Meeting Highlights
                                      CANS Board of Directors Meeting
          Saturday, April 30, 2005 , Sheraton Gateway Hotel, Los Angeles Airport

1.         Formal Call to Order
            The following members were present: Board of Directors:  Drs. Abou-Samra,
            Bonner, Caton,Colohan,Edwards (President), Hunstock, Johnson, Ott,
            Page,Robbins, Vanefsky; Consultants: Drs. Kusske, Lippe, Prolo, Smith ; other:
            Dr. Edwin Amyes. The minutes of the January 21, 2005 Board of Directors
            Meeting were approved.  

2.         Medical Justice, Inc.
            Newsletter editor Dr. Randall Smith has provided the CANS membership
            with information about Medical Justice, Inc., the firm that protects physicians from
            frivolous lawsuits. Future updates on litigated cases will be requested.

3.         Townhall Meeting
Although there was little interest in the CANS townhall meeting at this time, future meetings will be held regionally where appropriate.  Meeting notices will be sent via the newsletter listing proposed topics such as reimbursement, trauma coverage, malpractice, Workers’ Comp and collective bargaining. Members who attend are welcome to stay on for the Board of Directors meeting. The townhall meeting will be held next January in conjunction with the Annual Meeting.

4.         Lobbyist
The Board voted to hire Norwood and Mattoch to be CANS’ lobbyist pending review of his contract. He will be asked to focus initially for AB681, the Vargas bill that proposed to maintain Workers’ Comp fees at current level until 2009 and forestall the rumored January 1, 2006 imposition of an RBRVS type schedule. The lobbyist will be expected to keep the Board informed on various legislation that will affect neurosurgery and provide reports to Dr. Smith for the newsletter.

5.         LA County Trauma
The number of neurosurgeons covering the 8 private practice hospitals in LA County is down to 18 and the new county hospital with 625 beds will be ready in two years. Indigent patient resources continue to diminish in the LA system which is about to collapse.  The Board voted to pursue a state application for exemption from the Taft-Hartley law, through the CMA,  for trauma coverage that would allow trauma surgeons and neurosurgeons to collectively bargain for fees.

 6.       EMTALA 
Dr. Kusske currently serves on a CMS (Centers for Medicare and Medicaid Services) committee, the  EMTALA Technical Advisory Group (TAG), which is comprised of 19 physicians who are charged with  helping CMS develop rules to protect individual rights while minimizing unnecessary burdens on health care providers.  He is also the chair of sub-committee about on-call services. The hospital association  members of the TAG have recommended that CMS require physicians to take ER call as a condition of  participation in Medicare.  Dr. Kusske asked that anyone contact him with their specific ideas or concerns    about this proposal to present to his sub-committee which will then present to the general committee where all comments become public. The next meeting will be June 15 in Washington D.C. and one must register  in order to testify.

 7.        Membership
            It was noted that the CANS is slowly losing members. Manpower shortage remains
            a big problem and not only in California ; there are only about 2800
            neurosurgeons in the U.S. This shortage is partially attributed to interlopers such as
            ENT surgeons, spine surgeons, etc. A good recruitment tool will be available
            sometime next year when the California Medical Board begins tracking specialty
            designations on its website. This data should provide a more accurate count of the
            number of neurosurgeons in California .

 8.        Treasurer's Report
131 members have paid increased dues needed to hire the lobbyist.  Dues continue to be collected and it is hoped that sufficient funds will be received to avoid withdrawing finds from the reserve account. In an ongoing effort to reduce expenses, the Board agreed to discontinue reimbursement for Board meeting travel expenses until further notice.  The electronic newsletter has saved some printing and postage costs.

9.         Annual Meetings  
The January 2005 Annual Meeting made a net profit of about $4400 despite the decreased attendance.  The 15 exhibitors were the result of personal contacts made
by Dr. Hunstock. Preliminary program plans for 2006 include another pain management course and a presentation from the lobbyist. The 2006 meeting
will be held in San Diego and the 2007 meeting will be in Sacramento.

10.       NHIC CAC  
            Dr. Lippe recently attended the Medicare CAC meeting and presented the draft
            Local Coverage Determination (LCD)for Vestibular Function Testing to the Board
            members who were in support of the document as written with the addition of
            “Neurosurgeons” as preferred referring physicians. There are several other items of
             note from this meeting:  Medicare Part A and Part B carriers will be combined over  
            the next 2 years and will be regionally based rather than locally.  Dr. Barry Straube,
            Chief Medical Officer of Region IX, has been temporarily promoted to Chief
            Medical Officer of Medicare. Medicare fraud remains a huge issue, especially in
            southern California .

11.       Other Meetings Requiring CANS’ Participation  
            Dr. Robbins attended CMA’s Council on Legislation (COL) meeting in March
            where he was provided a good opportunity to see that a lobbyist is key if CANS
            want issues to be heard at capitol. Dr. Prolo attended  both the CMA House of
            Delegates meeting and the AMA meetings in March.  He prepared comprehensive  
            summaries of both meetings which are on file in the CANS office.  

12.        Emergency Services Proposal  
             Dr. E. Amyes, former ex-officio CANS Board member, presented a proposal
             about establishing a national  emergency care system modeled on the Emergency
             Services in Orange County . He has written to the Kaiser Family Foundation
             requesting financing to conduct a study with the Rand Corporation to collect    
            data about the present system.  This data would then be presented to Congressman
            Cox who is in charge of  homeland security, the premise being that there cannot be
            homeland security without an emergency care system; and there cannot be an
            emergency care system without neurosurgeons. The Board voted to contact         
            the Kaiser Family Foundation to lend support for Dr. Amyes’ plan pending a review
            of the grant criteria.

13.       Next Board Meeting  
            The next Board of Directors meeting will be held on Saturday, September 17,
            2005
from 7:00am - 12:00 at   the Resort at Squaw Creek to maximize attendance
            in conjunction with the meeting of the Western Neurosurgical Society.

 JT

CANS members may contact janinetash@sbcglobal.net for full text of meeting minutes.

 to home page