Vital Signs June 2012

June 2012 • Vol. 34 No. 6Official Magazine of

FRESNO COUNTYFresno-Madera Medical Society

KERN COUNTYKern County Medical Society

KINGS COUNTYKings County Medical Society

MADERA COUNTYFresno-Madera Medical Society

TULARE COUNTYTulare County Medical Society

June 2012 • Vool. 34 No. 6

Vital Signs

See Inside:

Steps to Avoid Medicare E-Prescribing Penalty

Risk Management Discounts Offered

FMMSGoes to Washington

2 JUNE 2012 / V ITAL S IGNS

S A N D I E G O

O R A N G E

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VITAL S IGNS / JUNE 2012 3

Official Publication of

Fresno-Madera Medical Society

Kings County Medical Society

Kern County Medical Society

Tulare County Medical Society

June 2012Vol. 34 – Number 6

Editor, Prahalad Jajodia, MDManaging Editor, Carol Rau

Fresno-Madera Medical SocietyEditorial CommitteeVirgil M. Airola, MDJohn T. Bonner, MDHemant Dhingra, MDDavid N. Hadden, MDRoydon Steinke, MD

Kings RepresentativeTBD

Kern RepresentativeJohn L. Digges, MD

Tulare RepresentativeGail Locke

Vital Signs SubscriptionsSubscriptions to Vital Signs are$24 per year. Payment is due inadvance. Make checks payable tothe Fresno-Madera Medical Society.To subscribe, mail your check andsubscription request to: Vital Signs,Fresno-Madera Medi cal Society,PO Box 28337, Fresno, CA 93729-8337.

Advertising Contact:Display:

Annette Paxton,[email protected]

Classified:Carol Rau,

559-224-4224, ext. [email protected]

ContentsVitalSigns

Vital Signs is published monthly by Fresno-Madera Medical Society. Editorials and opinion piecesaccepted for publication do not necessarily reflect the opinion of the Medical Society. All medicalsocieties require authors to disclose any significant conflicts of interest in the text and/or footnotes ofsubmitted materials. Questions regarding content should be directed to 559-224-4224, ext. 118.

EDITORIAL..................................................................................................................................5

CMA NEWS ................................................................................................................................6

NEWS

AMA E-PRESCRIBING: Must Act Now to Avoid the Medicare Penalty ............................................9

NORCAL: Risk Management Discounts & Overall Rate Decreases ............................................11

INSURANCE: Looking for Cost Effective Life Insurance ............................................................12

AIR QUALITY: FMMS in Washington ........................................................................................13

CLASSIFIEDS ...........................................................................................................................18

CME ACTIVITIES .......................................................................................................................18

FRESNO-MADERA MEDICAL SOCIETY .......................................................................................14

• President’s Message

• In Memoriam: David Shuster, MD

• Educational Series for FMMS Members

• CME Activity: Diagnosis & Management of Pulmonary Arterial Hypertension

KERN COUNTY MEDICAL SOCIETY ............................................................................................16

• Membership News

TULARE COUNTY MEDICAL SOCIETY.........................................................................................17

• Appeals, Refunds & Recoupment Requests Course Offered

Cover photography: “The Charming Couple,” red shouldered hawks in Sanger, Californiaby Howard Terrill, MD

Calling all photographers:Please consider submitting one of your photographs for publication in Vital Signs. – Editorial Committee



For individuals in these tough economic times, there seems to beless money available for things we need and want. Thegovernment is in a similar situation – less taxmoney and continuing and expanding costsfor goods and services they would like toprovide. The deficit is up, and we are goingdeeper into debt. Those within governmentand those receiving government services andfunds are looking for more money and notwanting to cut back on governmentprograms, knowing the deficits cannotcontinue to go up and up and up.

The Obama and Brown administrations have pushed raisingtaxes on “the rich” so that “they pay their fair share.” Analysis ofthe economics clearly shows that there are not enough “veryrich” people to put a significant dent in the deficits. Data alsoshow that the “rich” pay an extremely large percentage of thetotal federal income tax burden.

The conservatives argue that it is the “rich” that operate theprivate business sector, which employs workers and generatesprofits that support income taxes both through their own andtheir workers’ incomes. There is also clear evidence that if theincome taxes are too high, businesses will not take otherwiseworthwhile risks in expanding their businesses, since the returnafter taxes for their risk is not enough to justify the risks (allbusiness expansion has some risk).

No one knows how high income taxes have to get to stiflebusiness, but evidence from the past suggests any substantialincrease will have negative economic effects. It must beremembered that it is the private business sector, not thegovernment, that generates the true economic activity on whichour entire society depends.

This is the dilemma that has Congress in a log jam. We wouldlike more government funds available, but we won’t get there bydecreasing the activity of the business sector.

I have a proposed solution: Find a different tax that would notstifle the economy. For a long time we have had “sin taxes” ontobacco and alcohol. This generates money while keeping “badbehavior” down. I would suggest a tax on securities transactions –stocks, bonds, derivatives, options, etc. I believe that a relativelysmall percentage tax on such transactions would generatesignificant funds for the government. What is the downside? TheWall Street bankers, stock brokers, and speculators would findtheir business depressed. What a shame. As a conservative I

think this is a good idea. The Occupy Wall Street people oughtto like it also. Liberals should like it too.

I would propose a small tax,perhaps one percent, on alltransactions. This would notprevent investment in businesses,if it is a small percentage. Youcould still buy stocks and mutualfunds, etc. for investments, butfrequent buying and selling wouldtend to eat up your money.Buying and selling of stocks needsto be preserved. This is importantfor funding business start-ups andexpansion and needs to bepreserved. But speculation is not.

What this proposal wouldlimit are those “traders” andspeculators that are constantlybuying and selling. I view thesepeople as gamblers – they buy andsell pieces of paper and producenothing useful for society. Theysit in their glass offices, generatelots of paper, and think they areimportant people doingimportant work. All their moneygains come at someone else’s

expense. Their profits result in decreased return to legitimateinvestments – their money has to come from somewhere.Legitimate investments that fund new companies and businessexpansion would continue, as well as reasonable selling ofinvestments – this proposal would just discourage buying andselling frequently. If day traders and speculators want to engage ingambling they should have the decency to go to a Casino and doit honestly.

I don’t know what the proper tax rate should be: low enoughthat legitimate investment is not stifled but high enough todiscourage this harmful activity and generate some needed fundsfor proper government activities. I would hope that such aproposal could break the log jam in Congress and work to thebetterment of our society – not kill the goose that lays the goldenegg (business).

– Charles H. Touton, MD

Charles H.Touton, MD

IT MUST BEREMEMBEREDTHAT IT ISTHE PRIVATEBUSINESSSECTOR, NOT THEGOVERNMENT,THAT GENERATESTHE TRUEECONOMICACTIVITY ONWHICH OURENTIRE SOCIETYDEPENDS.

EDITORIAL

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GOVERNOR BROWN’S MAY REVISION2012-13 BUDGET PROPOSALGovernor Jerry Brown released his MayRevision of his January budget proposal.The total funding shortfall has increased to$15.7 billion, up from $9.2 billion inJanuary. This will be filled through thefollowing sources:

• Spending Reductions ($8.3 billion, upfrom $4.1 billion in January)

• Revenue Increases ($8.5 billion with aGeneral Fund ‘net’ of $5.6 billion, upfrom $5.1 billion in January)

• Other Sources/Funding Shifts ($2.5billion, up from $1 billion in January).

Issues of Concern to PhysiciansChanges to the Governor’s Proposed‘Coordinated Care Initiative’ for DualEligibles

The May Revision proposes to reducethe number of counties in the expandedDual Eligibles/Mandatory Managed Carepilot program from 10 to 8. The initial 4counties are Los Angeles, Orange, SanMateo and San Diego. In January, theGovernor proposed to add an additional 6counties (San Bernardino, Riverside, SantaClara, Contra Costa, Alameda andSacramento); now only 4 will be included.It is not yet public which two counties wereremoved from the demonstration

The effective start date for the transitionhas been moved from January 1st, 2013 toMarch 1st, 2013. However, this will notimpact the Open Enrollment period,during which Dual Eligible patients in thepilot counties may elect to ‘opt out’ of theshift into Medicare Advantage/managedcare. That open enrollment is still proposedto begin on October 1, 2012 and, despitethe extension of the pilot’s start date, willstill end on December 31, 2012.

In addition, the total amount scored insavings for this proposal has been reducedfrom $678.8 million in the 2012-13 budgetyear to $663.3 million, and down from $1billion to $887 million per year in the outyears, once the program is fullyimplemented. CMA opposes expandingthe duals pilots projects beyond the fourcounties authorized in law.

Healthy Families ProgramRate Reduction Still in Place

The January budget proposed to shift

CMA NEWS

Please see CMA News on page 7


gap between the $9.2 billion shortfall projected in the Januarybudget, and the $15.7 billion shortfall facing the state today uponrelease of the Revision. Details on the new cuts, revenues, andfund shifts are below.

Additional Spending Reductions:• Local trial court support – shift to local fundsfor state General Fund savings: ...........................$544 million

• Hospital and nursing homeMedi-Cal reductions: ...........................................$396 million

• Reducing In Home Supportive Services/IHSS hours by 7 percent: ......................................$99 million

• Altering funding formulas for theCalGrant program:.................................................$38 million

• Reducing state employee compensation by 5%: ...$402 million• National Mortgage Settlement proceeds7used to offset General Fund costs:....................$292 million

• Transferring cash assets previously held by redevelopmentagencies to the state:...........................................$1.4 billion

• Proposition 98 (K-14 education funding) adjustments:$1.5billion

TOTAL ...................................................................$4.67 billionAdditional Revenue Increase

Governor Brown’s temporary tax increases will be placed on theFall 2012 General Election ballot. The proposed initiativeincreases the State Sales Tax by one-quarter cent for four years. Italso increases the Personal Income Tax by 1% for those earningbetween $250,000 and $300,000; 2% for those earning between$300,000 and $500,000; and 3% for those $500,000 and above.

The proposed initiative would generate to $8.5 billion. $2.9billion of that amount will be set aside for schools and communitycolleges (K-14 education), leaving a remainder of $5.6 billion forthe state General Fund. This is an increase of $500 million overthe amount the initiative was slated to generate in January.

Other Sources/Funding Shifts• Loan Repayment Extensions: ................................$1.2 billion• Transfers and Loans from Special Funds: ............$612 million• Additional Weight Fee Revenues:.........................$385 million• Unemployment Insurance Interest Payment: ........$312 million• Other: ..................................................................$49 millionTOTAL.....................................................................$2.5 billion Contact: Carolyn Ginno, 916-551-2547 or [email protected];

David Ford, 916-551-2554 or [email protected]

HIGHEST MATCH RATE FOR U.S.MEDICAL SCHOOL SENIORS IN 30 YEARSMore than 95 percent of U.S. medical school seniors – the highestrate in 30 years – were matched to residency positions according tonew data released on March 16, 2012, by the National ResidentMatching Program (NRMP).

Part of the reason the match rate was so high this year was thedebut of the Supplemental Offer and Acceptance Program(SOAP), according to the NRMP. Developed to replace the“scramble” from previous years, SOAP is an automated processthat makes available the locations of unfilled positions sounmatched students can submit applications for these positionsthrough the Association of American Medical Colleges ElectronicResidency Application Service (ERAS).

After receiving applications through ERAS, residency programdirectors create a list of candidates in order of preference. TheNRMP then offers positions in that order in a series of up to eightrounds. Applicants are able to receive multiple offers in a single


CMA NEWS

Healthy Families program enrollees into the Medi-Cal program,and also reduce the rate paid to health plans for each beneficiary.The total savings scored for this shift was $64.4 million. TheRevision maintains the Administration’s commitment to cuttingthe rate paid for covering these individuals, but adjusts themonthly per-member per-month amount upward to $83.91 from$76.86. The current rate paid to Healthy Families plans is closer to$103 per-member per-month. This reduces the savings scored fromthis rate reduction to $48.6 million.

The May Revision continues the Governor’s proposal toeliminate the Healthy Families program over time and transitionthe children into Medi-Cal managed care. CMA has endorsed aproposal developed by AAP and others to transition only thosechildren who will move into Medi-Cal as a result of federal healthreform (the “Bright Line” children).

Potential Increase in Emergency Room Copayments in Medi-CalThe May Revision assumes the collection of copayments of $15

for nonemergency use of the ER, as well as $1-$3 copayments forpharmacy services. These proposals are scored for $20.2 million inGeneral Fund savings in 2012-13. Existing law contains authorityfor providers to collect $5 copayments for nonemergency use of theER, but it is not required, and the funding is not remitted to thestate. Proposition 10 Funding Reduction

The May Revision proposes to shift $40 million from the First5 California Children and Families Commission to the state’sGeneral Fund to fund Medi-Cal services for children under the ageof five.

Physicians’ Advocacy Drives Change in the Governor’s BudgetA portion of the increased shortage in the state’s financial

shortfall is directly attributable to CMA’s legal and advocacyefforts. The May Revision contains an increase in state costs of$245.5 million in 2011-12 and $174.6 million in 2012-13 as aresult of court ruling preventing Medi-Cal provider paymentreductions. In addition, the Revision includes an increase in statecosts of $555.3 million in 2012-13 as a result of the federalgovernment’s denial of the state’s efforts to impose copayments onthe Medi-Cal population for physician services, pharmacy services,hospital inpatient stays and other services.

Timelines and Next StepsNow that the Governor has released his May Revision budget

proposal, the Budget Committees in both houses of the Legislaturewill be meeting regularly over the coming weeks in order to finalizework on the budget bills. CMA will be actively lobbying againstreductions to health care programs and will inform members andstaff as appropriate.

The Governor’s temporary tax initiative will appear on theNovember 6, 2012 General Election ballot. CMA is officiallysupporting the initiative in an effort to eliminate the state’songoing structural deficit and the negative impact it has on vitalpublic programs such as Medi-Cal.

Filling the Gap – How the Additional Budget Shortage is Met Although they don’t directly impact the physician community,

the May Revision includes additional ‘savings’ needed to fill the

Continued from page 6


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round; if an offer is accepted, it is binding.This year, 1,246 residency positions

were available after applicants whomatched were notified. During SOAP,residency programs offered 1,131 of thosepositions and only 152 remained availableat the conclusion of three offer rounds.

The total number of applicants in thisyear’s Main Residency Match was 38,377.These students applied for 26,772positions. The positions included 146 inchild neurology, which joined the Matchfor the first time this year. Internalmedicine, anesthesiology and emergencymedicine saw the largest increases; withemergency medicine filling every availableposition. The number of family medicinepositions increased only slightly (1.1percent) following notable increases overthe last two years.Specialty trends

• Dermatology, orthopedic surgery,otolaryngology, plastic surgery,radiation oncology, thoracic surgeryand vascular surgery were the mostcompetitive fields for applicants.

• Emergency medicine programs offered61 more positions and filled all 1,668available positions.

• Anesthesiology programs offered 78more positions, and U.S. seniors filled725 of the 919 positions offered.

PROBLEMS GETTING PAID?The California Medical Association’s

Center for Economic Services providesdirect reimbursement assistance to CMAphysician members and their office staff.Reimbursement Help Line(888/401-5911)

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CMA News




AMA E - P R E SCR I B I N G

Background on the Medicare e-prescribing penalty program

The Medicare Improvements for Patients and Providers Act of2008 (MIPPA) established a five-year Medicare incentiveprogram beginning in 2009, to promote the adoption and use ofe-prescribing by eligible professionals, including physicians. Thelaw also included a penalty phase beginning in 2012 that runsthrough 2014 for physicians who are eligible for the Medicare e-prescribing incentive payments but fail to e-prescribe.

In November 2011, the Centers for Medicare & MedicaidServices (CMS) released the final regulation on the 2013Medicare e-prescribing penalty program. The penalty for notsuccessfully participating in the program or not filing for anexemption on time is a 1.5 percent payment reduction for allMedicare claims based on the 2013 fee schedule amounts duringthe year.

Avoiding the 2013 Medicare e-prescribing penaltyPhysicians and other eligible professionals who meet the

following criteria will not be subject to the 2013 Medicare e-prescribing penalty. If you meet one of the following criteria, youwill automatically be excluded from the penalty and no action isrequired on your part:

• You are not an MD, DO, Podiatrist, Nurse Practitioner, orPhysician Assistant as of June 30, 2012.

• Office visits and other services listed in the CMS e-prescribing measure specifications represent less than 10percent of your allowed Medicare Part B charges in the firstsix months of 2012 (January 1, 2012 through June 30, 2012)(Link to CMS’ measure specifications at: https://www.cms.gov/ERxIncentive/06_E-Prescribing_Measure.asp#TopOfPage and click on 2012 eRx Measure Specifications,Release Notes, and Claims-Based Reporting Principles [ZIP475KB]).

• Less than 100 of your claims for Medicare Part B patientservices contain visit and service codes that fall within thee-prescribing measure specifications for dates of servicebetween January 1, 2012 and June 30, 2012.

In addition, if a physician (MD, DO) or eligible professional(podiatrist, nurse practitioner, physician assistant) has alreadytaken one of the actions described below, the 2013 e-prescribingpenalty will not apply:

• You e-prescribed using a qualifying e-prescribing system orcertified electronic health record (EHR) and submitted 10or more e-prescribing codes (G8553) on your Medicare PartB claim forms from January 1, 2012 and June 30, 2012, andthe claims were received and processed by CMS by no laterthan July 31, 2012.o Note: Unlike the e-prescribing incentive program and the

2012 e-prescribing penalty program, to avoid an e-prescribing penalty in 2013, you do not have to tie theelectronic prescription to a qualifying visit or service whenyou report on 10 e-scripts during the first six months of

2012. As long as you e-prescribed for a Medicare patientyou treated, you can report the G8553 code on theMedicare Part B claim on any Medicare service or visityou rendered for your patient.

• You do not have prescribing privileges and you reported theG-code, G8644, at least one time on a Medicare Part Bclaim prior to June 30, 2012.

More ways physicians can avoid the 2013 Medicaree-prescribing penalty by applying for a hardship exemption

The final rule provides a number of ways physicians can avoidthe e-prescribing penalty that is scheduled to begin on January 1,2013. Below are the significant hardship exemption categoriesyou can apply for to avoid the penalty:

• Your practice is located in a rural area without high speedinternet access.

• Your practice is located in an area without sufficientavailable pharmacies for e-prescribing.

• You are unable to electronically prescribe due to local, Stateor Federal law or regulation, (e.g., physicians who mainlyprescribe narcotics but because of state law cannot submitthese prescriptions electronically can apply for thisexemption category).

• You prescribe fewer than 100 prescriptions between January1, 2012 and June 30, 2012.

Physicians should take steps NOWto avoid the 2013 Medicare e-prescribing penalty

Step 1: Determine if you meet the above criteria that wouldexclude you from being subject to the eprescribing penalty.

Step 2: If you do not meet the exclusion criteria, determineif you fall under one or more of the above mentioned significanthardship exemption categories that would exempt you from the2013 Medicare eprescribing penalty.

Step 3: If you meet one or more of the exemption categories,file for an exemption that applies to your particular hardshipsituation no later than June 30, 2012, by using CMS’ on-line Web-based tool. This link takes you directly to CMS’ on-line hardshipexemption request page: https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234

A user manual is also available on-line at: https://www.qualitynet.org/imageserver/pqri/documents/2012_PQRS_eRx%20Communication%20Support%20Page%20User%20Manual.pdf

Step 4: When you apply on-line for an exemption, be sure toinclude the following information in your request:

• Identifying information such as the TIN, individual NPI,name, mailing address, and e-mail address of all affected eligibleprofessionals.

o Please make sure to supply your Individual (not Group)NPI number in the NPI field.

o When requesting a hardship exemption, you must enter thelast 6 digits of the Tax Identification Number (TIN) used to

Must Act NOW to Avoid the MedicareE-Prescribing Penalty That Starts January 1, 2013

Please see e-Prescribing on page 10


bill Medicare. If no TIN is available, the last 6 digits of theSocial Security Number used to bill Medicare should beentered.

o Note: It is very important that you verify that you haveentered the correct TIN and NPI information whenrequesting an exemption. Entering inaccurate informationmay result in denial of your hardship exemption request.

• The significant hardship exemption category that applies.• A justification statement describing how compliance with

the requirement for being a successful e-prescriber for the2013 Medicare e-prescribing penalty program during thereporting period resulted in a significant hardship to you.

• An attestation of the accuracy of the information provided.

Important things to note if you are applying for an exemptionAlthough physicians are required to apply for one exemption

category to avoid the penalty, CMS will allow physicians to applyfor one exemption and explain in their justification statement allof the exemption categories that apply to their particularhardship. There is no appeals process, so please make sure youapply for an exemption that is applicable to your situation. If youare not sure whether or not you successfully participated in thee-prescribing program, or you are not sure if you are subject topenalties, you should go ahead and apply on-line for anexemption that pertains to your particular hardship.

Individual physicians must apply on-line via CMS’ Web-based tool for an exemption by no later than June 30, 2012, inorder to avoid the January 1, 2013, Medicare e-prescribingpenalty.

Applications cannot be submitted via mail, e-mail, or fax.Individual physicians must file directly and can not delegatethe on-line filing to their staff.

Any questions regarding the use of CMS’ Web-based toolshould be directed to the Quality Net Help

Desk. The Quality Net Help Desk's may be contacted viatelephone at 1-866-288-8912 or via email at [email protected]. Further information on the QualityNet Help Desk isavailable at: https://www.cms.gov/ERxIncentive/11_HelpDeskSupport. asp#TopOfPage.

CMS information on the recoupment processCMS currently plans to recoup the 1.5 percent penalty via a

1.5 percent reduction in 2013 payment schedule amounts forphysicians subject to the penalty. Physicians who are subject to apenalty are also required to adjust co-insurance or co-payamounts. For details, go to: https://questions.cms.hhs.gov/app/answers/detail/a_id/10560/kw/eRx/session/L3NpZC83OGxiWGVOaw%3D%3D

Medicare e-prescribing incentives available in 2012If you report the G-code (G8553) 25 times or more on your

Medicare Part B claim forms for eligible services and visits in2012, you are eligible for an incentive payment equal to 1

e-Prescribing


Please see e-Prescribing on page 18


News from NORCALMutual Insurance Company

For most doctors who practice as solos or in small groups of two to fourphysicians, you may now qualify for a seven percent reduction on yourNORCAL Mutual premiums.*

RISK MANAGEMENT DISCOUNT DETAILSNORCAL Mutual’s five percent discount for completing two risk

management CME credits is now seven percent for policyholders who completea third CME credit and remain a member of the medical society. Riskmanagement CME activities are available to NORCAL policyholders free ofcharge. CME credits can conveniently be earned online at MyNORCAL, thepolicyholder log-in area of the NORCAL Mutual website,www.norcalmutual.com. If you don’t currently have a MyNORCAL account,call NORCAL’s Policyholder Services at 877-443-7232 Monday through Fridayfrom 8am-5pm.

This expanded Risk Management Discount for medical society members isapplicable to policies renewing January 1, 2012 or later. Policyholders must haveearned the three CME credits and have been active members of the medicalsociety 90 days prior to their policy renewal in order to receive the seven percentdiscount in 2012.

Remember to keep your membership current in order to get the full sevenpercent discount for 2013. Please invite your colleagues to join the medicalsociety and to apply to NORCAL to become eligible for the seven percentdiscount.

AN OVERALL RATE DECREASE FROM NORCAL MUTUALIn addition to offering this extra savings medical society members, NORCAL

Mutual is also reducing California rates an overall 7.07 percent. The ratereduction impact per policyholder will vary depending on a number of factorssuch as the area of the state where they practice and their medical specialty.

This overall rate reduction will take effect retroactively to January 1, so thatthe majority of NORCAL’s policyholders, who renew on January 1 or later, willbenefit from the rate decrease. NORCAL will re-rate all policies that wereeither written or renewed in 2012 and apply the new rates. Policyholders canexpect to see their rate adjustment reflected in an upcoming, scheduled billingstatement, no later than July 1.

OTHER BENEFITSNORCAL has also eliminated the age requirement for the retirement tail

premium waiver. Policyholders can retire completely and permanently fromtheir practice of medicine at any age, and receive a free tail, as long as they havebeen a policyholder for the previous five years and remain retired. All otherprovisions allowing limited work remain unchanged, including, for example, theability for a physician to work on a limited basis for remuneration, or on acharitable basis, without jeopardizing their free tail.

If you have any questions about the Risk Management Discount or theoverall rate decrease, please call NORCAL’s Policyholder Services at 877-443-7232 Monday through Friday from 8am-5pm.

*If you are currently part of NORCAL Mutual’s surcharge program, you are noteligible for the Risk Management Discount Program.

California Rate Filing Changes

RISK MANAGEMENT DISCOUNT• For solo physicians and small groups (2-4

physicians) a 5% premium discount whenyou complete 2 CME credits.

• For solo physicians and small groups (2-4physicians) a 7% premium discount whenyou complete 3 CME credits and have acurrent membership with an endorsingmedical society.

• You must complete your CME credits 90days prior to your policy renewal to earnthe discount.

• CME activities are available topolicyholder on their MyNORCALaccount.

• Medical societies will be asked to providean updated membership list, quarterly.

RATE FILING INFORMATION• Overall 7.07% decrease in California • The amount of the decrease will vary

depending on a variety of factorsincluding:• Medical specialty• Area of the state you practice

• The rate filing was made retroactively toJanuary 1, 2012.

• Policyholders will see a change in theirpremium with the billing statement theyreceive on or before July 1.

• Outstanding billing statements should bepaid in full.

• Loss-rated accounts do not qualify for thisreduction.

OTHER RATE FILING INFORMATION• We have eliminated the age requirement

for the retirement tail premium waiver.• To be eligible for the free tail waiver

coverage, you must have been aNORCAL policyholder for at least fiveyears and retire completely andpermanently from the practice ofmedicine.

• We have decreased the claims made stepprocess from six years to five.

• There is an increase in the entity chargefrom 11 to 12 percent.

• There has been an adjustment in some ofthe medical specialty classifications.

For more information, please callPolicyholder Services at 877-443-7232Monday-Friday 8am-5pm PST.

NORC A L


Looking forCost EffectiveLife Insurance?

Rates Reduced 5%!Fresno, Kern and Tulare County MedicalSociety members may apply for up to$1,000,000 of life insurance on either a10-year level term or 20-year level termbasis.

Rates for the first 10 or 20 years of yourcoverage are locked in so that you do nothave to experience increases in premiumsolely as the result of getting older*. Thisresults in substantial premium savingsduring the term of the coverage. After theinitial 10 or 20-year term period, you canreapply for coverage at your then attainedage or transfer to the regular term lifeprogram if you no longer qualify throughunderwriting.

Thanks to positive program lossexperience, rates are being reduced by 5%effective July 1, 2012. So apply now!

You may also insure your spouse ordomestic partner for up to $1,000,000 andyour eligible employees for up to$500,000.

Each plan also includes two specialmember services: travel assistance servicesfor medical emergencies when you aretraveling away from home**; and afuneral planning and concierge service, atno additional cost to you***.

Call Marsh/Seabury & SmithInsurance Program Management for moreinformation at 800-842-3761, [email protected] orvisit www.CountyCMAMemberInsurance.com to download a brochure andapplication.

* The initial premium will not change for the first 10or 20 years unless the insurance company exercisesits right to change premium rates for all insuredscovered under the policy with 60 days advancewritten notice. Underwritten by ReliaStar LifeInsurance Company. Policy form LP08GP.

** ING Travel Assistance Services provided by EuropAssistance USA, Bethesda, MD 20814

*** Funeral Planning and Concierge Services providedby Everest Funeral Package, LLC, Houston, TX77056. d/b/a in CA Seabury & Smith InsuranceProgram Management; CA Ins. Lic. #0633005;AR Ins. Lic. #24554458761 (6/12) ©Seabury &Smith, Inc. 2012; 777 South Figueroa Street, LosAngeles, CA 90017; 800-842-3761;CMACou n t y . I n s u r a n c e@ma r s h . c om ;www.CountyCMAMemberInsurance.com

I N S UR ANC E


A I R Q U A L I T Y

In April the San Joaquin Valley Air Pollution Control Districttraveled to Washington, DC with a coalition of stakeholders tomeet with policy makers to advocate for incentive funding, makepolicy recommendations to assist the Valley in achieving cleanerair, and to seek assistance in meeting federal air quality standardsin the most cost-effective way possible.

Incentive funding has been a key tool over the past decade toencourage and assist businesses, farmers, and the public to tradehigher polluting equipment, pumps, tractors, and trucks for lowerpolluting or electric alternatives. Two from the Fresno-MaderaMedical Society were included in the trip, myself (GovernorAppointee to the Valley District’s Governing Board and to theCalifornia Air Resources Board), and Michelle Garcia, AirQuality Director for FMMS.

The group met with the Valley’s congressional delegation, keycommittee staff, and with high level EPA representatives. TheValley congressional delegation included Senators Feinstein andBoxer, and Representatives Cardoza, Costa, Nunes. The issuesthat the group advocated for included:

• Recommending that EPA take a “health risk”-basedapproach to implementing air quality standards rather thanthe current “mass based” approach in order to focus earlieston measures with the greatest public health benefits.

• Requesting additional resources for the installation ofadditional air quality monitoring devices.

• Requesting the continuation of $150 million in air qualityfunding primarily for incentives through the EQIP programunder the Farm Bill.

• Supporting the strengthening and continuation of airquality provisions in the transportation bill.

• Advocating for the establishment of a new designation of“Air Quality and Health Empowerment Zone” that wouldprovide funding for regions like the Valley that havesignificant air quality, economic and health challenges.

The advocacy efforts have already begun to pay off. First, EPAhas informed the District that they will be funding theinstallation of two near-road monitors in the coming year. Bettermonitoring is essential to developing scientifically sound risk-based standards. Second, Valley representatives have committedto introduce “Air Quality and Health Empowerment Zone”legislation in both the House of Representatives and the Senate.Bipartisan approaches still exist!

If you are interested in getting more involved in Air Districtactivities, there are a number of upcoming opportunities. TheDistrict is currently in the process of developing a plan to attainthe federal PM2.5 standard, including incorporating health riskbased elements. The PM 2.5s – the little and nastiest particles –are small enough to get into the alveoli and cause not just

FMMS Goes to WashingtonAlex Sherriffs, MD

and Michelle Garcia, FMMS Air Quality Director

pulmonary problems but also be absorbed into the circulation.More and more studies tie this to increased risks for heart attacksand strokes for our populations.

To receive information about this effort or any other Districtprograms you can sign up to receive email updates athttp://www.valleyair.org/lists/list.htm. I urge everyone in FMMSto sign up. If you could only attend one event in the coming year,it would be an important step for public health.

Let’s get FMMS out there! The Environmental Justice andCitizens Advisory Committees of the Valley Air Board also haveregular meetings open to the public, and your input, doctor,would be welcome. As Senator Boxer said when our delegationappeared: “Oh good, the Valley Air District! You have a REALair quality problem there!” I felt like the cavalry had arrived, onfoot. Your help is needed.

Seyed Sadredin, Air Pollution Control Officer for the San JoaquinValley Air Pollution Control District (left), and Dr. Alex Sherriffs, SanJoaquin Valley Air Pollution Control District Board Member andGovernor appointee to the California Air Resource Board inWashington, DC advocating for incentive funding.


Fresno-Madera

President’s Message

SERGIO D. ILIC, MD

QUICK FOLLOW-UP TO RAY KURZWEIL

The big day came and went pretty fast. May 11, that is. The lecture by Dr. Kurzweilwas very well attended. We sold 73 tableswith the attendance around 680. We willhave the final numbers and additionalphotos of the event in the July edition ofVital Signs.

The lecture was excellent, and thecomments by the attendees wereoverwhelmingly positive. Some peoplewere asking when we are going to bringanother speaker of the same caliber toFresno. They obviously want more of thesame.

Ray Kurzweil is a fascinating person, yet very accessible and accommodating toeveryone that wanted to meet or get a picture with him. He indicated he was happywith the friendly people of Fresno, and his question and answer period, which wassupposed to be 15 minutes – went on for almost one hour.

He has tremendous knowledge in all areas. I was surprised that his knowledge ofthe brain and the way it works is better than most physicians, and according to him,the changes that are coming in medicine are going to be profound andrevolutionary. The next 20 years are going to be very exciting.

I was a little disappointed though that he didn’t elaborate more about the mergerof humans and computers, which is supposed to happen about 2045, according tohis forecast.

A big thank you to our sponsors that made this event possible, to all the FMMSmembers and non members who bought tables or individual tickets and to thetireless work of the FMMS staff.

Back to our everyday problems and challenges. We have not yet heard from theSupreme Court about the Health Care Reform. Regardless of the outcome, wecontinue to have a tremendous problem with the uninsured and with the everescalating costs of medical care. Those need to be solved, and the solutions are noteasy and will affect everyone who delivers health care as well as the patients whoreceive it.

Post Office Box 28337Fresno, CA 93729-8337

1040 E. Herndon Ave #101Fresno, CA 93720

559-224-4224Fax 559-224-0276

website: www.fmms.org

FMMS Officers

Sergio Ilic, MDPresident

Ranjit Rajpal, MDPresident Elect

Prahalad Jajodia, MDVice President

Stewart Mason, MDSecretary/Treasurer

Oscar Sablan, MDPast President

Board of GovernorsA.M. Aminian, MD

Hemant Dhingra, MDUjagger-Singh Dhillon, MD

William Ebbeling, MDBabak Eghbalieh, MDAhmad Emami, MDDavid Hadden, MDS. Nam Kim, MD

Constantine Michas, MDKhalid Rauf, MD

Rohit Sundrani, MDMohammad Sheikh, MD

CMA DelegatesFMMS President

A.M. Aminian, MDJohn Bonner, MDAdam Brant, MDMichael Gen, MDBrent Kane, MDKevin Luu, MD

Andre Minuth, MDRoydon Steinke, MDToussaint Streat, MD

CMA Alternate DelegatesFMMS President-electDon H. Gaede, MD

Prahalad Jajodia, MDPeter T. Nassar, MDTrilok Puniani, MD

Dalpinder Sandu, MDSalma Simjee, MDSteven Stoltz, MDRajeev Verma, MD

CMA YPS DelegatePaul J. Grewall, MD

CMA YPS AlternateYuk-Yuen Leung, MD

CMA Trustee District VIVirgil Airola, MD

Staff:Sandi Palumbo

Executive Director

Ray Kurzweil and FMMS President Sergio Ilic, MD


DAVID SHUSTER, MD35-year member

David Shuster, MD, a retired diagnostic radiologist, passed away April 18, 2012at the age of 71.

Dr. Shuster was born in Montreal, Canada in 1940. He received his medicaldegree from McGill University in Montreal in 1966 and completed his internshipand residency training at the Jewish General Hospital in Montreal and the JewishHospital of Brooklyn . After practicing in Canada, Dr. Shuster came to Fresno in1976 and practiced with the San Joaquin Radiological Medical Group. He retiredin 2007.

Dr. Shuster is survived by his mother, wife, three children and fivegrandchildren.

Fresno-Madera

2012 Educational Series for FMMS membersAs a member benefit, a series of Financial Education seminars will be offered to FMMSmembers and their guests during the months of March, April, May and June - repeatingin August, September, October and November. In order to allow members attendanceflexibility, the seminars will be offered twice each month – the last Wednesday andThursday evenings at 6:00 pm.

JUNE 27 & 28, 2012“UNDERSTANDING SOCIAL SECURITY BENEFITS”presented by Michelle P. O'Haren JD, LLM, CPA, ChFC, CRC in conjunction withCentral Valley Physician Benefits.

Presentation will include:

• The history and benefits provided by Social Security

• Explanations of full retirement age, primary insurance amount and eligibility

• Strategies for optimizing Social Security benefits

• Issues related to the taxation of benefits

Seminars will be held at the Medical Society offices, 1040 E. Herndon Ave. #101 (NEcorner of First/Herndon). Space is limited, so please reserve your spot as soon as possibleby contacting the Medical Society at 559-224-4224, ext. 118 or at [email protected]. Alight meal will be available.

Eric Van Valkenburg and Amy Nuttall-Zwaan are Registered Representatives with andsecurities offered through LPL Financial. Member FINRA/SIPC.

Diagnosis &Management of

Pulmonary ArterialHypertension (PAH):State of the Art

Vijay Balasubramanian, MDMedical Director,

Pulmonary Hypertension ProgramAssistant Professor of Medicine

Division of Pulmonary & Critical CareUCSF Fresno

Tuesday, June 20, 20126:00-7:30pmFMMS offices:

1040 E. Herndon Ave. #101

1 hour, Category 1, CME CreditFMMS member: No ChargeNon-FMMS member: $20

• Determine early diagnosis of PAHand its appropriate classifications

• Evaluate and apply treatmentgoals for successful outcomes forPAH

• Know when to refer

Information and registration:559-224-4224, ext. 118 or

[email protected]

Need help? Contact CMA’sreimburse ment experts at 888-401-5911 or [email protected].

CMA’S MEDICAL-LEGALLIBRARY AVAILABLE ONLINEAT WWW.CMANET.ORGThe California Medical Associ -ation’s 24-hour online medi cal-legallibrary is the most compre hensivehealth law and medical practiceresource for California physicians.These docu ments are available freeto members at www.cmanet.org or bycalling the member help center at800-786-4262. Nonmembers canpurchase CMA ON-CALL docu -ments for $2 per page atwww.cmanet.

CMA News



2229 Q StreetBakersfield, CA 93301-2900

661-325-9025Fax 661-328-9372

website: www.kms.org

KCMS Officers

Joel R. Cohen, MDPresident

Wilbur Suesberry, MD President-elect

Noel Del Mundo, MDSecretary

Ronald L. Morton, MDTreasurer

Portia S. Choi, MD Immediate Past President

Board of DirectorsAlpha Anders, MDBrad Anderson, MD

Eric Boren, MDLawrence Cosner, MD

John Digges, MDJ. Michael Hewitt, MD

Calvin Kubo, MDMelissa Larsen, MDMark Nystrom, MDEdward Taylor, MD

CMA Delegates:Jennifer Abraham, MD

Eric Boren, MDJohn Digges, MD

Ronald Morton, MD

CMA Alternate Delegates:Lawrence Cosner, Jr., MD

Patrick Leung, MDMichelle Quiogue, MD

Staff:Sandi Palumbo, Executive Director

Kathy L. HughesMembership Secretary

ASTAKHOVA, Inga – 3700 Mall View Road, 93306 FAX: 334-2994BELLA, George – Delete information (pg. 71) BLACK, Jennifer – 3733 San Dimas Street, 93301 FAX: 635-3430CAMPOS, Marvin – 3501 Stockdale Hwy., 93309 FAX: 398-5057DIGGES, John – DBP*HARMON, David – 3501 Stockdale Hwy., 93309 FAX: 398-5057JAMALUDDIN, U. – Phone: 321-4310 LOOS, Donald – Move to Retired Section – 3821 Braeburn Dr.,

93306-3607MERCY HOSPITAL – Change name to Dignity Health

(Hospital Index Tab – Back) MORTON, Ronald – Email: [email protected], Nandakumar – [email protected], Madhavi – 3501 Stockdale Hwy., 93309 FAX: 398-5057SMITH, Shannon – 3733 San Dimas Street, 93301 FAX: 635-3430STAIGER, Pamela – 8800 Ming Avenue, 93311 FAX: 664-3729

KAISER PERMANENTE – Change the following addresses to:2531 Chester Avenue, 93301:

AUNG, Kyi – FAX: 337-7271BERTIZ, Augusto – FAX: 337-7271CHRISTOPHER, Robert – FAX: 337-7096DINH, Long – FAX: 337-7271HOFFMAN, Douglas – OTO*/HNS FAX: 337-7258HTOO, Aung – FAX: 337-7271LEVINS, Anthony – FAX: 337-7096MIRANDA, Elva – FAX: 337-7271MIRANDA, Rodrigo – FAX: 337-7253MISHKIND, Mark – FAX: 337-7253NALESNIK, Jeffrey – FAX: 337-7258NYSTROM, Mark – FAX: 337-7096PATEL, Umesh – FAX: 337-7271PENROSE, James – FAX: 337-7271SALES, Jonathan – FAX: 337-7253SELIGMAN, Jay – FAX: 337-7253STONE, David – HNS/FPS* - FAX: 337-7258TRAN, John – FAX: 337-7271TRAN, Tan – FAX: 337-7271VALOS, Nicholas – FAX: 337-7096YEIN, Thu – FAX: 337-7271

ORGANIZATIONS OF INTEREST TAB CHANGESAMERICAN DIABETES ASSOCIATION – Remove P.O. Box

Phone: 800-342-2383 BAKERSFIELD PREGNANCY CENTER – 326-1915EMERGENCY MEDICAL SERVICES OF KERN –

1800 Mt. Vernon Ave., 93306 PH: 321-3000 FAX: 868-0225 KERN AUTISM NETWORK – FAX: 588-4235KERN COUNTY CORONER’S OFFICE – FAX: 868-0149KERN COUNTY DENTAL SOCIETY – FAX: 327-1229KERN COUNTY HEALTH DEPARTMENT – Phone: 321-3000KERN COUNTY MENTAL HEALTH DEPARTMENT –

Phone: 800-991-5272KERN COUNTY VETERANS SERVICE DEPARTMENT –

FAX: 868-7301ODYSSEY HOSPICE – 5001 E. Commerce Dr. #140, 93309

Phone: 324-1232 / FAX: 324-0931ONE LEGACY – Remove address Phone: 800-786-4077SOCIAL SECURITY ADMINISTRATION – Remove Haley St.

Phone: 866-476-1489

2012 Membership Directory Changes

PO Box 1029Hanford, CA 93230

559-582-0310Fax 559-582-3581

KCMS Officers

Theresa P. Poindexter, MDPresident

Jeffrey W. Csiszar, MDPresident-elect

Mario Deguchi, MDSecretary Treasurer

Mario Deguchi, MDPast President

Board of DirectorsBradley Beard, MDJames E. Dean, MDLaura Howard, MD

Ying-Chien Lee, MDBo Lundy, MD

Michael MacLein, MDKenny Mai, MD

CMA Delegates:Jeffrey W. Csiszar, MD

Thomas S. Enloe, Jr., MDTheresa P. Poindexter, MD

CMA Alternate Delegates:Laura L. Howard, MD

Staff:Marilyn Rush

Executive Secretary

Kern Kings

Tulare


TCMS Offers Appeals, Refunds& Recoupment Requests Course

The Tulare County Medical Society (TCMS) in partnership with the Practice Management Institute(PMI) is providing you and your office staff the opportunity to attend a three hour course entitled“Appeals, Refunds & Recoupment Requests.” Securing accurate payment for services rendered hasbecome a minefield for providers. It takes skill to navigate through all the third-party payer rules, and,if you don’t submit claims correctly, there are Recovery Audit Contractors (RACs) and othergovernment and commercial payer audits on the lookout for errors and overpayments to take back.

Whether the issue is inadequate payment, denial or rejection, it is imperative to appeal claims ina timely manner with as much supporting documentation as possible. It is just as important toproperly write an appeal in order for your claim to be reconsidered and result in your favor.

This program will teach you the proper steps to appeal and win! Review sample appeal letters andreceive instruction on the five levels in the appeals process. Participants will walk away with theknowledge they need to appeal insurance claims efficiently and effectively, resulting in accuratereimbursement and how to enhance the overall reimbursement cycle.

Stay up-to-date on current rights and responsibilities. We will also discuss the new timelines forrefunds required to maintain compliance, and explore how to successfully respond to a variety ofrecoupment requests.

This Program will cover these topics:• Examining the reasons why a claim is delayed/denied• Fixing denials with a powerful appeal letter• Combating denials in the most efficient manner possible• Looking at the payer’s perspective• Following guidelines to avoid further delays• What to do if your claim still gets denied• Accessing financial support, if neededNo matter who is scrutinizing your claims, you will leave this program well-equipped to

handle tough issues in a timely manner.Please plan to join us on Friday, June 22 (9am-12pm or 1pm-4pm) at the Kaweah Delta Cancer

Center (aka Sequoia Regional Cancer Center). The cost of this course will be $119 per participant forTulare County Medical Society members and their staff. Should any additional information be helpfulplease do not hesitate to contact me. Otherwise, please simply complete the registration form on thereverse side and fax or mail it to TCMS with your payment as soon as possible to reserve your seat(s).

Please contact Gail Locke, Tulare County Medical Society for additional information 559-734-0393, [email protected].

TCMS presents Practice Management Institute’s“Appeals, Refunds & Recoupment Requests”Friday, June 22, 2012 • 9am-12pm or 1pm-4pm

Kaweah Delta Cancer Center (aka Sequoia Regional Cancer Center)Maynard & Pauline Faught Conference Room • 4945 W. Cypress, Visalia, CA

Fax this registration and mail your payment today to reserve your seat! Please hurry, seating is limited!Fax to TCMS at 559-334-0090 • TCMS Member Fee: $119 per participant

Name (s)

Please circle one: 9am-12pm or 1pm-4pm

Physician Name and Practice Address

Phone Please indicate amount of check/charge enclosed: $

Mail payment with “Appeals, Refunds & Recoupment Requests” in memo to:TCMS, 3333 S. Fairway, Visalia CA 93277

Credit Card Payment: ___Visa � ___MC � ___Discover Card � ___Amex

Credit Card # Exp. Date Security Code

Name on Card

Billing Street Address & Zip Code

Cancellation Policy: A full refund if cancellation is received 3+ days prior to program start day (6/19/12).A 50% refund if cancellation is 48 hours prior to start date (6/20/12). No refund if cancellation is lessthan 48 hours in advance. Please understand that we must strictly adhere to this policy. Thank you.

3333 S. FairwayVisalia, CA 93277

559-627-2262Fax 559-734-0431

website: www.tcmsonline.org

TCMS OfficersGaurang Pandya, MD

President

Steve Cantrell, MDPresident-elect

Thomas Gray, MDSecretary/Treasurer

Steve Carstens, DOImmediate Past President

Board of DirectorsVirinder Bhardwaj, MDCarlos Dominguez, MD

Parul Gupta, MDMonica Manga, MD

Christopher Rodarte, MDH. Charles Wolf, MD

CMA Delegates:Thomas Daglish, MD

Roger Haley, MDJohn Hipskind, MD

CMA Alternate Delegates:Robert Allen, MD

Ralph Kingsford, MD Mark Tetz, MD

Sixth District CMA TrusteeJames Foxe, MD

Sixth District CMA AlternateThomas Daglish, MD

Staff:Steve M. BeargeonExecutive Director

Francine HipskindProvider Relations

Gail LockePhysician Advocate

Thelma YearyExecutive Assistant

percent of your total Medicare Part Bpayments for the year (Remember: ReportG8553 10 times before June 30, 2012 toavoid a penalty in 2013). For moreinformation on e-prescribing incentives,go to: http://www.amaassn.org/resources/doc/hit/faq-cms-incentive-program.pdf. Inaddition, physicians who successfullyparticipate in the 2012 e-prescribingincentive program will also avoid an e-prescribing penalty in 2014.

Note: There have been some caseswhere vendors/billers/ clearinghouses haveinappropriately removed the G-code –G8553 – from a physician’s Medicare PartB claims thinking that the G-code wasreported in error. Please make sure that asyou begin reporting for 2012 that yourvendors/billers/clearinghouses understandwhy you are including the G8553 code onyour claims and make sure that they do notremove the G8553 code from yourMedicare Part B claims. Successfulparticipation in the e-prescribingincentive and penalty programs iscontingent upon e-prescribing and thereporting of a certain number of G8553codes.

• Remember to review your remittanceadvice regularly to ensure you receivethe N365 code when submitting theG8553 codes on your Medicare PartB claims. The N365 code is yourindication that the G8553 codepassed into the Medicare NationalClaims History (NCH) database.

• Physicians who have been un -successful in resolving their Medicaree-prescribing concerns can completea complaint form found on theAMA’s webpage at: http://www. ama-a s s n . o r g / a m a / p u b / p h y s i c i a nresources /hea l th- in format ion-technology/incentive-programs/cms-eprescribing-incentive-program.page.

Additional resources• AMA website on Medicare

enrollment: www.ama-assn.org/go/Medicareenrollment

• AMA website on health IT in -centive pro grams: www.ama-assn.org/go/hit (select “Incentive Programs”)

• CMS website on the E-Prescribingprogram: https://www.cms.gov/erxincentive/ and https://www.cms.gov/ERxIncentive/downloads/2012eRx_FuturePaymentAdjustments_01-30-2012_508_2.pdf


Classifieds

MEDICAL OFFICES

Gar McIndoe (661) 631-3808David Williams (661) 631-3816Jason Alexander (661) 631-3818

FOR LEASE2701 16th St. – 2,400

2031 17th Street – 1,776 sf.4817 Centennial Plaza Way – 2,370 rsf.Crown Pointe Phase II – 2,000-9,277 rsf.

2525 Eye Street – 3,000 – 6,173 – 12,315 sf.3115 Latte Lane – 5,637 rsf.

3115 Latte Lane – 2,660-2,925 sf.Meridian Professional Center – 1,740-9,260 rsf.

2204 “Q” Street – 2,894 rsf.3941 San Dimas Street – 3,959 rsf.

4040 San Dimas St. – 2,035 rsf.9300 Stockdale Hwy. – 3,743 - 5,378 rsf.9330 Stockdale Hwy. – 1,500-7,700 rsf.

SUB-LEASE4100 Truxtun Ave. – Can Be Split

Medical Records & Offices

DENTAL OFFICE FOR SALE

FOR SALECrown Pointe Phase II – 2,000-9,277 rsf.

Meridian Professional Center – 1,740-9,260 rsf.9900 Stockdale Hwy. – 2,000-6,000 rsf.

California Gastroenterology Associatesis announcing a change of their telephonenumber in their Fresno office. New number:559-299-9395, fax: 559-299-0400.Christine Lopopolo, MD announces herboutique obstetrics and gynecology prac-tice in Fresno. Accepting new patients. Call559-261-9320.University Psychiatry Clinic: A slidingfee scale clinic operated by the UCSFFresno Dept. of Psychiatry at CRMC M-F8am-5pm. Call 320-0580.

1,650 sf medical office space in Madera onYosemite Ave. Call Dr. T. Nassar at 559-674-0917.Medical office space 1,000 sf up to 2500sf at First & Herndon and First & Bullard,starting at $1psf++ by owner. Call 559-449-7668 or 559-284-2625.

ANNOUNCEMENT

FOR RENT / LEASE

MEMBERS: 3 months/3 lines* free;thereafter $20 for 30 words.NON-MEMBERS: First month/3 lines* $50;Second month/3 lines* $40; Third month/3lines* $30. *Three lines are approximately 40to 45 characters per line. Additional words are$1 per word. Contact the Society’s PublicAffairs Department, 559-224-4224, Ext. 118.

3,400 sq.ft. spaceSuitable for a Physical Therapy or

Individual practice; may be divided & remodeled to suit

Excellent parking andclose to St. Agnes Medical Center

Carl Abercrombie559-227-4658

c: 559-970-9035Jim Abercrombie

530-626-0321

Professional/Medical Office for LeaseCambridge Court

6335 N. Fresno Street, Fresno

NEWLYREMODELED1,200sq.ft. officewith fiveexam rooms

e-Prescribing


FRESNO/MADERA

TULARE

IM/FP needed to join Tulare outpatient clin-ic practice. Friendly, collegial work environ-ment. Part/full time. Competitive salary/benefits – paid vacation, holidays, retire-ment, loan repayment. Send resume [email protected]. or call Cathy at225-6100 ext. 6339.

PHYSICIAN/PROVIDED WANTED

You are not alone. Employment-related lawsuits are more common. What many physicians don’t realize is that help is literally a phone call away. FMMS/KCMS/TCMS members haveaccess to a unique blend of risk management services andinsurance specifically designed to assist physician groups inaddressing these important employment issues. Among thefeatures of the sponsored Employment Practices Liabilityprogram are:

• A Helpline staffed by experienced employment defense attorneys. Any manager, officer or principal ofyour practice has access to the Helpline for obtaining advice on handling workplace issues, includinginternal sexual harassment complaints, discipline and employee terminations.

• If a member seeks Helpline advice on an employee termination which later results in a claim, there isa 50% reduction of the member’s EPLI deductible for that claim.

• Free, comprehensive criminal background checks for newly hired and promoted managers/supervisors.

• EEO compliance training for managers/supervisors. An internet-based training program, compliant withCalifornia law, provides supervisors with sexual harassment training.

• A low, minimum premium of $1,500 annually.

• Wage and Hour Defense Coverage.

For more information on these important benefits, and the special FMMS/KCMS/TCMS First-Time Buyersprogram, please contact Marsh at 800-842-3761 or email us at [email protected].

A former employee sued me for wrongful termination.

What do I do now?

59791 (6/12) ©Seabury & Smith, Inc. 2012 • 777 S. Figueroa St., Los Angeles, CA 90017 • www.CountyCMAMemberInsurance.com • [email protected]

d/b/a in CA Seabury & Smith Insurance Program Management • CA Ins. Lic. #SL0633005 • AR Ins. Lic. #245544 • 800-842-3761

Sponsored by:

MARSH 59791, Fresno, (6/12)

Full Size: 8.5” x 11” Bleed: 8.75” x 11.25 Live: 7.5” x 10”Folds to: N/A Perf: N/AColors: 4c=(Process)Stock: N/APostage: N/AMisc: N/A

Fresno-Madera Medical SocietyKern County Medical Society

Tulare County Medical Society

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VITAL SIGNSPost Office Box 28337Fresno, California 93729-8337

HAVE YOU MOVED?Please notify your medical society ofyour new address and phone number.

PRSRT STDU.S. Postage PAIDFresno, CAPermit No. 30

CALL 1-800-652-1051 OR VISIT NORCALMUTUAL.COM

Proud to be endorsed by the Fresno-Madera Medical Society and the Kern, Kings and Tulare County Medical Societies.

Great service 24/7.

Hard-working numbers you can count on.

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Vital Signs June 2012

Documents

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