News From ACFAS

The health reform debate is in a state of flux this week. Events last week raised questions about the political viability of proposals by the Senate Health and Senate Finance committees after the Congressional Budget Office (CBO) released its cost estimates. Both Committees have gone back to the drawing board. On Friday, the House Democrats unveiled their health reform bill which includes the controversial public plan option.

Another CBO report received less attention but may have more impact in the long run. In its report, Health Care Reform and the Federal Budget, the CBO emphasized, among many things, that “to ensure that current legislation puts the federal budget on a more sustainable path will probably require creating a framework for federal health care spending that imposes ongoing pressure to increase efficiency over time--particularly in the case of providers.” The CBO’s mandate is to provide objective and impartial analysis to Congress on the budgetary implications of legislation. The CBO report can be viewed using the Web link below.

Learn about this Medicare physician bonus incentive program, and whether it makes sense for your practice to participate, in this concise “question and answer” analysis available on the College's Web site. Access it now using the Web link below.

First year residents will receive a complimentary ACFAS membership, thanks to a joint initiative of the College’s Board of Directors and the ACFAS Regional Division Presidents Council (DPC).

“This provides a tremendous opportunity for new residents throughout the country to access a variety of ACFAS resources and benefits, including the journal, online publications, interaction with more seasoned members, and member pricing for the Annual Scientific Conference,” said DPC Chairman Marc Kravette, DPM.

ACFAS will be communicating with first-year podiatric surgical residents in July, and the memberships will begin October 1.


Learn recession-survival skills at the Coding and Practice Management Seminar September 25-26 in Chicago. With outstanding faculty, this comprehensive program will provide important coding, operations and marketing tools to optimize reimbursement and reduce overhead. Register online using the Web link below or phone 800.421.2237.

Foot and Ankle Surgery

FDA Panel Urges Approval of Savient Gout Drug

An FDA federal advisory committee on Tuesday recommended approval of a drug developed by Savient Pharmaceuticals to treat severe cases of gout. The drug, called Krystexxa, would be the second gout treatment approved in 2009 following a drought of more than four decades, if the FDA follows the advice of the committee, which is usually does. Uloric, from Takeda Pharmaceutical, was approved in February.



Performing Salvage Ankle Arthrodesis With Blade Plates After Total Ankle Arthroplasty Yielded Excellent Results

Researchers from the Netherlands report that use of a blade plate for tibio-talar fusion seems to produce the best results when arthrodesis is indicated for salvaging a patient’s ankle after total ankle arthroplasty (TAA). Among 18 ankles studied, all seven treated in this way fused successfully. All the patients originally received a mobile-bearing TAA prosthesis and underwent salvage surgeries following failure, including seven tibio-talar fusions and 11 tibio-talar calcaneal fusions.



Plantar Foot Donor Site as a Harvest of a Split-thickness Skin Graft

Ronald Belczyk, DPM, John J. Stapleton, DPM, Peter A. Blume, DPM, FACFAS, and Thomas Zgonis, DPM, FACFAS, present a minimally invasive procedure for harvesting a split thickness skin graft (STSG) from the plantar surface of the foot as an option for soft tissue reconstruction of diabetic foot wounds to help restore form and function and prevent amputation. The researchers do not recommend the technique for all soft tissue wounds of the toes and plantar aspect of the foot but believe it could be an option for selected small diabetic foot wounds.



Temple Podiatry Receives NIH Grant to Develop Personalized, Visual Diabetes Education Program

Researchers at Temple University's School of Podiatric Medicine have received a four-year grant from the National Institutes of Health valued at up to $650,000 to test the effectiveness of a personalized, visual diabetic foot education strategy developed through use of data collected at Temple's Gait Study Center. "Many of our diabetic patients don't understand simple foot care instructions and fail to perform even basic preventive measures, such as inspecting their feet daily or wearing protective shoes," says Jinsup Song, director of the center and assistant professor of podiatric medicine and orthopedics.

Practice Management

CMS Warns Industry about Fax Scam

CMS issued an alert to many providers on June 18, advising them about a fax scam by an entity seeking to obtain Medicare billing information by posing as a Medicare Administrative Contractor. According to CMS, the faxes warned the providers that if they did not provide certain billing information within 48 hours, they would experience gaps in Medicare payments.



GE to Offer Electronic Medical Record Financing

General Electric's GE Capital division will make no-interest loans to healthcare providers that purchase GE's healthcare information technology. GE said it expects to offer $100 million in interim financing for projects that are expected to qualify for funds from the federal economic-stimulus package.



New Group Seeks Incentives for Electronic Ordering

A group of providers and vendors has formed the Imaging e-Ordering Coalition to lobby for incentives that would encourage electronic ordering for diagnostic imaging. Members of the Coalition include the American College of Radiology and GE Healthcare. The Coalition will also act as a resource to CMS and plans to work on developing e-ordering standards.



The Fear Factor in Healthcare Costs

The issue of physicians practicing “defensive medicine” is back in the spotlight with President Obama’s statement to the AMA that he would consider some type of malpractice insurance reform as part of a health care reform package. A 2008 PricewaterhouseCoopers study found that 50% of all health care spending in the US is “wasteful” and that defensive medicine is the biggest driver of wasteful spending.

Health Policy and Reimbursement

Health Insurers Refuse to Limit Rescission of Coverage

Even in the face of intense bi-partisan criticisms, executives of Wellpoint Inc., United Health Group and Assurant testified to a House subcommittee that they would not stop the practice of cancelling individual insurance coverage for some patients with expensive illnesses over innocent mistakes in policy applications. When the executives were asked directly whether they would agree to only cancel a policy if there was intentional fraud, all three answered “no.” The three companies cancelled the policies of 20,000 people over five years, saving $300 million in medical expenses.



More Medical Schools Beef Up Conflicts Policies

The Pew Prescription Project and the American Medical Student Association released their annual “AMSA PharmFree Scorecard,” which rates medical schools on efforts to reduce conflicts of interest with drug and medical device makers. This year, 45 medical schools (about a third) earned an A or a B, which means that “they made a serious attempt to address the appropriate relationship of medical faculty” to industry. While many schools have not made significant progress, the number that has more than doubled from 2008, when only 21 received an A or a B.



New York Doctors Race to Abide by In-office Surgery Law

A New York state law requiring physicians who perform office-based surgery to upgrade their offices or find new space will take effect on July 14. The Patient Protection Bill will require doctors doing surgery to have their offices accredited by one of three existing agencies by July 14 or face penalties for professional misconduct should they continue to perform operations in their offices. Depending on specialty, the requirements could force such changes as larger elevators, improved ventilation, and backup power and equipment with the ability to run for longer periods.

Technology and Device Trends

Mexican Salamander May Yield Clues for Amputees

Study of the endangered Mexican salamander axolotl could yield clues for helping amputees. The axolotl can regrow injured limbs, jaws, skin, organs, and parts of its brain and spinal chord. The Pentagon has given a $6.25 million research grant to scientists studying the salamander with the aim of eventually helping the more than 1,000 soldiers who have come back from Iraq and Afghanistan with amputated extremities. Unlike in humans, blood vessels contract quickly and limit bleeding and skin cells work fast to cover the wound site after amputation in salamanders, forming a collection of stemlike cells that will eventually become the new body part.



Powerful Ideas: Wii Aids Doctors and Patients

The Nintendo Wii's motion-sensitive wireless controller could help surgeons to refine their motor skills and performance in a surgical simulator, and a group of researchers will soon launch a full surgical training system designed for the Wii where trainees can practice suturing and other procedures. "With the Wii, we have a very easy and inexpensive platform where surgery residents can learn and develop their skills," says Banner Good Samaritan Medical Center endoscopic surgeon Mark Smith. Researchers are particularly interested in employing the Wii in the teaching of robotic surgery.



Abstract News © Copyright 2009 INFORMATION, INC.

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