MINUTES
CANS
Board of Directors Meeting
Sheraton Gateway Hotel, Los Angeles Airport,
1.
Formal Call to Order
The
meeting was called to order at
2. ER
Membership Survey
The
Board agreed that the survey done by Dr. Scott Lederhaus in October 2003 and
presented at the January 2004 Annual Meeting is a good tool to use when
negotiating with hospital administration about ER compensation.
The survey may help hospitals to better understand the problems
neurosurgeons face regarding coverage and reimbursement.
It was decided that the survey should be done every 3-5 years to refresh
the data.
3.
CME/AANS Accreditation
Due to complaints received from
some CANS’ members about AANS policy changes regarding acceptable CME roved
courses, a motion was
approved to write
to AANS for
clarification of its policy and
to explain that the current policy will be detrimental to neurosurgeons and
other specialists in
4.
Secretary/Membership Report
Two
new applicants were approved for
membership: Ali Najafi, M.D. of
5.
Manpower/Recruitment
Dr.
Caton expressed concern that practicing neurosurgeons are on the decline,
especially in southern
6.
Treasurer's Report
CANS
monthly operating income and expenses are stable with late dues still
being collected, The 2004 Annual
Meeting expenses were about $5000 over income with a hotel penalty due to the
room block not being met.
Overall meeting attendance was not as high as expected and the
Board feels that the current state of organized medicine and neurosurgery has
had an affect on lower attendance. Compared with past meetings, the number of
exhibitors also has decreased over the years.
This meeting would be the last joint meeting held with the Association of
California Neurologists (ACN). The program was excellent with very positive
evaluations forms returned. Final
attendance figures:
Neurosurgeons / Neurologists / Total
Exhibitors
9
5
14
Dinner
63
20
83
SocioEcon
60
26
86
Fluoroscopy 22
7
29
TBI
24
14
39 (includes 1 other specialty)
Pain Mgmt
43
19
68 (includes 6 other specialties)
7.
2005 Annual Meeting
The
San Jose Fairmont has been secured for the next meeting
·
Hoover Institute speaker on
the changing tide of medical economics to redirect health care in US.
·
astronaut Story
Musgrave, M.D., an astronaut who would be an excellent banquet speaker
·
Dr.
Jack Lewin, Executive VP of CMA
·
Mayor Jerry
Brown who was the Governor of California when MICRA was passed
·
workshop on ER/hospital
negotiations
·
Will
there be a neurosurgical crisis in next 5 years?
·
Pain
management course (6 CME hours)
8.
2006 Annual Meeting
The 2006 Meeting will be held in
9.
Bylaws Committee
The Board approved a motion to amend
CANS bylaws to direct CSNS
and CMA delegates to be appointed by the president rather than elected by
the membership.
The
Long Range Planning Committee last met on
11.
Workers’ Compensation/Fee
Schedule
Dr.
Steven Levine, chair of the Workers’ Comp Committee of the Association of
California Neurologists (ACN), was invited to present an update on the new
Workers’ Comp legislation. SB228 originally called for a fee scale single
conversion factor of 120% of Medicare (Insurance Commissioner Garamendi
suggested 115%). For surgical,
neurodiagnostic, internal medicine and pain medicine, that would have been a
large blow; for Evaluation & Management, a large increase.
Dr. Levine and ACN have proposed a multiple conversion factor limiting
losses within specialties; however, the CMA met between December 2002 and summer
2003 and would not support anything that would maintain the old fee scale unless
the specialties were unanimously in favor. Consequently,
a proposal was passed mandating a 5% cut across the board; this was most simple
way for legislators who do not understand this complex issue. The law will only
be in effect until
12.
Workers’ Comp/ACOEM/ASIPP Guidelines
Dr.
Lippe reported that
the main stakeholders are the insurance industry, the employers, the injured
workers and the legal system; health care providers are very small stakeholders.
Now that the Industrial Medical Council (IMC) no longer exists, the
Commission on Health Safety in Workers’ Comp (CHSWC),
which is comprised of labor and employers, and the Rand Corporation are in the driver’s
seat. Another
problem is with the guidelines for disability evaluations which have all
changed. The 5th edition of the AMA guidelines now govern how
disability evaluations are done, but the AMA guides are for impairment, not
disability. Rand and CHSWC have
consultants who are trying to relate the AMA guidelines for impairment rating
and the
The
Division of Workers’ Comp (DWC) is seeking qualified surgeons to participate
in a program to provide second opinions when treating physicians request
authorization for spinal surgery for injured workers.
Physicians will be paid $250 for paper review or $500 for a clinical
review. The DWC wants as many people in the program as possible who are board
certified and actively practicing with current privileges and experienced in
spine.
14.
CAC Meeting
Dr.
Lippe and Dr Rodriguez both attended the April 21 Medicare Carrier
Advisory Committee meeting
in
15.
CMA/House of
Delegates
Dr.
Polo reported on the status of the three CANS resolutions presented at CMA’s
March House of Delegates meeting:
a. “Contravention
of House of Delegates Policy”
by CMA staff was
disapproved. This Resolution was
aimed at the CMA staff altering policy of the 2003 HOD that stipulated the new
Workers’ Compensation (WC) fee schedule should not be solely based on the
federal RBRVS and that a
b. “California
Official Medical Fee Schedule (OMFS) Advisory Committee Funding” proposed
a 10 cent levy on each WC claim that would provide around $500,000 yearly from
the 5 million claims in Workers’ Compensation to fund a fee schedule
committee that
neither the CMA nor Division of Workers’ Compensation had the financial
resources to underwrite. This was disapproved because of opposition by
occupational medicine and family practice physicians, who covet the federal
RBRVS to the chagrin of most other specialties.
c. “Nursing
Ratio and Healthcare Access” asked for a more flexible formula for nursing
ratios based on acuity. A
complimentary proposal was accepted stipulating the CMA take action to address
patient safety and quality of care issues created by the implementation of
nurse-patient ratio law.
CMA
has accepted several of CANS’ recommendations for various CMA committees.
Robert Meredith, MD was reappointed to the Council on Ethical Affairs; Patrick
Wade, MD was reappointed to the Committee on Professional Liability; and
17.
Legislation
CANS
wrote letters of
support for SB1821 that will raise the age for buying cigarettes from 18 to 21;
and SB1569 which allows physicians to go to court if they are not paid
appropriately by managed care organizations.
Some
of the Board members felt that CANS needs a legislative advocate in
19.
Council of State Neurosurgical Societies (CSNS)
Dr.
Wade provided a written summary of resolution action at the April 30 CSNS
meeting:
a.
Proposed Change to CSNS Rules & Regulations Allowing Appointees to be
Officers
amended resolution
adopted
b.
Hospital Coverage of Medical Professional Liability Insurance in Exchange
for ER
Services
– referred to Medical Legal Committee
c.
Survey to Assess the Effects of the Current Medical Liability Crisis on
Providing
Neurosurgical Care – not adopted
d.
Supporting Increased Organ Donation – not adopted
e.
Motorcycle Helmets – adopted substitute resolution
f.
Statement on the Ethics of Non-Participation in Medicare – not adopted
g.
State Society Listings in the E-Bulletin Calendar – adopted amended
resolution
The next Board of Directors meeting will be held
JMT