Marin Medical Society

MMS News Briefs


December 2010

President Obama signs one-month Medicare stopgap measure

President Obama has signed a one-month, stopgap measure to block Medicare cuts from taking effect, after the House of Representatives followed the Senate’s lead and passed the legislation.


Under the Sustainable Growth Rate (SGR) formula, Medicare was scheduled to cut physician reimbursements by 23% during December. But with the latest patch, no cuts are slated until Jan. 1, when SGR calls for a 25% reduction in reimbursements.


Congress plans to remain in session until the Christmas holidays working on a legislative package that includes a plan to block SGR cuts for a year. The proposal costs about $17 billion, and committee staff are engaged in final negotiations on funding offsets to cover the costs.


Congressional talks look promising at this point. CMA continues to work closely with California AARP, which recently placed radio and print ads in California to help with the SGR campaign. CMA urges all physician leaders to continue to call, write and meet with your members of Congress if you have not already done so.

Still time to update your Directory listing

MMS is still accepting updates for the 2011 Marin County Physician Directory. The directory features photographs and detailed listings for all MMS members, including their specialty(s), special medical interest and medical training. Basic information for nonmember physicians is included as well.


Physicians can update their listings by returning the verification form that was mailed earlier this fall. If you need a copy of the form, contact Ashleigh Strasheim at 415-924-3891 or


Nonmember physicians can complete a simple online membership application at

Winter issue of Marin Medicine addresses infectious diseases

The recent pertussis outbreak in Marin County is the lead story in the Winter 2011 issue of Marin Medicine, which focuses on infectious diseases. Also included in that focus are articles by local physicians on herd immunity, MRSA infections and HIV/AIDS. Outside the main theme, the issue features updates on noise-induced hearing loss, carbohydrates for diabetics and disaster preparedness, among other topics.


Every MMS member receives a subscription to the magazine, which is also read by many other physicians and health professionals throughout Marin County. Upcoming themes for 2011 include reproductive health (spring issue), exercise (summer issue) and levels of care (fall issue). Physicians interested in contributing articles on these topics or any others should contact the editor, Steve Osborn, at or 707-525-0101.

Time to declare Medicare participation for 2011

It's that time of year again—time for physicians to decide about their participation in Medicare. Physicians have until Dec. 31 to make changes to their status for 2011. Participation decisions are binding for one year, unless you choose to opt out entirely. Once you opt out, you cannot opt back in for two years.


As always, physicians have three choices regarding Medicare: be a participating provider; be a nonparticipating provider; or opt out of Medicare entirely. A participating provider must accept Medicare allowed charges as payment in full for all Medicare patients.


A nonparticipating provider can choose to accept or not accept assignment on Medicare claims on a claim-by-claim basis. Nonparticipating physician fees are 95% of participating physician fees. If you choose not to accept assignment, you can charge the patient 9.25% more than the amounts allowed in the participating physician fee schedule.


Physicians who opt out of Medicare are bound only by their private contracts with their patients. Medicare's limiting charges do not apply to these contracts, but Medicare does specify that these contracts contain certain terms. When a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract.


For more information on physicians' Medicare participation options, see CMA On-Call document #0151, “Medicare Participation (and Nonparticipation) Options.” On-Call documents are free to members at Nonmembers can purchase the documents for $2 per page at

AMA survey finds preauthorization policies impact patient care

Policies that require physicians to ask permission from a patient’s insurance company before performing a treatment negatively impact patient care, according to a new AMA survey. The survey of 2,400 physicians was the first to quantify the burden of insurers’ preauthorization requirements for a growing list of routine tests, procedures and drugs. Results indicate that such requirements delay or interrupt patient care, consume significant amounts of time, and complicate medical decisions. Among the findings:


• More than one-third of physicians experience a 20% rejection rate from insurers on first-time preauthorization requests for tests and procedures.


• Nearly half of physicians experience difficulty obtaining approval from insurers on 25% or more of preauthorization requests for tests and procedures.


• Nearly two-thirds of physicians typically wait several days to receive preauthorization from an insurer for tests and procedures, while one in eight wait more than a week.


• Nearly two-thirds of physicians report it is difficult to determine which test and procedures require preauthorization by insurers.


"Nearly all physicians surveyed said that streamlining the preauthorization process is important and 75% believe an automated process would increase efficiency,” said AMA Immediate Past President Dr. James Rohack. “The AMA is urging health insurers to automate and streamline the current cumbersome preauthorization process so physicians can manage patient care more efficiently.”


The Marin Healthcare District (MHD) has begun providing management assistance for the West Marin Medical Center in Point Reyes Station. The medical center, established four decades ago by Dr. Michael Witt, has struggled to stay afloat in recent years. With the support of MHD, however, the clinic has hired Dr. Eileen Gleber and Dr. Colin Hamblin to accommodate continuing demand for its services. Dr. Joel Sklar, chief medical officer at Marin General Hospital, noted, “By taking this action, MHD is enabling West Marin residents to continue to have the care they need without having to go elsewhere.”


Marin General Hospital has received full accreditation as a Chest Pain Center from the Society of Chest Pain Centers for its treatment of acute coronary syndrome (ACS). The hospital is the first in Marin County to receive the designation, and only the 21st in California. Dr. Brian Strunk, the hospital’s chief of cardiology, explained, “We spent hundreds of hours to demonstrate we could meet stringent standards for effective ACS care and that processes are in place to significantly reduce patient mortality.”


Docsite is a commercial online service that helps physicians access their Medicare Physician Quality Reporting Initiative bonuses, which can average about $3,400 per physician. For details, visit


CMA has published a free guidebook for members on how to obtain federal funding for electronic health records. The guidebook, available at, explains the “meaningful use” measures needed to qualify for federal EHR funding. Physicians who use the guidebook can begin reporting on meaningful use as early as January 2011.


The Alameda-Contra Costa Medical Association is offering a free webinar on medical record documentation from 12:30 to 1:45 p.m. on Tuesday, Dec. 7. Topics include protective progress notes, medication management, and informed consent. To register, visit and click on the Seminars & Webinars link.


CMA is hosting a members-only webinar on ICD-10 coding from 12:15 to 1:15 p.m. on Wednesday, Dec. 8. Instruction will include a guide for implementation steps, planning and staff training. Content includes analysis of HIPAA-related transaction standards, new coding characteristics and changes in timeframes. Coding books are not required for webinar. To register, visit at least two hours before the start time.


CMA On-Call is a repository of thousands of pages of medical, legal, regulatory, and reimbursement guidance. All documents are available free to CMA members on the members-only website at Topic headings parallel the chapters of CMA’s California Physician’s Legal Handbook, such as “Managed Care,” “Medical Board,” and other familiar medical-legal terms. To see a list of documents by topic, simply select that topic.


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


© MMS 2010
PO Box 246
Corte Madera, CA 94976