The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

November 20, 2008 #3,405 Editor-Barry Block, DPM, JD

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Janet Simon Receives APHA’s Toth Award

The American Public Health Association (APHA) held its 136th Annual Meeting on October 26-29, in San Diego, CA. where Janet Simon, DPM of Albuquerque, NM became the Podiatric Health Section chair and was presented with the Stephen Toth, DPM Distinguished Service Award.

Dr. Janet Simon

Dr. Simon is leading the profession's public health efforts and anticipates an active agenda in the coming two years. The section will be continuing its data collection of humanitarian/missionary/community Medicine projects that many podiatrists are active in along with participating in the 2009 Public Health Week, themed "Building the Foundation for a Healthy America."

The APHA Podiatry Section in coordination with APMA is proposing a project to assist members in developing walking programs for their referral sources and patients. "One of the key messages I would like every podiatrist to recognize is that what we do every day in our varied podiatry practices is related to public health and that networking with the public health system not only can be professionally fulfilling, but personally as well." stated Dr. Simon.

Amerx Health Care Corporation Names Lab at OCPM

Amerx Health Care Corporation recently made a donation of $35,000 to the Ohio College of Podiatric Medicine’s Stepping Towards the Future Naming Campaign to name the “Amerigel Radiology Laboratory” at OCPM’s new school in Independence, Ohio. Justice Anderson, President of Amerx said, “While we do not manufacture or sell any products, software, or imaging equipment, it is more important to Amerx that we continue our commitment to support the future of podiatry. We are proud to be a part of OCPM and we look forward to more opportunities to be involved with the college, OCPM students, and the profession.

(From Left) Dr. David Nicolanti, OCPM Executive Vice President, Chris White, Director of Podiatry, Amerx Health Care, and Thomas V. Melillo, OCPM President

The Amerigel Radiology Lab is dedicated 100% to clinical training in radiology and only involves 3rd and 4th year student training. The training is taught in the lab centers around mastery of common skills and recognition of common pathologies. In addition, it emphasizes normal anatomy and the algorithmic approach toward radiographic interpretation.

NJPMS Installs New Officers

John DePalma, DPM, become the 89th president of the New Jersey Podiatric Medical Society (NJPMS) upon taking the oath of office at the society’s Annual Installation and Dinner Dance held at the East Brunswick Chateau.

Dr. John DePalma

Since joining NJPMS in 1995, Dr. DePalma has held various positions on the Society’s Executive Board of Directors, including terms as secretary, treasurer and vice president. Additionally, he served as co-chairman of the NJPMS Building Committee. Dr. DePalma also served as co-chairman of the NJPMS P-PAC Committee.

(Left to right) Steven Maffei, DPM, President-Elect; John DePalma, DPM, President; Herman Hammerschmidt, Executive Director; James Ricketti, DPM, Vice President and Terry Spilken, DPM, Treasurer.

In addition to the installation of Dr. DePalma, Dr. Steven Maffei of Mercerville became President Elect; Dr. James Ricketti of Hamilton Square became Vice President; Dr. Terry Spilken of Livingston became Treasurer and Dr. Marshall Feldman of Rahway became Secretary. News of the officers’ appointments was announced at the Society’s Annual Meeting in Atlantic City, NJ.

NY Podiatrist Overbilled State: Audit

Eight healthcare providers on Long Island were among 20 in New York who overbilled the state millions of dollars in this decade, the state comptroller’s office has said. An audit conducted last year by the comptroller’s office found that the eight Long Island providers submitted $10 million in inflated claims, mostly by waiving patients’ out-of-network fees for the Empire Plan, the state’s largest employee health plan.

The audit reviewed billing between January 2001 and December 2007. Not all providers’ billing records were inspected for the entire seven years. Among those overbilling was podiatrist Dr. Edward Fryman of Seaford, NY. Fryman billed the Empire Plan for $2.1 Million dollars during that period, of which $ 507,786 was inflated.

The most common way of overstating charges was for the provider to waive an Empire Plan member’s out-of-network costs. The patient’s share of the bill, including out-of-network costs, would then be passed on to the state, according to the audit. Out-of-network providers are not locked into the Empire Plan fee structure and can charge more. Reimbursements for out-of-network providers are typically 77 to 83 percent higher than for network providers, the audit found.

Source: Derrick Henry, New York Times [11/14/08]

MD Podiatrist Charged With Medicare/Medicaid Fraud

Maryland Attorney General Douglas F. Gansler has announced that Edward Michael Horvath, 50, of Laurel, Maryland, was charged in the Circuit Court for Baltimore City with one count of Felony Medicaid Fraud and one count of Felony Theft from the Medicare Program. Horvath was charged with falsely billing the Medicaid and Medicare programs over a five year period for podiatry services that he did not perform. Horvath's podiatry practice is based in Prince George's County and he submitted his requests for payment to the Department of Health and Mental Hygiene located in Baltimore City.

Medicaid Fraud is a felony punishable by up to five years in prison and/or a $5,000 fine. Felony Theft is punishable by up to 15 years in prison and/or a $25,000 fine. Criminal charges are but an accusation, and an individual is presumed innocent unless the State proves him guilty beyond a reasonable doubt.

Source: Maryland Attorney General’s Office

RE: Varus 5th Hammertoe in a 12 Year Old (Richard Frost, DPM)
From: Multiple Respondents

I'd suggest flexor tendon release and capsulotomies for now, with splinting of the 4th and 5th toes. Try to do this during some season when your athletic patient is not actively involved in a sport. This is relatively non-invasive, and you can warn the patient and her folks that later down the road she may need bony correction.

Paul Busman DPM,RN, Clifton Park NY, BREWERPAUL@aol.com

The condition can be nicely treated with a simple flexor tendon tenotomy and a plantar capsulotomy of the IP joint, both performed through a single percutaneous incision. Then, splintage of the toe for 3-4 weeks. No need for arthroplasties or other bony procedures.

Donald Jay Arenson, DPM, darenson@pol.net

Congenital juvenile curly toes respond quite well to FDL transfer to the dorsal extenser apparatus at the PIPJ level. Make the incision either dorsal-medial or dorsal-lateral from the tip of the digit to proximal to the PIPJ. Raise a full-thickness flap and dissect out the FDL from its sheath. Follow the FDL to the distal insertion and release. Bring the distal end of the FDL to the dorsal PIPJ area, reduce the deformity manually and suture the FDL to the capsule. Drive a small K-wire from the distal digit into the proximal phalanx.

You may need to anchor the wire into the metatarsal if the purchase in poor in the phalanx. Nevertheless, growth plate interruption is highly unusual when using smooth K-wires. Close the skin with 5-0 Vicryl and let the sutures fall out when the patient begins to bathe. Sutures removal in kids is a nice thing to avoid if possible. Splint or cast to protect the wire and the transfer. 12 year olds will not stay off the operative foot.

David T. Taylor, DPM, Flint, MI, dttaylor_19@yahoo.com

RE: NY Podiatrist Overbilled State: Audit
From: Mark Levine, DPM

A recent item appeared that doesn’t bode well for podiatry and medicine, in general. The New Yorkk Times ran a story about providers who were investigated by the state who were billing the insurance company for state employees OUT-OF-NETWORK. They were charged with overcharging and not charging for deductibles. One of the doctors happened to be a podiatrist. Most of the doctors have repaid large sums of money and some still have the charges pending. Since when have there been limits on how much can be charged. The insurance company only needs to reimburse based on customary and reasonable fees.

With government at all levels going broke, the doctors are the easiest targets. Insurance companies who investigate providers can get the FBI involved since most of the billing is interstate and this could only open a Pandora’s box for the affected provider.

To top this all off, if congress doesn't act within the next year, Medicare reimbursements will go down an estimated 20%. Of course they'll say everyone has to chip in to save the feds, but we've gotten far less than the CPI total in the past 8 or 9 years. I'm sure these little items will start appearing more and more as governments, local and federal try to cut down on reimbursements and insurance companies do whatever they can in order to squeeze the provider till there's nothing left.

Mark Levine, DPM, Middle Village, NY, MarkLevineDPM@verizon.net

RE: Web-Based Appointment Scheduling Software (Robert Schwartz, C Ped)
From: Martin G. Miller, DPM

Chronilist by Integra Computing works very well for me. I have been using this application for years. It is fast, inexpensive, easy and allows for multiple users at once spread across a network. You can get it at integracomputing.com.

Martin G. Miller, DPM, Freeport, NY, mgmiller@optonline.net

RE: ASPS, APMA’s New Surgical Affiliate (Irv Kanat, DPM)
From: Multiple Respondents

Kudos to Irv Kanat for his thoughts, and his commitment to our profession.

I think that individuals who look at this issue on the surface only, have failed to look out for our profession. Unity is what has allowed our profession to advance to the levels that it sees today. As we look towards parity through Vision 2015, this can only be accomplished with a complete team effort. One must look deeper into what caused the APMA to make their decision and what caused ACFAS to make their decision. Knowing the leadership of the APMA well, I can assure each of you that this was an extremely difficult decision. We will advance as a profession only if we can function with joint benefits that we all have to bring to support our profession.

I applaud the APMA for making this very complicated resolution and hope that, in turn, the ACFAS will look at their recent decisions and make an effort to bring the profession back together. Dividing as we are doing now, will not benefit our profession and I am sorry that ACFAS made the decisions that they did.

I have ended my support of ACFAS and will support ASPS with the hope that other members will do the same. My hope is that this will force the ACFAS to look at their choice and come back to the table to work with the APMA.

Rob Katz, DPM, MBA, Sarasota, FL, rkatz@ips-med.com

What I find perplexing, are those who blame the APMA for this "decision." The decision was made by the ACFAS board when they decided not to require APMA membership (a requirement in APMA bylaws). By placing ACFAS (an APMA affiliate) in conflict with APMA bylaws, they "decided" not to be affiliated with APMA. I'm sure most ACFAS members didn't fully understand the ramifications of the recent vote, since the ballot language was misleading.

If the ballot would have read ... "Voting Yes will place the ACFAS affiliate status in APMA in jeopardy, and in doing so APMA may designate another surgical affiliate," The vote may have been different. Unfortunately, the ACFAS board fully understood these ramifications and they brought this upon themselves. APMA is just being responsive to ACFAS’ decision.

Lee C. Rogers, DPM, Des Moines, IA, Lee.C.Rogers@gmail.com

I have reason to doubt the recent posting stating ACFAS enjoying an increase in membership. It was my understanding there was a significant reduction in membership after ACFAS decided to not require APMA membership to belong to their organization. I know for a fact, that a huge number of us in Maryland, immediately resigned from ACFAS after the decision. I know colleagues across the country who, similarly, have resigned. So where did all these new members of ACFAS come from?

Regarding members of APMA resigning and joining ACFAS, that is never going to happen. APMA is our profession's main supporter and advocate. They represent all podiatrists, surgical and non-surgical. They are not elitist, and have been increasingly opening their doors to members getting involved and active. To the contrary, ACFAS has always represented only surgically practicing podiatrists. In my 20 years of being a member of ACFAS, before my resignation, I rarely saw an instance where ACFAS's singular actions made a change in my practice, state law, or any issue that affected me on a daily basis.

Forgotten in this process, is the manner in which ACFAS went about their decision regarding APMA membership. Their board made a decision to change, THEN consulted its membership, and then made a confusing referendum to change bylaws and go backwards to what was the policy previously.

Finally, chances are that having 2 organizations will not be as beneficial as having just one. But, ACFAS created this situation, and bears a lot of responsibility for the outcome. Ultimately, I believe we will have one organization with few APMA members (ACFAS), and another with all APMA members (ASPS). I choose to align with the later, recognizing my indebtedness to APMA for all they have done for me over many, many years.

Brian Kashan, DPM, Baltimore, MD, drbkas@worldnet.att.net

Editor’s note: An extended-length note by Walter W. Strash, DPM appears at: http://www.podiatrym.com/letters2.cfm?id=23183&start=1

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

PODIATRISTS NEEDED - CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ISO CONSULTING/MANAGERIAL OPPORTUNITIES FLORIDA

Established practitioner, with extensive clinical and practice management experience, is retiring to Florida, and is seeking consulting/managerial opportunities within podiatry or in general health care in the Broward County/Palm Beach County area. Could also provide expertise in product/educational development. Please email responses to retiredpod@gmail.com

EQUIPMENT FOR RENT - EXTREMITY MRI

Now you can rent an extremity MRI, have the scan performed, read by a board-certified radiologist and derive all the income. two convenient locations, Manhattan East 60th street between Park and Lexington, and Plainview, Long Island. Conforms to the Stark amendment; call for information (516) 476-1815.

LOOKING FOR FINANCIAL SECURITY?

Our practice continues to grow and we’re in search of a motivated, well-trained DPM who is great with patients. Our multi-office practice is located in the scenic Hudson Valley region of New York State. This is a great career opportunity for the right person(s), with an excellent compensation package available. Please reply to Hudson Valley Foot Associates, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.com

ASSOCIATE POSITION – MASSACHUSETTS

Excellent opportunity for a highly-motivated, entrepreneurial individual to join a very successful, rapidly growing multi-office practice, North of Boston. Seeking a PSR-24/36 trained podiatrist to join our group. We offer a competitive salary/benefit package with the opportunity of partnership after one year, for the right individual. Send CV and letter of interest to drfleishman@nefootankle.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicagoland and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

ASSOCIATE POSITION – ST. LOUIS, MISSOURI

Excellent opportunity for PSR 24-36 foot and ankle surgically-trained physician. Looking for hard-working, personable, highly-motivated individuals to join our group and build their own practice. Position leading to partnership. Great opportunity with excellent salary and benefits. Please e-mail CV and references to cavallinig@foothealers.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for part-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Please send CV to slurie@papapc.net

POSITION - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes.Top hospitals. Fax CV with references to 703-491-9994

ASSOCIATE POSITION –GEORGIA

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