April 2016 nl

By Sara Rose Wells, Assistant Director of Government Aff airs

The 2016 General Assembly adjourned on March 11, one day earlier than expected, after working for two months on thousands of proposed bills. This was a particularly busy session for the Medical Society of Virginia (MSV), with more than 200 pieces of legislation within our bill tracker. Here are a few of the highlights: Prescription Drug MisuseWith drug overdose deaths now outnumbering those resulting from motor vehicle accidents in Virginia, legislators were focused on developing ways to combat this serious epidemic. A wide variety of bills were fi led on the topic, dealing with everything from the prescription drug monitoring program to opioid prescribing continuing medical education. MSV actively engaged with the bill patrons to provide the physician perspective to these issues, as well as amendments to create eff ective, workable solutions. MSV is proud of our eff orts to be part of the solution to this crisis in Virginia and is pleased with the results of our work.

Initially, SB 513, carried by Sen. Siobhan Dunnavant, M.D. (R-Henrico), and HB 293, carried by Del. Charniele Herring (D-Alexandria), would have required mandatory querying of the PMP for all prescriptions of opioids or benzodiazepines, except when prescribed after a surgical procedure or in hospice or palliative care. MSV was able to successfully achieve the following amendments to these bills, which will alleviate the burden on physicians while maintaining eff ective delivery of care.

2924 Emerywood Parkway, Suite 300Richmond, VA 23294Phone: (804) 353-2721Fax: (804) 355-6189www.msv.org

House of Medicine Wins

continued on page 4

06 President’s Update: World Without MSV

07 Advocacy Champion Spotlight: OrthoVirginia

08 Thank you,WCOC!

14 New Benefi ts and Savings with MSV Marketplace

20 MSV Salutes Exceptional Physician Leaders

IN THIS ISSUE

LEGISLATIVE WRAP-UPMEDICAL SOCIETY OF VIRGINIA

2016

ChairRandolph J. Gould, M.D.

Vice ChairClaudette E. Dalton, M.D.

DelegatesDavid A. Ellington, M.D.Edward G. Koch, M.D., FACOGHazle S. Konerding, M.D. Mitchell B. Miller, M.D. Lawrence K. Monahan, M.D.

Alternate DelegatesCliff ord L. Deal III, M.D.Thomas W. Eppes Jr., M.D. Russell C. Libby, M.D. Bhushan H. Pandya, M.D. Sterling N. Ransone Jr., M.D.

William C. Reha, M.D., M.B.A. Cynthia C. Romero, M.D., FAAFP

Medical Society of Virginia2924 Emerywood Parkway, Suite 300, Richmond, VA 23294

Offi cers, Board Members and AMA Delegates

PresidentEdward G. Koch, M.D., FACOG

President-ElectBhushan H. Pandya, M.D.

Immediate Former President

William C. Reha, M.D., M.B.A.

Secretary-TreasurerAlan L. Wagner, M.D., FACS

Speaker of the HouseKurtis S. Elward, M.D.,

M.P.H., FAAFP

Vice SpeakerArthur J. Vayer Jr., M.D.

DirectorsMichael S. Amster, M.D. Joel T. Bundy, M.D., FACP, FASNJohn F. Butterworth IV, M.D.Sandy L. Chung, M.D., FAAP, FACHECliff ord L. Deal III, M.D., FACSEhsan Dowlati

James R. Dudley, M.D., M.B.A. Jacqueline M. Fogarty, M.D. Stuart F. Mackler, M.D., FACSIbe O. Mbanu, M.D., M.B.A., M.P.H. S. Hughes Melton, M.D., M.B.A., FAAFPMohit Nanda, M.D. Patricia A. Pletke, M.D.William S. Prominski, M.D.

Jonathan T. Schaaf, M.D.John D. Ward, M.D.Alan H. Wynn, M.D., FACP

Associate DirectorsTeresa W. Babineau, M.D.Samuel D. Caughron, M.D. James J. Gooding, M.D.Joshua Lesko, M.D.Michael S. Martin, M.D.

Monica MelmerLarry G. Mitchell, M.D.Edilberto O. Pelausa, M.D., FACS, FRCSCPradeep Pradhan, M.D.Timothy L. Raines, M.D. Richard A. Szucs, M.D.Chi Young, M.D.

AMA delegation

MSV Leadership

2 www.msv.org

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Each day thousands of physicians treat their patients with confi dence in knowing that MSVIA is their insurance partner. Building on the Medical Society of Virginia’s legacy of caring about Virginia physicians, our team stands ready to support you with unbiased guidance and exceptional service.

Request a quote at www.msvia.org/RequestQuote.

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Advocate for My Profession

Legislative Wrap Up - continued from page 1

• Prescribers are required to check the PMP when initiating a new course of treatment of opioids (benzodiazepines have been removed from the law entirely) that is expected to last longer than 14 days.• Checks are not required in the following instances:

• Non-refillable prescriptions after a surgical or invasive procedure• Hospice or palliative care• In-patient treatment• Patients in assisted living or nursing homes• The PMP is non-operational• A prescriber cannot access the PMP due to emergency or disaster• Prescribers can designate a member of office staff that has routine access to private patient records to handle PMP checks.• There is a sunset date of July 1, 2019.

HB 657, carried by Del. John O’Bannon, M.D. (R-Henrico), directs the Department of Health Professions to develop an advisory panel comprised of relevant stakeholders to determine the criteria for unusual prescribing or dispensing of opioids. HB 829, carried by Del. Chris Stolle, M.D. (R-Virginia Beach), directs the Board of Medicine and the PMP advisory board to determine a threshold for prescribing of covered substances, which will then be used to determine if a physician needs to take continuing medical education on relevant topics such as pain management and addiction. There is a sunset date of July 1, 2022 on this legislation.

MSV was able to successfully kill two bills dealing with prescribing that would have legislated standards of care. HB 278, carried by Del. Jason Miyares (R-Virginia Beach), suggested that a physician perform a urine drug screen on a patient when initiating a 90-day or more course of opioids or benzodiazepines, which is already part of the standard of care. HB 1265, also patroned by Del. Miyares, called for specific limits on physician dispensing of any medication to a patient in a certain time period. Certificate of Public NeedAnother high profile issue this Session was Certificate of Public Need (COPN) reform. Out of the long list of COPN bills filed, Del. O’Bannon (R-Henrico) and Del. Kathy Byron’s (R-Lynchburg) bills moved the furthest in 2016. Each passed the House of Delegates and were heard by the Senate Education and Health Committee, including a special COPN subcommittee.

Del. O’Bannon’s HB 193, included the most significant reforms, removing everything except nursing homes, open heart surgery, and organ/tissue transplant services from the current process and putting them into a new permitting process. This process created a set of standards an applicant must meet in order to receive the permit, which were:

• Charity care requirement that is enforced• Quality care standards for the specific specialty service that are consistent with nationally recognized standards for the service.• Equipment standards and standards for appropriate utilization of equipment and services• Requirements for monitoring compliance with quality care standards

Del. Byron’s HB 350 included the recommendations of the COPN work group headed by Sec. of Health and Human Resources William Hazel, M.D., which were mainly process changes, along with removing a couple of services from COPN. The bill was further amended to include the permitting process found in Del. O’Bannon’s bill, as well as placing imaging services into this process.

MSV supported both of these bills, as they aligned with our COPN policy, but unfortunately both bills were carried over until the 2017 legislative session. Sen. Steve Newman (R-Forest), Chairman of the Senate Education and Health Committee, assured stakeholders that this issue is important to him and will come back again next year. Speaker Bill Howell (R-Fredericksburg) has also committed to working toward significant COPN reform in 2017.

Associate PhysiciansDel. Stolle sponsored legislation to create a new level of licensure for medical school graduates who do not match into residency called “associate physician”. This license would have been for a two year, non-renewable license for a graduate to practice under supervision of a physician. MSV does not believe that this untested and unknown option would truly set graduates up for better success at matching into a residency in the next two years. With significant support from the MSV Student Section, the Virginia Academy of Family Physicians and the Virginia Academy of Physician Assistants, MSV opposed this legislation, as the underlying issue of lack of residency spots is the true problem that should be addressed. The legislation was carried over until the 2017 session in the Senate Education and Health Committee.

April 2016 5


Graduate Medical EducationA very exciting development that came out of the budget is that the General Assembly agreed to fund 25 new residency slots in Virginia beginning July 1, 2017. Of the 25 slots, 13 will be designated for primary care and 12 will be for other high need specialties. Preference will be given for spots in medically underserved areas.

Scope of PracticeA multitude of bills were filed dealing with nurse practitioner (NP) independent practice, ranging from only in underserved areas or in free clinic settings to granting complete independent practice. MSV worked with the bill patrons to propose alternatives to independent practice, which were accepted.

One bill will help address the issue of NPs losing their team lead physician due to reasons including death, retirement, revocation of license, etc. To prevent disruption in care, an NP will now be able to notify the Boards of Medicine and Nursing of the loss of their physician and receive a 60 day grace period in which they will be able to continue seeing current patients according to their existing practice agreement, while they look for a new physician lead. If after the initial 60 days is up and the NP is unable to locate a new physician, they receive an additional 60 days to continue their search. After the subsequent time is up, they are not able for additional time and must discontinue practicing.

The other piece of legislation addressed a telemedicine based pilot program for connecting NPs in rural and medically underserved areas to physicians who are willing to serve as patient care team leads. Funding from the budget was provided in the budget to support this initiative.

Medicaid Substance Use Disorder Benefit FundingAnother victory included in this year’s budget was an increase in the Medicaid Substance Use Disorder (SUD) benefit. The current benefit is woefully inadequate in both reimbursements for physicians and access for current Medicaid members, but this new proposal expands the availability of treatment to all current Medicaid members, as well as bringing reimbursements for physicians equal to commercial rates. With an increased focus to crack down on prescription drug misuse, MSV is pleased to see that the General Assembly is taking substance use treatment seriously with additional state resources.

Workers’ CompensationLast year’s Workers’ Compensation work group, led by Del. Peter Farrell (R-Henrico), reviewed implementing a Medicare-based fee schedule. The stakeholders determined that reform is needed, but must keep providers whole while maintaining access to care for patients. The group concluded the best solution to be a fee schedule developed by an actuary hired by the state with the objective of keeping providers whole. Funding was included in the budget for the actuary. Only payments from workers comp claims will be included.

Thank YouThanks to all of the physicians, residents, medical students, physician assistants, physician assistant students, practice managers and staff who worked with the MSV team to advocate on behalf of the House of Medicine this year. If you’re interested in getting more involved in the legislative process, please consider attending the MSV Legislative Summit, which will be held on May 13 in Richmond. You can find more information, as well as register for the summit, at www.msv.org/legsummit. Please also make your 2016 MSVPAC contribution by visiting www.msvpac.org, mailing a check to MSVPAC, 2924 Emerywood Pkwy, Ste. 300, Richmond, VA 23294, or contacting Lindsay Larkin at 804 |377-1037 or [email protected].

MSV Participates in National Advocacy Conference By Lindsay Larkin, Government Affairs & Political Advocacy Manager

In February, MSV leadership and staff. along with hundreds of physicians from across the country. attended the American Medical Association’s 2016 National Advocacy Conference in Washington, D.C. to discuss current health care issues. MSV President Edward G. Koch, M.D., Randy Gould, M.D., Josh Lesko, M.D., Melina Davis-Martin and Lindsay Larkin spent an afternoon on Capitol Hill to meet with congressmen, senators and legislative aides regarding key federal health care concerns such as the opioid abuse epidemic, meaningful use regulations and telemedicine legislation. MSV would like to thank Rep. Bobby Scott, Rep. Barbara Comstock, Rep. Don Beyer, Rep. Scott Rigell, Rep. Dave Brat, Sen. Mark Warner, Sen. Tim Kaine and their staffs for taking the time to meet with us to discuss issues important to Virginia physicians.

“Oh, I don’t know. I guess you’re right. I supposed it would have been better if I’d never been born at all.”

This famous quote is from the character George Bailey in the classic movie It’s a Wonderful Life. The movie depicts how one man’s allegedly small contributions changed a town for the better during the Great Depression.

So what does this have to do with physicians and the practice of medicine? Over the years, organized medicine has experienced ebbs and flows. Some wonder in the rapidly changing world of health care, what can an association do anymore especially in the face of new laws and regulations.

The world of health care would look very different without MSV and organized medicine. Just take a look at some bills introduced in the 2016 General Assembly session.

Without MSV: • Physicians would be mandated to conduct a urine screen before prescribing anyone an opioid or benzodiazepine• All medications would be limited to a 3-day dose• Law enforcement and health plans could evaluate physicians’ prescribing patterns• The punitive damages cap would be increased to $500,000

These are just a few examples where MSV pushed back and made a lasting impact on behalf of Virginia physicians and patients. Your calls, emails, and visits made the difference on these bills. By sharing your stories and expertise legislators are able to understand the real life implications these bills would have on health care.

And while the General Assembly session is important, it’s also just one piece of the puzzle in addressing the many challenges physicians face. That’s why your continued support and engagement in organized medicine is so significant; every contribution—no matter the size— strengthens MSV and empowers all physicians across Virginia.

Without MSV health care in Virginia would be compromised. But without you, MSV wouldn’t have the ammunition to continue to fight to make Virginia the best place to practice medicine and receive health care.

Sincerely,

Edward Koch, M.D., FACOGMSV President

A World Without MSV

President’s Message

6 www.msv.org

April 2016 7


After merging with The Orthopaedic Center of Central Virginia earlier this year, OrthoVirginia now includes more than 100 physicians and 21 offi ce locations across the state. Through this merger, the practice has made it their mission to develop quality standards on diagnosis and treatment of patients to reduce complications and variation in care while reducing costs.

OrthoVirginia remains committed to the belief that cost-eff ective care can only be achieved by providing the highest quality of patient care. “The biggest change for physicians has been taking up more responsibility for the total care package, whether it’s for bundled pricing or at risk contracts,” says MSV member Anthony Shaia, M.D. “Physicians are now managing the whole episode of care.”

OrthoVirginia physicians have lent their expertise on various issues over the years by participating on internal taskforces and direct advocacy at the General Assembly. Most recently, members of OrthoVirginia worked closely with MSV and the Virginia Orthopaedic Society on Worker’s Comp reform to improve the system for all stakeholders and control health care costs.

OrthoVirginia continues to be a champion for MSV advocacy eff orts. Not only do they contribute time, but OrthoVirginia is the Medical Society of Virginia Political Action Committee’s (MSVPAC) largest group supporter. Through their contributions, MSVPAC is able to increase our political infl uence.

MSVPAC and the government aff airs team extend its gratitude to OrthoVirginia for all of their hard work and support. We extend a special thank you to E. Claiborne Irby Jr., M.D., Julious P. “Jody” Smith III, M.D., John Bowman, M.D., David Romness, M.D., and Karen Simonton.

Make sure to follow OrthoVirginia’s lead and support MSVPAC today! To contribute, visit www.MSVPAC.org or make checks payable to MSVPAC and mail them to MSVPAC, 2924 Emerywood Pkwy, Suite 300, Richmond, VA 23294.

By Lindsay Larkin, Government Aff airs & Political Advocacy Manager

Advocacy Champion Spotlight: OrthoVirginia

The Medical Society of Virginia Political Action Committee (MSVPAC) works to elect legislators who will make Virginia the best place for medicine — for physicians and patients.

Your contribution to MSVPAC supports General Assembly legislators and candidates who will serve as strong advocates for Virginia’s patients and physicians. MSVPAC understands that advocacy requires a year-round commitment. Please join our eff orts by making a donation to MSVPAC! Visit www.msvpac.org or call 800 | 746-6768 to contribute today.

Please make checks payable to “MSVPAC” and use the form provided below to remit payment to:

MSVPAC2924 Emerywood ParkwaySuite 300Richmond, Va 23294

To be an eff ective force in health care, you must become an active voice in Virginia politics.

Disclaimer: MSVPAC is a segregated fund established by the Medical Society of Virginia. Contributions to MSVPAC/AMPAC are not deductible for federal income tax purposes. Voluntary political contributions by individuals may be personal or corporate. $100 of the suggested contribution amount is transmitted to AMPAC or $10 for a student or resident. Funds from corporations will be used for political education activities and/or state election activities where allowed. Contributions are not limited to suggested amounts. Neither the AMA nor MSV will favor or disadvantage anyone based upon the amounts of or failure to make PAC contributions. Voluntary political contributions are subject to limitations of FEC regulations.

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By Hedi Cho, Communications Manager

This year the General Assembly tackled a number of major issues impacting physicians – from independent practice of nurse practitioners to Virginia’s prescription drug epidemic. Much of MSV’s success this year is due to the more than 350 White Coats on Call (WCOC) participants who came to speak on the issues that are important to the practice of medicine. MSV held nine WCOC days during the 60-day legislative session and is grateful to all our attendees, especially to those participants that took time out of their busy schedules to come out more than once

MSV’s WCOC program is unique in that it brings together physicians, residents, medical students, practice managers, physician assistants, physician assistant students, local medical societies, and specialty societies

to speak to the issues impacting the practice of medicine in the Commonwealth. These personal visits with their delegates and senators were the key to our success.

Thank you to all the local and specialty societies that came out in support of our White Coats on Call eff orts:

• American College of Physicians (ACP-VA)• Arlington County Medical Society (ARLCOMS)• Danville-Pittsylvania Academy of Medicine • Psychiatric Society of Virginia (PSV) • Richmond Academy of Medicine (RAM) • Virginia Academy of Physician Assistants (VAPA) • Virginia Chapter, American College of Physicians (VA-ACP)• Virginia Chapter, American Academy of Pediatrics (AAP-VA) • Virginia Chapter, American College of Surgeons (VA-ACS) • Virginia Chapter, American College of Radiology (VC-ACR) • Virginia College of Emergency Physicians (VACEP)• Virginia Orthopaedic Society (VOS) • Virginia Society of Anesthesiologists (VSA) • Virginia Society of Eye Physicians and Surgeons (VASEPS)

… And thank you to all of the individual attendees, as well!

Thank You, White Coats on Call!

lan D. Abrams, PA-C*Robin Allen Diane Allison Eric J. Ambroz Courtney Amburgey Michael Samuel Amster, M.D. Kenneth Anderson, PA-C Ashani Andrews Sri Lekha Anne Hadi Bin Anwar, M.D. Bethany Arbogast Lesley Arthur Evangeline Kamalini Arulraja Teresa Wirth Babineau, M.D. K.C. Barney Samuel Thomas Bartle, M.D., FAAP, FACEP Harry D. Bear, M.D., PhD

Amber Beckman Jim Beckner Allison Bivens Lawrence E. Blanchard, M.D. Lauren Blankenship Norman Douglas Boardman, M.D. Sean Ross Bodin Brigette Booth David Thomas Boyd, M.D., M.B.A. Jenn Brandon Kelly Braun Peter Breslin, M.D. Owen W. Brodie, M.D. Stephanie Bruton Hugh McLellan Bryan, M.D. Joel Thomas Bundy, M.D.,

FACP, FASN Sarah Burke John F. Butterworth, M.D.*Patricia Nicole Caldwell James D. Cannon, PA-C, MS Elisabeth T. Cardwell, M.D. Taylor Carlson Chesney Carroll John Carter Victoria Ashley Carter Kelli Cash Suzanne Cassidy Stacy Castro Samuel D. Caughron, M.D. Ann Cebrelli Bandhan Chakraborty, M.D. Abigail Chang Jane B. Chappell

Seth Adam Cheatham, M.D. Jiabi Chen Adrianna Choi Sandy Lee Chung, M.D., FAAP, FACHE Claire Marie Cifaloglio, M.D. Bret Clawson Joel Martin Clingenpeel, M.D. Amanda N. Collins, PA-C, M.B.A. Russell Collins Erin Comerford Maggie Connealy Danielle Cormier Tiana Crawford, M.D. Fay Crawshaw Kaitlyn Crites Jenna Crozier


Stephen Crum Brooke Csaky Meghan Culbert John Moncure Daniel, M.D. Phillip D. Davis, PA-C Philip Arthur Dawson, M.D., FAAP Adam Kyle Deal, M.D. Clifford L. Deal, M.D., FACS*Georgean G. DeBlois, M.D. Egidio Giacomo Del Fabbro, M.D. Shea A. Dempsey, PA-C Jessica Dennis Craig S. Derkay, M.D., FACS, FAAP Lynsey Marie Deudne Tiffany Dietz Dani Dobratz Ehsan Dowlati Daniel B. Drysdale, M.D. James Roane Dudley, M.D., M.B.A. Nam Quang Duong Katherine Elizabeth Eberly Janie Ehle Rachel Ellenbogen Kurtis Scott Elward, M.D., M.P.H., FAAFP Thomas W. Eppes, M.D. Chereen Eskender *Erika Euker Jamie Ewing David S. Falkenstein, PA-C*Timothy Patrick Farrell, M.D. Mina Fawze Alison Fenter Scott Cameron Fligor Victor Wei-Kwong Fong, M.D. Helen Montague Foster, M.D.*Michael Alan Fowler, M.D. William Edward Fox, M.D.,

FACP Erika Renaud Francis, PA Megan Freismidl Jessica Anne Fugate Ryan Thomas Gabriel, M.D. Kate Gabriel Brandon Gallo Inna Garber, D.O. Evelyn Marie Garcia, M.D. Keva Garg Kaitlyn Garnett Rochelle Gerber Laura Giambra Wilford Keith Gibson, M.D. Stephanie Gill Alyssa Gilman Robert A. Glasgow, PA-C, M.P.A.S, M.P.H. Hannah Goldberg Stephanie Gomolka James John Gooding, M.D. Randolph J. Gould, M.D., FACS Colleen Grassley Chelsea Greenspan Margaret Johnson Gregorczyk, M.D. Kelsey Griffitts Amelia Grover, M.D. John Benjamin Groves, D.O. Charu Gupta Khalila Guzman Elizabeth Hammond Jessica Hansroth Charles Albert Harris, M.D., FACS Caroline Harris Margaret Harris Margaret Harris Sheila Hautbois Andrea Hawkins Samantha Hay Stuart I. Henochowicz, M.D.,

M.B.A., FACP*Alexis Higgins Robert Hill Michael Gabriel Hillegass, M.D. Derrik Holladay Eliza Thomasson Holland, M.D. Kirby Holland Christine Hollenbeck, PA-C Kevin Bradford Hoover, M.D. Caroline Rose Horton Elizabeth Howell Jacqueline Hrobak Kelly Eileen Hughes Lauren Hummel Jennifer Hunt, PA-C Jackson Mark Hylton*Brian Ingram Emma Victoria Jarman Clifton Rupert Jenkins-Houk Allen Jewell Ariana Jones Charles V. Jones Anita Ann Joseph, D.O. Caroline Elizabeth Joseph Suraj Jay Kabadi, M.D. Serena Kalish Chadwick Kanney Francis Kelleher, PA-C Peter John Kemp, M.D. Tyler B Kemp Wilton C. Kennedy, PA-C Heath Kershaw Rajkamal S. Khangura, M.D. Brenda R. Kiessling, M.D. Shannon Kim Lara Watson Knowles*Edward G. Koch, M.D.*Hazle S. Konerding, M.D.*Karsten F. Konerding, M.D. Hannah Elizabeth Koontz Gift Kopsombut Arun Krishnaraj, M.D.

Scott Kruger, M.D. Julian Lagoy Reed Larson Walter Lawrence, M.D.*Kevin Leaman Kelly LeDoux Maxine Mae Lee, M.D., M.B.A. Joshua David Lesko, M.D. Shoshana Tovah Levi Margaret Li Brook Libby Stephanie Lin Philip Louden George Luzaich Stuart F. Mackler, M.D., FACS David W. MacMillan, M.D. Rhoda B. Mahoney, M.D. Mark Gordon Malkin, M.D., FRCPC Mary Mann Andrew Mann Salvatore Manzella Stephanie Lynn Marcy, D.O. Emily Marquina Laurel Marsac Michael Scott Martin, M.D.*Michael Mathews Andrew Arthur Matz, M.D. Amanda Mauck Anita Marie Maybach, M.D. Ibe O. Mbanu, M.D., M.B.A., M.P.H.*Julia McAdams Mia McDonald Charlotte Ann McKnight, M.D. Naureen Mehdi Monica Nierle Melmer S. Hughes Melton, M.D., M.B.A., FAAFP Catherine Meyer Hinda Yasmin Mezaache Thomas K. Miller, M.D.

April 2016 9

10 www.msv.org


Kyle Eric Miller, M.D. Brandon Heath Mitchell, M.D. Thomas Lee Moffatt, M.D. Mark Brown Monahan, M.D. Jose M. Morey, M.D. Steven Gabriel Moylan, D.O. Kelly Mulhern Lauren Murphy Biran S. Myer, M.D. Allysa Nagy Mohit Nanda, M.D. Brandi Tamara Nicholson, M.D. Aradhya Nigam Emily Ann Nilson Morgan Nowak, PA-C Daniel Andrew Ortiz, M.D. Jonathan Osborn Joseph M. Otonichar, D.O. Lee Ouyang Jefferson Willard Overlin Bhushan H. Pandya, M.D.*Diane Elise Pappas, M.D., J.D. Sara Park Todd Allen Parker, M.D. Judy Pascarella Jeevan Paul David Paulk, PA-C, Ed.D., DFAAPA Joseph J. Pechacek Edilberto O. Pelausa, M.D., FACS, FRCSC Scott David Pennington, D.O. Cat Perry James A. Pickral Meredith Craig Pinsker, M.D.*Patricia Ann Pletke, M.D. James Plews-Ogan, M.D. Annie Poetker Stephanie Pond Elyse Pope Pradeep K. Pradhan, M.D., FACP

Lauren Price Susan Prizzia, M.D. William E. Prominski, M.D. Rebecca Lynn Puetz Kenneth Deng Qiu Rachel Quinn Rachel Quist Helen Nwanganga Ragazzi, M.D. Timothy Lee Raines, M.D. Rajesh Ramanathan, M.D. Robert Ramsey, CAE Sterling N. Ransone, M.D., FAAFP Hirza Raza William C. Reha, M.D., M.B.A. Matthew Patrick Rhames, M.D., FAAEM Joel Riemer Jacob Foster Riis, M.D. Fareed Rahman Riyaz, M.D. Jillian Robideaux Kaitlin Roehl Barry Edward Roper, M.D. Amy Rosenblum Effe Rosenzweig Brianna Rosskamp Emiko Rubin Carl Thomas Rudebusch Rhonda Runion Jordan Russo Annie Rose Rutherford, PA-C, M.S.P.A.S.* Frances Saccoccio Jenna Sackenheim Julia Saddington, PA-C Omar Amin Salman Marie Anne Sankaran Raval, M.D. Kathleen Scarbalis, PA-C, M.P.A.S*Jonathan Tyler Schaaf, M.D. Ryan K. Schlobach

Brittany Schneider James John Schuster, M.D. Megan Schweid Kevin Robert Scott, M.D. Jessica Scudder Aimee Perron Seibert*Patricia W. Seo-Mayer, M.D. Nirish S. Shah, M.D. Jacob Shank Carol S. Shapiro, M.D., M.B.A. Timothy Roddy Shaver, M.D. Ginny Lee Shelton, M.D. Joseph Sikorra Jenelle Sills Austin J. Sim Kara Sims Jessica Sites Ashley Woolfolk Skelly, PA-C Jonas Preston Slackman Stephanie Smith Mark Robert Sochor, M.D., FACEP Rajesh Sood Katharine Noble Sourbeer Adam Wayne Specht, M.D. Mikayla Sroder *Kevin Staggenborg Keith Richard Stephenson, M.D. Katherine Sterner Rebekah Miller Stovall Dibya Subedi Alyssa Suchar Donald M. Switz, M.D. Richard Alexander Szucs, M.D.*Nehal Thakkar, M.D. Eric Mark Tirnauer, M.D. Ife Torrence Donald Scott Trawick Elissa Trieu Ashley Tromblay John Henry Unkel, M.D., M.P.A.,

D.D.S. Kathryn Vasco Mark Edward Vaughn, M.D. Arthur J. Vayer, M.D. John Paul Verderese, M.D. Anthony Joseph Viti, M.D. Alan Lewis Wagner, M.D., FACS*Susan Jervey Waller, M.D. Kenneth William Waller Alexandra Christine Walsh John David Ward, M.D., M.S.H.A. Gerald Robert Weniger, PA-C Savannah White D. Calloway Whitehead Kathryn Williams Reagan Williams Rhonda Williams Andrea Willis Savannah Wills Charles H. Wilson Elizabeth R. Wolf, M.D., M.P.H. Patrick James Wolfgang, M.D. Patrick M. Woodward, M.D. Alan Howard Wynn, M.D., FACP Jie Xu John Gerald Yassin, M.D. Daniel J. Young, M.D. Chi Young, M.D. Leigh Anne Young, M.D. Kirsten Alyse Zimmerman

April 2016 11


Why Come to White Coats on Call?By Sara Rose Wells, Assistant Director of Government Affairs

If you’ve never had a chance to attend one of our WCOC days, let some of our 2016 attendees tell you in their own words why they choose to participate!

“It was an awesome experience for my residents and also for me. I found it incredibly valuable to experience firsthand how important decisions are made about health care policy and speak directly to the representatives about current bills that impact physicians in Virginia. I highly recommend this experience—we plan to be back every year.” —Amber Fedin D.O., Family Medicine Residency Program Director, Danville Regional Medical Center

“Decisions made in Richmond during legislative session directly impact our careers, how we practice, our patients and the future of our profession. It is so important that the legislators hear from us as they are making decisions on laws related to healthcare and medicine. Every year I attend MSV’s White Coats on Call days because I can make a bigger impact by being part of a unified group of physicians. The more of us who speak up together, the more they will hear our message!” —Sandy Chung, M.D., FAAP, FACHE, Director, District 10

“Before coming to PA school, I would have never thought that I would be able to go to the capital and lobby for things that matter to our profession (or lobby for anything for that matter). Politics, talking with people of authority, and speaking up for things that matter intimidate me, and I typically shy away from opportunities that involve these things. I actually really enjoyed the experience and would like to continue doing lobbying in some form in the future. That day I learned that the world is run by the people who show up. I realized that my voice does matter and I can make a difference by speaking up for the PA profession and health care in general. As a person who tends towards being shy, I learned that being assertive and advocating for my profession is not only something I am perfectly capable of doing, but I also enjoy doing. I look forward to more opportunities in the future!” —Liz Howell, PA Student, Shenandoah University class of 2017)

“It was an amazing opportunity to be a part of White Coats on Call and the physician/student advocacy boot camp. Not only did it reinforce the importance of being politically active, it also gave me the resources and tools about how to do so. I was able to learn from fellow classmates, other MSV medical students, residents, and physicians as to why advocacy is so important, while at the same time getting firsthand experience speaking with legislators.” —Jess Fugate, M1, VCU School of Medicine

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12 www.msv.org


Following MSV’s strategic plan, RISE, the medical student section (MSS) is facilitating the involvement of medical students as leaders in health care. Committed to advancing MSV’s legislative agenda, the medical student section created an expanded emphasis on engaging in the legislative process. Students participated with physician leaders in an advocacy workshop prior to White Coats on Call, started grassroots e-mail campaigns with their peers by utilizing MSV’s Legislative Action Alerts and provided testimony during a Senate subcommittee meeting.

Not all of the medical students who engaged in these activities and events were initially passionate about legislative policy. For many, this was their first exposure to the government affairs arena. Each student had their own motivating factors for engaging, such as social reasons, networking, leadership or a deep passion for health policy. Regardless of what specifically brought them to the General Assembly, students left their experience noting how important participating in the process is for the profession.

Here is what some of the students had to say:

“I think that patient and physician advocacy through activities like White Coats on Call and speaking at subcommittee meetings should be an integral part of physicianhood and zealously advocating for one’s patients. No matter the ability or empathy of a physician, he or she can only do so much good within a broken system. It is only by working at the macro level, in addition to the micro level, that patient care can be truly optimized. Securing additional GME funding, which has more or less been frozen federally since 1996 and preventing the establishment of so-called “associate physician” will help to ensure that patients throughout Virginia will continue to receive the highest quality of care from fully qualified physicians. While the prospect of speaking with delegates and senators initially seemed intimidating, the support from the MSV put me at ease when the time came and allowed me to advocate effectively on behalf of patients and physicians throughout the Commonwealth.” —Austin Sim, UVA MD/JD candidate

“Participating in White Coats on Call was great. As students, we had unparalleled access to our physician mentors. I spoke to about 10 of them at length. They were funny, their advice was heartfelt, and their stories were full of surprises. The legislation being discussed in the General Assembly building has the potential to change how we practice just as much as the next drug being developed in the lab, so it is important to me that, as the future of medicine, our voice is heard. My peers and I had plenty to talk about on the way back to VCU from the General Assembly building. I was stopped in between classes at least a dozen times that week by students who wanted to know what it

was like, what was said by whom, and where they could learn the latest update on the bill. I really enjoyed getting that inside look on how government makes its decision.” —Nam Duong, VCU M1

“I attended White Coats on Call, a truly exceptional experience where we were able to lobby for increase graduate medical education funding and engage in productive conversation concerning legislative action to continue to improve patient care and the health care field. White Coats on Call is just one example of the wonderful opportunities MSV has to offer and I am excited to continue to be involved with MSV as I continue my journey to becoming a physician!” —Kami Arulraja, VTC M2

“White Coats on Call was a great experience for me. I was surprised that we were talking directly to the legislators, giving a face to all of the emails that we had been sending out. What I found most interesting was that the legislators knew almost nothing about the issues we brought about. I always think of our representatives to be all-knowing in order to appeal to their diverse constituents. However, none of them were well versed in medicine and health care, so we were in fact very helpful in proving why our issues are relevant to every Virginian.” —Ryan Schlobach, EVMS M1

“As a first-year medical student, I’m excited to respond to legislative action alerts and to demonstrate my opinion at the VA General Assembly because I consider it a vital part of my medical education as an aspiring physician leader. From standing with my peers in opposition to HB 900, for example, I’ve already learned how efficacious sharing our professional experiences can be in the legislative decision-making process; I was pleased to see the great extent to which our Senators valued our feedback and insight! It’s been empowering to exercise my voice as a future physician through MSV, and it’s even more exciting to know that I’m learning to affect change in health policy. My involvement now helps me feel assured that I’ll be prepared to advocate for my patients and for the future direction of the health care system as I grow as a physician leader.” —Emily Schutzenhofer, UVA M1

Medical student advocacy spotlightsMark Hylton, a 4th year medical student at Virginia Commonwealth University School of Medicine, went above and beyond in his advocacy efforts this year. On top of attending three White Coats on Call days, he went back to the General Assembly two additional days to sit in the House and Senate chambers to listen to the floor discussion. His admirable engagement with MSV’s legislative efforts and personal commitment to drive positive legislative health care changes are to be commended.

Continued on page 14

Medical Students, Leaders in Health CareBy Jenny Young, Engagement Manager

April 2016 13

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Manage My Pratice


The Medical Society of Virginia (MSV) is excited to introduce its newest member resource, the MSV Marketplace! Our Marketplace is a preferred vendor program where we research, assess and recommend products and services to our members. Vendors included in the program have to successfully complete a comprehensive application process and offer exclusive rates and superior service on competitive solutions for MSV members.

MSV is proud to announce the following inaugural vendor participants in the MSV Marketplace:

• LendKey, a free service for use by college graduates to compare new student loan refinancing rates• VA Drug Card, a program launched to help lower out-of-pocket prescription costs• Total Merchant Services, a national merchant bankcard business that employs smart card technology• HIPAA Secure Now, a provider of HIPAA compliance services specializing in working with ambulatory medical practices• iMedicor, a national provider of comprehensive secure communications solutions for the health care community• 1st Healthcare Compliance, a comprehensive compliance program management solution for health care providers• Digital Benefit Advisors, provider of life and health insurance solutions• 1752 Financial, a provider of long term care, disability and life insurance products• MSVIA, the insurance agency of MSV, providing property and casualty services through highly rated AM Best companies,

along with the best resources possible for employee benefits and for life and disability insurance needs

The Marketplace just launched at www.msv.org/msvmarketplace. Included on the site are details of each vendor as well as specifics regarding the negotiated rates and benefits for MSV members. If you have any suggestions for who MSV should solicit to participate in the MSV Marketplace or if you have any questions regarding this new member offering, please contact Business Development Director Dustin Beekman at [email protected] or 804 | 422-3100 x1006.

Medical Students - continued from page 12Having the opportunity to network with colleagues and attendings, learn about health policy, and lobby with my Virginia Delegates and Senators was icing on the cake for a month long elective health administration and policy rotation. All of our elected officials enjoy speaking to their constituents, especially students, as they are able to learn a ton of information on topics they may have only been briefed on by their legislative assistants. Being an active member in MSV and health policy in general is very important as our elected officials go to bat for us when we feel health policies need changes or reform. I recommend that every physician and soon to be physician become active and do your part as a Virginian.” –Mark Hylton

Matt Wallace, a 3rd year medical student at Virginia Commonwealth University School of Medicine, spoke on behalf of the medical student section providing testimony opposing HB 900 in front of the Senate subcommittee on health professions. HB 900 was a bill to create a new category of licensure for “associate physicians”. During Matt’s testimony, he expressed the medical student section’s appreciation for the legislature recognizing the plight of medical students, but tactfully pointed out that the “associate physician” proposal moves the system in the wrong direction. He also used the opportunity to express the need for Virginia’s legislators to focus on enhancing and expanding residency programs in the Commonwealth.

“Advocacy is an important aspect of MSV and as medical students it is essential we get involved, especially regarding policies affecting our patients and practice as future physicians. Providing testimony at the Senate Health Professions Subcommittee was a wonderful experience and reinforced my belief that we as medical students have an influential role in the political decision making process. The sub-committee was particularly interested in hearing from a student’s perspective and we articulated our position very well. It was an enjoyable experience with lively debate. Several legislators after the meeting commented on how impressed they were with our representation. This speaks volumes to the strength of our medical student section. This experience highlights the importance of getting involved as a medical student. I learned from this experience that even as a student, you can make a large impact on the future of healthcare in the Commonwealth.” —Matt Wallace

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WE ARE UNWAVERING IN OUR MISSION TO DEFEND, PROTECT,

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16 www.msv.org

Care for my Patients

By Lynne Hughes, MSVF Director of Development and SYNC/evolve speaker on burnout prevention and work-life balance

As physicians, you are faced with a daily onslaught of stress and pressure. You are also constantly giving yourselves to others, from administering your expert medical care, to listening and nurturing others. These circumstances make it easy for you to get depleted, neglect your own health and wellness or worse—experience professional burnout. It is important to make sure you take time for yourself for your own wellness and health. In doing so, you will also set an example for your co-workers and staff in order to help them stay balanced and avoid burnout, too. Listed below are some simple tips and strategies:

Take action with daily coping strategies: • Step outside/walk the parking lot• Eat lunch outside the offi ce• Take fi ve minutes for yourself• Call a loved one• Chat with a colleague about something unrelated to work• Post favorite quotes in a visible place as reminders• Refl ect on a funny or happy memory• Focus on a future activity such as a vacation or an upcoming fun event• Plan for times you know you will be “out of balance” and take special care of yourself• Holidays • Major life transitions (i.e. death, divorce, wedding, baby, move, new job)• Vacations• Professional conferences, exams and meetings • Year-end school activities (if applicable)• Practice mindfulness by keying in on the “now,” being present and paying attention to whatever it is you are currently doing• Schedule time for yourself at least once a week in order to do something just for YOU

Know what you DO have control over:• Where you work• Who you work for• Attitude• Ability to practice self-care• Relationships with others• Capacity to implement balance in your life• Level of resiliency and willingness to adapt (or decide not to change)

Prosper! Flourish! - How MSV Classes and Audits Can HelpBy Hedi Cho, Communications Manager

Are you taking advantage of all of the benefi ts and services that the Medical Society of Virginia (MSV) off ers you, its members? More than anything, MSV wants to help you succeed in the business side of medicine. We off er you pertinent classes, audits and resources so you can get the tools and answers you need to succeed in practicing medicine and providing quality care.

What can MSV do?MSV off ers the following courses in Richmond this summer. Register now to reserve your spot in these popular courses at www.msv.org/classes.

• Professional Medical Coding Curriculum Course (PMCC)• Certifi ed Professional Biller (CPB™)

Continued on page 20

Simple Strategies to Avoid Burnout

18 www.msv.org

MSV news


The Medical Society of Virginia (MSV) cannot achieve any of its legislative successes without you. We want to hear your top priorities for MSV’s 2017 legislative agenda. Your input is critical to our advocacy eff orts.

This year’s summit will be held on:

May 13, 20162:30 p.m. to 5:00 p.m. MSV headquarters2924 Emerywood Parkway, 2nd FloorRichmond, VA, 23294

If you have an idea that you would like to be considered as part of MSV’s 2017 legislative agenda, you simply need to submit a proposal online at www.msv.org/legislativesummit by April 29. All MSV members, local medical societies and specialties are encouraged to submit proposals. To submit a proposal, please visit www.msv.org/legislativesummit, by April 29th. In order for your proposal to be heard at the legislative summit, you must present in-person at the summit or send a designee on your behalf. Get involved now by registering to attend the Legislative Summit.

After the summit, MSV’s Legislative Committee reviews the input provided and prioritizes issues for possible legislative initiatives based on MSV policy, available resources and the current political landscape. The issues are then presented to MSV’s Board of Directors for fi nal consideration. Visit www.msv.org/legislativesummit to register, submit a proposal and see our Frequently Asked Questions.

Impact 2017 and Beyond – Share your ideas at MSV’s Legislative Summit

for MSV to pursue in 2017?Submit a legislative proposal at www.msv.org/legislativesummit.

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The Virginia Medical News Spring Issue, April 2016 (ISSN 1532-8058) is published four times a year by the Medical Society of Virginia, 2924 Emerywood Pkwy., Ste. 300, Richmond, VA 23294 for members of the Medical Society of Virginia, a non-profi t organization with membership devoted to the advancement of the medical profession in Virginia. Periodicals postage paid at Richmond, VA and at additional mailing addresses. POSTMASTER: Send address changes to Virginia Medical News, 2924 Emerywood Pkwy., Ste. 300, Richmond, Virginia 23294.

This association is not responsible for the authenticity of opinion or statements made by authors or advertisers, or in communications submitted to Virginia Medical News. Advertisers must conform to the policies and regulations established by the Medical Society of Virginia. The Virginia Medical News is a member subscription and payment is included in annual dues. Copyright 2016. Medical Society of Virginia.

Presented by:

Member ResourcesGet the most out of your involvement with MSV by taking advantage of our many valuable resources, publications, educational

opportunities, professional services and practice management tools. Most of these services are available to only MSV members so please join today to enjoy these exclusive benefits.

Free resources• Practice Services helpline

800 | 746-6768, EXT 1060 • Member information center

800 | 746-6768, EXT. 1050 for questions regarding membership

• Relationship staff • JobBoard

www.msv.org/jobboard• Physician Directory• Health plan hassles

www.msv.org/hasslefactor

Leadership• Committees and task forces • House of Delegates and Board of

Directors

• State leadership opportunities

Information• Grassroots action center

www.msv.org/grassrootstoolkit• MSV Legislative Updates, MSV

E-News, Virginia Medical News, Practice Services Updates www.msv.org/publications

• Issue backgrounders • Knowledgebase

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Events• White Coats on Call lobby days • Advocacy boot camps • MSV Annual Meeting • Medical student section events

Education• evolve™ • SYNC

Discounted• Coding webinars and classes

www.msv.org/classes• Local consultation

Additional services• Property & casualty insurance • Life & health insurance• DOC Rx Relief

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April 2016 19


MSV news

By Lynne Hughes, MSVF Director of Development

Who “wows” you with their efforts in volunteering and contributions to the medical profession? The MSVF Salute to Service Awards honors phenomenal physicians and medical students with Salute to Service Awards in the following categories:

• Service to the Profession • Service to the Uninsured and Underserved • Service to the International Community • Service by a Medical Student or Resident • Service to the Commonwealth for Advancing Patient

Safety and Quality Improvement

Share their stories and help MSVF give them a salute! Nominating is easy – simply complete the online form by clicking here. MSVF staff is also available to help guide you through completing the form or answer any questions. Email [email protected] or call 804-377-1047.

Winners will be recognized with a wonderful tribute at this year’s Physicians’ Gala during the Annual Meeting at the Hotel Roanoke and Conference Center on Oct. 15. The awards are sponsored by The Doctors Company.

For additional information, call 804 | 377-1053 or e-mail [email protected].

MSVF Salutes Exceptional Physician Leaders

It’s easy to nominate someone! Simply complete the online form at: http://foundation.msv.org

20 www.msv.org

MSV Classes and Audits - continued from page 16If you don’t have room in your schedule to fit in one of our classes, MSV also offers specially-priced medical chart reviews, documentation audits and coding assessments. We help practices determine if they are correctly following guidelines from the Centers for Medicare and Medicaid Services (CMS) and other payers for appropriate billing. These reviews help strengthen the financial health of the practice and offer protection from the risk of audits with medical chart reviews.

MSV’s assessments provides practice with the opportunity to identify areas of improvement in the documentation, coding and billing processes as well as areas to use national best practices. The chart reviews include:

• quality review of each chart’s documentation and coding by a certified professional medical coder;• detailed audit report of the findings along with recommendations and cross references to coding guidelines; and• consultative session to review the audit report and provide training and education based on the findings.

With our assessments, MSV helps your practice determine if there have been any inaccurate coding or any other weaknesses in medical record documentation that may expose it to problems with payers. For more information on our consulting services, please visit www.msv.org/practiceservices. Please note that coding assessments are offered as consulting services at special rates to individual MSV members and practices with at least 50 percent membership. Please contact us at [email protected] or 800 |746-6768 if you have any questions.

’

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April 2016 nl

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