerbate the very deficit problem that so concerns many senators; in 2005, the cost of repealing the SGR was $48 billion over ten years and physicians were facing cuts of 3.3 percent; today, the price tag to permanently repeal the SGR is $245 billion and next year's scheduled cut is 21.5 percent.

    The AMA shares concerns about federal deficits but we believe the responsible thing to do is to finally stop the Ponzi-like scheme to manage the SGR. Instead, Congress must once-and-for-all fulfill its obligation to senior citizens and the physicians who treat them. They can do this by wiping the slate clean and adopting a realistic baseline not predicated on physician payment cuts of 40 percent over the next several years.

    This effort to permanently fix the SGR isn't over, but we should acknowledge a few positive developments associated with S.1776 including continuing strong support and leadership by Sen. Stabenow and active support from the AARP and the Military Officers Association of America. We also need to thank the 47 Democratic senators who voted for cloture.

    We need to take a moment to clear up erroneous trade press reports over an Oct. 13 meeting with Sens. Reid, Baucus and Dodd and senior White House staff. At that meeting, the AMA did not agree to support a Senate bill still being drafted. While expressing our ongoing commitment to achieving meaningful health system reform goals this year, we reiterated clearly the AMA's continuing concerns with a number of provisions of the Senate Finance Committee's recommendations. These concerns have yet to be fully addressed. [...]

    So, moving forward, what can you expect from the AMA? The AMA has advised Congress and the Obama Administration that we do not support another short-term fix that grows the SGR deficit.

    We stand by our seven essential elements for health system reform. Consideration of the House and Senate health reform bills coming up for floor votes in the coming weeks will be evaluated based on the following metrics: 1) Does the legislation adequately address the AMA's seven essential elements of health system reform? 2) Does the legislation correct existing failures to fulfill current obligations to patients and physicians? 3) Are new obligations based on sound policy and financial foundations that are sustainable and will deliver on the promise of real access to care?

    In closing, we thank state, county and national specialty societies and individual medical students, residents and physicians for their outstanding response to our grassroots campaign on S. 1776. Over 42,000 contacts to Senate offices were generated in just five days. This was a tremendous demonstration of how medicine can mobilize to support a common goal.

    Sincerely, J. James Rohack, MD, President, Rebecca J. Patchin, MD, Chair, Board of Trustees"

Call for Data on Seasonal Flu Vaccine Non-delivery
The companies making seasonal influenza vaccine are badly backlogged and some physicians are being told they won't get the second half of their order until the first of the year, if ever. All of the companies apparently diverted their efforts to producing the H1N1 as per an order from President Obama. Executive Director Comment: We've heard multiple reports of non-delivery of the seasonal flu vaccine to solo and small group practices, while at the same time the large stores have the seasonal flu vaccine. Please email me at Gehring@SDCMS.org or fax us at (858) 569-1334 if you have details/specifics that would help us address this issue systemically!

CONTENTS

  • H1N1 Influenza Weekly Update From the County of San Diego (Oct. 21, 2009)
  • State Temporarily Exempts H1N1 From Mercury-free Vaccine Law
  • "Pandemic 2009 H1N1 Influenza: Top 10 Things You Need to Know!"
  • H1N1 Video Presentations by and for San Diego County Physicians
  • Physicians' Personal Data Stolen
  • "California Healthcare Decisions Week" October 25-31, 2009
  • Do You Have Any Unsolved Palmetto Medicare Issues?
  • Send Us Your "Joy of Being a Doctor" Experience for Our December 2009 Issue of San Diego Physician Magazine!
  • SDCMS Members-only Benefit Spotlight: Practice Management FAQ Website Search Tool!
  • "Preparing to Practice" Workshop • Saturday, November 14, 2009
  • EVENTS

H1N1 AND SEASONAL INFLUENZA

H1N1 Influenza Weekly Update From the County of San Diego (Oct. 21, 2009)
The County of San Diego is reporting one additional death associated with the pandemic H1N1 influenza virus (a 31-year-old female with underlying medical conditions). San Diego County has had 348 hospitalized cases of pandemic H1N1 influenza to date. There have been 25 deaths of San Diego County residents associated with H1N1, plus three deaths of non-residents. For additional information on pandemic H1N1 influenza, visit the County of San Diego's website, the CDC's website, SDCMS' website, or call 2-1-1 San Diego.

State Temporarily Exempts H1N1 From Mercury-free Vaccine Law
California's Department of Public Health (DPH) announced it would temporarily exempt the H1N1 vaccine from the state law banning the use of mercury-containing vaccines for pregnant women and small children. Exemptions to the ban are allowed in the event of potential public health emergencies, including an epidemic or vaccine supply shortage. DPH agreed to waive the ban for six weeks (Oct. 12 – Nov. 30) because there are not enough doses of thimerosal-free vaccine to comply with the law and the health threat from H1N1 outweighs the worries about mercury-containing vaccines. CMA is also encouraging all healthcare workers with patient contact to get the H1N1 vaccine. Click here to read the Oct. 15 letter from the DPH to physicians and here to read the Oct. 15 letter from the DPH to interested parties.

"Pandemic 2009 H1N1 Influenza: Top 10 Things You Need to Know!"
Click here to download the County of San Diego's "Pandemic 2009 H1N1 Influenza: Top 10 Things You Need to Know!" patient flyer, in PDF format.

H1N1 Video Presentations by and for San Diego County Physicians
Below is a series of three "quick and easy" videos for physicians and office staff on H1N1:

STATE

Physicians' Personal Data Stolen
More than 10,000 California physicians contracted with Anthem Blue Cross and Blue Shield of California are being notified that their personal information, including Social Security numbers, taxpayer IDs, and NPI numbers, may have been compromised when a laptop containing sensitive data was stolen in late August in Chicago. Physicians who use their Social Security numbers as their taxpayer IDs should have received a letter notifying them of the data breach, urging them to take advantage of the free credit monitoring services being offered to affected physicians by the insurers. For more information on what you should do if you believe you are a victim of identity theft, see CMA ON-CALL document #0608, "Whose Got Your Number? How Physicians Become the Victims of Identity Theft." ON-CALL documents are free to CMA members at CMA's website. If you have questions about the Blue Cross/Blue Shield data breach, call the Blue Shield Provider Liaison Unit at (800) 258-3091 or Blue Cross Provider Relations at (800) 933-6633. Click here to read Anthem Blue Cross' letter to providers. Click here to read Blue Shields' letter to providers.

"California Healthcare Decisions Week" October 25-31, 2009
"California Healthcare Decisions Week" is an opportunity to raise awareness of the importance of end-of-life planning and advance healthcare directives. In addition to advance directives, in California we also have POLST (Physician's Orders for Life Sustaining Treatment) available for patients with advancing illness who may desire limitation of aggressive treatments. More information is available at the California Coalition for Compassionate Care website. As Terri Schiavo's situation clearly revealed, having an advance directive can be valuable for all adults, regardless of age or health status, and can prevent prolonged, unwanted, and burdensome treatments.

FEDERAL

Do You Have Any Unsolved Palmetto Medicare Issues?
Member Physicians: If you have any outstanding Palmetto issues, please communicate them to Marisol Gonzalez, your SDCMS physician advocate, at (858) 300-2783 or at MGonzalez@SDCMS.org so that we can communicate them to Palmetto senior management in early November. Please note that we are looking for members who are in extremis, i.e., you haven't been paid in months or you're having problems enrolling in the Medicare program. We will get these problems directly into Palmetto's hands at our meeting.

LOCAL

Send Us Your "Joy of Being a Doctor" Experience for Our December 2009 Issue of San Diego Physician Magazine!
In an effort to remind physicians that the care they give their patients and the service they render to their communities is little short of magical, SDCMS is devoting the December 2009 issue of San Diego Physician magazine to "The Joy of Being a Doctor." SDCMS member physicians are invited to take a moment to share with SDCMS and with your fellow physicians an experience you turn to to remind yourself why you became a physician in the first place. Submissions should be up to 300 words and sent to Editor@SDCMS.org before Oct. 31, 2009. Contact Kyle Lewis at (858) 300-2784 or at KLewis@SDCMS.org with any questions.

Executive Director Comment: This (directly below) is a treasure trove of answers to questions that we've been collecting now for three years — check it out!

SDCMS Members-only Benefit Spotlight: Practice Management FAQ Website Search Tool!
Did you know you have access as an SDCMS member to hundreds of practice management questions and answers at SDCMS' website? SDCMS members can search from among hundreds of economic, legal, employment, licensure, and other topics critical to managing your practice. If you don't find the answer you need, you can as well submit your question from our website and we'll get it to you. For assistance in logging onto SDCMS' website, contact Kyle Lewis at (858) 300-2784 or at KLewis@SDCMS.org.

"Preparing to Practice" Workshop • Saturday, November 14, 2009
Young physicians, residents, and physicians just starting your practices, on Saturday, November 14, 2009, we will hold our bi-annual free workshop: "Preparing to Practice: What You Need to Know BEFORE You Begin Your Practice." Contact Lauren Wendler at (858) 300-2782 or at LWendler@SDCMS.org for further information or click here.

EVENTS • [top]

"Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan 'press on' has solved and always will solve the problems of the human race."
— Calvin Coolidge, 30th President of the United States (1872–1933)

Read more about: H1N1, healthcare reform, SDCMS News and Updates, Workforce and Compensation Survey, News You Can Use

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