The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

January 11, 2007 #2,787 Editor-Barry Block, DPM, JD

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The Term “Heels Spurs” is Wrong: OH Podiatrist

Dr. Kristin Titko, a podiatrist, says the term “heel spurs” is wrong . “It's not actually the spur or the bone that causes the problem, but rather the soft tissue in the inflammation around the heel that's causing the pain,” she said.

Dr. Kristin Titko

She said plantar faciitis or pain in the heel can be especially bad in the morning or following any change in activity. You can also get it from wearing the wrong kind of shoes.

“When we stand up in the morning, we put our weight down, our heel on the ground, and we feel an instant pain in our heel. That is the plantar facia stretching in an uncomfortable way, which sets up an inflammatory response,” she said.

Source: WHAM-TV (Rochester)[1/9/07]

Sarmiento Appointed to NY State Board of Podiatry

Stacey Sarmiento, DPM, has been appointed to the New York State Board for Podiatry. Appointments were made by the members of the Board of Regents.

Dr. Stacey Sarmiento

This is the first time Dr. Sarmiento has been appointed to the board. Her term began on November 1, 2006 and will continue until October 31st, 2011. Dr. Sarmiento is dual-board certified by the American Board of Podiatric Surgery and The American Board of Orthopedics & Primary Podiatric Medicine. Her practice has served the Rochester-area community since 1985.

Source: The New York Podiatrist [January 2007]

IN Appellate Court Upholds Restrictive Covenant Against Podiatrist

The Court of Appeals of Indiana on January 9, 2007 reversed a trial court decision which had held that the restrictive covenant between Central Indiana Podiatry (CIP) and Kenneth Krueger, D.P.M., was unenforceable. Krueger ran into “some financial troubles” in March 1996 and entered into an employment agreement with COP which contained a restrictive covenant.

On July 25, 2005, CIP terminated Krueger’s employment for cause – specifically, “misconduct in connection with” his employment duties and his responsibility “to treat . . . office medical staff in a professional and dignified manner.” This included kissing an employee.

Before leaving the practice, Krueger downloaded a list of his patients, which, after securing employment with Meridian Health Group, he utilized to send a notice to these patients. CIP asserted that it lost revenue as a result of Krueger’s action.

Ed. Note: For an explanation of the trial court’s rationale in initially denying an injunction, as well as the appellate court’s reasons for reversing that decision, see:

http://www.in.gov/judiciary/opinions/pdf/01090702cld.pdf

Query: Medicare COP for H&Ps

I recently approached one of my local hospitals regarding the new law allowing podiatrists to do H&P. I was told by the CEO that because they were accredited by AOA (American Osteopathic Association) instead of JACHO, that they are NOT allowed or obligated to allow podiatrists to do H&P’s. Is this true? I thought this was a Medicare COP and if they participate in Medicare, they would have to comply. Is there a site I can go to that I can download the specific law to take to the CEO of the hospital?

Edwin Oghoorian, DPM, Glendora, CA

Editor’s comment: PM News does not provide legal advice. The new CMS regulations “allow” podiatrists to perform H&Ps in hospitals, but do not “mandate” hospitals to do so. Hospitals still maintain the right to credential who can and cannot perform H&Ps. This still represents an historic victory for podiatry because we joined a class of “physicians” ((as defined in section 1861(r) of the Act),who are now allowed to perform H&Ps.

The conditions of participation are found at
http://www.apma.org/s_apma/bin.asp?CID=981&DID=20630&DOC=FILE.PDF

RE: PM Celebrates Its 25th Anniversary
From: Marc Haspel, DPM

I would like to extend my congratulations to Podiatry Management on its 25th anniversary. I just received the January issue and was very impressed by the wonderful comments offered by many of our podiatric leaders. In particular, I also want to congratulate the editor, Barry Block and associate publisher, David Kagan on their inspirational work in producing a publication that has become a cornerstone of this profession. I find useful and helpful information in every issue. I am honored to have been given a chance to contribute to this fine magazine. I wish Podiatry Management much continued success in the future.

Marc Haspel, DPM, Clifton, NJ

RE: Patient Fee for Service vs. Medicare Advantage
From: Ken Malkin, DPM

This is clear guidance on how to approach a situation in which you treat a patient that is thought to be fee for service but is really in a Medicare HMO type product. The following was posted on EmpireMedicare site but has relevance for all states:

Background
In some cases, MA enrollments with retroactive dates are processed by CMS systems. The result is that Medicare may pay for the services rendered twice; once under fee-for-service and second by the MA payment systems in the monthly capitation rate to the plan.
The FFS contractor reverses the fee-for-service payment, recovers from the provider, and the provider, then bills the MA plan. The plan adjudicates the claim and pays the claim at the plan's rate (if the provider is part of the network) or pays the provider at the Medicare fee-for-service rate if the provider is not part of the network. If the plan denies payment then the provider may bill the beneficiary.

FFS Claims Paid in Error
Due to CMS beneficiary eligibility system updates, beneficiaries enrolled in MA organizations may be identified as having been inappropriately paid on a fee-for service basis. FIs, carriers, and A/B MACs will adjust these claims and seek overpayments. Where such an overpayment is recovered from a provider, the related remittance advice for the claim adjustment will indicate Reason Code 24, which states: “Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.”

Whenever CMS reverses fee-for-service payments as a result of confirmed retroactive enrollment in an MA plan, the provider must bill the MA plan. The plan adjudicates the claim and pays the claim at the plan's rate (if the provider is part of the network) or pays the provider at the fee-for-service rate if the provider is not part of the network. If the plan denies payment then the provider may bill the beneficiary.

Information on which plan to contact can be determined through an eligibility inquiry or by contacting the beneficiary directly. To associate plan identification numbers with the plan name, go to http://www.cms.hhs.gov/HealthPlansGenInfo/claims_processing_20060120.asp#TopOfPage "

Ken Malkin, DPM, Caldwell, NJ, drmedicare@aol.com

ASSOCIATE POSITION—NORTH COASTAL CALIFORNIA

Two fully staffed rural offices with continually growing patient load. We take care of all aspects of podiatry: assisted-living centers, palliative care, wound care, biomechanics, surgery, diabetic care. Hospital privileges are available to those properly qualified. If you are interested in challenging and hard work leading to partnership, send your CV to jimf@humboldt1.com

PODIATRIST WANTED - MARYLAND / WASHINGTON D.C.

Mid-Atlantic Permanente Medical Group (MAPMG) has a full-time position for a board eligible/certified podiatrist to join our team. PSR 24 or PSR 36 preferred. The practice includes all aspects of podiatric medicine, including forefoot surgery, rearfoot and reconstructive surgery, diabetic foot care, limb salvage, sports medicine and general podiatry. Operating under the Kaiser Permanente umbrella, MAPMG is a family of over 800 physicians who proudly serve 500,000 health plan members. We offer an excellent starting salary and full benefits, including professional liability coverage, shareholder opportunities and bonuses based on group performance.

To apply online, go to http://physiciancareers.kp.org or send C.V. to: Pattie Dascenzo at MAPMG, 2101 East Jefferson Street, 3rd Floor East, Rockville, MD 20852. EOE

ASSOCIATE POSITION - CINCINNATI, OHIO

One of the largest podiatry practices in the United States is again in need of a PSR 24-36 Associate. All present doctors are in their thirties with similar training. Everyone is treated equally and there is definitely no limit to your success. Please submit resume or contact Karen Roesch via email or phone. Kroesch4poh@aol.com (513) 729-4455

OFFICE SPACE TO SHARE – MANHATTAN / PLAINVIEW, NY

East 60th and or East 22nd in Manhattan and on South Oyster Bay Road Plainview. Turnkey operation, all equipment needed is available as well as an extremity MRI, fluoroscopy, x-ray and surgical equipment. Each office has an operating room with anesthesiologist available for iv sedation. Call 516 476-1815 or email to podo2345@aol.com include a phone #.

ASSOCIATE POSITION – MISSISSIPPI

Well established, busy, 3-doctor practice seeks PSR 12 or 24 trained podiatrist for associate position to fill vacancy of retiring member. East central location is a great area to raise a family and is a prime location for accessibility to several major cities. Competitive salary, benefits, and incentives. Partnership possible in 2 years to right individual. June - July start date. Applicant must be ethical, personable, and motivated. Please E-mail CV and letter of intent to shanegan@bellsouth.net

ASSOCIATE POSITION - LOS ANGELES/SOUTH BAY AREA

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227

POSITION AVAILABLE-SOUTH FLORIDA/BROWARD COUNTY

Needs 2 or 3-year post surgical training in forefoot and rearfoot
Salary plus incentives Email responses to office email: advfoot@bellsouth.net

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE POSITION - NORTHERN VIRGINIA

Well-established, busy, diversified, multioffice/multidoctor practice seeking associate with opportunity for partnership. Must be highly motivated and ethical with strong interpersonal and patient skills. Excellent opportunity for PSR 24 or higher trained individual to complement a full-scope podiatric medical and surgical practice. Competitive salary and benefits package. Please send CV and references to saglag2@aol.com or fax to (703) 368-5103.

ASSOCIATE POSITION – ST. LOUIS, MISSOURI

Immediate Opening. Busy practice in prime suburban St. Louis location looking for a surgically trained associate, possible partner. Must be honest, ethical and hardworking. ABPS preferred, but not required. Please reply with CV and requirements to mdwrtw@aol.com

ASSOCIATE POSITION- PALM BEACH COUNTY, FLORIDA )

Excellent opportunity for a hard working, motivated podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Partnership opportunity available. Seeking a board eligible/certified trained foot and ankle surgeon for a well rounded podiatric practice. Position is available immediately. Competitive salary. Please respond to springwm41@aol.com

ASSOCIATE WANTED FOR SOUTH MIAMI AREA

Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead, FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com. I can also be reached at 305-331-4501.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

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