11/14/2013    Pete Smith, DPM, Mike Davis

OPEIU Guild 45 and Obamacare (Bryan Markinson, DPM, DPM)

The Guild does react to issues that are brought up
by the State Associations, because that is the
general direction that we (the Guilds) were
created to take. We also have responded to
requests for assistance on national regulatory or
legislative issues when asked by APMA, or as
decided in a joint meeting with APMA.

Finally, we have acted in response to individual
member's problems when they are sent to our
attention. We have worked that way in eliminating
foot care limits in plans, eliminating
discriminatory LCD's locally and nationally,
eliminating plan payment discrimination and
securing sponsorship for Title XIX. If you have a
problem, please contact your State Association and
ask it to involve the Guild.

Having said that, when an individual's request
comes to us, we do immediately contact the state
association, or the APMA. The Guild was never
intended to be a "cheap alternative" to the state
association, or APMA. We are an adjunct pathway,
in conjunction with and available to the State
Association or APMA. When we approach a medical
plan, or legislature or regulatory body, we always
coordinate with the state AFL-CIO or local
affiliate. Through the Guild , we can bring more
"weight" to the table, because we are no longer
"just another provider" in the eyes of the Plan or
the Department we need to talk to. It is the
combination of the State Association, or the APMA,
with the extra "weight" of labor behind them that
gets us more attention.

This does not mean that we are successful 100% of
the time, but we have tipped the scales on major
projects in industry, regulatory and legislative
forums. Our intervention in New York was a perfect
example of our ability to aid an association. Our
ability to set up a meeting with the indemnity
plan that was blocking the legislation came from
the fact that labor represented over 200,000 paid
lives in the company plans. That meeting allowed
Len Thaler, the NYSPMA Executive Director, to make
the argument for ankle privileges directly to the
President of the Company that was blocking them.
That company then promptly withdrew its
objections, and the Bill moved forward and was
eventually passed by the NY State Assembly and
into law.

If you want to make a request directly to the
Guild, please contact a Guild officer, Dr. John
Mattiacci, Dr. Phil Morreal, Dr. Michael Wodka,
Dr. Kirk Contento, Dr. Ed Smith, Dr. Stanley
Gorgol, Dr. Terence McDonald, Dr. Robert Herpen,
or Michael Davis at PPMA.

Pete Smith, DPM, VP PPMA
Mike Davis, Executive Director, PPMA

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