|March 2012||George W. Meyer, MD, FACP, ACP Governor|
- Governor's Message
- California Northern Chapter Governor-Elect Designee
- Blue Cross required to pay health care providers money owed to them, dating back to 2007
- ACP Launches Depression Care Guide
- Leadership Strategic Planning Retreat
I am writing this brief interim newsletter to inform you about several important events that have occurred since the last newsletter:
- Governor-elect-designee: Congratulations to Gordon Fung, MD FACP the Governor-elect-designee for the CANO Chapter. He will become the CANO Chapter governor at the completion of the ACP annual meeting, Internal Medicine 2013, in San Francisco in April 2013. Thanks to Sheela Kapre, MD, FACP for her candidacy and willingness to remain active as a Chapter leader.
- Strategic Planning meeting: On 7 Jan 2012 many Chapter members met in a conference room of The Doctors Company in Napa to develop a Strategic Plan for Dr. Fung’s term in office. We would like to officially thank The Doctors Company for allowing us to meet. We would also like to thank Dr. Ana Maria Lopez, Governor of the ACP Arizona Chapter, for her time and outstanding report(The results of the plan and action items are attached).
- Anthem Blue Cross: On January 12, the California Department of Managed Health Care (DMHC) ordered Anthem Blue Cross to pay health care providers money owed to them, with interest, for services provided dating back to 2007. (read more with the attached message)
- ACP Launches Depression Care Guide; A Free Online Resource (see attached message)
- Leadership Day: although we have limited funds to reimburse those who wish to participate in D.C. Leadership Days on 6/7 June 2012, we would be happy to help support administratively anyone who wishes to attend. We will make every effort to support medical students and residents who wish to attend.
California Northern Chapter Governor-Elect Designee
My name is Gordon Fung. I’d like to thank George Meyer for the opportunity to introduce myself as your Governor-Elect Designee for CANO. I suspect most of you may already know me if you took part in the recent election. I am a general clinical cardiologist at UCSF Medical Center.
I am a third generation San Franciscan with family roots and an extended family in San Francisco dating back to the 1890’s. I went to Lowell High School, then UC Berkeley to receive my B.A. in Economics; followed by UCSF School of Medicine and UCBerkeley, School of Public Health Joint MD/MPH program with a public health focus in Hospital Economics and Administration; and while in private practice I attended the California Institute of Integral Studies for graduate studies in Chinese Philosophy and received my Ph.D. in 2008.
My post-graduate training in Internal Medicine was at Highland General Hospital for four years including a chief medical residency and then clinical cardiology at Veterans Administration Medical Center, Martinez, CA. I started my career in private practice serving the primarily Chinese American community in San Francisco and was recruited to UCSF in 2000 to direct Cardiac Services at the Mount Zion Campus and assumed the roles of Director of the ECG Lab at UCSF and established the nation’s first Asian Heart & Vascular Center in 2007. In 2007, I also took the certifying exam and am now a Certified Specialist in Hypertension by the American Society of Hypertension.
Currently I spend the majority of my time in direct clinical care both in the inpatient and outpatient settings. I also spend about 10% of my time in clinical trials research and about 10% in administration. I have and continue to be an active volunteer at UCSF school of Medicine in the school activities and immediate past president of AAUCSF, with the San Francisco Medical Society as past president and current Editor of the San Francisco Medicine Magazine; the American Heart Association as a current Board Member of the San Francisco Division, and the American College of Cardiology as Immediate Past Governor of the Northern California Chapter.
I currently live in San Francisco with my wife, Peggy, of 32 years with 2 of our three children at home. Our youngest is Jana, Events Manager at Marin Software and Everett, Case Manager for Lash Medical Group. Our fist daughter, Kelly is a 4th year medical student at Drexel University and married in 2011. Also, I come from a very large extended family mainly in the San Francisco Bay Area.
Blue Cross required to pay health care providers money owed to them, dating back to 2007
On January 12, the California Department of Managed Health Care (DMHC) ordered Anthem Blue Cross to pay health care providers money owed to them, with interest, for services provided dating back to 2007. The action is a result of Anthem’s refusal to remediate providers following a financial claims audit that identified errors in payment of medical claims.
California Medical Association (CMA) President James T. Hay, M.D., applauded DMHC for their recent announcement. “We provide necessary care to our patients based on the assumption that the health plans will promptly and accurately reimburse us for services rendered,” Dr. Hay said. “Anthem Blue Cross’s refusal to pay for a mistake on their end puts an undue burden on those of us who provide care.”
In 2008, DMHC launched provider claims audits of the seven largest health plans in California due to a growing pattern of complaints from providers regarding late and inaccurate payments and inappropriate claim denials. These audits found claims payment violations above the threshold allowed under California law at all seven health plans.
In response to the audits, DMHC required the plans to pay providers the money they were owed and to demonstrate improvements to the plans’ claims processes to prevent future errors. In addition, each plan entered into settlement agreements to pay administrative fines. To date, six of the seven plans have undertaken provider remediation efforts.
Anthem has refused to pay providers for the claims violations uncovered in the audit. Now, Anthem Blue Cross has 30 days to submit to DMHC a corrective action plan to identify the claims that were not correctly paid and pay the providers as prescribed by law.
ACP Launches Depression Care Guide
A Free Online Resource
On any given day in any primary care practice, as many as 10% of patients exhibit symptoms of depression. The good news is that effective treatment can reduce symptoms of depression and improve quality of life, and that primary care clinicians can efficiently identify and manage most cases of depression.
That's why ACP has released its new Depression Care Guide, an evidence-based, free online resource providing concise, practical information and strategies to enable physicians and other health care professionals to reduce treatment gaps existing in depression care. The Guide focuses on team-based care, evaluation, psychiatric and medical comorbidity, self-management resources as well as tools to help implement depression care. Multiple-choice questions are available to help you test your knowledge on the Care Guide and earn applicable continuing education credits based on your professional status.
Access the ACP Depression Care Guide now. You'll need an ACP Online account to use the Guide. Login or create an account now.
More About the Guide:
- Created by a committee of 13 leading depression specialists from internal medicine, family practice, psychiatry, psychology, nursing and the physician assistant professions
- Organized to help you efficiently access information most important to you
- Examines the core components necessary for an effective collaborative care model
- Earn educational credit: after answering 40 multiple-choice questions, gives you the ability to earn AMA PRA Category 1 Credits™, continuing education credits approved by the American Psychological Association if you are a psychologist, or continuing education contact hours approved by the PA State Nurses Association if you are a registered nurse or nurse practitioner
Access the ACP Depression Care Guide now.
Leadership Strategic Planning Retreat
January 7, 2012
Submitted by Ana Maria Lopez, MD, MPH, FACP
Strategic planning process overview and thoughts on implementation:
The strategic planning process is an iterative process that will begin with reflections on the identified priorities as identified through the survey. These reflections will inform our discussion on where CANO is and where it is going. These goals can then be broken down into objectives and prioritized as identified paths to reach the goals. Each goal is accompanied by definable, measurable and attainable processes that can be sorted and assigned to CANO’s Committees.
Read more of the strategic plan.