The Voice of Podiatrists

October 02, 2006 #1,703 Editor-Barry Block, DPM, JD

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CA Podiatrist Vies For City Council Seat

Two incumbents, are seeking two spots on the five-member Vista, CA City Council in the Nov. 7 election. Challengers include Michael Dinnel, a podiatrist, who is making his third attempt for the council seat.

Dr. Michael Dinnel

Dinnel criticized the city for allowing City Hall to deteriorate. Dinnel said, “When I went to Europe, most of the city halls were over 300 years old and were functioning. Why? Good stewardship.”

On Thursday, candidates were asked to address the topic of illegal immigration, and most agreed it was a federal issue. However, Dinnel disagreed and said citizens can do things locally, such as boycotts.

Source: Matthew Rodriguez, Union-Tribune, [9/30/06]

OCPM Breaks Ground

The ground is broken. Let construction begin. The Ohio College of Podiatric Medicine in Independence broke ground for its expansion of the old Realty One building in Independence.

OCPM and Independence Officials Break Ground

The expansion, a 7,000-square-foot lecture hall, will be added to the neo-Georgian, 115,000-square-foot exiting building. Inside the existing structure, office space will be renovated, the cafeteria will be updated, and there will be a new computer and media center, high tech lab and a library facility.

At the groundbreaking ceremony, Mayor Fred Ramos said he looks forward to a long relationship with the college. It's a historical day for Independence , he said. We're adding another important member to our family. Dr. Henry Green, chairman of the OCPM board of trustees, said, May this building serve as a reminder of the strength and accomplishments we've obtained. Ramos added, We're thrilled the Ohio Podiatric College chose Independence as its home.

Source: Tara Quinn, The Sun Courier, [9/28/06]

OIG Releases 2007 Work Plan

The following are some of the highlights applicable to podiatrists which appear in the recently released 2007 OIG Work Plan:

Billing Service Companies
We will identify and review the relationships between billing companies and the physicians and other Medicare providers who use their services. We will identify the types of arrangements that physicians and other Medicare providers have with billing services and determine the impact of these arrangements on physicians’ billings.

Wound Care Services
We will determine whether claims for wound care services were medically necessary and billed in accordance with Medicare requirements. Medicare-allowed amounts for certain wound care services billed by physicians increased from approximately $98 million in 1998 to $147 million in 2002. We will also examine the adequacy of controls to prevent inappropriate payments for wound care services

Review of Evaluation and Management Services During Global Surgery Periods

We will determine whether (1) physicians received separate payments for evaluation and management (E&M) services provided during the global surgery period and (2) industry practices related to the number of E&M services provided during the global surgery period have changed since the global surgery fee concept was initially developed in 1992. Under the global surgery fee concept, physicians bill a single fee for all their services usually associated with a surgical procedure and related E&M services provided during the global surgery period. E&M services related to the surgery provided during the global period should not be billed for and paid separately by Medicare. The global surgery fee includes payment for a certain number of E&M services provided during the global surgery period.

Medicare Payments for Therapeutic Footwear

We will determine whether therapeutic footwear furnished by individual suppliers was reasonable and necessary for the beneficiaries to whom it was provided. Under certain circumstances, Medicare covers therapeutic footwear for beneficiaries who have diabetes and at least one of several related conditions. Medicare payments for therapeutic footwear totaled more than $130 million in 2003. A previous OIG report indicated that a significant percentage of payments made for therapeutic footwear did not have adequate documentation to support the beneficiaries’ medical need for the footwear.

The URL for OIG’s Fiscal Year 2007 Work Plan can be found at http://tinyurl.com/hobr8

Query: Sterilizing Non-Surgical Instruments

For years we have been sterilizing our 312 blades, etc. using our steam autoclave, but I am wondering what others are doing for nippers, chisels, etc that may be less costly in terms of the sterilizing envelopes, time, blades dulled by the heat, etc. These are not items to be used with blood, or purulent matter. They are just used for debriding calluses.

Howard Bonenberger, DPM, Nashua, NH, HOWARDBON@aol.com

RE: Changes to DMERC
From: Paul Kesselman, DPM

CMS has made two shocking announcements regarding changes to DMERC (now known as DMAC).

The first stunner is that Palmetto GBA long the Medicare contractor for region C is being replaced by Cigna. CMS expects Cigna to take over operations within region C no later than April 1, 2007.DMAC region C covers the following states: AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, U.S. Virgin Islands, VA, and WV.

In addition to being the contractor for SADMERC, NSC and the owner of other contractors involved with DMERC operations Palmetto GBA had long held the contract for DMERC region C. Palmetto has the right to file a protest with the Government Accountability office. This change would effectively change 2 of the four DMAC contractors within the last year. Cigna has a wealth of experience handling DME claims having been the former contractor for Region D. I would not expect those providers in region C to be subjected to the same problems those of us experienced in DMAC A., as NHIC the DMAC A carrier had no previous experience handling Medicare DME claims.

The second stunner is that Medicare has effectively dropped its requirement that all DME claims be sent to one electronic address, controlled by yet another carrier. This demand has effectively been dropped because regions A, B and D already have set up their own data centers which would have functioned similar to those already in operation by regions A B and D.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

RE: Treating Patients via the Internet
From: Bob Kornfeld, DPM

It is my understanding that the patients you treat on the internet must reside in a state where you have a current license. If they do not, then you are literally practicing without a license and are subject to prosecution.

Bob Kornfeld, DPM, Lake Success, NY, Holfoot153@aol.com

RE: Digital Scanning For Orthotics (Craig Payne and Bruce Williams, DPM)
From: Dennis Shavelson, DPM

We are avoiding the real question in this debate which is whether or not a scan or foam or neutral casting can produce orthotics with superior outcomes. Australia ’s recent publications and an article in The New York Times opine that podiatrists are producing “Chevrolet” outcomes.

For Mr. Payne to state that digital scanners are “no different to plaster casts” shows a lacks of exposure to state of the art plaster casting. Furthermore, to promote the spin that “quick and less messy is better” reminds me of the spin of the minimal incision surgeons of the 80’s Biomechanics is the last vestige of practice where we have time to close the widening gap between our rhetoric and our ability to produce “Mercedes” outcomes when compared to the rest of the field. If Craig and Bruce are correct, a teenager can scan a foot, ask the lab to “post to cast” and produce “Mercedes” orthotics. What does that say about the future of podiatry?

We all agree that “Root” theory needs revision, but to take the easy way out and let technology replace our foundational training and practice skills reduces the ability of podiatry to lead the custom foot-bed pack.

Dennis Shavelson, DPM, Medical Director, The FootHelpers Lab, DrSha@footworldusa.com

NURSING HOME ASSOCIATE NEEDED- PHILA AREA

Extremely high volume nursing home and home care practice. Well-established and respected Suburban Philadelphia practice seeking an associate who is hardworking. Full-time or part-time available. Very busy practice which can be worked every day and be very lucrative for a hard-working individual. No nursing home further than ½ hour away from office. Email CV and contact info to: mrgpod@hotmail.com or fax CV to 610-668-5175

PRACTICE FOR SALE/ASSOCIATE/PARTNERSHIP - WASHINGTON, DC

Established busy practice for sale in hospital's medical building. Fully equipped. All aspects of podiatric medicine/surgery. Large diabetic practice with wound care clinic. Large referral base. Hospital to be renovated and expanded. Charcot, forefoot, rearfoot, orthopedics. Residency required for privileges. Moving - will stay for transition. Associateship until purchase. Unbelievable potential to expand. Will finance sale with adequate down-payment. Serious inquires only. Contact scottr0666@yahoo.com

IMMEDIATE ASSOCIATE NEEDED - PHILLY SUBURBS

High volume office-based practice suburban Philadelphia. Very diverse, all ages seen. Sports medicine, trauma, forefoot and rearfoot surgery. Full-time office, near hospitals for surgery, consults, and in-house pt. care. Candidate must be hard-working dedicated to pt. care and well-trained. Needs to be personable. PSR12/24/36 Board Certified/Eligible required for a fast-paced, fun atmosphere to work. Email CV and contact info to: mrgpod@hotmail.com or fax CV to 610-668-5175

POSITION WANTED - SOUTHEAST

Seeking position as associate, partner or to purchase practice. Licensed in FL, GA, AL, and TN. 35+ years of active practice in all aspects of podiatric medicine and surgery. Available immediately (770) 403-2874 or handor@aol.com

PRACTICE FOR SALE - TEXAS

Practice for sale in fast growing suburb of Dallas, TX. Fully furnished office in medical building on busy street. General Podiatry, including routine care, orthotics, surgery, etc. Currently part-time office, can be full-time. Hospital privileges available. Excellent Opportunity. Must sell fast. Please respond to: P.O. Box 796757, Dallas, TX 75379 or fax contact info to: (972)267-1815.

ASSOCIATE POSITON - 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-INDEPENDENT CONTRACTOR – FLORIDA

High Income position for ethical hard working podiatrist, great for semi-retired or to supplement office practice, part time. Must have Florida license and active Medicare/Medicaid numbers. FAX CV or Resume to 727-785-4697

WELL ESTABLISHED PODIATRY PRACTICE IN MT. AIRY, NC

Dr. John H. Hodges had a well established podiatry practice in Mt. Airy, North Carolina that is either for sale or in need of an associate/partner to come on board to take over patient care. Dr. Hodges unexpectedly passed away in January 2006, leaving approximately 3,500 patients without a podiatrist to care for them. This is a unique opportunity to be able to begin work in an extremely busy podiatric practice. If interested, contact Carolyn McMackin at (336)577-2886 or cmcmackin@triad.rr.com

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

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