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Four years after September 11 and while in the wake of Hurricane Katrina, we should ask ourselves to consider medical issues which may arise after natural or unnatural disaster. We also need to consider the overall impact on our health care system. Fast forward to the time after which initial emergency responses are complete. Ongoing care is provided at temporary clinics set up at shelters and to persons who have been incorporated into remote communities accommodating evacuees. From a public health standpoint, the challenge is to deliver quality medical care, albeit basic, in a compromised setting, while considering the burden to the healthcare system. The onsite physicians are faced with multiple new patients all at once. After an evacuation, patients may need to regain diabetic control, stabilize hypertension, asthma, seizure disorders or other chronic illnesses. What about cancer patients on chemotherapy? Many people don't know the names or dosages of their medications. Even if they did, without medical records, should medications be dispensed based on the patient's recollection? Each person needs evaluation and often, multiple visits and follow-ups are needed before an effective treatment regimen is established. What if, however, instead of having no medical records, the front line physicians have ready-access to medical history for each individual? One option might be to have computer chips implanted under the skin. A second option is to have identification cards that carry medical histories. Still another option would be to create a centralized database using fingerprint identification. Any one of these would assure that medical information on a patient evacuated from New Orleans could be accessed in a Houston shelter. A physician seeing a patient in a Baton Rouge temporary clinic could read the computer chip and immediately continue the patient's medication regimen while avoiding adverse drug interactions. A child's anti-seizure or asthma medication could be continued without further interruption. Would this data help to avoid complications from under-treated conditions and therefore lessen the strain on healthcare delivery? The technology could be used to reunite families. Lost young children, seniors, those who do not know their name or address or individuals who simply cannot speak, could carry such information in a readable chip implanted under the skin. This technology is here - how would the stored data get updated? Would it be entered into a central data bank? What would be the physical ramifications of implanting a foreign body? Would it migrate? How could that be prevented? Could the individual still have a MRI without disabling or dislodging the chip? Alternatively, should the information be scanned into an identification card that each of us would carry at all times. What if the card got lost or stolen? What would that be like? (Have any of you experienced a lost credit card or driver's license?) While it seems like a big step away from keeping records confidential, realize that most of us are used to carrying a driver's license that has an identification number which provides access to much of our personal information. Some of us allow a store clerk to record this number when making a purchase by check. In the medical field we continually strive to protect the privacy of patients’ medical information. However, emergency situations may require us to consider additional priorities. Is our society ready for such availability of personal information that can potentially be accessed without permission? Physicians and colleagues --- think more about these issues both from a public health and personal point of view. As we move into the future, we need to consider these advanced technologies in the delivery of quality medical care.
As this edition of NACMED NEWS is going to print. Hurricane Rita is about 12 hours away from making landfall somewhere along the Texas/Louisiana Coast. No one yet knows the extend of damage or loss of life this latest hurricane will bring upon the region. However, it can be said with great certainty that both will be substantial. The information on page 8 was prepared following Katrina however, most relief agencies noted therein will be responding to both disasters. We also urge you to look on our website at www.nacmed.com For more information.
We are all saddened by the Recent Hurricane disasters and concerned for the survivors. The devastation is mind-boggling and currently there are thousands of square miles under federal disaster declaration. Conditions in the disaster area are harsh and both food and drinking water are scarce. Temperatures are frequently over 90 degrees. Please understand that there will be many citizens needing care and assistance for at least six months and most likely more. There are already centers and clinics being set up in some of the neighboring geographic areas. These clinics will be open 24 hours a day, seven days a week and the work will be extremely taxing on the local physician communities. In other words, there will be a long and fixed need for medical volunteers. Many people are wondering how they can help in the emergency relief efforts that are underway. The New York State Department of Health is coordinating directly with the federal agencies involved in the disaster relief and has deployed a team of DOH staff personnel to Louisiana to help with the management of medical services. Physicians wishing to be placed on a volunteer list to be made available to the DOH should contact Ann Teirno at MSSNY (516) 488-6100 ext. 304 or via email at atierno@mssny.org. Please supply your name, specialty, county and phone number. Physicians have been asked NOT to attempt to go to the disaster areas ON THEIR OWN. The DOH expects that physicians from New York assisting in disaster relief will be organized in teams and that the teams will likely be hospital or clinic-based. Deployment would be for at least 2 weeks. Physicians who might ultimately go to the disaster area should be in good physical health. We will keep you informed as to developments as they are passed on from DOH. These
are several websites you can visit:
The Centers for Medicare & Medicaid Services (CMS) will administer its first national implementation of the Medicare Contractor Provider Satisfaction Survey (MCPSS) in January 2006. The MCPSS is designed to measure provider satisfaction with and perceptions about the services provided by Medicare Fee-for-Service (FFS) Contractors. The survey will give providers the opportunity to rate their Contractor(s) on seven business functions: provider communications, provider inquiries, claims processing, appeals, medical review, provider enrollment, and provider reimbursement. The national implementation of the MCPSS will include all Medicare FFS Contractors, including Fiscal Intermediaries (FIs), Carriers, Durable Medical Equipment Regional Carriers (DMERCs), and Regional Home Health Intermediaries (RHHIs). The survey will be sent to a sample of approximately 30,000 Medicare providers and suppliers. Sampled providers/suppliers will have the opportunity to submit their responses via a secure Internet website, or may request a paper copy of the survey instrument and submit their responses via mail or fax. CMS has requested clearance from the Office of Management and Budget (OMB) for the MCPSS national implementation. To obtain copies of the supporting statement and any related forms, you may access CMS' Paperwork Reduction Act website at http://www.cms.hhs.gov/regulations/pra http://www.cms.hhs.gov/regulations/pra or contact the Reports Clearance Office at mailto:Paperwork@cms.hhs.gov Paperwork@cms.hhs.gov or (410) 786-1326. Comments regarding the burden or any other aspect of this collection of information must be mailed and/or faxed to the designees referenced below by October 4, 2005:
In order to provide member services in keeping with the mission of the Academy of Medicine, the John N. Shell library will remain open during the reconstruction of that section of the building. The services provided during this time will be very limited and those persons utilizing the library will have limited access to the publications in the library. At this time, on-line searches or other requests for items not currently in our library will not be filled. We will keep you updated.
Richard S. Blum, MD, has been named Medical Director of the Medicare Part D (Prescription Drug Benefit Plan) Initiative for IPRO in Lake Success. Beginning in January, 2006, Medicare beneficiaries will have access to private plans that contract with Medicare to provide the new Part D prescription drug benefit. Beneficiaries will be able to enroll in prescription drug plans, (PDPs) and get all other benefits from traditional Medicare, or they can enroll in Medicare Advantage plans, such as HMOs or PPOs, for all Medicare Benefits, including drug coverage.
Physicians Reciprocal Insurance (PRI) is sponsoring a doctor’s Expo and technology symposium at the Huntington Townhouse on November 2. CME credits are available for attending courses on current topics in medicine including: present challenges of medical practice, new fraud and abuse dangers, and risk management. Registration is limited for CME courses. To enroll, contact Communications Associates at (212)-949-6160 or by visiting www.drexpo.com.
Governor Vetoes Two Bills VOWS TO WORK WITH MSSNY We are disappointed to report that Governor Pataki has vetoed legislation (A.5158, Dinowitz/S.5578, Bonacic) that would have required no-fault carriers to reimburse health care providers for the emergency care that they provide to intoxicated drivers. Current law permits auto carriers to deny payment for this care. We thank all the physicians who sent letters to the governor and their legislators in support of this measure. The governor’s veto message articulated three concerns: First, that there are an undetermined number of health care providers impacted by this problem; second, that the bill could be manipulated by those seeking to defraud the system; and third, that it is not part of a comprehensive reform package to target No-Fault fraud. We do note, however, that the governor also expressed a commitment to work with MSSNY and other groups to arrive at some solution to the completely unfair situation that faces physicians who provide care to these patients. The veto message stated the following: “While I am constrained to disapprove the bill, I also recognize that current law imposes an inequitable result on health care providers who may be unable to collect reimbursement for treatment that, in many instances, they are both legally and ethically obliged to provide. Therefore, I am directing my staff to work with the sponsors and supporters of this bill, as well as other affected stakeholders with respect to this issue, to collect data regarding the magnitude of this problem and to explore options for assisting doctors, hospitals and other health care providers in dealing with the fiscal burdens created by drunk drivers.” Again, while we are greatly disappointed by this outcome, MSSNY will continue to pursue resolution of this inequitable situation. In the coming days and weeks, MSSNY will be reaching to the physician community to obtain additional information to more fully document how significant a problem this is for some physicians, including documentation regarding the inability of physicians to obtain reimbursement from other sources such as health insurance. Governor Vetoes Bill Requiring Personal Appearance
of MDs in Court
Wednesday
- October 19, 2005 - 7:00 pm Wednesday
- October 26, 2005 - 5:00 pm Wednesday
- November 9, 2005 - 6:00 pm
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