News From ACFAS

The House has scheduled a vote for tomorrow (November 19) on HR 3961, which would scrap the flawed “sustainable growth rate” formula for paying physicians in Medicare and avert a scheduled 21 percent cut in physician payment on January 1, 2010. The issue of paying for a permanent fix could present a major stumbling block if the bill passes in the House and moves to the Senate. A few weeks ago, the Senate rejected a free-standing permanent fix. Moreover, the Congressional Budget Office issued a report that HR 3961 would cost seniors $49 billion in higher premiums over the next 10 years.

ACFAS’ popular — and free — coding podcast is a great resource for you and your billing staff. Christine Weikert, DPM, FACFAS, president of Podiatric Billing Specialists, walks listeners through common coding and billing mistakes that result in lost revenue. The podcast is one hour long and is an important investment in your practice’s bottom line.

The second mailing of the 2010 Annual Scientific Conference Program and Registration Information has been sent. Don't delay; register today for this one-of-a-kind educational opportunity.

If you haven’t received the program, call 800-421-2237 to request one, or visit acfas.org/lasvegas for complete information.

The November issue of Update, the ACFAS member print newsletter, will be arriving soon in your mailbox—but you can download the PDF at the Update web page and read it now!

Learn about the importance of Regional Divisions from ACFAS President Mary E. Crawford. Explore the new features you’ll find at the Annual Scientific Conference. And, find out how some ACFAS members view the progress of the profession from a perspective of more than 40 years.

No need to wait — download the November Update any time.

Foot and Ankle Surgery

The Distally Based Posterolateral Supramalleolar Neurofasciocutaneous Island Flap for Coverage Defects Over the Distal Third of the Leg and Foot

A traditional-designed distally based sural flap centralized on the axis of the sural nerve and the lesser saphenous vein has been used widely for coverage of the distal third of the leg, ankle, malleoli, and foot. However, significant flap necrosis after the flap elevation and transposition has been recorded, due largely to the unreliability of the distal part of the flap. Researchers analyzed the effectiveness of a distally based posterolateral supramalleolar neurofasciocutaneous island flap centralized on the longitudinal chain-linked axial vascular network in reconstructing and covering the defects over the distal third of the leg, lateral malleolus, foot and Achilles tendon. They concluded that the procedure is reliable and very useful, especially in young children.



Peroneal Tendon Tears: Associated Arthroscopic Findings and Results After Repair

Researchers in this study sought to identify the intra-articular pathology associated with peroneal tendon tears and report the outcomes after tendon repair or tenodesis with arthroscopic treatment. They found that all patients with peroneal tendon tears involved in the study had associated intra-articular pathology, with the majority of patients having more than one intra-articular lesion. For patients meeting surgical criteria, correction of the tendon tears and arthroscopic treatment of the intra-articular lesions produced statistically significant improvement in results and patient satisfaction.

Practice Management

Nickel and Dime Leakage That's Costing You Big

Practice management consultants note that many practices lose money on “small leaks” that when identified can save thousands of dollars. Examples include memberships and services practices pay for but don’t use. For example, one practice was still paying $500 a year on a contract for insurance card scanners that they hadn’t used for three years, and $400 a year for an antivirus protection that was redundant. Sometimes monthly vendor bills don’t receive the scrutiny that they should and practices do not discover they are being overcharged. Other areas consultants suggest for review include making sure you are paying competitive rates for janitorial services, credit card processing and staff overtime. They suggest that overtime be approved in advance by a supervisor.



Medicare Paid Over $92 Million in Incentives for 2008 Under PQRI

CMS announced that it has paid $92 million to 85,000 physicians and other “eligible professionals” who reported quality data to Medicare in 2009 under the Physician Quality Reporting Initiative. The payments far exceeded the $36 million paid in 2007, due primarily to greater participation by physicians. The payments to individuals averaged $1,000, with the largest payment totaling over $98,000 — likely a large group practice.



Doctors Embrace Social Networking

Doctors are using social networking tools to bring patients' families and the general public into operating rooms, sometimes sharing step-by-step medical procedures. They favor real-time updates and videos as a way to reduce the fear factor of surgeries and educate people about the realities of certain procedures. Doctors can keep their patients' identities private by using just one of their initials and by keeping posts vague enough that strangers will have trouble figuring out what kind of operation is being performed.

Health Policy and Reimbursement

Tort Reform Law Challenged in Georgia

Emergency care will suffer if a tort reform measure about medical liability lawsuits concerning emergency care is not upheld in Georgia, according to a friend-of-the-court brief the Medical Association of Georgia and the Litigation Center of the American Medical Association and State Medical Societies filed in a case pending before the state Supreme Court. In Gliemmo v. Cousineau, the court will determine the constitutionality of the 2005 reform measure, which mandated a higher burden of proof in such lawsuits. Plaintiffs must prove by a standard of clear and convincing evidence that a physician committed gross negligence. Physicians credit the statute with lowering their professional liability insurance costs and keeping emergency doctors in practice.



Maine Finds a Health Care Fix Elusive

Maine has struggled unsuccessfully for years with finding solutions for rising healthcare costs. It is a poor state, and health insurance premiums and healthcare spending per-person are still among the highest in the country. Several years ago Maine unveiled a state-sponsored insurance plan, but enrollment is capped at 9,000 because of funding issues. Most participants buy plans with a $15,000 deductible, which can lead to delaying preventive and needed care. Poor Maine residents receive care from clinics that are federally supported. Many Mainers now conclude that a solution is beyond the means of the state and must be addressed on the federal level.



State's Poor Being Shifted to Different Medical Plan

Minnesota's General Assistance Medicare Program (GAMC) for adults making less than $7,800 a year is scheduled to be eliminated March 1, potentially leaving some 36,000 recipients—many with chronic illnesses and often homeless and mentally ill—without regular access to medical care. Under a new proposal, some 28,000 will be automatically enrolled in MinnesotaCare, a subsidized health insurance plan, with the remainder being those whose GAMC eligibility is running out or who already are applying for MinnesotaCare.

Technology and Device Trends

Applause for the SmartHand

Researchers from Israel and Europe have succeeded in wiring an artificial hand to the existing nerve endings in the stump of a person with a severed arm. The bionic hand, called the SmartHand, resembles a real hand in function, sensitivity, and appearance. It features four electric motors and 40 sensors to replicate the movement of a human hand and provide a sensation of feeling and touch. The researchers say the same technology could be used to build a bionic leg.



Study Notes SPECT-CT as Influential in Making Talar Lesion Treatment Decisions

Research comparing MRI and single-photon emission computed tomography scans of osteochondral lesions of the talus revealed that single-photon emission computed tomography (SPECT-CT) images caused physicians to change 59 percent of their treatment decisions. To determine the influence of SPECT-CT images, researchers asked three orthopedic foot and ankle surgeons to analyze the MRI and SPECT-CT scans of 26 patients with osteochondral lesions of the talus. The study was presented at the 25th Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society.



MACI Shows Promising Results as a Salvage Procedure for Talar Defects

Matrix-induced autologous chondrocyte implantation (MACI) may be an option for patients with full-thickness lesions of the talus who were unsuccessfully treated with curettage or microfracture, according to research presented at 25th Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society. The study included 10 patients with osteochondral defects of the talus measuring greater than 1 square centimeter. The patients had an average of 1.7 procedures prior to the MACI and were followed for 2 years after the procedure.



Abstract News © Copyright 2009 INFORMATION, INC.

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