Marin Medical Society

MMS News Briefs


January 2010

URGENT: Physicians need to contact legislators to support Medicare GPCI fix

Congressional leaders are expected to merge the House andSenate health care reform bills into one final bill during the next threeweeks. CMA has sent a delegation to Washington, DC, to lobby for improvements,but needs your help to preserve the House bill’s update of California’sMedicare payment localities, also known as the “GPCI fix.”

All physicians are urged to contact the senators andrepresentatives listed below and tell them to update California’s MedicarePhysician Payment Locality borders by supporting the California GPCI fix in theHouse bill. Please make all the calls or e-mails you can. If you have only afew minutes, the top priorities are Sen. Feinstein, Sen. Boxer, and Rep.Pelosi. Every call or e-mail counts!

When contacting senators or representatives, give your name,specialty, city and county, and urge the senator or representative to supportthe California GPCI fix in the House bill. The GPCI fix will improve access tocare in 14 California counties, including Marin. (For a sample e-mail and moreinformation on the GPCI fix, visit the “Resources” page When contacting Speaker Pelosi, Rep. Stark and Rep.Waxman, please also thank them for fighting for California physicians on thisissue.

·      Sen.Dianne Feinstein. Send an e-mailor use the AMA’s grassroots hotline at 800-833-6354.

·      Sen.Barbara Boxer. Send an e-mail or usethe AMA’s grassroots hotline at 800-833-6354.

·      SpeakerNancy Pelosi. Send an e-mail or call202-225-4965.

·      Rep.Henry Waxman. Send an e-mailor call 202-225-3976.

·      Rep. PeteStark. Send an e-mailor call 202-225-5065.

·      Rep. LynnWoolsey. Send an e-mailor call 202-225-5161.

Final decisions are being made now. Please call today!Thank you!

MMS to publish 2010 Marin County Physician Directory in March

MMS, whose membership has increased 8% over the past year,will be publishing the 2010 edition of the Marin County Physician Directory inMarch. The directory, a standard reference book for local medical offices,includes photos and complete specialty, address and training information forMMS members, along with an alphabetical listing of almost all local physicians,various specialty indexes, and a guide to medical resources.

Each MMS member receives one free copy of the directory.Additional copies cost $30 for members, $40 for nonmembers and health carefacilities, and $55 for all others. To order, visit orcontact Jessica Whittom at jessica@marinmedicalsociety.orgor 924-3891.

MMS toy drive produces bevy of gifts for kids at Marin Community Clinics

About 40 MMS members attended a reception at the MarinCommunity Clinic in San Rafael on the evening of Dec. 8. The event included atour of the facility, but the highlight of the evening was a toy drive thatnetted dozens of gifts for the clinic’s youngest patients. The clinic, which servesthousands of uninsured and underinsured patients, is part of a network thatalso includes clinics in Novato and Greenbrae. For information on volunteeringat the clinics, visit

Local medical news roundup

·      The MarinHealthcare District board, which is elected, approved a change in itsbylaws to allow for appointment of an “operating board” after Sutter departs Marin General Hospital in June. Theoperating board will share governance of the hospital with the elected boardand can include members with a financial stake in the hospital. The electedboard also increased the salary of Lee Domanico, the district’s CEO, to$550,000, with almost $400,000 in additional bonuses and benefits.

·      The BuckInstitute received a $1.6 million grant for stem cell research from theCalifornia Institute for Regenerative Medicine and is poised to break ground ona $39 million addition to its facilities in Novato. The new building, designedby noted architect I.M. Pei, will house a stem cell repository and researchfacilities.

·      The AmericanLung Association gave mostly D’s and F’s to 12 Marin cities for theirtobacco control efforts during 2009. City officials blamed lax enforcement onbudget problems. The only city to score a positive grade was Novato, whosestrict anti-tobacco rules were deemed worthy of a B. 

Congress at the brink of health reform

After more than a year of debate, Congress is at the brinkof passing historic legislation to expand health care coverage to millions ofAmericans. The final legislation will contain a number of provisions that CMAhas been fighting to achieve for years, such as insurance industry reforms toprotect patients, measures to make coverage more affordable for low-incomefamilies, as much as $350 billion in physician payment fixes in Medicare andMedicaid, and increased funding for primary care, physician training, andwellness and prevention. Unfortunately, the legislation will also contain someprovisions that CMA opposes.

House and Senate leaders are meeting over the next few weeksto reconcile the remaining differences between the House and Senate reformbills. Despite these differences, CMA fully expects that the House-SenateConference Committee will have the votes to produce legislation that will passboth houses of Congress and be signed by the President as soon as the end ofJanuary.

Outstanding issues still remain that CMA believes must beaddressed if the legislation is to deliver on its promise of increased accessto care. Now is the last chance to improve the legislation on six criticalissues:

Repealing theMedicare Sustainable Growth Rate. The current formula would cut funding by40% in future years if left in place and would hurt senior citizens’ ability tofind a doctor to treat them. The viability of Medicare is crucial as millions ofbaby boomers retire and enter the program.

Eliminating ormodifying the proposed Independent Payment Advisory Board (IPAB), whichcould slash spending and coverage options for senior citizens with little inputfrom others.

Increasing Medicaid’slow reimbursement rates. As it is, patients covered by Medi-Cal oftenstruggle to find a doctor because rates are so low that only about one-third ofthe state’s physicians participate in the program. Both bills dramaticallyexpand eligibility, meaning up to 2 million more patients could enter Medi-Cal,further complicating access.

Updating the Medicarelocality system to reflect changes in practice costs.

Ensuring that anyphysician quality reporting program is accurate, fair, and offersphysicians an opportunity to correct mistakes in the data or process.

Ensuring patientshave the right to privately contract with Medicare physicians.

You can get more information and details in CMA’s letterto the House-Senate Conference Committee, which is available on CMA’s health reform webpage.

Medicare switches from consultation codes to E&M codes; CMA offers billing guide

Despite strenuous objections from CMA and others inorganized medicine, Medicare is no longer recognizing inpatient and outpatientconsultation codes. Effective Jan. 1, physicians must instead bill usingE&M codes from the Office and Other Outpatient Services, Initial HospitalCare, and Initial Nursing Facility sections of the 2010 CPT. While CMS hasincreased the work RVUs for new and established office visits, as well asinitial hospital and nursing facility visits, these changes may result insignificant losses for some practices.

The new policy—and the short notice—have already caused agreat deal of confusion as physicians and billing managers try to make sense ofthe new rules.

To help you understand what the switch means, CMA haspublished a 4-page billingguide that includes an overview of the issue, a code crosswalk, and linksto additional resources. The guide is available to CMA members only at (You may also request a copy bycalling the CMA member help center at 800-786-4262.)

CMA members can get additional information and guidance onthis issue through a members-onlywebinar with Palmetto Medical Director Arthur Lurvey, MD. Dr. Lurvey willanswer physician questions and explain how to bill for these services in 2010and beyond. This one-hour webinar begins Wednesday, Jan. 20, at 12:15 pm.Registration is free, but space is limited, so reserve your space today.If you are unable to participate in the live webinar, it will be available foron-demand viewing beginning the following day.

Physicians who use a third-party billing service are urgedto call their vendors to make sure they are aware and prepared for the rulechange. Feel free to provide them with a copy of the CMA consult code crosswalkand billingguide.

CMA is also surveying major payors in California to find outwhich of them plan to follow Medicare’s lead and eliminate consults. Once wehave gathered this data, we will make it available to members.

For additional questions about the new rules, call the CMAmember help center at 800-786-4262 and ask to speak with a reimbursementspecialist.

CMA hosts webinar on electronic health records on Feb. 2

At 12:15 p.m. on Feb. 2, CMA is hosting a webinar titled,“Meaningful Use—Choosing the Right EHR for Your Practice.” The webinar willcover the EHR system offered by athenahealth to CMA members. Click here toregister, or visit the members-only section of

Yosemite Institute for primary care physicians March 26-28

The 59th annual Postgraduate Institute for primary carephysicians will be held at the Yosemite Lodge in Yosemite National Park from March26 to 28. Tuition is $375 for physicians, $300 for allied health professionals,and $100 for medical students, interns or residents. The event qualifies for upto 16 hours of Category 1 credit. To register, visit fmms.orgor call 559-224-4224.


Shahla Chehrazi, MD, Psychiatry*,Child Psychiatry*, 35 Wolf Grade, Kentfield 94904, 925-1445, Fax 461-6112,, Univ Tehran 1969

Natalie Karishev, MD,Family Medicine*, 101 Rowland Way #220, Novato 94945, 878-7200, Fax 878-7201,, Arkhangelsk Med Inst 1983

Jason Ruben, MD,Emergency Medicine*, 250 Bon Air Rd., Greenbrae 94904, 925-7200, Fax 925-7219,, UC Los Angeles 1998

* board certified


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The Marin Medical Society, a 501(c)(6) nonprofit association,supports local physicians and their efforts to enhance the health of thecommunity. We are affiliated with the California Medical Association and theAmerican Medical Association.

© MMS 2010
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Corte Madera, CA 94976


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