Archive for September, 2019

ALAPAC Ends with Record Year!

Posted by on
ALAPAC Ends with Record Year!

 

Last week, ALAPAC capped off its FY 2018-2019 fundraising campaign on a high note. Although we narrowly missed our total fundraising goal, ALAPAC set multiple new giving records thanks to the generosity of Alabama physicians.

In total, nearly 120 physicians gave more than the standard amount of $250!

Specifically, 10 physicians contributed $1,000 or more; 44 physicians contributed over $500; and, 63 physicians contributed between $250 and $500.

Thank you! Thank you! Thank you!

Below is a list of the physician “top donors” who helped make 2019 a record year. ALAPAC sincerely appreciates all of our contributors and appreciates each and every dollar donated.

$1,000 + Donors

Aaron Timothy Shinkle, M.D.

Amanda Jean Williams, M.D.

Bradley Phillip Katz, M.D.

David P. Herrick, M.D.

Mark H. LeQuire, M.D.

Marnix Ernestus Heersink, M.D.

Patricia Louise Frierson, M.D.

Robert Howard Story, M.D.

Sarah Kathleen Mullican, M.D.

William Jay Suggs, M.D.

$500+ Donors

Alfred LaShawn Malone, M.D.

Charles R. Horton, Jr., M.D.

Collin King, M.D.

David Thomas Cozart, M.D.

Donald Hodurski, M.D.

Earl M.B. Wyatt, M.D.

Gregory Scott Tucker, M.D.

Grigor Merijanian, M.D.

Hernando Carter, M.D.

J. Eugene Lammers, M.D.

J. Noble Anderson, Jr., M.D.

James B. Byrne, Jr., M.D.

James D. Izer, M.D.

James Vann Worthen, M.D.

Jane Ann Weida, M.D.

John David Moorehouse, M.D.

John F. Cabelka, M.D.

John Lyman Drew, D.O.

John Olen Newcomb, M.D.

Jorge A. Alsip, M.D.

Julia L. Boothe, M.D.

Kurt Arnold Senn, M.D.

Leisa DeVenny, M.D.

Masoud Hamidian, M.D.

Michael F. DeVenny, M.D.

Michael W. Cantrell, M.D.

Michelle Downing, M.D.

Neil Yeager, M.D.

Patricia Wade, M.D.

Paul Michael Nagrodzki, M.D.

Paul W. Pickard, M.D.

Richard Henry Esham, Sr., M.D.

Robert Joseph Stanley, M.D.

Robert Wood Nesbitt, M.D.

Roland Spedale, Jr., M.D.

Ron Benton Pitkanen, M.D.

Sebastian B. Heersink, M.D.

Stephanie Snyder Jiminez, M.D.

Thomas Harvey McCulloch, M.D.

Thomas James Weida, M.D.

Thomas Martin, M.D.

Tim Melson, M.D.

William Bennett, M.D.

William Scheider, M.D.

$250+ Donors

Adam Jay Handwerger, M.D.

Alan Thomas Mann, D.O.

Albert Fox Haas, M.D.

Alexis Tanishia Mason, M.D.

Anthony DeVan Hollman, M.D.

Arden LeRoy Aylor, Jr., M.D.

Bendt P. Petersen, III, M.D.

Beverly F. Jordan, M.D.

Brett Lee Storm, M.D.

Burt Fowler Taylor, M.D.

Charles Henry Wilson, IV, M.D.

Charles Hugh Holloway, M.D.

Christopher Jason Green, M.D.

Christopher Rauf Ahmed, M.D.

Christopher T. Nichols, M.D.

Clint Thomas Wade, M.D.

Clinton W. Howard, IV, M.D.

Dewey H. Jones, IV, M.D.

Eric Conrad Lund, M.D.

Glenn M. Woods, M.D.

Guy Leslie Rutledge, III, M.D.

Ivan Daniel Sequera-Sanchez, M.D.

Jacob Fant Kidder, M.D.

James C. Mann, M.D.

James Keith Spain, M.D.

James L. West, III, M.D.

James M. Cockrell, M.D.

James Nicholas Rachel, M.D.

James Reza Fernandez, M.D.

James Scott Bolton, M.D., PC

Jeffrey M. Conrad, M.D.

John Sansbury Meigs, Jr., M.D.

Joseph F. McGowin, III, M.D.

Julia Ann Alexander, M.D.

Leon Williams Bell, III, M.D.

Liang Gu, M.D.

Lowell Dean Mason, II, M.D.

Matthew Lloyd Busbee, M.D.

Michael A. Eslava, M.D.

Michael Andrew Cochran, M.D.

Michael Devon Smith, M.D.

Michael F. Blum, M.D.

Michael Todd Ellerbusch, M.D.

Milton A. Wallace, Jr., M.D.

Nina L. J. Terry, M.D.

Richard E. Jones, III, M.D.

Richard Matthew McKean, M.D.

Robert Ball McGinley, M.D.

Robert Carl Baird, III, M.D.

Robert Evans Egbert, M.D.

Robert Neil Honea, Jr., M.D.

Robert Wayne Williams, Jr., M.D.

Sara Margaret Mullins, M.D.

Stephen B. Cope, M.D.

Stephen Louis Fernandez, M.D.

Suzanne S. Blaylock, M.D.

Thomas M. Barbour, III, M.D.

Timothy L. Frerichs, M.D.

Todd David Engerson, M.D.

Todd K. Volkman, M.D.

Weston James Welker, M.D.

William Isaiah Park, IV, M.D.

William W. Beckett, Jr., M.D.
 

 

Pin It

Posted in: Uncategorized

Leave a Comment (0) →

ALAPAC Ends FY2019 on a High Note

Posted by on
ALAPAC Ends FY2019 on a High Note

Over the past few months, ALAPAC has been in the midst of its summer fundraising campaign, seeking to raise $75k in 75 days. This week, both the summer campaign and the 2019 giving cycle came to a close.

First and foremost, thank you to all the physicians who chose to contribute to ALAPAC this year! We cannot succeed without your continued support.

Although we missed our summer goal by just $10,000, ALAPAC raised over $19,000 in the last month alone. Moreover, physician-giving made it possible for ALAPAC to positively impact special elections this year, with both ALAPAC-supported candidates (Charlotte Meadows and Van Smith) winning their primaries and advancing to the general election.

In the coming weeks, we will recognize all ALAPAC contributors and those individuals who went above and beyond. Also, we will provide a snapshot of the top specialties whose physicians donated to ALAPAC.

For now, we simply want to say THANK YOU!

Pin It

Posted in: Advocacy

Leave a Comment (0) →

Alabama Hospitals Want to Limit Physician In-Office Procedures

Posted by on
Alabama Hospitals Want to Limit Physician In-Office Procedures
The Alabama Hospital Association (ALAHA) submitted a letter to a state health agency this week complaining of increasing instances of physicians performing interventional procedures in their offices instead of in acute care hospitals.  The ALAHA letter states “We strongly believe most interventional procedures should be done in a general acute care hospital setting.”  It further states “…the growing number of interventional/therapeutic procedures being done in a physician’s office setting where the providers are requesting letters of non-reviewability is alarming.”
Read the letter here, and provide us feedback.
Pin It

Posted in: Uncategorized

Leave a Comment (0) →

Sign-on Letter: Improving Seniors’ Timely Access to Care Act

Posted by on
Sign-on Letter: Improving Seniors’ Timely Access to Care Act

September 9, 2019

Dear Members of Congress:

The undersigned patient, physician, health care professional, and other health care stakeholder
organizations strongly support the Improving Seniors’ Timely Access to Care Act of 2019 (H.R.
3107) recently introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger
Marshall, MD (R-KS), and Ami Bera, MD (D-CA). This bipartisan legislation would help
protect patients from unnecessary delays in care by streamlining and standardizing prior
authorization under the Medicare Advantage program, providing much-needed oversight and
transparency of health insurance for America’s seniors. We urge you to join your colleagues in
supporting this important legislation.

Based on a consensus statement on prior authorization reform adopted by leading national
organizations representing physicians, medical groups, hospitals, pharmacists, and health plans,
the legislation would facilitate electronic prior authorization, improve transparency for
beneficiaries and providers alike, and increase Centers for Medicare & Medicaid Services (CMS)
oversight on how Medicare Advantage plans use prior authorization. Specifically, the bill
would:

  • Create an electronic prior authorization program including the electronic transmission of
    prior authorization requests and responses and a real-time process for items and services
    that are routinely approved;
  • Improve transparency by requiring plans to report to CMS on the extent of their use of
    prior authorization and the rate of approvals or denials;
  • Require plans to adopt transparent prior authorization programs that are reviewed
    annually, adhere to evidence-based medical guidelines, and include continuity of care for
    individuals transitioning between coverage policies to minimize any disruption in care;
  • Hold plans accountable for making timely prior authorization determinations and to
    provide rationales for denials; and
  • Prohibit additional prior authorization for medically-necessary services performed during
    a surgical or invasive procedure that already received, or did not initially require, prior
    authorization.

The demand and need for such reforms is growing — particularly as more seniors choose
Medicare Advantage for their health insurance needs. According to a recently released Kaiser
Family Foundation report, “A Dozen Facts About Medicare Advantage in 2019,” Medicare
Advantage enrollment has nearly doubled in a decade. One-third (34%) of all Medicare
beneficiaries — 22 million people — are enrolled in Medicare Advantage plans, and nearly four
out of five enrollees (79%) are in plans that require prior authorization for some services. The
Congressional Budget Office (CBO) projects that beneficiaries enrolled in Medicare Advantage
plans will rise to nearly half of all Medicare beneficiaries (about 47%) by 2029. Recognizing the
need to protect a growing number of Medicare beneficiaries, more than 100 members of
Congress called for such reforms in a letter last year to the CMS.

For our seniors — and as representatives of organizations seeking to protect patients from delays
in care and relieve unnecessary administrative burdens that impede delivery of timely care—we
are committed to advancing this legislation in Congress and ask that you join Representatives
DelBene, Kelly, Marshall, and Bera in co-sponsoring H.R. 3107 and securing its enactment.
Thank you.

Sincerely,

ACCSES
Aimed Alliance
Alliance for Aging Research
Alliance for Balanced Pain Management
Alliance for Patient Access
Alliance of Specialty Medicine
Alzheimer’s Association
Alzheimer’s Impact Movement
AMDA – The Society for Post-Acute and Long-Term Care Medicine
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology Association
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology – Head and Neck Surgery
American Academy of PAs
American Academy of Physical Medicine & Rehabilitation
American Academy of Sleep Medicine
American Alliance of Orthopaedic Executives
American Association of Clinical Endocrinologists
American Association of Clinical Urologists
American Association of Hip and Knee Surgeons
American Association of Neurological Surgeons
American Association of Nurse Practitioners
American Association of Orthopaedic Surgeons
American Association of Pediatric Ophthalmology and Strabismus
American Association on Health and Disability
American Autoimmune Related Diseases Association
American Brain Coalition
American Cancer Society Cancer Action Network
American Clinical Laboratory Association
American Clinical Neurophysiology Society
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Emergency Physicians
American College of Gastroenterology
American College of Mohs Surgery
American College of Obstetricians and Gynecologists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiation Oncology
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Congress of Rehabilitation Medicine
American Dance Therapy Association
American Gastroenterological Association
American Geriatrics Society
American Glaucoma Society
American Group Psychotherapy Association
American Liver Foundation
American Medical Association
American Medical Rehabilitation Providers Association
American Medical Women’s Association
American Music Therapy Association
American Nurses Association
American Occupational Therapy Association
American Osteopathic Association
American Osteopathic Colleges of Ophthalmology and Otolaryngology
American Physical Therapy Association
American Psychiatric Association
American Psychoanalytic Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society for Radiology and Oncology
American Society for Surgery of the Hand
American Society of Anesthesiologists
American Society of Cataract & Refractive Surgery
American Society of Clinical Oncology
American Society of Echocardiography
American Society of Hematology
American Society of Interventional Pain Physicians
American Society of Nephrology
American Society of Neuroimaging
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Ophthalmic Plastic and Reconstructive Surgery
American Society of Plastic Surgeons
American Society of Retina Specialists
American Society of Transplant Surgeons
American Spinal Injury Association
American Urological Association
American Uveitis Society
American Vein & Lymphatic Society
American-European Congress of Ophthalmic Surgery
America’s Physician Groups
Arthritis Foundation
Association for Molecular Pathology
Association of Academic Physiatrists
Association of American Medical Colleges
Association of Black Cardiologists
Association of Rehabilitation Nurses
Association of University Professors of Ophthalmology
Beyond Type 1
Brain Injury Association of America
Bridge the Gap – SYNGAP Education and Research Foundation
Cancer Support Community
CancerCare
Caregiver Action Network
Child Neurology Foundation
Children with Diabetes
Christopher & Dana Reeve Foundation
Clinician Task Force
CMSC- Consortium of Multiple Sclerosis Centers
Coalition For Headache And Migraine Patients
College Diabetes Network
College of American Pathologists
Community Oncology Alliance
Congress of Neurological Surgeons
Cornea Society
Crohn’s & Colitis Foundation
Delaware Academy of Ophthalmology
Depression and Bipolar Support Alliance
Derma Care Access Network
Diabetes Patient Advocacy Coalition
DiabetesSisters
Digestive Disease National Coalition
Disability Rights Education and Defense Fund
Dystonia Advocacy Network
Dystonia Medical Research Foundation
Epilepsy Foundation
Eye and Contact Lens Association
Eye Bank Association of America
Federation of American Hospitals
Free2Care
GBS|CIDP Foundation International
Global Alliance for Behavioral Health and Social Justice
Global Healthy Living Foundation
Global Liver Institute
Healthcare Information and Management Systems Society
Hematology/Oncology Pharmacy Association
IFAA – International Foundation for Autoimmune & Autoinflammatory Arthritis
International Essential Tremor Foundation
International Foundation for Gastrointestinal Disorders
International Society for the Advancement of Spine Surgery
Interstitial Cystitis Association
Lupus and Allied Diseases Association, Inc.
Medical Group Management Association
METAvivor
Movement Disorders Policy Coalition
Multiple Sclerosis Association of America
National Alopecia Areata Foundation
National Association for the Advancement of Orthotics & Prosthetics
National Association of Rural Health Clinics
National Association of Social Workers
National Association of Spine Specialists
National Association of State Head Injury Administrators
National Association of State Mental Health Program Directors
National Comprehensive Cancer Network
National Diabetes Volunteer Leadership Council
National Health Council
National Infusion Center Association
National Lipid Association
National Medical Association, Ophthalmology Section
National Multiple Sclerosis Society
National Osteoporosis Foundation
National Pancreas Foundation
National Patient Advocate Foundation
NephCure Kidney International
North American Neuro-Ophthalmology Society
Ocular Microbiology and Immunology Group
Outpatient Endovascular and Interventional Society
Partnership to Advance Cardiovascular Health
Partnership to Fight Chronic Disease
Partnership to Improve Patient Care
Prevent Blindness
Pulmonary Hypertension Association
Remote Cardiac Services Provider Group
Renal Physicians Association
Restless Legs Syndrome Foundation
RetireSafe
Sjogren’s Syndrome Foundation
Society for Cardiovascular Angiography and Interventions
Society for Vascular Surgery
Society of Critical Care Medicine
Society of Gynecologic Oncology
Society of Hospital Medicine
Spine Intervention Society
The Headache and Migraine Policy Forum
The Leukemia & Lymphoma Society
The Marfan Foundation
The Michael J. Fox Foundation for Parkinson’s Research
The Retina Society
The Society of Thoracic Surgeons
Tourette Association of America
Treatment Communities of America
Uniform Data System for Medical Rehabilitation
United Spinal Association
US Hereditary Angioedema Association
Alabama Academy of Ophthalmology
Alabama Society for the Rheumatic Diseases
Lakeshore Foundation
Medical Association of the State of Alabama
Neurosurgical Society of Alabama
Alaska Rheumatology Alliance
Alaska Society of Eye Physicians and Surgeons
Denali Oncology Group Alaska Chapter ASCO
Arizona Medical Association
Arizona Neurosurgical Society
Arizona United Rheumatology Alliance
The Arizona Clinical Oncology Society
Arkansas Medical Society
Arkansas Ophthalmological Society
Arkansas Rheumatology Association
Association of Northern California Oncologists
California Academy of Eye Physicians and Surgeons
California Association of Neurological Surgeons
California Medical Association
California Rheumatology Alliance
Medical Oncology Association of Southern California, Inc.
Cedars/Aspens, non-profit society of ophthalmic surgeon educators
Colorado Medical Society
Colorado Neurosurgical Society
Colorado Rheumatology Association
Colorado Society of Eye Physicians and Surgeons
Connecticut Rheumatology Association
Connecticut Society of Eye Physicians
Connecticut State Medical Society
Delaware Society for Clinical Oncology
Delaware State Neurosurgical Society
Medical Society of Delaware
Medical Society of the District of Columbia
Florida Medical Association
Florida Neurosurgical Society
Florida Society of Clinical Oncology
Florida Society of Ophthalmology
Florida Society of Rheumatology
Georgia Society of Clinical Oncology
Georgia Society of Rheumatology
Medical Association of Georgia
Hawaii Medical Association
Hawaii Society of Clinical Oncology
Association of Idaho Rheumatologists
Idaho Medical Association
Idaho Society of Ophthalmology
Illinois Medical Oncology Society
Illinois Society of Eye Physicians & Surgeons
Illinois State Medical Society
Illinois State Neurosurgical Society
Indiana Academy of Ophthalmology
Indiana Chapter, American College of Cardiology
Indiana Oncology Society
Iowa Medical Society
Iowa Oncology Society
Midwest Neurosurgical Society
Kansas Chapter, American College of Cardiology
Kansas Hospital Association
Kansas Medical Society
LeadingAge Kansas
Midwest Rheumatology Association
Kentucky Academy of Eye Physicians and Surgeons
Kentucky Association of Medical Oncology
Kentucky Chapter, American College of Cardiology
Kentucky Medical Association
Louisiana Academy of Eye Physicians and Surgeons
Louisiana Chapter, American College of Cardiology
Louisiana Neurosurgical Society
Louisiana State Medical Society
Rheumatology Alliance of Louisiana
Maine Medical Association
Maine Society of Eye Physicians and Surgeons
Maryland Chapter, American College of Cardiology
Maryland DC Society of Clinical Oncology
Maryland Society for the Rheumatic Diseases
Maryland Society of Eye Physicians and Surgeons
MedChi, The Maryland State Medical Society
Massachusetts Society of Clinical Oncologists
Massachusetts Medical Society
Michigan Society of Eye Physicians and Surgeons
Michigan Society of Hematology & Oncology
Michigan State Medical Society
Minnesota Medical Association
Minnesota Neurosurgical Society
Mississippi Arthritis and Rheumatism Society
Mississippi Oncology Society
Mississippi State Medical Association
Missouri Oncology Society
Missouri Society of Eye Physicians & Surgeons
Missouri State Medical Association
Montana Medical Association
Montana Neurosurgical Society
Montana State Oncology Society
Nebraska Chapter, American College of Cardiology
Nebraska Medical Association
Nebraska Rheumatology Society
Nevada State Medical Association
Northern New England Clinical Oncology Society
New Hampshire Medical Society
Medical Oncology Society of New Jersey
Medical Society of New Jersey
New Jersey Academy of Ophthalmology
New Jersey Neurosurgical Society
New Mexico Medical Society
Empire State Hematology & Oncology Society
Medical Society of the State of New York
New York State Neurosurgical Society
New York State Ophthalmological Society
New York State Rheumatology Society
North Carolina Medical Society
North Carolina Rheumatology Association
North Carolina Society of Eye Physicians & Surgeons
North Dakota Medical Association
North Dakota Society of Eye Physicians and Surgeons
Ohio Association of Rheumatology
Ohio Chapter, American College of Cardiology
Ohio Hematology Oncology Society
Ohio Ophthalmological Society
Ohio State Medical Association
Ohio State Neurosurgical Society
Oklahoma Academy of Ophthalmology
Oklahoma Chapter, American College of Cardiology
Oklahoma Neurosurgical Society
Oklahoma State Medical Association
Oregon Academy of Ophthalmology
Oregon Medical Association
Oregon Rheumatology Alliance
Oregon Society of Medical Oncology
Pennsylvania Academy of Ophthalmology
Pennsylvania Medical Society
Pennsylvania Neurosurgical Association
Pennsylvania Rheumatology Society
Philadelphia Rheumatism Society
Pittsburgh Ophthalmology Society
Pennsylvania Society of Oncology & Hematology
The Hospital and Healthsystem Association of Pennsylvania
Puerto Rico’s Hematology and Medical Oncology Association
Rhode Island Chapter, American College of Cardiology
Rhode Island Medical Society
Rhode Island Neurosurgical Society
Rhode Island Society of Eye Physicians and Surgeons
South Carolina Medical Association
South Carolina Oncology Society
South Carolina Rheumatism Society
South Carolina Society of Ophthalmology
South Dakota Academy of Ophthalmology
South Dakota State Medical Association
Tennessee Chapter, American College of Cardiology
Tennessee Medical Association
Tennessee Rheumatology Society
State of Texas Association of Rheumatologists
Texas Medical Association
Texas Ophthalmological Association
Society of Utah Medical Oncologists
Utah Medical Association
Utah Ophthalmology Society
Vermont Medical Society
Medical Society of Virginia
Virginia Association of Hematologist & Oncologist
Virginia Chapter, American College of Cardiology
Virginia Society of Eye Physicians and Surgeons
Neurosurgical Society of the Virginias

Washington Academy of Eye Physicians and Surgeons
Washington Rheumatology Alliance
Washington State Medical Association
Washington State Medical Oncology Society
West Virginia Academy of Eye Physicians & Surgeons
West Virginia State Medical Association
West Virginia State Rheumatology Society
Wisconsin Academy of Ophthalmology
Wisconsin Association of Hematology & Oncology
Wisconsin Medical Society
Wisconsin Rheumatology Association
Wisconsin State Neurosurgical Society
Wyoming County Community Health System
Wyoming Medical Society
Wyoming Ophthalmological Society

Pin It

Posted in: Medicare, Uncategorized

Leave a Comment (0) →

Send Us Examples of Misleading Health Advertising

Posted by on
Send Us Examples of Misleading Health Advertising

In 2019, the Medical Association drafted and supported, and will be supporting again in 2020, specific “truth in advertising” legislation in Alabama to prohibit misleading health care advertising and require all licensed health professionals to clearly communicate their credentials to patients.  These are critical elements to increasing patient education.  

Thanks to those who’ve already submitted examples of health care advertising in Alabama that is misleading.  To reinforce the need for this legislation, the Association is asking all its members to send examples of misleading health care advertising anywhere they see it.  

Want to help? 

Email a link to the misleading health advertising to cflack@alamedical.org

– or – 

Email a screenshot of the misleading health advertising to cflack@alamedical.org. 

Pin It

Posted in: Advocacy

Leave a Comment (0) →

First Impressions

Posted by on
First Impressions

In the last few years, healthcare providers have come to realize the effect of consumerism on their practice.  Consumers increasingly view healthcare as a commodity to be compared and shopped. Social media has allowed patients to share experiences, good and bad.  Online reviews are visible on many websites, it is now more likely for consumers to seek reviews or ask friends before selecting a practice or physician. Even a physician referral may be only a suggestion not an assurance the patient will present for care.

Many physicians fail to realize the first impression is the initial phone call not the initial visit.  Seventy-five percent of patients who abandon calls do not call back. It is important to measure the abandonment rate in multiple departments of your practice.  A practice should have no more than five options on an automated attendant. The first option is usually a prompt for making an appointment. These calls should be answered promptly and never go to voicemail.  A queue can be utilized to line calls into a holding pattern allowing staff to manage a larger volume of calls and give undivided attention to the caller. The goal of the patient is to finalize the call; a voicemail does not allow the patient to finalize the call by obtaining an appointment or other service.  The front office staff should focus on patients who are arriving to see a provider; they should not answer calls for appointments or other high volume tasks. The timeline to an appointment is very important to capturing a new patient. If a patient has to wait more than 2-4 weeks for an appointment, they will seek service elsewhere depending on the specialty.  I worked with a practice last week, the physician had no idea there was a six month wait for a new patient appointment and a two month wait for a follow-up appointment. Providers should track no-shows in correlation to wait time to appointment.

Sometimes, a first impression is based on the effectiveness of the practice website.  A good website is easy to navigate and it showcases important information related to making an appointment and information related to the physicians and other providers.  Phone calls can be controlled by offering requests for appointments via the website or patient portal. Patients prefer to communicate through various methods; most pediatric practices use a portal to communicate with parents of established patients.  The parents can speak directly to a nurse and obtain an answer quickly.  

Another important first impression is the preparation for a visit.  Most patients prefer to register online via link from an automated appointment confirmation.  Online registration allows the patient to use their own device to complete needed information. The staff receives the information before the appointment allowing for quick verification of coverage, and it reduces the time in the waiting room upon arrival.  It also prepares the front office staff with accurate information related to the co-pay and other benefit considerations.

Managers and staff often enter the practice through a side or back door and never see the practice from the perspective of the patient.  I visited a practice a couple of years ago, the carpet was soiled and the receptionist was seated behind a frosted glass window not allowing her to see presenting patients.  In addition, a sign was posted on the glass stating “Don’t tap on the glass, have a seat until called.” It was evident they did not care about first impressions. Assure a manager or supervisor is entering through the front door daily to see the reception area through the eyes of a patient.  The call volumes and wait to obtain an appointment should be closely monitored to assure a good balance between scheduling and availability.

Patient satisfaction surveys are instrumental in measuring patient satisfaction.  The practice culture is essential to engaged and well-trained employees who care about high patient satisfaction.  

You only have 12 seconds to make a good first impression!  Review all the steps a patient must take to make it to the exam room.  If it is not a pleasant experience, make the necessary changes and continue to monitor the steps and the staff performing each step.  Compare yourself to your fiercest competitor, are you keeping staying abreast of changes in technology and healthcare?

Article contributed by Tammie Lunceford, Healthcare and Dental Consultant, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.

Pin It

Posted in: Uncategorized

Leave a Comment (0) →

The United States Court of Appeals for the Eleventh Circuit Issues Helpful Ruling For Providers Concerning Fair Market Value in Space Rental Agreements

Posted by on
The United States Court of Appeals for the Eleventh Circuit Issues Helpful Ruling For Providers Concerning Fair Market Value in Space Rental Agreements

By Jim Hoover

On July 31, 2019, the United States Court of Appeals for the Eleventh Circuit issued a ruling that provides clarity and helps healthcare providers with space lease agreements.  The ruling in Bingham v. HCA, Inc., Case No. 1:13-cv-23671 (11th Cir. 2019) provides that a relator or whistleblower in a false claims/qui tam case has an affirmative burden of proving that the rental rate charged in the lease agreement was below fair market value (FMV), which is an essential element to establishing the existence of remuneration. Equally as important from a litigation procedural view point, the Eleventh Circuit also held that a relator cannot rely upon information obtained in discovery to satisfy the Federal Rule of Civil Procedure Rule 9(b)’s pleading requirements.

In Bingham v. HCA, Inc, the Relator alleged that HCA, Inc. violated the False Claims Act (FCA) due to improper arrangements with physicians who rented space at HCA facilities. Specifically, the Relator’s claims related to leases for medical office building space between HCA-hired developers and physicians who had the ability to refer patients to HCA hospitals. The Relator alleged that HCA provided subsidies to the developers, which the developers then used to provide physician-tenants with “benefits” such as free marketing, office improvements, low initial lease rates, restricted use waivers, and cash flow participation agreements for tenants who signed long-term leases. In return for these “benefits,” the Relator alleged the physician-tenants referred patients to HCA hospitals. Thus, according to the Relator, these arrangements violated the Anti-Kickback Statute (AKS) and led to Stark Law and FCA violations.

Relator argued that the arrangements violated the AKS and Stark Law despite HCA having received fair market value opinions that the rental rates offered were consistent with FMV. The Eleventh Circuit disagreed with Relator and affirmed the district court’s granting of summary judgment because Relator had not established that the alleged “benefits” to the physicians were in excess of fair market value. Significantly, the court ruled that the issue of fair market value is not limited to a healthcare provider’s safe harbor defense, but is something the Relator must affirmatively prove in order to show that a defendant offered or paid remuneration to physician-tenants. The court reached this conclusion by analyzing the definition of “remuneration,” an essential element of an AKS violation. Based on the dictionaries the court consulted, remuneration requires that a benefit be conferred; thus, “[i]n a business transaction like those at issue in this case, the value of a benefit can only be quantified by reference to its fair market value.” The civil monetary penalties statute, 42 U.S.C. § 1320a-7a(i)(6), corroborated this conclusion, according to the court, because the statute defines remuneration to include the “transfer of items or services for free or for other than fair market value.” Although the physicians did receive financial benefits as part of the lease agreements, Relator had not presented evidence that these benefits were outside of the range of fair market value benefits for physicians signing the type of long-term leases used in the arrangements.

The important AKS takeaway from this case is that there is no “remuneration” for AKS purposes unless a benefit is conferred that is other than the FMV. Stated another way, as long as compensation, which includes the value of benefits, to/from a referral source is consistent with fair market value, the AKS is not implicated.

Relating to the Stark Law allegations, the Court found that there was no genuine factual dispute over whether a prohibited indirect compensation arrangement under the Stark Statute existed because it plainly did not. First, any relationship between HCA and the physician-tenants could only be indirect because remuneration flowed through the developers. Second, the Stark Law defines an indirect compensation arrangement to require “that compensation received by a referring physician ‘varies with, or takes into account, the volume or value of referrals or other business generated by the referring physician.’” Finally, because HCA showed that there was no correlation between the physician tenants’ space leases and their referrals to HCA and Relator failed to show that the rental rates or other benefits allegedly given by HCA physician-tenants were at all correlated with the volume or value of referrals from the physician-tenant, Relator failed to create a genuine factual dispute as to whether an indirect financial relationship existed and implicated the Stark Law’s prohibitions.

Also an important ruling on a procedural point when defending a false claims/qui tam case, the federal district court initially allowed the Relator to survive a motion to dismiss and proceed with discovery. The Relator subsequently amended the allegations in the complaint after discovery had begun. HCA filed a subsequent motion to dismiss, which the federal court granted, refusing to allow the Relator to use information gained through discovery as the basis to amend the complaint.  The 11th Circuit affirmed the district court’s ruling and explained that although courts should freely grant leave to amend pleadings, the amendments that include information obtained during discovery may not be appropriate in cases in which the heightened specificity pleading standard of Rule 9(b) applies if the amendment would allow the Relator to circumvent the purpose of Rule 9(b). The Circuit Court, therefore, affirmed the lower court’s decision to grant HCA’s motion to strike information in the amended complaint that was obtained through discovery. The Court then affirmed the dismissals of the related claims because, absent information learned in discovery, the Relator did not satisfy the pleading requirements of Rule 9(b) because “Relator does not provide specific details or evidence to support his claims that long-term ground leases were grossly undervalued or included overly generous terms.”

These holdings should be welcomed by defendants of alleged AKS, Stark Law, and False Claims Act violations. This case is especially welcomed since the ruling was issued by The United States Court of Appeals for the Eleventh Circuit. Accordingly, the federal district courts in the Eleventh Circuit, such as all of the federal district courts in Alabama, must follow the Eleventh Circuit’s ruling.

Jim Hoover is a Partner at Burr & Forman LLP practicing in the Health Care Industry Group.

Pin It

Posted in: Legal Watch

Leave a Comment (0) →

Alabama Hospitals File Suit Against Opioid Manufacturers, Distributors

Posted by on
Alabama Hospitals File Suit Against Opioid Manufacturers, Distributors

Hospitals experience significant financial and operational harm as opioid crisis continues

EVERGREEN, Ala., Sept. 10, 2019 /PRNewswire/ — After two decades of providing frontline care in response to the opioid crisis, a group of 21 Alabama hospitals have filed a civil lawsuit in Conecuh County Circuit Court against the manufacturers, distributors, and retailers of opioid-based drugs. As the opioid crisis has reached epidemic levels, Alabama hospitals have made substantial investments in people, processes and facilities to properly care for patients who have multiple health problems associated with treating the complications of opioid addiction.

The complaint alleges defendants engaged in a decades-long practice of making false assurances about the addiction risks associated with opioid products and used other deceptive marketing tactics to persuade physicians and health care providers to broaden prescribing patterns. The result has been widespread addiction, suffering, and loss of life in communities across Alabama and the nation, with hospitals bearing the financial burden of care and treatment for the victims.

In 2017, 107.2 opioid prescriptions were written for every 100 people in Alabama, the highest prescribing rate in the country and nearly twice as high as the national average of 58.7 per person. There were 167 deaths involving prescription opioids in Alabama in 2017, an increase from 124 in 2016.

“The deceptive marketing efforts of the defendants substantially contributed to an explosion in the use of opioids across the country – and the aftereffects are felt in hospitals every single day,” said Robert King, attorney with The King Law Firm, representing the hospitals. “Hospitals have provided heroic levels of care to opioid-addicted patients and saved countless lives. But the financial, operational and emotional expense for hospitals is staggering. The defendants are at the root of this crisis.”

Industry analysts estimate the country’s healthcare system incurred more than $215.7 billion in costs related to the opioid crisis from 2001 to 2017. The costs were largely attributable to overdose-related emergency department visits.

The hospitals’ complaint alleges negligence, fraud and civil conspiracy by the defendants, which include Purdue Pharma, Johnson & Johnson, Abbott Laboratories and more than 40 other companies and individuals involved in the manufacturing, distribution, and sales of prescription opioids.

“With the appropriate financial resources, no party is better positioned to lead us out of this public health crisis than hospitals,” said Stephen Farmer, attorney with Farmer Cline & Campbell PLLC.

“Hospitals have experienced significant, measurable damages and must be active participants in any opioid settlement discussions,” adds Farmer, who serves as additional counsel for the plaintiffs.

Last month, former Ohio Governor John Kasich and West Virginia University President Dr. Gordon Gee recognized hospitals’ unique position to positively impact the opioid crisis by announcing the formation of Citizens for Effective Opioid Treatment at 130aday.com. The 501(c)(4) organization is working to educate business and community leaders and the public about the negative impact the crisis is having on the nation’s health care infrastructure while advancing evidence-based solutions to the opioid epidemic.

Also last month, the American Hospital Association urged a judge hearing one of the opioid cases “to ensure that needed funds are directed to the hospitals and health systems that are on the forefront of caring for the victims of this epidemic. With additional resources, hospitals can broaden access to post-overdose treatment in emergency departments, increase training of physicians to treat substance use disorders, cover the costs of lengthy stays and follow-up care for infants with neonatal abstinence disorder, and invest in electronic health information systems to improve coordinated care and prevent overprescribing.”

The Alabama hospitals join hundreds of other hospitals across the country that have filed similar suits against opioid manufacturers and distributors.

The Alabama hospitals who filed suit this month include:

  • DCH Health Care facilities in Tuscaloosa, Northport and Fayette
  • Baptist Health medical centers in Montgomery and Prattville
  • Medical West in Bessemer
  • Evergreen Medical Center in Evergreen
  • Jackson Medical Center in Jackson
  • Flowers Hospital in Dothan
  • Medical Center Enterprise in Enterprise
  • Grandview Medical Center in Birmingham
  • Gadsden Regional Medical Center in Gadsden
  • South Baldwin Regional Hospital in Foley
  • Grove Hill Memorial Hospital in Grove Hill
  • Princeton Baptist in Birmingham
  • Walker Baptist Medical Center in Jasper
  • Shelby Baptist Medical Center in Alabaster
  • Citizens Baptist Medical Center in Talladega
  • Brookwood Baptist in Birmingham
Pin It

Posted in: Opioid

Leave a Comment (0) →

Congress is Tackling Surprise Billing Legislation

Posted by on
Congress is Tackling Surprise Billing Legislation

12th hour negotiations are taking place in Congress to get Surprise Billing legislation passed before the end of the year. The Medical Association has been engaged on this issue since the beginning of the year advocating for a fair independent dispute resolution process to resolve out of network payment disputes. However the insurance industry has been pushing to set a benchmark for out of network payments to physicians at or below Medicare rates.

Several bi-partisan proposals on the subject have been introduced and are working their way thru the legislative process. Legislation by Sens. Lamar Alexander (R –Tenn) and Patty Murry (D-Wash) has been approved by the Senate Health and Labor Committee and a bill by Reps. Frank Pallone (d-NJ) and Greg Walden (R-Ore) has been approved by the House Energy and Commerce Committee.

The House Ways and Means Committee and the House Education and Labor committees are expected to begin their work on the legislation once Congress returns to Washington. Differences in the competing versions of the legislation exist and mainly surround the issue of how to calculate insurance payments to out of network physicians and hospitals that prevent patients from being stuck with high medical bills.

The Medical Association of the State of Alabama, the AMA, and most national physician specialty organizations are supporting an Independent Dispute Resolution (IDR) as a fair and transparent method of determining the appropriate reimbursement without burdening the patient.

The health insurance industry is pushing back on that approach and supporting a proposal that would set out of network rates at the median in-network rate. Under this method, health insurance companies and the federal government would be setting reimbursement rates for both in-network providers and out of network providers which is a flawed approach and should be opposed.

The Medical Association has sent out several alerts in previous weeks to the membership encouraging physicians to contact Congress in support of the IDR solution. We continue to encourage physicians to make those contacts through our Advocacy Portal.

The Medical Association has also partnered with the Alabama State Society of Anesthesiology to author an op-ed piece that can be found here.

Pin It

Posted in: Advocacy

Leave a Comment (0) →

Guidance on Practice and Ethical Issues

Posted by on
Guidance on Practice and Ethical Issues

The Medical Association’s Office of General Counsel can help guide members on certain practice and ethical issues.  The Office is comprised of the General Counsel, Cheairs Porter, and Paralegal, Angela Barentine.  The General Counsel is the chief legal advisor to the Board of Censors, and provides legal advice daily to the Executive Director.

Mr. Porter, a Montgomery native, started as General Counsel of the Medical Association in December 2012.  He currently has over 23 years of related legal experience, including an advanced legal degree in health law and substantial practice in regulatory health care matters.

Ms. Barentine, a Milbrook native, graduated Magna Cum Laude in 2002 with a B.S. from Auburn University.  She began work with the Medical Association in April 2015.  She has a Master of Public Administration with a concentration in Health Care, and a Certificate in Non-Profit Management and Leadership.  Ms. Barentine has 20 years of related experience.

While the Office is very busy handling a wide mix of contracts, business issues, legislative, administrative law (agency) matters and matters coming from various departments, as well as staffing the Council on Medical Services, it also can provide general guidance on the law in particular areas, such as:

  • Separation from a practice;
  • Starting a practice;
  • Medical records policy;
  • HIPAA issues;
  • Certain prescription drug matters;
  • Overpayments;
  • Ethics;
  • Medicaid; and
  • Some billing and charging issues.

If you are searching for general guidance, please feel free to contact Cheairs Porter at (334) 954-2540 or Angela Barentine at (334) 954-2541 for assistance.

Pin It

Posted in: Legal Watch, Members

Leave a Comment (0) →
Page 1 of 2 12