Wayne County Medical Society of Southeast Michigan

January 4, 2010

Congress Returns To Start Conference On Health Care Reform Bill
Feds Issue Standards And Incentive Proposals For EHR
AMA To Review Proposed EHR Rules
Medicare To Hold Payments For 10 Days
Dr. Chaturvedi Appointed To Journal Editorial Board
WSU Associate Dean To Join Veterans Administration
Kroger Donates $341,986 To Karmanos, Cancer Research
Holiday Party Contributors 2009

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Congress Returns To Start Conference On Health Care Reform Bill

Democratic lawmakers will begin this week to try to hammer out a compromise between the House and Senate versions of a health care reform bill as they keep an eye on votes for the measures.

Bloomberg reports that Senate Democrats will have the "upper hand as U.S. lawmakers return to Washington this month to confront the last major hurdle" to passing health reform legislation. "Senate Democrats have more clout because they have no room for defections, analysts and lawmakers said. Even so, House members will push for their provisions, including the public insurance program, likely making the negotiations among the most complex in congressional history." Senate Democrats say there isn't much room to move away from the Senate plan as "Finance Committee Chairman Max Baucus of Montana called the coalition in his chamber 'fragile' and Nebraska Senator Ben Nelson, the last Democrat to sign onto the legislation, said his continuing support wasn't guaranteed" (Jensen and Gaouette, 1/4).

Los Angeles Times: When the conference does convene, "Senate and House negotiators could choose to meet in a formal conference committee to work out the differences or instead work out a deal in a looser, give-and-take fashion. Even though the conference committee would ostensibly be a more public forum, the nitty-gritty will be worked out in private no matter what" (Oliphant, 1/3).

Roll Call reports that House Democratic leaders are returning this week to start talking to their Senate counterparts on a compromise. "House Democratic leaders and committee chairmen will be on the Hill 'discussing differences in the bills and priorities for the final bill,' a senior House Democratic aide said. It remains unclear whether lawmakers will convene a formal House-Senate conference, as conversations have already been taking place by telephone" (Bendery, 1/4).

Among the provisions getting a second look, The New York Times reports, is a last-minute addition that "singles out the construction industry for special treatment, in a way that benefits union members and contractors who use union labor." The provision in the Senate bill would exclude construction companies from the small businesses that would not be penalized if they failed to provide insurance (Pear, 1/4).

Other groups, including the American Medical Association, are pushing to change the final product, American Medical News reports. Among the concerns of the AMA is the Medicare advisory board proposed in legislation. The AMA "is asking for revisions that would more fairly spread out the burden of reducing Medicare spending," ensure transparency in the board and allow legitimate spending increases (Glendinning, 1/4).

Business Insurance reports that some expect the negotiations to be completed "sooner rather than later." Moreover, "the measure the Senate approved Dec. 24 appears more palatable," to employers, observers say (Hofmann, 1/4).

Finally, negotiators still have to reconcile how the two reform bills treat the Children's Health Insurance Program, The New York Times reports. "The Senate bill would preserve the program, known as CHIP, and would extend federal financing through 2015, two years past its expiration date under current law. … The House bill, by contrast, would end CHIP and redirect the millions of children either to Medicaid, the federal-state insurance program for the poor, or to new health insurance exchanges where moderate-income Americans would be able to buy private coverage using new federal subsidies to help offset the cost."

Some worry that children could fall through the cracks and become uncovered, but others say that providing subsidies for whole families to purchase insurance makes defending the maintenance of CHIP difficult (Herszenhorn, 1/3).

This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

This information was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

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Feds Issue Standards And Incentive Proposals For EHR

Last week, the Obama administration put two Health Information Technology regulations on display at the Federal Register. The Centers for Medicare and Medicaid (CMS) issued the first proposed rule which outlines the provisions governing the electronic health record (EHR) incentive programs including the definition of "meaningful use." The second rule is an interim final regulation issued by the Office of the National Coordinator for the Department of Health and Human Services (HHS) which describes the standards that must be met by certified EHR technology to exchange health care information. The administration reached out to the AMA prior to the publication of the rules to emphasize that these are proposed rules and the administration is extremely interested in receiving comments. Both rules have a 60 day comment period which begins on the day both rules are published which the administration anticipates will be January 16. Over the coming weeks, the AMA will analyze the regulations and work with the Federation to develop comments. Below is the press release which HHS issued today which includes links to download both rules.

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AMA To Review Proposed EHR rules

Statement Attributable to:
Steven J. Stack, MD
Board Member, American Medical Association

"The AMA is committed to EHR adoption that streamlines physician practices and helps them continue providing high quality care to patients. We will carefully review the proposed rules on standards for EHR use and incentives and provide our formal comments before the 60-day comment period ends.

"We have provided ongoing input this year on standards for the use of EHRs, and have stressed the importance of realistic timeframes for adoption, the removal of extraneous requirements that would delay successful adoption and reasonable reporting requirements. We want physicians in all practice sizes and specialties to be able to take advantage of the stimulus incentives and adopt new technologies that can improve patient care and physician workflow."

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Medicare To Hold Payments For 10 Days

The last week of December, Congress acted to avert the 21.2 percent Medicare physician payment cut and on December 19, the President signed into law the Department of Defense Appropriations Bill (H.R. 3326), which will stop the cuts until March 1, 2010. Other changes reflected in the 2010 Medicare Physician Fee Schedule final rule will still take effect on January 1, 2010, and may have a slight impact on the conversion factor used for the first two months of 2010. Similar to other years, since Congress acted so late in the year to avert the cut, the Center for Medicare and Medicaid Services (CMS) will hold claims for the first 10 business days of January (January 1 through January 15) for 2010 dates of service to allow its contractors time to update their systems and pay claims based on the updated rates. CMS does not anticipate any cash flow problems for physicians since by law no claims are paid prior to 14 days after receipt.

In addition, CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010. Physicians still have time to consider their participation options with the Medicare program. Additional information can be found on the AMA’s web site here (pdf). The effective date for any participation status change during this extension remains January 1, 2010, and will be in force for the entire year. Medicare contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are received or post-marked on or before March 17, 2010.

CMS announced the claims processing delay and extended participation enrollment period in a December 21 communication that was developed prior to the Congressional action and, therefore, inaccurately suggests that payments may still be cut on January 21. The AMA is concerned that the announcement will prove confusing to physicians and has asked CMS to update and clarify the notice.

For more information about reimbursement issues, contact Stacie Saylor, CPC, at MSMS at 517-336-5722 or ssaylor@msms.org. Get additional news and information from MSMS publications, such as Medigram, Michigan Medicine and the Monthly Top 10, online

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Dr. Chaturvedi Appointed To Journal Editorial Board

Seemant Chaturvedi, MD, professor of the Department of Neurology at the Wayne State University School of Medicine, has been appointed to the editorial board of the journal Neurology.

Dr. Chaturvedi, director of the Wayne State University/Detroit Medical Center Stroke Program, will join the board in January.

Neurology is the official journal of the American Academy of Neurology and is the most read and widely cited journal in the field. The editorial board represents leading international neurology experts.

"It is an honor to be asked to join the company of the current group of international neurology authorities," Dr. Charturvedi said.

In October, Dr. Chaturvedi was selected for the AAN’s Palatucci Advocacy Leadership Forum in 2010. The forum, established in 2003, has trained more than 200 leaders who act as advocates for the science of neurology and patients in the United States and 13 other countries. The AAN invites neurologists to apply for the training, and the most promising

Those selected for the forum receiving training in development advocacy plans, media training and instruction in how to bring their issues before legislators.

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WSU Associate Dean To Join Veterans Administration

Tom Roe, MD, associate dean of Undergraduate Medical Education for the Wayne State University School of Medicine, has announced that he will leave the school next year for a position with the US Veterans Administration.

Dr. Roe, who has been a member of the faculty since 2001, is leaving Jan. 4, 2010, to take a position as a full-time clinical physician with the VA’s Locum Tenens Program.

“My main motivation for deciding to change career paths at this time is my desire to return to full-time clinical practice, particularly when a new, unique and exciting opportunity has presented itself in the form of the Veterans Administration Locum Tenens Program for physicians,” Dr. Roe said. “It is also a good time to go now that we here at the School of Medicine have achieved our Liaison Committee on Medical Education accreditation and launched the clinical campus initiative, projects that have preoccupied me a great deal over the past few years.”

The Locum Tenens program provides primary care physicians to temporarily fill vacancies at VA facilities across the country until permanent doctors are recruited. The program base and training site are in Phoenix, Ariz., where Dr. Roe’s son, daughter-in-law and other family members reside. The program covers all housing, board and transportation costs, and is shifting focus toward recruitment of family physicians and ambulatory care, areas of Dr. Roe’s interest.

There are openings across the country and assignments are generally three months in length, affording Dr. Roe to experience a number of facilities and regions. “I’m excited about the possibility of exploring different parts of the country with the potential of eventually finding a place where I’d like to spend the rest of my career,” he said.

“Tom will be missed greatly,” said Valerie Parisi, MD, MPH, MBA, interim dean of the School of Medicine. “He is a team player and would always put the concerns of the medical students foremost. He is beloved by the medical students and the people with whom he worked closely. He has been an invaluable member of the school’s family, and we wish him the best in his new career and hope that he remains in contact with all his friends and colleagues at the medical school.”

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Kroger Donates $341,986 To Karmanos, Cancer Research

Kroger’s Michigan Division announced Jan. 4 that it will donate $341,986 to cancer research initiatives, with proceeds going to the Barbara Ann Karmanos Cancer Institute and the American Cancer Society, Great Lakes Division.

The donation will take place Tuesday, January 5 at 3 p.m. at the Barbara Ann Karmanos Cancer Institute Thomas Angott boardroom (4th Floor) at 4100 John R, located in Detroit. The donation by Kroger was raised through coin box donations set up at checkout lines, proceeds from its Recipes for Hope cookbook, sales of participating products, and various other store campaigns supported by Kroger partners, customers and associates.

“Kroger is committed to funding research to help find a cure for cancer and the Karmanos Cancer Institute and the American Cancer Society are uniquely suited to lead this effort,” said Rick Going, president of Kroger’s Michigan Division. ” We’re thrilled to partner with the Karmanos Cancer Institute and the American Cancer Society and hope that this donation, through the generous support from our partners, customers and associates, will have even more impact on cancer research initiatives.”

“The Kroger Company is a tremendous force in our fight against cancer,” said Nick Karmanos, vice president of development at the Barbara Ann Karmanos Cancer Institute. “Kroger’s continued generosity to provide resources for cancer research and education is an exceptional example of corporate partnership and their commitment to this community.”

“This funding boost will have great impact on research efforts at the American Cancer Society,” said Jamie Mitchell, associate director of the American Cancer Society, Great Lakes Division. “Supporting scientific research is critical to provide new hope and an eventual cure for our loved ones and friends.”

The American Cancer Society estimates that more than 1.4 million new cases of cancer will be diagnosed in the United States this year, including over 53,500 people in Michigan. Cancer remains the second leading cause of death in Michigan, making it the eighth highest ranking state in the United States for cancer incidence and death.

Kroger employs more than 326,000 associates who serve customers in 2,469 supermarkets and multi-department stores in 31 states under two dozen local banner.

Located in mid-town Detroit, Michigan, the Barbara Ann Karmanos Cancer Institute is one of 40 National Cancer Institute-designated comprehensive cancer centers in the United States. Karmanos cares for nearly 6,000 new patients annually on a budget of $216 million, conducting more than 700 cancer-specific scientific investigation programs and clinical trials.

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Holiday Party Contributors 2009

The following is a list of contributors to the WCMS Foundation’s 24^th Annual Holiday Party for underprivileged children that took place Dec. 5 at the New Detroit Science Center. For more information, or to contribute, call (313) 874-1360 or visit www.wcmssm.org

Robert Brent, MD

William Knapp, MD

Nancy Goll

Elizabeth Edmond, MD

Martin Daitch, MD

Benjamin Ramos, MD

Peter Cracchiolo

Robert Borchak, MD

Julian Alvarez, MD

Beth Ann Brooks, MD

Dr. & Mrs. Sajal Choudhury

William L. and Betty G. Knapp

Drs. Safwan Halabi & Razan Asbahi

Joe Weiss & Marilyn Shapiro

Dr. & Mrs. George C. Hill

Neela Sripathi

Homer M. Smathers, MD

Sidney Baskin, MD

John C. Somogyi, MD

Charla Blacker, MD

Todd R. Williams, MD

Iris and Fred Whitehouse

Joseph M. Beals, MD

Stephanie Flom, MD

Dr. & Mrs. Mark F. Pezda

Eudoro Coello, MD

Christopher W. Hughes, MD & Debra J. Hughes

Claus Petermann, MD

Richard D. Cieslak, MD

Daniel S. Moore

Drs. Peter & Alice Watson

Drs. Rachel and Brian Silver

Kathleen Yaremchuk, MD

Anne-Mare' Ice, MD

John M. Malone, MD

Anne Nachazel, MD

Eastside Surgical Specialists

Paul Mazzara, MD

Dr. Richard Pollard

Michael G. Taylor, MD, FACS

Drs. Kenneth & Deborah Granke

Aaron Lupovitch, MD

Keith P. Bartold, MD

Rev. William and Dr. Mary Logan

Scott Monson, MD

Arthur J. Frazier, MD

M. Natacha Umlauf, MD

Phyllis A. Vallee, MD

Michael Schaldenbrand, MD

Heidi R. Gunderson, DO

Paul J. Sullivan, MD

S.V. Mahadevan, MD

Indu & Bala Pai

Chris and Janet Bush

Eve M. VanEgmond, MD

Taufiek Alhadi, DO

Gwendolyn H. Parker, MD

Dr. Ray and Mrs. Marcia Littleton

Drs. Daniel & Margarita Morris

Dr. & Mrs. Laurence E. Stawick

Dr. & Mrs. John Calwell

S. Rao Talla, MD

Ghaus M. Malik, MD

Eastlake Pediatrics PC

Vernon F. Strand, MD and Jane P. Strand

Martin H. Daitch, MD

John Kurtz, MD

Dr. & Mrs. Dan Michael

Mohammed Arsiwala, MD

Livonia Urgent Care

Margaret Dowling, MD

Dr. S. Maitra

George Mogill, MD

Dr. MaryJean Schenk & David Fry

Dr. Grace Engler & Ms. Anna Fedor

Dr. & Mrs. Donald M. Ditmars Jr.

James A. Rowley, MD

Sion Soleymani, MD

Madjid Mesgarzadeh, MD

Dr. & Mrs. Allan Dobzyniak

Helene C. Dombrowski, MD

Drs. Lalitha and Babu R. Vemuri

Robert G. Borchak, M.D.

Patricia A. Kolowich, MD

Joan & Bob Allaben

Advanced Family Health Care

Marcie Treadwell & Gregory Goyert

Dr. Michael Sandler

Tom & Nancy Coles

William G. Nutting, MD

Dr. & Mrs. Edmund M. Barbour

Dr. Philip C. Hessburg

Ron & Diane Strickler

Joseph Mark Tuthill, MD

Deloris Ann Berrien-Jones, MD

Vincent C. Yu, M.D.

Andrew J. Mitchell, MD

Barbara & Adrian Sheremeta

Fred R. Nelson, MD

Ronald E. Trunsky, M.D. & Judy Jenkins Trunsky

Michael R. Harbut, MD

Dorothy M. Kahkonen

Dr. and Mrs. H. Michael Marsh

Lisa T. Cooper, MD

Volna Clermont, MD

Dr. & Mrs. Kost Elisevich

Terrence R. Lock, MD

Halim D. Haber, MD

Dr. & Mrs. James Fordyce

Thomas J. Ruane, MD

Clara and Federico Mariona

Dr. Richard & Gail Smith

Jeff & Wendy Page

Dr. & Mrs. Gilbert B. Bluhm

Robyn J. Arrington, Jr., MD

Irene and Oscar Signori

Gehring T. Sauter, MD

Dr. & Mrs. E. N. Obianwu

Dr. B.J. & Marcia Woodley

Dr. Estigarribia

George H. Shade Jr., MD

Karen Chapel, MD & Doug Arenberg, MD

Clarence H. Schultz, MD

Dr. Stephen Lemos

Robert G. Borchak, MD

Dr. & Mrs. William J. Cosgrove, Jr.

Dr. and Mrs. Mark A. Kelley

Steven A. & Deborah L. Portney

Hassan Amirikia, MD

Sheryl Wissman, MD

Dr. Adnan Munkarah

Paul & Debbie Natinsky

Dr. & Mrs. Mark Tuthill

Dr. Orlando S. Sison

Guat and Dionisia Sy, MD's

Giovanni A. Morreale, MD and Lisa J. Morreale

Dr. & Mrs. Theodore B. Jones

Dragos M. Galusca, MD

Julius V. Combs, MD

Dr. and Mrs. Charles Barone

Melvin L. Hollowell, MD

James Sunstrum, MD

Aaron Lupovitch, MD

Catherine A. Nordby, MD

Claus Petermann, MD

Dr. Amorn Manadee

Michael F. Schaldenbrand, MD

Richard J. Pollard, MD

Mary Beth Hardwicke, MD

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