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December 2012

From the Governor

This edition of the newsletter includes a recap of our recent chapter meeting and some items of interest. As always I would like to hear back from ACP members about we can be doing to bring new initiatives to the chapter. I can be contacted at jneal6@iuhealth.org or (765) 747-4350.

J. Matthew Neal, MD, MBA, FACP
Governor, Indiana Chapter

Indiana Chapter Annual Meeting Recap

The annual Chapter Meeting was held November 9-10 at the Marten House Hotel & Lilly Conference Center in Indianapolis and was again a great success. Dr. Michael Dickinson provided a stellar keynote address regarding the current state of cardiology and cardiac transplantation.

In addition to our exceptional presentations, Dr. Kristine Hess conducted a skin biopsy workshop, and expert internists from the area reviewed ABIM self-assessment modules on inpatient medicine and general internal medicine.

Dr. Marie Brown, Governor of the Illinois Chapter Northern Region and ABIM board member, gave an excellent presentation on updates on the ABIM’s Maintenance of Certification.

Indiana Chapter Laureate Awards were given to distinguished internists Lisa Harris and Greg Gramelspacher for their outstanding contributions to internal medicine. The Governor’s Award was given to Caitilin Kelly. I would like to thank Dr. Rich Kohler, chair of our Awards Committee, and the other Awards Committee members for helping to select such distinguished internists.
Lisa Harris, MD, with Bill Tierney, MD, MACP

Greg Gramelspacher, MD, FACP, with Lyle Fettig

Caitilin Kelly, MD, FACP

Congratulations to IU Health Ball Memorial Hospital for winning the 2012 “Doctor’s Dilemma” academic competition. The team of Rey Arcenas, Adrian Singson, and Xavier Laurente will be traveling to San Francisco in April for the National competition.

Congratulations to our 16 poster presenters.

View/download all posters

The 1st place winners in each category will have the opportunity to present their posters at the ACP National meeting in San Francisco in April.

Clinical Vignette Category:

1st Place: Sean Teagarden, Indiana University School of Medicine

2nd Place: Naasha Gheyara, IU Health Ball Memorial Hospital

3rd Place: James Chan, IU Health Ball Memorial Hospital

Research Category:

1st Place: Khaled Abdeljawad, Indiana University School of Medicine

2nd Place: Cristina Perez, Indiana University School of Medicine

3rd Place: Jason Cadwallader, Indiana University School of Medicine

Patient Safety/Quality Improvement:
1st Place: Luis Nuñez, St. Vincent Hospital

Another highlight was the always-popular “Stump The Docs” event where our three residency program directors (Craig Wilson, Mitch Goldman, and Ryan Johnston) tried to figure out difficult cases presented by our residents.

Thanks to our judges: Brad Allen, Kapil Mehta, Kevin Tolliver, Graham Carlos, Buvi Burugapalli, and Heidi Lakanen (not pictured).

I would like to thank our Dr. Brandon Dickey for being a superlative Program Chair and Dr. Chrissy Doan, our Associates’ Chair, for helping to organize all the activities. Thanks also to Donna Seawards and Stacey Meyer (without whom we could not have pulled off the meeting), to the Planning Committee, and the other members of the Associates’ Council. Thanks especially to Kirsten Kirby, our Chapter Liaison, who created an excellent brochure and had many suggestions on how to improve the program. The 2013 meeting will be tentatively held again at the Marten House on November 15-16, 2013. We will be sending out a questionnaire soon to determine our learning needs for the conference and things we can improve upon. Also hold the date for a reception from 5-7 pm on Thursday, November 14 at the Marten House. We will be sending out a “needs assessment” survey in the next week or two so that we can determine how to best optimize our meeting for next year, so your comments and suggestions are welcome.


2012 Chapter Excellence Award

I am pleased to announce that our chapter has again received the 2012 Chapter Excellence Award! The award recognizes chapters which successfully meet the standards for managing a chapter. In order to achieve the Chapter Excellence Award, chapters must meet all basic criteria and seven optional criteria. Criteria include such activities as formulating an effective Governor’s Council and committees, communicating frequently with membership, providing educational opportunities, recruiting and advancing members and celebrating membership through local awards. I would like to extend a special thanks to Dr. Michael Sha (our Immediate Past Governor), Dr. Brandon Dickey (Treasurer), Dr. Bob Crook (our ACP Services President), Donna Seawards (our Executive Director), Kirsten Kirby (our Chapter Liaison in Philadelphia) and those other chapter members who assisted in this endeavor. For their hard work and dedication, we received this award.


Items of General Interest: Obama Administration Unveils New ACA Regulations

Much of the coverage of newly-released ACA rules casts them as giving states greater flexibility even as they require insurers to cover people with pre-existing conditions.

USA Today (11/21, Kennedy) reports that "the Obama administration released new health care regulations Tuesday that preclude insurers from adjusting premiums based on pre-existing or chronic health conditions, tell states what benefits must be included in health exchange plans, and allow employers to reward employees who work to remain healthy." The rules give guidance on how to implement provisions within the 2010 healthcare law. After noting that the regulations are not final, the article says that "there is a 90-day comment period during which the government and participants can negotiate to adjust the regulations."

The Wall Street Journal (11/21, Radnofsky, Subscription Publication) reports that the new rules issued Tuesday gives states additional discretion over their plans. Kathleen Sebelius, secretary of the Department of Health and Human Services, remarked, "I'm confident states will have what they need to move forward with creating these critical new insurance markets."

Reuters (11/21, Morgan) quotes HHS Secretary Kathleen Sebelius, who said during a conference call with reporters, "The information we're putting out today will answer many of the states' remaining questions, as will additional guidance to be issued in the days and weeks ahead." She added that she plans to "sit down" with governors to talk with them about their concerns.

CQ (11/21, Adams, Subscription Publication) reports that "after months of delay, the Centers for Medicare and Medicaid Services [CMS] on Tuesday released a proposed rule that establishes the essential benefits that health insurance plans must offer under the health care law." Separately, the CMS "issued a guidance to states on the types of benefits that Medicaid programs must include if they expand coverage under the health care law." The article details that "under the essential benefits proposed rule, health plans in the individual and small-group markets - both in and outside of the new exchanges - would have to provide coverage in the 10 categories of services that the health care law requires."

The Los Angeles Times (11/21, Levey, Bureau) reports that the "Obama administration reaffirmed key requirements of the new healthcare law Tuesday, setting out how insurance companies will cover nearly all Americans, even if they are already ill, and provide plans with minimum benefits." The article says that "in state and federally run exchanges, insurance companies will be prohibited from denying coverage to sick Americans." According to the Times, "insurers will no longer be able to charge more from women or customers with medical conditions."

NPR (11/20, Rovner) reports in its "Shots" blog that under the new rules, "premiums are allowed to vary according to certain factors, including age, smoking status, location and family size. But, and it's an important but, coverage can't be cancelled because of an illness." HHS Secretary Kathleen Sebelius told health reporters on a conference call, "The proposed rules and guidance we're releasing today would make it illegal for insurance companies to discriminate against the approximately 129 million Americans with pre-existing health conditions."

In its "Healthwatch" blog, The Hill (11/21, Baker) reports that the new regulations "require insurance companies to cover people with preexisting medical conditions - one of the most popular provisions of President Obama's healthcare law." However, the article notes that "the regulations still leave key questions unanswered, including the structure of a federally run insurance exchange in the roughly 30 states that won't set up their own." According to the blog, "HHS officials said more information on the federal exchange will be coming soon."

An article in CQ (11/21, Reichard, Subscription Publication) observes that "missing from Tuesday's massive release of hundreds of pages of proposed rules filling in the details of the sweeping redesign of the insurance market, set in motion 32 months ago by passage of the health care law, were details on an entity looming ever larger in delivering the fruits of that legislation: the federally facilitated exchange." CQ later mentions that "during a press call about the rules that are ushering in unprecedented changes in the cost and components of health coverage, Gary Cohen, a senior official at the Centers for Medicare and Medicaid Services, said that 'we will be putting out additional guidance on the federally facilitated exchange in the near future.'"

The New York Times (11/21, A17, Pear, Subscription Publication) reports that "the proposed rules, issued more than two and a half years after President Obama signed the Affordable Care Act, had been delayed as the administration tried to avoid stirring criticism from lobbyists and interest groups in the final weeks of the presidential campaign." According to the article, "insurance companies are rushing to devise health benefit plans that comply with the federal standards." Beginning in October, "people can enroll in the new plans, for coverage that begins on Jan. 1, 2014."

Bloomberg News (11/20) reports that "UnitedHealth Group Inc. (UNH) and other health insurers would be able to vary their premiums based only on age, tobacco use, family size or geography under proposed U.S. rules meant to protect people with pre-existing illnesses." Additionally, "the Department of Health and Human Services outlined conditions and services insurers must cover, and laid out rules to let companies expand employee wellness programs, according to proposed regulations posted online today." The article details that "the first rule targets 50 million to 129 million Americans who have conditions such as diabetes and cancer that insurers have cited to deny coverage or increase premiums, the department said in its filing."

The Washington Post (11/21, Aizenman) reports that the new rules "would loosen some of the 2010 health-care law's mandates on insurers while tightening others." For instance, the article points out that "the law permits insurers to set their premiums for tobacco users 1.5 times higher than those for non-smokers," but "insurers wouldn't be allowed to impose the surcharge on smokers enrolled in smoking-cessation programs."

Analysis: Public Largely Unaware Of Healthcare Law Changes

The Washington Post (11/21, Kliff) reports that "after surviving a Supreme Court decision and a presidential election, the Obama administration's health-care law faces another challenge: a public largely unaware of major changes that will roll out in the coming months." While "states are rushing to decide whether to build their own health exchanges and the administration is readying final regulations," an increasing "body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what's coming." The Post says that "policy decisions are being made now that will affect tens of millions of Americans, and the lack of public awareness could jeopardize a system that depends on having many people involved."


HHS Extends Deadline to States to Submit Plans for Exchanges

The U.S Department of Health and Human Services (HHS) has extended the deadline for states to decide whether to set-up their own health insurance exchanges to December 14, 2012. States that are considering partnering with the federal government on exchanges will have until January 15, to declare their intentions. The extension will give states that delayed their decisions until after the elections more time. The original deadline was November 16, 2012.


The National Governors Association Unveils New State Health Policy Option Website

The National Governors Association (NGA) unveiled a new website, "State Health Policy Options". The website is intended to provide "state policymakers seeking solutions to their common health care problems with innovative approaches." To access the website, go to http://statepolicyoptions.nga.org.


Contact Information

Indiana Chapter Governor:
J. Matthew Neal, MD, MBA, CPE, FACP, FACE
Email: jneal6@iuhealth.org
(765) 747-4350; Fax (765) 751-1451

Donna Seawards
Executive Director
Email: donnaseawards@gmail.com
Ph: 623-225-5527

Chapter Address:
4319 West Clara Lane, PMB #288
Muncie, Indiana 47304