The Voice of Podiatrists

Serving Over 10,000 Podiatrists Daily

December 19, 2007 #3,121 Editor-Barry Block, DPM, JD

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FL Professor Testifies That IA Podiatrist Acted Reasonably

A podiatric medicine professor testified Friday that a Dubuque podiatrist acted reasonably when performing a foot procedure on a Dubuque man using a circular frame. "This is not a case of malpractice," said Dr. Charles C. Southerland Jr., a professor at Barry University in Miami Shores, FL.

Dr. Charles C. Southerland Jr.

Southerland testified the use of the circular frame was appropriate for treating Day's foot deformity. "It allowed Mr. Day to ambulate immediately post-op," Southerland said. Immediately being able to walk, Southerland testified, would have limited the risk of muscular atrophy for Day, who faces increased risk of wasted muscles because of his progressive Charcot-Marie-Tooth disease.

The plaintiff contends that the defendant, Dr. Michael Arnz did not adequately treat an infection that began at the site of pins drilled into the tibia to hold Day's circular frame in place. Southerland testified the care provided by Arnz met the standard of podiatric medical care.

Source: Erik Hogstrom, Dubuque Telegraph Herald (IA) [12/15/07]

Fight over Physician Quality Ratings Moves to Massachusetts

Despite deals in New York that insurers pledge will improve their tiered networks nationwide, physicians are not assured that networks based on quality ratings will be to their liking.

One of the hottest battles over tiered networks is going on in Massachusetts. It involves the tiered network system mandated by the Massachusetts state employees health insurance program, the Group Insurance Commission. In November, the GIC started accepting proposals from health plans that would set up networks covering not only 250,000 state employees, but also potentially another 330,000 municipal employees as the program expands to cover any state and local public employee.

Katherine Atkinson, MD, a family physician in Amherst, MA said GIC health plans have sent notices to physicians informing them that they are in low tiers without offering an explanation, and without any chance to appeal their ranking. Worse, she said, the rankings are based largely on cost, but patients don't know that -- they assume the doctor must be incompetent or have committed malpractice.

Source: Emily Berry, AMNews [12/24/07]

Query: Anti-Aging Seminar

Has anyone attended the Anti-Aging Medicine World Congress seminar in Paris. Was it worthwhile? Was it tax deductible? Any suggestions?

Joe Borden, Reseda. CA

Query: Medicare Overpayment Request

I received an overpayment request from my Medicare carrier, First Coast Service Options, Inc., for services rendered this past March. The letter states that the beneficiary was enrolled in a risk-based managed care organization.

I subscribe to an online service the connects to CMS to check Medicare eligibility, and get a print out on each and every Medicare patient immediately prior to the visit. In this situation, I have the print out that shows that the patient was eligible for Medicare Part "B", and there is no reference to any risk-based managed care organization. NOTE: If a patient is enrolled in a risk based managed care organization the site will specifically state so, and will give the name of that organization.

When I called First Coast Service Options today, I was told that when they updated their records with Social Security on November 27, 2007 that they discovered this overpayment. Hence, my receiving a request to refund money to them.

So, my question is, how are we supposed to know? If the system is backlogged for six months, then we are potentially liable to pay back reimbursements for services rendered, even though all of the information that they provide to us (at the time of the service) says that First Coast is the responsible payer? What is our recourse in a situation such as this?

Richard Simmons, DPM, Viera, FL

Response: I would run this past your state association and have your CAC rep try to address this. You should likewise report this to APMA's Health Policy Committee.

It is unfair when the provider does everything correctly in checking eligbility, render appropriate services, and be asked for a refund because Social Security is unable to timely update the carriers' software.

I would reply to the refund request and simply state the scenario as you outlined in your post and that asking for money back is unfair and unwarranted.

Tony Poggio, DPM, Alameda, CA

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RE: Multi-Specialty Groups (Jennifer B. Ryder, DPM)
From: Steven J. Tilles, DPM, Steven J. Tilles, DPM

Our practice has been a part of a large, multi-specialty group for the past 5 years. It has been a very successful, rewarding move for us. There are some great benefits being a part of a larger group, namely better insurance contracts, EMR, OSHA and HIPAA oversight and integration within the medical community. I would be happy to talk with you about some things you may want to consider. Also, Podiatry Management did an article entitled The Pro’s and Con’s of a Multi-Specialty Practice. http://www.podiatrym.com/pmarticle.cfm?id=69

Steven J. Tilles, DPM, steven.tilles@cornerstonehealthcare.com, High Point, NC

I am in a multi specialty group with 15 endocrine doctors we are the largest group in the country with 90,000 patients in northeast Florida, and my experience has been nothing short of excellent. I have a referral base that is unlimited and my practice has grown exponentially in the last year. I am seeing an average of 150 patients a week and 20 new patients a week. Being associated with my group has put our profession in the spotlight which is very good for us as a profession and I have not regretted my decision one bit. My partners are well-versed in their fields and treat me with the same respect any other doctor, even though we are different specialties. If you are able to have a chance with a group with diverse dynamics such as endocrine or cardiac or optometry, I would say do it, but do your homework and make sure it’s a good fit for you..

Ronnie Bateh, DPM, Jacksonville, FL, jbateh@aol.com

ASSOCIATE POSITION – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

ASSOCIATE POSITION/ BUY-IN -COASTAL SE NC

Excellent opportunity for well trained, articulate, hardworking individual competent in all phases of practice. Long term position available with buy-in also an option. Strong salary and benefits. Gorgeous coastal area. Don't miss this one! Contact kinggy@atmc.net

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

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

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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 -- www.homephysicians.com

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