Summary of
MINUTES
CANS Board of Directors Meeting
Saturday, September
7, 2002, Wyndham Hotel, San Jose, California
1.
Pain
Medicine
A letter of clarification was sent to National Heritage Insurance
Company (NHIC) stating that CANS supports the American Academy of
Pain/California Academy of Pain (AAPM/CAPM) at NHIC’s Carrier Advisory
Committee as the legitimate voice to represent the various disciplines that have
an interest in pain medicine. This letter was prompted by a request from the San
Diego Academy of Neurological Surgeons.
2.
American Board of Spinal Surgery (ABSS)
The
Medical Board of California approved the application of the American Board of
Spinal Surgery (ABSS) in May 2002 despite CANS’ opposition.
The CANS Board is concerned that the ABSS may not meet the stringent
requirements of the American Board of Neurological Surgery (ABNS) which
encompasses all forms of spine surgery. The
ABSS may have a negative impact on neurosurgery causing a further fragmentation
of the specialty of neurosurgery. This
issue will be presented to the CSNS meeting September 20-21, 2002.
3.
AANS Nominations
Nominations
for AANS officers for 2003 have been submitted as agreed upon at the May 2002
CANS Board meeting.
CANS nominated Volker Sonntag, M.D. for President-Elect; Lawrence M.
Shuer, M.D. for Member-at-Large; and George H. Koenig, M.D. to the
Nominating Committee.
5.
CSNS Resolutions
CANS
had no resolutions to submit to the September CSNS meeting; however, Dr. Shuer
reviewed all other resolutions submitted to obtain feedback from the
Board:
a.
CMS and Medicare Attitudinal Survey
This resolution would survey CSNS membership for opinions regarding CMS
and Medicare.
Action:
Survey is too
limited to be of value. An
amendment will be presented at the meeting to broaden the scope of the
survey to include all attendees at the general session and not just the CSNS
delegation.
b. Resident
Work Hours
This
resolution was written by the NeuroTrauma Committee, which is chaired by Dr.
Hoyt. Effective
July 2003, all
residency training programs will be mandated to comply with Public Health Law
405.4, a.k.a. “Libby
Zion
Law” (legislated in New York State) which limits the number of working hours
of residents.
The law
states
that a resident
cannot be worked more than 80 hours per week; must have a rest period of 10
hours between
shifts; and must have one day off per week. The resolution requests that an
immediate survey be done of
academic neurosurgeons in New York on the impact of this law. Action:
CANS will support.
c.
Restricted Physician Workforce
This resolution asks that the CSNS Workforce Committee and the
Washington Committee provide data to support
legislation that would offset burdens of increasing practice costs, decreasing
reimbursements and decreasing
resources. Action:
CANS is neutral.
d.
Pay Shortfall for Neurosurgeons in the U.S. Military
This
resolution would increase the financial compensation of active duty
neurosurgeons to make it feasible for
long-term retention of qualified neurosurgeons. Action: CANS
will support.
e.
Reserve Medical Officer Civilian Practice Insurance
This
resolution would provide financial protection for reserve officers who are
recalled for active duty for periods
greater than 90 days. Action:
CANS will support.
f.. Neurological
Surgery Resident Work Hour Survey
In light of the law limiting resident work hours, this resolution will collect
and analyze data on the impact of current
resident workweek and caseload management. Action: CANS
will support.
g.
Creation of a New 501(C6) Tax Exempt Organization for Neurosurgery
This
resolution would create a 501C6 neurosurgical organization to allow for no
limitation in the amount of lobbying
activity. Action:
CANS will support.
h.
Merger of AANS and CNS
This
resolution requests that AANS and CNS contact the leadership of the American
College of Physicians (ACP)
and the American Society of Internal Medicine (ASIM), which had merged four
years ago, to inquire of the
benefits of the merger. Action:
CANS will support.
6.
Secretary’s Report/Membership
Report
Membership
was approved for
Drs. Nicole Moeyeri, Charles Schnee and Neil Brown.
7.
Treasurer's Report
Treasury is in sound shape and efforts continue to collect delinquent dues.
The Board directed the executive office to implement a credit card plan
to provide an alternative way for members to pay their dues and to pay Annual
Meeting fees.
8.
Bylaws Committee
A
motion was made and seconded to amend the bylaws to expand the Board of
Directors to include 2 new directors (3-year term) under the age of 45 to
represent young and new neurosurgeons. Wherever possible, one should be from
northern California and the other from southern California.
9.
2003 Annual Meeting
The
Annual Meeting will be held in conjunction with the Association of California
Neurologists (ACN) the weekend of January 17-19, 2003 at the Sutton Place Hotel
in Newport Beach. It
was decided to market Saturday and Sunday as a bundle to encourage attendance at
a discounted rate. The bundled price will not include Friday’s QME course
which will be a separate registration. Meeting highlights:
a.
FRIDAY - QME
Six hours of QME/CME credit will be available by attending a Workers
Comp/QME course presented by Dana Livingstone-Lopez.
b.
SATURDAY - Socioeconomic Session
The Board agreed that the socioeconomic session should focus on the topics
of HIPAA and
MICRA (What will Happen if MICRA is Repealed?).
Other topics being explored are Medicare private contracts and a Workers Comp/IMC update
c.
SUNDAY - Pain course
A
6-hour pain course will be presented followed by a second course planned for
January 2004 (for the remaining six hours required). Dr. Lippe has agreed to be
one of the three speakers; the American Academy of Pain Medicine (AAPM) is
negotiating for two additional speakers. The AAPM is an ACCME-approved sponsor
of the course.
10.
Communications Committee
a.
Newsletter
Dr. Bonner reported that only 28 people (out of 670
surveyed) responded to CANS’ survey about electronic vs. paper
copy of the newsletter. The majority (18) indicated that the paper copy should
continue.
b.
Website
There
are now reports available from the CANS website about number of hits and topics
requested. It was decided that CANS will not at this time
sell space to advertisers so that exhibitors are not detracted from attending
the meeting. Links have been added to AANS, CNS and ANSPAC.
11.
Workers’ Compensation/
IMC Update
Dr. Lippe reported on the progress of the conversion of the Official Medical
Fee Schedule (OMFS) to a
resource-based methodology which is an analysis of work and time. The Industrial
Medical Council
(IMC) contracted with The Lewin Group which is analyzing three phases: (1) work
study and preliminary
analysis
of the impact of redistribution of work values; (2) physician practice expenses
(results due end of September); and (3) E&M codes which have been determined
to be about 30% more difficult in the Workers Comp arena. There may be a 27%
increase in work values. Negative
effects on some surgical specialties
can be offset by ground rule changes,
geographical variables and multiple conversion factors. The
Board agreed that it will wait and see what the impact of the study will be.
The preliminary documents released caused much concern and if the end
result is unacceptable to all specialties, CMA is sure act.
There will be plenty of time to protest during the IMC public policy
comment period.
12.
EMTALA
Dr. Shuer recently wrote to the Centers for
Medicare and Medicaid (CMS) stating that their proposed
regulations to the EMTALA rules fail to adequately address
critical on-call issues.
13. Legislation
CANS
has opposed AB470 (Chu) which would expand the scope of practice
of California psychologists. CANS wrote to Governor Davis urging him to sign AB3006 which
would maintain Medi-Cal reimbursements at the current level.
14.
CME/CNS
Dr.
Smith is working with the Congress of Neurological Surgeons (CNS) to designate
CME hours by category at their Annual Meeting.
If successful, California neurosurgeons should be able to satisfy the
12-hour pain CME requirements by attending one AANS meeting and one CNS meeting
between now and 2006.
15.
Board Meeting Schedule
The Board agreed that CANS’ fall and spring Board meeting should be
scheduled 3-4 weeks prior to the CSNS meeting so that resolutions can be
discussed.
The next Board of Directors meeting will be held from 1:00-5:00 p.m., Friday, January 17, 2003 at the Sutton Place Hotel in Newport Beach in conjunction with the Annual Meeting.