Summary of
MINUTES
CANS Board of Directors Meeting
Friday, January 17,
2003, Sutton Place Hotel, Newport Beach, California
1.
ABSS
The application of the American Board of Spinal
Surgery (ABSS) requesting recognition from the Medical Board of California was
reported to the Council of State Neurosurgical Societies (CSNS), but there is
not much that can be done to prevent the application process; no further action
at this time.
2.
DiskCure
A letter requesting an investigation of a procedure
called DiskCure was sent to the California Medical Board as directed by the
Board of Directors. CANS is
concerned that DiskCure has not passed scientific scrutiny for the treatment of
disk problems. Per the Medical
Board, the matter is under investigation and there is no further action needed
at this time.
3. CSNS Meeting
Dr. Shuer and Dr. Zusman summarized the resolutions
presented at the September 2002 meeting of the Council of State Neurosurgical
Societies (CSNS):
Pay Shortfall for Neurosurgeons in the U.S. Military
Resolution adopted; CSNS will ask AANS/CNS to
communicate with the Surgeon Generals of the Army, Navy and Air Force to
recommend that they support increased compensation for active duty neurosurgeons
to make it feasible for long-term retention of qualified neurosurgeons.
Creation of a New 501(c)(6) Tax Exempt Organization
for Neurosurgery
Resolution adopted.
Merger of AANS and CNS
Resolution not adopted at this time; the AANS/CNS
will review the impact of the recent merger of the American College of
Physicians (ACP) and the American Society of Internal Medicine (ASIM).
Resident work hours survey
Resolution adopted; data will be obtained that may
improve the potential problem with restrictions on resident work hours.
4.
CSNS Voluntary Contribution
The Board of
Directors agreed to pay the 2003 annual contribution of $1500 requested by the
CSNS. This money has funded
projects such as practice management and resident programs and is not used for
travel expenses associated with meeting attendance.
5.
AANS Nominations
Over twenty signatures of CANS members were collected
to nominate Randall Smith, M.D. to the office of Vice President of the AANS.
Ballots will be sent by the AANS the first week of March.
This effort was pursued so that California would have a stronger voice
nationally.
6.
Executive Office Report
The most significant change to operations this past year was the purchase of
credit card software so that members would have an alternative method for paying
meeting fees as well as membership dues.
7.
New Members
Membership was approved for Adam
Jason Brant, MD, Sanjay Ghosh, MD, Marc Stuart Schwartz, MD
and
Mario Cuevas, PA-C.
8.
Treasurer's Report
Dr. Abou-Samra reported that the operating budget remains stable and that the
Annual Meeting is expected to at least pay for itself.
9.
Annual Meeting
Attendance is
down from last year and it is hoped that better marketing can be done this
year to attract more participants next January 16-18, 2004 in Newport Beach.
The same venue in southern California was selected because the
Sutton Place Hotel offered the same room rate of $149 for both 2003 and
2004. Cost reduction was main
reason to stay with the Sutton Place since San Francisco is becoming too
expensive.
Several Board members discussed meeting planning and felt that more emphasis
should be placed on socio-economic topics rather than scientific ones to
conform with the reason that CANS was formed in the first place.
It was agreed that the membership should be surveyed about what will
draw them to meetings, i.e., topics, location, length of meeting,
socioeconomic vs. scientific topics, social events, theater, lectures (wine,
music), etc. It is also important to secure exhibitor commitments early in
the year while budgets are being reviewed.
10.
Global Surgical Fee Schedule
Dr. Phillip Kissel asked the Board for a position about abolishing the
global fee reimbursements. It
was recommended that this be put into the form of a resolution for CSNS and
routed to the Board of Director via e-mail for review and approval.
11.
CMA Resolutions
Dr. Prolo asked the Board to review and endorse
four resolutions he plans to present to the CMA House of Delegates in March.
CANS has endorsed (1) JUSTICE, COST
ESCALATION, RE-PRIVATIZING HEALTHCARE;
(2) COMPARABLE WORTH,
RBRVS, WORKER’S COMPENSATION, OMFS (Requests that CMA reject RBRVS
methodology); and (3) WORKER’S
COMPENSATION, NEGOTIATIONS, STATE ACTION EXEMPTION. CANS
did not endorse JUSTICE, FREEDOM, FEDERAL HEALTH RESERVE BOARD
12. Workers Compensation
CMA OMFS Meeting
Dr. Florin gave a summary of a CMA
meeting held on December 17, 2002 with CSIMS and other specialties to
examine whether a transition from RBRVS to OMFS was feasible. The difference
between the Medicare fee schedule and the RBRVS conceived at the December 17
meeting is huge. An effort to
use old OMFS data and existing charges and relativity, and then matching it
against the good parts of medical fee (while retaining relativity across
specific codes) would be a big step forward in working out a sensible
transition. Dr. Florin is
currently working on a computer model that would make it possible to
transition current relative values for medical codes against OMFS dollars
with a conversion factor of $65/unit. Relative
values for spine (especially 63000) have been reduced so severely by CMS
that they stand out. A project
of this dimension will require significant input from all specialties.
Gannon Presentation
Dick Gannon, the Administrative Director of the
California Division of Workers’ Compensation who was appointed by the
Governor in June 1999, presented an overview of the IMC’s plan to update
the OMFS. The following is a summary of Mr. Gannon’s major points:
* It is time to revise the OMFS which is over 18 years old
* Mr. Gannon is not interested in cutting off access to qualified physicians
for injured workers; he made it very clear that he is not out to reduce
reimbursements to physicians.
* Medical costs are escalating rapidly in the Workers’ Comp system.
* According to the Workers Comp Research Institute Cambridge, the California
fee schedule is one of the lowest in the country/E&M has had no
increases in 18 years.
* Agency is underfunded, understaffed and working with an outdated computer
system.
* Since 1995, there has been a 25% personnel decrease and now the DWC is
working with a $1.8M shortfall.
* The DWC is working with the Lewin Group to study the impact of moving to a
resource based schedule. Lewin found that the work involved in Workers’
Comp is different than general medicine, requiring more work, more time and
higher practice expenses.
* Current timetable for OMFS conversion:
February-April: Ground
rules will be posted on web with public comment period.
May: Pre-public
rulemaking meetings scheduled and the ground rules will be redrafted; Lewin
will
then analyze the study based on the new ground rule
August: Final recommendation by Lewin
October: Formal rulemaking
April 2004: Culmination
of project
* All public input welcomed; Mr. Gannon assured the Board that he will listen
to CANS’s input.
* The ultimate fee schedule, if working well, should be revised
annually. Mr. Gannon said he wants a fee schedule based on facts with the
bottom line being good medical treatment.
He is very much open to other fee schedules. Alternatives will be considered; however, the Office of
Administrative Law (OAL) is the final approval.
13.
Next Board Meeting
The next CANS Board meeting will be held Saturday, May 10, 2003 at the
Gateway Sheraton Hotel at LAX.