Meeting of April 19, 2015 – Kansas City
John O. Stanley, MD, Kansas City, President, presided. Ravi Johar, MD, St. Louis, was elected President Elect. Warren Lovinger, MD, Nevada, was elected Chair. Rob Schaaf, MD, St. Joseph, was elected Vice Chair. David Redfern, MD, Springfield, was reelected Secretary. George Hruza, MD, St. Louis, was reelected Treasurer.
Meeting of July 12 – Jefferson City
Proving that MSMA provides value for your annual Association dues, the MSMA Council voted during its July Council Meeting in Jefferson City to keep your membership dues steady for 2016 at $395, which is one of the lowest state medical association dues in the nation. Studying its membership to increase quality programming and services, MSMA will undertake new processes to reach out to new and established members.
MSMA also celebrated big wins for medicine this year with the passage of tort reform in Missouri and the elimination of the SGR, nationally. MSMA’s Legislative Review, a complete summary of the 2015 legislative session, showcases the strength of organized medicine in Missouri. Watch for it in the mail.
David Redfern, MD, Chair of the Legislative Committee, updated members on the Assistant Physician licensure, and other important issues, such as the ICD-10 transition, tort reform, APRN scope of practice expansion, Medicaid managed care, and maintenance of licensure.
The Legislative Committee also considered several resolutions referred by the House of Delegates. MSMA Staff will carry out amended Resolution #3 - Patient-Physician Continuity upon Health Plan Termination, which calls for extension of the continuity of care window when a physician is terminated from a health plan.
Resolution #4 - Opposing the Interstate Medical Licensure Compact directs MSMA to oppose the Federation of State Medical Board’s Interstate Medical Licensure Compact. Two resolutions, Resolution #5: Truth in Advertising and Resolution #6: Qualification for Usage of the Term “Board Certified” in Physician Marketing were combined and adopted, directing MSMA to support Truth-In-Advertising legislation for all health care providers in Missouri, and empowering individual licensing boards to adopt advertising requirements and restrictions and allowing them to discipline licensees or violations thereof.
In other Council activities, MSMA President, John Stanley, MD, reported that he represented MSMA at component societies in Washington and Poplar Bluff. Growing membership and encouraging early career physicians to become active are priorities. Dr. Stanley also represented Missouri physicians at the Iowa Medical Association Annual Meeting and at the AMA Annual Meeting in June.
Your Association is continuing to receive reports of tax fraud on physicians through an IRS identity theft scam, and has reported more than 100 cases to the FBI, Secret Service, and the IRS. If you think you are a victim, visit www.msma.org/TaxIdentityTheftScam.
A national publisher is considering printing a book based on articles featuring near-death experiences that were published in MSMA’s Journal, Missouri Medicine, over the last two years.
Resolutions from Annual Convention
Resolution #13 calls on MSMA to support the “Start by Believing” public awareness campaign, which encourages victims of sexual assault to report incidents. Council instructed staff to draft a policy statement in support of the following resolution’s intent to be considered at the next board meeting.
Resolution #7 - Flexibility in Scheduling Pre- Authorized Events - calls on MSMA to initiate conversations with Missouri insurance companies to better understand what their policies are and to alleviate some of the administrative difficulties faced by physician offices related to pre-authorizations for re-scheduled appointments and/or procedures.
Resolution #8 - Reduced Payments for Subsequent Services with the Global Period - asked MSMA to oppose the medical insurance company practice of reduced procedural fees for services performed during the global period, was not adopted. The AMA has opposed this practice since 1992 and has since reaffirmed opposition numerous times.
Resolution #11 - Preparation of Inpatients for Discharge - directs MSMA to collaborate with Missouri Hospital Association on a medication reconciliation quality initiative related to patient discharge.
Missouri Physicians Health Program
Bob Bondurant, Director of Missouri Physicians Health Program (MPHP), reported an addiction psychiatrist, Dr. Dan Angres, will make presentations across the state to physicians on the topic “Disease of Addiction.” Charles Sincox, MD, MPHP Medical Director, stated that in addition to alcohol and drug addiction, the MPHP is seeing more workplace disputes and boundary issues.
MSM Foundation
In 2016 the Missouri State Medical Foundation will increase its $2,500 scholarship to each of the six schools in the state from the current five per school to eight per school.
Continuing Medical Education
After evaluation summaries from the 2015 Annual Convention indicated the CME content was clinically relevant, potential topics for CME at the 2016 Annual Convention include Physician Burnout; Physician Addiction; Fee-for-Service Physician Reimbursement; and Ethics/Ethical Issues.
MSMA granted reaccreditations to SSM St. Mary’s Hospital, Jefferson City and Mercy Hospital, St. Louis. The Commission accepted progress reports from Lake Regional Health System and Cape Girardeau County Area Medical Society, and accepted an activity review from the Phelps County Medical Center.
Alliance
As one of the main functions of the Alliance is to raise funds for the MSM Foundation, the organization will sponsor its annual Holiday Sharing Card this fall, and also “Wild, Wild West” fundraiser at the 2016 MSMA Annual Convention.
Alliance President Elect Jana Wolfe reported that Alliance President Sue Ann Greco traveled across the state to preside over officer installations at five local Alliances. Missouri was represented by eight Alliance members at the AMA Alliance Annual Meeting in Chicago in June. She also encouraged all Council members to make sure their spouses are members.
AMA Report
Lent Johnson, MD, Missouri Delegate, reported your state was well represented at the AMA Annual Meeting in June, with representatives discussing the ongoing lack of residency slots for recent medical school graduates, improving medical education, Maintenance of Certification, possible elimination of the three-day inpatient requirement for long-term care under Medicare, implementation of ICD-10, brain damage to young athletes, e-cigarettes, and repeal of the SGR. David Barbe, MD, an MSMA Past President and the Immediate Past Chair of the AMA Board of Trustees, has announced that he will run for AMA President Elect in 2016.
District Reports (selected)
David Pohl, MD, District #3, stated that Washington University medical students are working on projects with University engineers. The SLMMS Physician Leadership Institute will be held in January 2016. Lancer Gates, DO, District #7, reported that the Kansas City Medical Society will host a program on practice modalities on September 22, and Betty Drees, MD, indicated there is some support for the establishment of an Academic Physician Section at the AMA.
James Conant, MD, representing the Organized Medical Staff Section at the state and national level, applauded the programming for medical staffs during the AMA Annual Meeting, which included the increasing event of overdoses, expansion of Medicaid, and nurse practitioners being given medical staff privileges. Josephine Doo, Medical Student Section, reported each allopathic and osteopathic school in the state is working on joint projects getting ready to launch a new school year.
Meeting of October 18 – Jefferson City
MSMA’s new website was unveiled at the October Council Meeting in Jefferson City. The new vendor, Weblink International, and MSMA staff worked diligently to create a more user-friendly and mobile website and to also expand online dues payment options.
In other actions, the Council discussed proposed guidelines for prescribing opioid drugs in hospital emergency departments, and approved a request to endorse the “Tobacco 21” campaign to raise the lawful age for buying or selling tobacco and nicotine products from 18 to 21. The Council also established an ad hoc committee to study possible MSMA support for Missouri to become a “Start by Believing” state and to send a message to the Missouri General Assembly in support of this initiative.
Advocacy
Your MSMA, along with the Missouri Association of Osteopathic Physicians and Surgeons and Missouri Hospital Association, recently sent letters to the Missouri Department of Social Services and the Centers for Medicare and Medicaid Services regarding the implementation of ICD-10 and its effect on the MO HealthNet and the Medicaid programs. And MSMA voiced deep concern in a letter to the Missouri Department of Insurance regarding the merger of Anthem and Cigna insurance companies, emphasizing the implications for physicians and their patients.
David Redfern, MD, chair of MSMA’s Legislative Committee, reported two new issues for the 2016 Legislative Session: exclusion of team physicians for state licensing requirements while traveling with their team in the state; and requiring real-time Explanation of Benefits. Issues from 2015 that will return in 2016 are APRN practice restrictions, Missouri’s Prescription Drug Monitoring Program, maintenance of licensure, and Medicaid managed care. Also MSMA member Senator Bob Onder, MD, was elected Assistant Floor Leader in the Missouri Senate.
The Council heard that the Board of Healing Arts is close to promulgating the final rules for public comment on Assistant Physician licensure. And in ongoing collaboration efforts, MSMA met with the Board of Healing Arts, MAOPS, and the Missouri Academy of Family Physicians.
Annual Convention
Topics for the 2016 MSMA Annual Convention General Sessions are Genome Testing Ethical Issues; Patient Access to Cost Prohibitive Drugs/Therapies; Update on Transition from FFS to Value-Based Reimbursement, Evolving Alternate Payment Models and Measurement Programs; Update on Stroke Management; and Physician Burnout.
The following entities were reaccredited for CME activities: CoxHealth, Hannibal Regional Hospital, Esse Health, and St. Louis STD/HIV Prevention Training Center.
MSMA hosted a CME provider training session in October for 11 CME coordinators. Sandra Ahlum, MD, and MSMA staff will attend the ACCME State Medical Society in Chicago in December.
Membership
MSMA has surveyed both members and non-renewals to get feedback on programs and services. A list of new statewide members was distributed to Council who were urged to contact and welcome them to the Association.
Missouri Physicians Health Program
Bob Bondurant, MPHP Executive Director, reported on fundraising activities for contributions to the MPHP. Contributions for the MPHP can be made in honor of Jack Croughan, MD, its first medical director, who passed away earlier this year.
Alliance
Alliance President Sue Ann Greco reported the group co-hosted the North Central Leadership Conference in St. Louis in October. To celebrate the 20th anniversary of the AMA Allance’s SAVE (Stop America’s Violence Everywhere), Missouri’s own Alliance Fall Conference was held in Columbia in October with presentations on the Missouri CASA program and MU’s campus safety against sexual assault. The Alliance is planning its Foundation fundraiser, “Wild, Wild West,” scheduled for March 18, 2016, in conjunction with the MSMA Annual Convention. Council members also received the Alliance’s Holiday Sharing Card.
AMA
Edmond Cabbabe, MD, chair of the Missouri AMA Delegation, reported the AMA Interim Meeting will be held in Atlanta this month. Issues such as the Code of Ethics and price increases for generic drugs will be considered. At the June 2016 AMA Annual Meeting, MSMA Past President David Barbe, MD, will run for AMA President Elect. Dr. Cabbabe also encouraged all Council members to make contributions to the AMA Missouri Honor Fund. Once the fund has reached its fundraising goal, it will make a donation to a clinic in Missouri.
Councilor District Reports (Selected)
David Pohl, MD, District #3, St. Louis, reported that its members are supporting World Food Day. SLMMS will also conduct a Physician Leadership Initiative program in February 2016. Michael Stadnyk, MD, SLMMS President, contacted the St. Louis Dispatch regarding ads placed by health professionals other than physicians that were not identified as advertisements. The Post Dispatch will now label these as advertisements.
James DiRenna, DO, District #7, Kansas City, stated physicians in Cass County requested that they be incorporated into the Kansas City Medical Society rather than be part of the West Central Medical Society. MSMA staff is investigating the procedure for incorporation.
Charles Lawson, MD, District #10, reported the Cape Girardeau County Area Medical Society is participating in the matching funds program with the Missouri State Medical Foundation, which provides scholarships to medical students. The Cape Society has presented membership society meeting programs on breast cancer and human trafficking.
Meeting of January 17, 2016 – Jefferson City
At its meeting on January 17, 2016, your MSMA’s Council approved teaming up with the Missouri Hospital Association (MHA) and the Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) in a letter to the Missouri Department of Insurance and the Missouri Attorney General, asking for a thorough review of the individual and cumulative effects of the Anthem-Cigna merger, as well as the proposed Aetna-Humana consolidation (particularly for its impact on Medicare Advantage patients). The letters, distributed at the January Council Meeting in Jefferson City, can be found on MSMA’s website at www.msma.org. We will keep you posted as this issues continues to develop.
In other advocacy efforts, a joint press release on Opioid Prescribing Recommendations was issued by MSMA, MHA, MAOPS, the Missouri Academy of Family Physicians, Missouri College of Emergency Physicians, and the Missouri Dental Association.
Councilors received a recap of issues discussed at the recent State Legislative Strategy meeting in Washington, DC, including a push to increase GME funding and the termination of meaningful use. Discussion was held on numerous issues already before the 2016 General Assembly, including APRN independent practice, defining pain clinics, telehealth, and expert witness. The Committee recommended that Senator Dan Brown be the recipient of the 2016 MSMA Legislative Award, to be presented at MSMA’s Annual Convention in March.
The Council adopted the following policy statement regarding victims of sexual violence:
“The Missouri State Medical Association believes that victims of sexual violence should be met with full compassion and understanding in the health care setting, no matter the circumstances. MSMA further believes that all such victims should be strongly encouraged to report the incident and seek out appropriate emotional support services and follow-up care to aid in their recovery.”
PCPI and MIPS Update
Alexander Hover, MD, reported on recent activities on PCPI/MIPS. MACRA has consolidated PQRS/VBPM/MU into MIPS. The Measure Development Plan draft was published on December 18 with a comment period until March 1 and the final rule due May 1. Current MIPS/MDP priorities include PROMS-person and caregiver centered experience and outcomes; communication and coordination of care and treatment with other providers; appropriate use and resource use. The MDP strategy includes continuum of care; patient outcomes including PROM; multiple level of accountability; uses EHR data across national population; aligns multiple models and required reporting.
Commission on Medical Education
Sandra Ahlum, MD, reported the Commission is planning the upcoming MSMA Annual Convention and will offer ABIM Maintenance of Certification points for four of the General Sessions. The Commission adopted the ACCME’s 2015 Markers of Equivalency. Dr. Ahlum and staff attended the AAM/ACCME SMA Meeting in Chicago in December. Attendees received a Council on Medical Education Update, discussed AMA’s strategic initiatives, and AMA/ACCME alignment of policies. Discussion was held regarding an increase in annual maintenance fees; Council directed staff for more research and information.
Membership
The Membership Committee is researching new vendors and partners with potential benefits to MSMA members. New programs will be announced soon.
MSMA Insurance Agency
MSMA members are encouraged to contact the Agency for any insurance needs they may have.
Missouri Physicians Health Program
Bob Bondurant, MPHP Executive Director, reported there were 24 new participants in 2015 and there are currently 97 participants in the program.
AMA
Edmond Cabbabe, MD, reported highlights of the recent AMA Interim Meeting. David Barbe, MD, is up for election for AMA President Elect at the June AMA Annual Meeting. Jerry Kennett, MD, continues as a member of the Council on Legislation. Dr. Cabbabe is seeking an appointment to the AMA Council on Long Range Planning and Development. He encouraged the Council members to make a donation to the MSMA AMA Foundation Honor Fund and urge their colleagues to do the same.
Alliance
The Alliance held its Fall Conference and Board Meeting on October 20–21. The Conference honored the 20th Anniversary of the AMA Alliance SAVE Program – Stop American’s Violence Everywhere. Presentations included a program on the Missouri CASA program, which provides advocates for children in foster care in the State, and a presentation from the University of Missouri Police Department who spoke on the University’s efforts to protect students from sexual assault on campus.
The Alliance raised over $2,500 with their Holiday Sharing Card. The Alliance Day at the Legislature and Winter Board meeting will be held February 23–24. The Alliance Fundraiser at the MSMA Annual Convention is themed “Wild, Wild West’ and will include a Jail and Bail fundraiser.
District Reports – (Selected)
In District #3, Samer Cabbabe, MD, was installed as the President of the St. Louis Metropolitan Medical Society (SLMMS). Dr. Cabbabe is the son of Edmond Cabbabe, MD, and this is third instance of a father and son as President of the Society. SLMMS, the Anders Health Care Services and Healthcare Management Alternatives will be holding a Physician Leadership Institute on February 13, February 27, March 12, April 2, and April 23. The Institute topics include Foundations of Healthcare; Finance and Revenue; Practice Management; Risk and Compliance; and Leadership Skills.
Martin Willman, MD, in District #4 reported that the St. Charles-Lincoln County Medical Society presented an MSMF scholarship award to a local medical student.
David Kuhlmann, MD, thanked MSMA President Dr. Stanley for attending a meeting of the Pettis County Medical Society and reported Districts #6 and #7 are working together as Cass County is in the process of moving from District #6 to District #7.
Brian Biggers, MD, reported from District #8 that eight medical students from the University of Missouri-Columbia will soon be doing their third and fourth years at the new educational facility in Springfield. The number of students will increase within a few years.
Charles Lawson, MD, reported physicians in Cape Girardeau, District #10, are working with foster children in the area and providing some financial assistance to help meet their basic needs. The Cape Girardeau Society also recently held two CME events.
Additional reports included the Organized Medical Staff Section, the International Medical Graduate Section, the Young Physician Section, and the Publications and Editorial Board.