Welcome to the DCMS E-Newsletter!
In This Issue:
 President's Message
Private Vs. Public: You Choose
DCMS 2010 Board of Directors
Begin Writing Your Resolutions Now!
March 13: The Skinny on Diets Seminar has been Rescheduled
CMS Postpones PECOS Requirements for Ordering and Referring Providers
Important 2010 Election Dates
Student Chapter Update
Medical Records Reproduction Fee Schedule for 2010
Writing Op-Ed articles
Welcome New Members
2010 Calendar of Events
President's Message
By Gwendolyn Poles, DO
It’s 2010! Just a decade ago we feared Y2K (LOL). With every passing year, decade, and century, changes occur - oftentimes amazing and unimaginable changes. Our hope is that these changes equate to progress in terms of better lives for our children, advances in technology and medicine, improved access to quality education and health care, peaceful relations in our nation and abroad, etc., etc., etc.
The year 2010 marks for me the beginning of a two-year term as President of the Dauphin County Medical Society (DCMS). The question I have asked myself in anticipation of assuming this position is, “What would I like to see the DCMS accomplish under my leadership?” The choices are many, given the current state of affairs directly and indirectly related to medicine and health care.
One current “hot topic” is disparities in health care. This has actually been an issue for decades, if not centuries, but surfaces periodically for discussion and proposed action. Unfortunately, even with the myriad of scientific and electronic advances, and acknowledgement, discussion, and proposals to address this issue, significant disparities in health care persist. Sadly, these disparities are not merely explained by socioeconomic status (i.e., income and educational level).
The Office of Minority Health in the U.S. Department of Health and Human Services recently released for comment a 203-page document, “Changing Outcomes - Achieving Health Equity, The National Plan for Action.” To quote from the introduction, “The intent of the National Plan for Action (NPA) is to set up a nationwide, comprehensive, community driven, sustained approach to combating health disparities and to move the nation toward achieving health equity.” Five core areas for improvement are identified: awareness, leadership, health and health system experiences, cultural and linguistic competency, and coordination of research/evaluation.
Some attention has recently been given to awareness of health disparities and to improving cultural and linguistic competency. Little to no attention has been given to the other core areas. Members of the DCMS are well positioned to become more engaged in this and many other pressing issues and to assist in developing new leaders in our profession and our communities.
A critical component of health and health system experiences relates to “improving educational attainment for minority and underserved populations by promoting school readiness and strengthening community supports.” In the January 31, 2010, issue of The Patriot-News, Bill Davidson, a Philadelphia school teacher, cites an example of a student named Tiffany as a clear example of our public school systems failing our students. This is repeated over and over again in cities across America, including here, in Harrisburg, PA, where less than 10% of district students can read at a level above proficiency.
“But I’m a physician, not a teacher” and “I don’t even live in the city of Harrisburg.” True. However, statistics show that the physicians most likely to practice in underserved communities are minority physicians. Conversely, minority health professionals are underrepresented in health schools and in the health care workforce.
In the 2004 Sullivan Commission report, “Missing Persons: Minorities in the Health Professions,” the influence of insufficient numbers of minority health professionals on persistent racial and ethnic health disparities was highlighted. The report went on to state “A diverse health care and health research workforce can improve access to and quality of health care for minorities, especially as our country shifts to become a “minority-majority” population in the next few decades.”
As I encourage DCMS members to become more involved in organized medicine for the sake of our rapidly changing profession and the future of our children, I also implore each of us to engage and influence our communities on local issues directly and indirectly related to health care and the persistent disparities thereof.
“Changing Outcomes - Achieving Health Equity, The National Plan for Action”
Some questions that we need to explore include, “How well is my local school district exposing and preparing students to enter health related professions? Does the exposure and preparation begin early enough? Are the disparities in educational opportunities for minorities in my community being addressed? How can I influence my local school district and/or community college to increase minority student success in health related professions?”
I look forward to hearing from our membership with comments, suggestions, and examples of community involvement impacting health disparities. We can collectively impact health disparities in Dauphin County and our nation.
Private Vs. Public: You Choose
Robert Ettlinger, MD, Chair, Networking and Membership Task Force
Recently, many politicians and political pundits have pointed to the evils of the insurance industry as one of the reasons why a government-run system would be an improvement. They point to examples of how insurance companies deny services such as hospital stays, tests, procedures, medications, and other services. They claim that, in doing so, they're killing and maiming people on a regular basis, all in the name of their unethical greed for high profits. The logical conclusion to this disgraceful behavior would be to have the public sector call the shots, because a government-run system will avoid a profit incentive, exhibit better management of budget outlays, and will be benevolent in providing "universal care" to all Americans in need of preventive and illness-based services.
With this argument in place, a predictive model about how health care would be appropriated under this system can be surmised by looking at current public health options. The vast majority of Americans getting public-funded health care are covered under three systems--Medicare, Medicaid, and military-related programs such as CHAMPUS and TRICARE.
As a practicing physician, which health delivery system (private insurance companies vs. public-funded programs) do you find to be more or less cumbersome? How often do each of them deny your prescription choices, your decision to hospitalize a patient, to order an MRI scan, to keep a sick patient in the hospital one more day, or to allow payment for a surgical procedure instead of a month of physical therapy? Which system is most flexible when extraordinary medical calamities arise that need intervention? Which insurance system, the private sector or the public sector, gives you the most headaches, and is least likely to pay for services that benefit your patients?
...Yeah, me too.
DCMS 2010 Board of Directors
Dr. Gwendolyn Poles became the 144th president of DCMS on January 6. Dr. Poles has been a member of the Society for over 20 years. She is the Medical Director of PinnacleHealth System’s Kline Health Center and also serves as a faculty member of PinnacleHealth’s Internal Medicine Residency Program. She will do a great job on everyone’s behalf. Other physicians elected as officers for 2010 are John D. Goldman, MD, President-Elect; Robert A. Ettlinger, MD, Vice President; and Daniel Fischman, MD, Secretary-Treasurer. Andrew J. Richards, MD, will automatically serve as Immediate Past President and an officer.
from left to right, Drs. Fischman, Goldman, Poles, Richards and Ettlinger
Society members also elected the following physicians to their Board of Governors: Lawrence L. Altaker, MD; David A. Amato, DO; Bryan E. Anderson, MD; Michael D. Bosak, MD; Kenneth B. Conner, MD; Elena R. Farrell, DO; Virginia E. Hall, MD; Randy M. Hauck, MD; Anne M. Manning, MD; Kenneth J. Oken, MD; Mukul L. Parikh, MD; Jaan E. Sidorov, MD; and Andrew R. Walker, MD.
Begin Writing Your Resolutions Now!
We encourage the members of the Dauphin County Medical Society to begin writing your resolutions now for the House of Delegates, scheduled for October 23-24, 2010.
Writing a Resolution
A resolution is the vehicle that conveys to the House of Delegates a proposal from an individual, a component or specialty society, or a section on a particular subject. The traditional format is basically in two parts. Statements beginning with "Whereas" comprise the first part. These usually include the introductory facts or circumstances, which logically develop into a formal conclusion or the "Resolved." The prefacing "Whereas" statements should be concise and clear and logically support the "Resolved" portion. It is important that those prefacing statements themselves do not cause disagreement and debate to the detriment of the main resolution.
The formal conclusion is the second part, or the "Resolved" portion of the resolution. The "Resolved" portion should stand alone as a complete and understandable statement without referring to ideas contained in the Whereas statements. The "Resolved" portion, if adopted by the House, actually becomes the policy of the Pennsylvania Medical Society; and the "Whereas" statements are discarded.
Submitting Resolutions
There are several facts you should know about submitting resolutions:
Resolutions may be authored by any member of the Pennsylvania Medical Society, however, they must be introduced into the House by an official delegate.
We ask that resolutions be submitted as far in advance of the deadline as possible. In order for the DCMS delegation to have time to review submissions, please submit your resolutions to the Dauphin County Medical Society no later than Monday, August 23. To save time, please email your resolutions to our office at dauphincms@pamedsoc.org.
To avoid duplication, your resolution will be compared to existing policy in the Society’s Policy Compendium. Afterward, it will be presented to the DCMS delegation for review. If approved, a DCMS delegate will introduce your resolution to the House of Delegates.
It is mandated that resolutions be accompanied by fiscal notes when there is a financial impact to the State Society. Staff will be happy to assist resolution authors in determining the appropriate fiscal notes.
Authors wishing to remain anonymous should state that fact when submitting resolutions; however, resolutions must initially contain authors' names.
Authors of resolutions should be sure to spell out in full at least the first mention of any word or phrase that may later be abbreviated in the resolution.
Resolutions Directing AMA Action
Submission of excessive, redundant, and/or irrelevant resolutions to the AMA potentially diminishes the reputation and credibility of the Pennsylvania Delegation. Therefore, the following caveats have been established:
Discretion should be used in requesting AMA action.
The Speakers shall advise reference committee chairs to conscientiously consider all resolveds dealing with the AMA and to recommend to the House the deletion of marginal resolveds.
Pennsylvania Delegation members shall attend reference committee hearings and speak against forwarding those resolutions that are existing policy or do not appear appropriate to be submitted to the AMA, or may also speak in that regard from the floor of the House.
The Pennsylvania Delegation to the AMA has the responsibility to determine when and in what format a resolution, adopted by the Pennsylvania Medical Society House of Delegates, will be submitted to the AMA.
Conclusion
All resolutions accepted as business of the House will be considered at open hearings of reference committees, which will be held at staggered intervals on Saturday, October 23.
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The DCMS March 13 program, “The Skinny on Diets,” is being rescheduled for a later date. Be on the lookout for a new date and registration information that will be coming your way.
If you have any questions please contact Lauren Ramsey, DCMS Meeting Manager, at (717) 558-7841 or lramsey@pamedsoc.org
The Centers for Medicare and Medicaid Services (CMS) has postponed requirements that ordering and referring providers be enrolled in Medicare’s Provider Enrollment, Chain and Ownership System (PECOS) from April 5, 2010, to Jan. 3, 2011.
CMS also has clarified those requirements, which were causing confusion among health care providers. Previously, CMS indicated that providers who order or refer services would be required to enroll in PECOS, but it has now clarified that providers can either be in PECOS or in the Highmark Medicare Services (HMS) claim system.
The following will apply as of Jan. 3 for claims for items or services submitted with an ordering or referring provider:
Claims that are the result of an order or a referral must contain the National Provider Identifier (NPI) and the name of the ordering or referring provider.
The provider must be of a type or specialty that can order or refer that service.
The ordering or referring provider must be enrolled in the PECOS or in HMS’s claim system.
If the ordering or referring provider is not in PECOS, HMS will search its claims system for the ordering or referring provider.
If the ordering or referring provider is not in PECOS and is not in the claims system, the claim will not be paid.
Important note: Those who order or refer durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) will still be required to be in PECOS. DMEPOS claims submitted with an ordering or referring provider who is not enrolled in PECOS will begin to be denied Jan. 3.
The Pennsylvania Medical Society strongly encourages all physicians to enroll in PECOS. Considering the wide range of items classified as DMEPOS, it is likely that most physicians will order or refer these items or supplies at some point.
Visit the CMS website for more on ordering and referring items and services and ordering and referring DMEPOS.
To find out if you are enrolled in PECOS visit the CMS website.
Please make a difference by participating in the political process!
February 16, 2010
First day to circulate petitions for Governor, Lt. Governor, U. S. Senator, Congress, PA General Assembly
March 9, 2010
Last day to circulate and file petitions
April 19, 2010
Last day to register before the Primary
May 11, 2010
Last day to apply for a civilian Absentee Ballot
May 18, 2010
Primary Election
The Penn State College of Medicine Medical Student Chapter would like to thank DCMS for its support of the various activities we have hosted. Over our holiday break, students participated in Four Weeks of Fitness as part of the AMA's Healthier Life Steps Program (details about the National Service Project can be found here). Sixty-five students committed themselves to eating healthier, avoiding tobacco and alcohol use, and regular physical exercise. It was great to lose weight, rather than gain it during this holiday season! We would like to congratulate our winners:
1st Place - Albert Cheung
2nd Place - Jennifer Montgomery
3rd Place - Emilie Muelly
On January 29th, we hosted a lunch lecture for first-year medical students explaining the importance of organized medicine. We are grateful to Dr. James Goodyear for speaking at this event and to the Pennsylvania Medical Society for its financial support. Students learned the importance of organized medicine at national, state and local levels. We are continuing to work hard recruiting a few more students to participate with us.
Coming up, we will be making breakfast for the Ronald McDonald House in Hershey on March 27. If you would like to participate, please contact us at jstucki.psu@gmail.com so we can set that up, because space is limited. This would be a great opportunity for you to meet a few medical students and inspire them with your experience. Thank you again for your support as we strive to be a strong influence for good in our community.
The Pennsylvania Medical Society receives a significant number of inquiries from physicians and their office staff concerning medical record copying fees. While physicians have not traditionally sought to make a profit on providing medical records, they have sought to recover their costs, particularly when a medical record is substantial.
A patient may request a copy of their record for his or her own use. It is important to note that the medical record for a patient is defined by state regulation as all "clinical information pertaining to the patient which has been accumulated by the physician, either by himself or through his agents." This includes diagnostic test results, x-rays, physician notes, and any records from prior treating or consulting physicians. The following charge list does not apply to an X-ray or any other portion of a medical record which is not susceptible to photostatic reproduction.
The Department of Health and Human Services has stated that, under HIPAA, medical record copying fees for patients may not include costs associated with searching for and retrieving the medical record. For a subpoena, attorney, or insurance company requests, you may charge the Act 26 fees, including the search and retrieval fee. To determine your cost for copying and mailing medical records for a patient request under HIPAA, you should consider the following:
Salary and benefits of the person who does the copying. Include all steps of the process, i.e., verifying validity of authorization, pulling the chart, reviewing the record, removing the records, copying, preparation for mailing, re-assembling the chart, and re-filing the chart.
Cost of the supplies, i.e., paper, toner, envelopes, etc.
Cost of equipment, i.e., prorated lease or depreciation expense.
Retrieval Fee
Act 26 (2010): $19.68
HIPAA: $0
Charge to Patient: $0
Pages 1-20
Act 26 (2010): $1.32/page
HIPAA: Cost of copying and mailing
Charge to Patient: Cost up to $1.32/page
Pages 21-60
Act 26 (2010): $.98/page
HIPAA: Cost of copying and mailing
Charge to Patient: Cost up to $.98/page
Pages 61+
Act 26 (2010): $.33/page
HIPAA: Cost of copying and mailing
Charge to Patient: Cost up to $.33/page
In addition to the amounts listed, charges may also be assessed for the actual cost of postage, shipping and delivery of the requested records. Neither Act 26 nor HIPAA mandates that charges be assessed for copies of medical records. It merely sets the maximum fees that can be charged.
If a district attorney requests a medical record for an action or proceeding, a flat fee of $19.68 may be charged. No independent or executive agency of the Commonwealth is required to pay any costs associated to medical charts or records unless required by law. At this time, Workers' Compensation (utilization review) and Auto (peer review) pay $.12 per page, plus actual mailing costs (scope of release is limited to the treatment of the work related or auto injury). Attorney requests for Workers’ Compensation and Auto treatment records are not subject to the $.12 limitation. If the medical record is requested for the purpose of supporting a claim or appeal under the Social Security Act, a flat fee of $24.94 plus postage may be charged (the attorney should be able to supply a copy of the Appointment of Representative from the Social Security Administration). Note: Some health insurance contracts may require the physician to forward patient records to another physician within a network at no charge.
DCMS members are encouraged to write opinion pieces for local publications. Heather Long of The Patriot-News recently published this article on how to successfully submit an article.
Want to write for us? Here are some tips
Active Members
Geoffrey J. Brent, MD, Ophthalmology
Premier Eye Care Group
Gina M. Creutzburg, MD, Dignoistic Radiology
Quantum Imaging & Therapeutic Associates
Jill M. Eckert, DO, Anesthesiology
Penn State Milton S. Hershey Medical Center
Oluwamayowalea Folaranmi, MD, Neonatal-Perinatal Medicine
Pediatrix Medical Group
Michael F. Hilden, MD, Hospitalist
PinnacleHealth Specialists
Allan A. Hunter, III, MD, Ophthalmology
Premier Eye Care Group
Robert G. Little, MD, Family Medicine
PinnacleHealth Family Care Halifax
Gerald F. Maenner, MD, Obstetrics & Gynecology
Women First Obstetrics & Gynecology, PC
Catherine L. Nelson-Horan, MD, Emergency Medicine
York Hospital Emergency Medicine
Thu T. Pham, MD, Ophthalmology
Premier Eye Care Group
Justin D. Rosenberger, DO, General Surgery
Central PA Surgical Associates, Ltd.
Jeffrey Martin Small, DO, General Surgery
Central PA Surgical Associates, Ltd.
Jose Antonio Stoute, MD, Infectious Disease
Penn State Milton S. Hershey Medical Center
Administrative Members
Kathy L. Bridge, Spring Road Family Practice, Inc.
Resident Members
Sufana Jawed Khan, MD
Rodrigo Medardo Mancheno, MD
Khuong Cun Phui, DO
Julianne Rich, MD
Student Members
Eric John Ahlers
Malika Atmakuri
Carolyn Helene Baloh
Trey Banbury
David Fryzel
Kanchana Nicuful Herath
Meagan Marie Horst
Neelima Krisnapriya Marupudi
James Dylan Pagana
Matthew James Piotrowski
Kevin Louis Rakszawski
Sunny Sahajwani
Christine Amanda Schleich
Isaac James Spears
Daniel Lee Swank
Erick J. Vargas
Angeliki Vgontzas
Board of Governors Meetings
March 10, June 2, September 1, December 1
6:15 PM at Society headquarters
Executive Committee (Officers)
April 7, May 5, July 7, August 4, October 6, November 3
6:30 PM at Society headquarters
PA Medical Society Annual Business Meeting - House of Delegates
October 23-24, 2010
at the Hershey Lodge
To opt out of future electronic (email and fax) communications, please write to dauphincms@pamedsoc.org with the word UNSUBSCRIBE NEWSLETTER in the subject or call (717) 558-7849.
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