County Line
Newsletter XLI June 2003
Contents
Health Care
Practitioner Reporting
2003-2004 CCMS
Board of Trustees
Clark County
Health District Disease Statistics – April 2003
Health Care Practitioner Reporting
National
Practitioner Data Bank and Health Care Integrity and Protection Data Bank
By
Weldon (Don) Havins, MD, Esq.
C.E.O. and Special
Counsel
The Health
Care Quality Improvement Act of 1986 (HCQIA), 42 USC 1111, et
seq, provided for the establishment of the National
Practitioner Data Bank (NPDB). The
purpose of the NPDB, which became operational on September 1, 1990, is to
"protect patients from poorly performing practitioners and allow health
care entities and state licensing boards to make more informed decisions
regarding licensing and credentialing."
Hospital clinical privileges sanction actions (over 30 days and
involving patient quality care issues) and medical malpractice payments of any
amount must be reported to the NPDB.
Licensure sanction actions and Medicare/Medicaid exclusions must also be
reported. Hospitals are required to
query NPDB for every physician on their staff every two years. State licensing boards and managed care
organizations may query the NPDB without limitation. Physicians and dentists, the only subjects of
the NPDB, may self-query the NPDB regarding their own information held by the
NPDB. The public may not query the NPDB.
HOSPITAL AND HEALTH CARE ORGANIZATION REPORTING
Adverse actions by health care organizations, such as
hospitals, are reportable if they are in effect for at least 30 days. (See NPDB Guidebook - available online at
http://www.npdb.com/pubs/gb/NPDB%20Guidebook.pdf) Summary, or interim, suspensions must also
be reported if they were made to prevent imminent danger to the health of any
individual. A hospital must report
acceptance of a physician's voluntary resignation of staff privileges if the
physician is under investigation for possible incompetence or improper conduct,
or surrenders his or her privileges to avoid an investigation. Hospital staffs should be aware that courts
have held that immunity for good-faith reporting to the NPDB does not apply
when there has been inadequate investigation prior to revoking a physician's
staff privileges [Brown v. Presbyterian Healthcare Services, 101 F.3d 1324
(10th Cir. 1996)] and when the revocation was based on a false report [holding
that a reasonable jury could find that the person making the report knew it was
false - Simon v. Union Hosp., 1999 WL 95774 (4th Cir.)] A hospital may be liable for the original
report and for all reasonably foreseeable "republications" of the
report by the NPDB. [Stephan v Baylor Medical Center, 20
S.W.3d 880 (Tex.App. -
Dallas 2000)]. Delay in
correcting a false NPDB may support a defamation claim for republications of
the report prior to the correction. [Wuchenich v Shenandoah Memorial Hosp.,
215 F.3d 1324 (4th Cir. 2000)].
Interestingly, over 50% of "active" registered hospitals have
never submitted a clinical privileges report to the NPDB.
CHALLENGING INFORMATION IN THE NPDB
If a physician or dentist does not agree with their
information held by the NPDB, the practitioner can provide a statement which
becomes part of the NPDB reports, can notify the reporting entity and ask that
a correction be sent to the NPDB, or can initiate a dispute and/or Secretarial
Review process. A practitioner may
dispute either the factual accuracy of the action described in a report or
whether the report was submitted in accordance with Data Bank reporting requirements
(i.e., was a reportable event). The
Secretarial Review of a report may result in three main decisions by the
Secretary:
1. Out of Scope
The report
is no longer in dispute and the practitioner may add a statement. The only issues raised concern whether a
payment should have been made or an action should have been taken.
2. Accurate
An
explanation of the decision is sent to the practitioner. The practitioner may add a statement to the
report.
3. Inaccurate
The report
is ordered corrected or is voided.
PENALTIES FOR NON-REPORTING AND FOR IMPROPER DISCLOSURE
Federal law
provides Civil Money Penalties of up to $11,000 per instance for failure to
report (to the NPDB), or for violation of confidentiality of NPDB reported
information. The United States Code of
Federal Regulations (45 CFR Ch. V section 1003.102(b))
provides that the OIG (Office of Inspector General, Health Care, HHS) "may
impose a penalty … against any person … whom it determines … improperly
discloses, uses or permits access to information reported…." Section 1003.103(c) provides the OIG may
impose a penalty of not more than $11,000 … for each improper disclosure, use
of access" to NPDB information.
Since 1991, these penalties apply for negligent failure to report and
for negligent disclosure or use, as well as intentional or reckless failure to
report, or improper disclosure or use.
HOW TO OBTAIN YOUR NPDB
INFORMATION
Extensive information about the NPDB and the HIPDB is available on the web site: http://www.npdb-hipdb.com Forms for practitioner self query of the data bases are available on this web site. The cost is $10 for a report from either of the data banks and this must be paid with a credit card, online, at the time of completing the query form. The completed query form does require notarization before mailing to the NPDB. CCMS members may obtain notarization of their forms, free of charge, from either Dot Freel, CCMS office manager, or from Deborah Barton, CCMS public relations coordinator, at the medical society office during normal working hours. Please call the society, 739-9989, before arriving at the office to ascertain that one of them is available.
HOW WELL IS THE NPDB WORKING?
Through
2001, about 180,000 reports have been made against individual practitioners
with about 70% of those against physicians.
Over 70% of reports concerned malpractice payments, and 9% of those were
obstetrics related cases, which have the highest average malpractice payment
amounts. Medical malpractice payers
(professional liability insurers or individual uninsured physicians and
dentists) must submit reports to the NPDB within 30 days of the date of
payment. Insured individual
practitioners are NOT required to report to the NPDB. If an individual is dismissed before settlement
or judgment, there should be no report on the individual, unless the dismissal
was a condition of the settlement and a payment occurred. In settling a malpractice suit brought
against a hospital (or other entity, such as a physician's corporation) and an
individual physician, the parties may agree to drop the individual physician's
name from the suit to avoid the NPDB reporting requirement. Dropping the suit against the physician
avoids the subsequent adverse effects on the physician's malpractice insurance
premiums since corporations are not reported to the NPDB. This use of the "corporate shield"
strategy to protect physician reporting is the subject of proposed changes to
the regulations. The proposed
regulations clarify that practitioners, for whose benefit payment is made, must
be reported even if the practitioner is not named in the malpractice
action. This language is likely to
engender troublesome and complex determinations of which "un-named practitioners"
are the motive for the payment made.
REQUIRED REPORTING TO THE HIPDB
The Health
Insurance Portability and Accountability Act (HIPAA) of 1996 provided for the
establishment of the Healthcare Integrity and Protection Data Bank
(HIPDB). This data bank is designed to
identify health care practitioners, providers, and suppliers who may be
involved in acts of health care fraud and abuse. The reports to the HIPDB involve
practitioners, providers, and suppliers.
The data bank contains reports of health care related criminal
convictions, health care related civil judgments, and other adjudicated
actions. The HIPDB may be queried by
federal and state government agencies and health plans. Health care providers, suppliers, and
practitioners may self-query only. Like
the NPDB, the HIPDB information is not public information and the public cannot
query the data banks.
Health
plans failing to report to the HIPDB can be fined up to $25,000 for each
instance of failure to report. Disputes
as to the facts reported to the HIPDB can be addressed through the same process
as that for the NPDB.
NEVADA STATE LAW REPORTING REQUIREMENTS
AB 1 of the
special session of the Legislature, 2002, mandates that licensee physicians
report to their respective boards within 30 days of a medical malpractice claim
filed against them in District Court.
Unfortunately for licensees, a claim filed in District Court may not be
served upon the defendant for up to 120 days after the date of filing. (Nevada
Rules of Civil Procedure, Rule 4) Thus,
a licensee is required to report to the licensing board, at times, before the
licensee physician has received notice of being sued. Non-compliance with this legislative statute
alone can base a licensure disciplinary action.
Licensees
can query the Blackstone database of the Eighth Judicial District (Clark
County) and enter their name into a "party search" to determine if a
claim has been filed against them.
Information on filings are entered into the
database within 2 days of filing, normally.
Physicians should search both under their last name ("Doe")
and their last name with their professional degree, "Doe (MD)" or
"Doe (DO)". There doesn't
appear to be any other practical manner of determining whether a claim has been
filed prior to receiving formal notice (service of the summons and complaint)
of the lawsuit. Again, this is a
legislative mandate, not
regulations of the board.
However, the board is mandated by the legislature, through NRS 630.130,
to enforce the provisions of NRS 630.
A bill (SB
250) currently reposed in the Senate Judiciary Committee contains a provision
which would amend this provision of Nevada law to require licensee reporting
within 45 days of being served notice of the lawsuit. Whether (or not) this amendment will be
enacted into law remains to be seen.
Licensees
should also be aware that reports of medical malpractice settlements,
judgments, arbitrations, and mediations must be reported to the respective
licensing boards within 30 days. This
must be done by the licensee as well as the insurer. Reports must also be made to the Division of
Insurance and to the National Practitioner Data Bank by the insurer,
or by the licensee if payment is made without involvement of an insurer. SB 250, as presently constituted, provides
for a licensee fine of up to $5,000 for non-reporting a medical malpractice
claim within 45 days of receiving notice of the claim.
Reporting of malpractice actions is mandated in both state and federal law. Physicians should be familiar with those mandates and comply to avoid sanctions by either or both of the sovereigns.
President’s Message
By Warren Evins, M.D., PhD, 2002-2003 CCMS President
Keep Our Doctors in Nevada
I have to
write these columns so far in advance (today is May 5th), that sometimes
unexpected things happen. Last month,
the Nevada State Senate overturned the Judiciary committee's amendment to SB 97
(the Keep Our Doctors in Nevada -KODIN-
Initiative proposal in an amendable bill
form). The amendment deleted the
entire bill by substituting some provisions penalizing professional liability
insurers. Only very rarely does the
entire Senate overturn a Senate committee's extensive amendment. The next day the Senate passed SB97 and sent
it to the Assembly.
Senator
Mark Amodei (Capital Senatorial District), the Senate
Judiciary committee Chairman and President pro Tempore of the Senate, voted against rejection of the amendment and then
voted against passage of SB97. He was
the only republican to vote against the bill.
All of the other Republicans and one Democrat, Senator Michael Schneider
(Clark, no. 11) voted for SB97. All of
the other Democratic Senators voted against the bill.
The bill
then went to the Assembly Judiciary committee, chaired by Bernie Anderson,
Washoe, no. 31, the Assembly Majority Whip (Democrat). What will occur in the Assembly is not yet
known. However, we have to be prepared
to support an extensive and expensive drive to pass the Initiative proposal in
the November 2004 general election if significant legislation such as SB 97 is
not enacted into law. We can expect the
trial lawyers to raise constitutional issues and attempt to have the Nevada
Supreme Court bar the Initiative proposal from the ballot. KODIN's attorneys
are prepared to defend the Initiative in court, but a lot more money will be
needed.
The 72nd
Session of the Nevada State Legislature ends on Monday, June 2, 2003. At this point, no tax compromises have been
reached and it is unclear what new tax measures will be passed. There has been some speculation about the
occurrence of a Special Session only with taxation.
NSMA House of Delegates Meeting
By the time
that you receive this issue of County Line the 2003 Annual meeting of NSMA's House of Delegates at Reno's Atlantis Casino Resort
will be history. CCMS nominated Dr.
Joseph Hardy, a Family Practice physician from Boulder City, past Boulder City
councilman and Clark County Board of Health member, and current State
Assemblyman, for the NSMA Community Service Physician of the Year. He is scheduled to receive the award at the
NSMA Banquet.
Senators
Ann O'Connell and Sandra Tiffany (both of Clark, no. 5) were nominated by CCMS
and shared the 2003 Nick Horn Award for Non-Physician Community Service of the
Year. These two Senators established the
Keep Our Doctors in Nevada Political Action Committee and organized the
Initiative petition drive. They acted as
advisors to NSMA and CCMS on pending legislation, and counseled our
lobbyists. Senator O'Connell,
especially, introduced and supported several bills on behalf of
physicians. We are proud that NSMA
accepted our nominations for these prestigious awards.
Board of Medical Examiners
The Nevada
State Board of Medical Examiners (BME) held workshops to hear public testimony
on the proposed competency regulations for MD license renewal in 2005. The Reno workshop on April 29th drew 30-40
physicians and public citizens who all seemed opposed to the regulation. On April 30th in Las Vegas, 60 to 70
physician and public attendees forced the workshop into a larger meeting room
and spoke against the proposals. Both
NSMA and CCMS presented written and oral testimony opposing competency
testing. The BME is meeting in Reno
(video-conferenced to Las Vegas) on May 30th to
formally act on the Regulation changes.
Medicaid and Worker's
Compensation Insurers Propose to Lower Physician Re-Imbursement
The State
of Nevada signed a contract with First Health, the low bidder, to oversee
portions of the Nevada Medicaid program. First Health replaced Health Insight,
Nevada's Quality Improvement Organization (previously known as a Peer Review
Organization) in which NSMA and CCMS have participated. Health Insight only held the contract for a
matter of months, but had managed to eliminate the PAR (Prior Authorization
request) requirements for most medications and simplified PARs
for treatments and referrals. Medicaid
appears to be reverting to the onerous PAR system used previously.
Medicare
has adopted the so-called Resource Based Relative Value System (RBRVS) for
physician payment. Under this system,
payments for cognitive (evaluation and management) services were supposed to
substantially increase and payments for procedural services were expected to
decrease. However, Medicare instituted
many budget cuts along the way. Despite
years of increased physician expenses, payments have not improved. Medicare physician payments were to increase
under a formula that severely restricted growth. The initial calculation of the Medicare
sustainable growth rate was done using incorrect numbers. Despite extensive physician lobbying, the
formula has not been corrected. These
continued miscalculations caused annual decreases in payments. Another substantial decrease this year was
narrowly averted when Congress made a temporary correction in the formula. This correction was supposed to result in a
small payment increase in 2004, but recent recalculations have projected
another significant decrease.
Physicians
are receiving decreasing payments for Medicare services due to this flawed
formula. Congress says it wants to correct the formula, but cannot pass the
needed legislation (the same as with the Medicare medication benefit). Many
private insurance companies have based their physician payments on a percentage
of Medicare's allowed fees. Now, both
Medicaid and worker's compensation insurance carriers are attempting to change
their payment schedules to a fixed percentage of Medicare's payments, using
RBRVS. These lower payments were
apparently projected in Governor Guinn's recent budget. We have protested these large budget cuts, which
will significantly affect surgeons, orthopedists, anesthesiologists and pediatric
specialists especially.
Installation of the 2003-2004
Officers and Board
The installation of Dr Ed Kingsley, President, and the newly elected officers and Board of Trustee members is on May 31st at the Green Valley Ranch resort. They will assume office on July 1st. I offer them my best wishes.
2003-2004 CCMS Board of Trustees
Edwin Kingsley, M.D.
President
3730 S Eastern Ave
Las Vegas, NV 89109
952-3400
Michael Colletti,
M.D.
President-Elect
2470 E Flamingo Rd #D
Las Vegas, NV 89121
734-2242
Warren
Evins, M.D. Ph.D.
Past President
1769 E Russell Rd
Las Vegas, NV 89119
383-3600
David Steinberg, M.D.
Treasurer
2767 N Tenaya Wy
Las Vegas, NV 89128
240-1232
LeRoy Bernstein, M.D.
Secretary
3006 S Maryland Pkwy #530
Las Vegas, NV 89109
796-7000
Carol van der Harten-Algier, M.D.
CCMS Delegate Chair
4230 S Burnham Ave #250
Las Vegas, NV 89119
733-7866
George Alexander,
M.D.
Trustee
3150 N Tenaya Wy
#620
Las Vegas, NV 89128
242-6776
Michael Clifford,
M.D.
Trustee
7151 Cascade Valley Ct #103
Las Vegas, NV 89128
944-5444
Michael Gross, M.D.
Trustee
1750 E Desert Inn Rd #200
Las Vegas, NV 89109
732-2438
Florence Jameson,
M.D.
Trustee
5281 S Eastern Ave
Las Vegas, NV 89119
262-9676
Jerry Jones, M.D.
Trustee
400 Shadow Ln #207
Las Vegas, NV 89106
384-5400
David Mulkey, M.D.
Trustee
4230 Burnham Ave #250
Las Vegas, NV 89119
733-3779
Annette Teijeiro,
M.D.
Trustee
P. O. Box 93953
Las Vegas, NV 89193
837-3538
Arnold Wax, M.D.
Trustee
3730 S Eastern Ave
Las Vegas, NV 89109
952-3400
Ex Officio Members
John Ellerton, M.D.
Scholarship Fund
Chairman
2020 W Palomino Ln #110
Las Vegas, NV 89106
384-0808
Michael Harter, Ph.D.
Vice Dean, UNSOM
2040 W Charleston Blvd # 400
Las Vegas, NV 89102
671-2230
Lynn Horne, M.D.
AMA Delegate
2915 W Charleston Blvd #4
Las Vegas, NV 89102
657-5620
Donald Kwalick, M.D.
Clark County Health
Officer
625 Shadow Ln
Las Vegas, NV 89106
383-1201
Annette Mohs
CCMS Alliance
Co-President
Marietta
Nelson, M.D.
AMA Alternate
Delegate
2020 Goldring Ave #401
Las Vegas, NV 89106
384-2020
Robert Shreck, M.D.
NSMA Past President
2225 E Flamingo Rd #101
Las Vegas, NV 89119
733-8803
New Members for April 2003
Congratulations and
Welcome to the Clark County Medical Society
- Kayvan Taghipour-Khiabani, MD, Plastic Surgery, 2040 W Charleston Blvd, Ste 302, Las Vegas, NV 89102
Reinstated Member
- Maureen Mackey, MD, Physical Medicine and Rehab, 1120 Almond Tree Ln #201, Las Vegas, NV 89104
Membership Applicants To Go
Before Credentialing Committee
If you have any pertinent information about the following membership candidates, please contact:
Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120
- Michael
J Anderson, MD, Radiation Oncology
- Roger
A. Fontes, MD, Orthopaedic Surgery
- Jay
W Kang, MD, Radiology
- Jeffrey
J Roth, MD, General Surgery
- Paul
K Treadwell, MD, Radiation Oncology
- Randall T Weingarten, MD, Otolaryngology
For information on becoming a member of the Clark County Medical Society, call Marlaina Burns at 739-9989
CEO Editorial
By Weldon (Don)
Havins, M.D., J.D., CCMS CEO and Special Counsel
Nevada is
not the only state with medical liability reform activity. In March alone, three states passed medical
liability tort reform bills of substantial significance.
WEST VIRGINIA
West
Virginia's crisis can be characterized as worse than Nevada's when measured by
the percentage of Ob-Gyns, orthopaedists, and
neurosurgeons that left the state. Two
years ago the plaintiff attorney-friendly legislature passed "tort
reform" which magnanimously "capped" non-economic damages at one
million dollars and which "punished" insurance companies. That, of course, did absolutely nothing to
help the crisis. Experienced,
established physicians continued to leave the state. The number of professional liability insurers
shrank into the low single digits.
The voting
citizens of West Virginia expressed their disgust with the ability of the
sitting legislators to ameliorate the situation. Four physicians were elected to the lower
house of their legislature, and the executive director of the West Virginia
medical association was elected to the Senate.
On March 11, Governor Bob Wise (Democrat) signed House Bill 2122 into
law. This law takes effect July 1 and
will lower the cap on noneconomic damages from
$1,000,000 to $250,000 excepting for cases of wrongful death, permanent
physical deformity or mental injury that precludes self-care. In the later circumstances, the cap on noneconomic damages will be $500,000. H.B. 2122 also eliminates Joint liability in
favor of Several Liability only in medical negligence actions. After July 1, West Virginia physicians will
only be responsible to their degree of fault in medical negligence actions. The deep pocket health care provider will be
history in West Virginia.
ARKANSAS
On March
25, Arkansas Governor Mike Huckabee (Republican)
signed emergency legislation that became effective on the same day. H.R. 1038, known as the Civil Justice Reform
Act of 2003, replaced joint and several liability with several liability only,
except when a defendant acts in concert with another person or entity or that
person or entity acts as a party's agent or servant. (This is similar to
Nevada's comparative negligence law, NRS 41.141, wherein several liability applies when the plaintiff is partially at fault,
unless the exceptions exist.) Arkansas's
new several liability is not absolute, however. If a prevailing tort plaintiff cannot collect
all damages from the liable defendants, the defendants who are able to pay are
allocated the unpaid damages according to their degree of fault. If a defendant's fault is 10% or less
however, there is no allocation of damages on the defendant. H.B. 1038 also capped punitive damages at
$250,000 or three times compensatory damages, whichever is greater, with an
absolute punitive damages cap of $1,000,000.
However,
Arkansas' new law did not cap noneconomic
damages. The several liability provision is so conditional as to make it nearly worthless
to other defendants when one of the defendants declares bankruptcy. Because punitive damages are so very rarely
awarded in non-intentional medical negligence actions, the punitive damages
provision is virtually irrelevant. One
can reliably predict that the "smoke and mirrors" of Arkansas' H.B. 1038
will not significantly ameliorate Arkansas' medical liability crisis, and that
the Arkansas legislature will be revisiting "real" medical liability
reform in the not terribly distant future.
IDAHO
Idaho
Governor Dirk Kempthorne (Republican) signed H.B. 92
into law on March 26. This law caps noneconomic damages at $250,000. Their previous law, passed in 1987, capped noneconomic damages at $400,000 with a CPI indexing
scheme. The noneconomic
damages cap under that scheme has risen to $682,000 with annual
adjustments. The non-indexed, stable
$250,000 cap on noneconomic damages becomes effective
on July 1st. Joint liability will only
apply when parties act in concert, when a person or entity acts as an agent or
servant of another party, in cases of illegal toxic waste disposal, or in
product liability of medical or pharmaceutical cases. Several liability
will apply in medical negligence actions.
H.B. 92 caps punitive damages at $250,000 or three times compensatory
damages, which ever is greater. Punitive
damages will require "clear and convincing evidence" of oppression,
fraud, malice, or outrageous conduct.
Idaho's new
law proves, once again, that indexing noneconomic
damages does not control medical liability insurance premiums. California's flat cap of $250,000 on noneconomic damages was implemented in 1975 and has
remained at that level. Under the
provisions of MICRA,
including the stable $250,000 cap, California's medical liability insurance premiums have remained under control.
Position of the Clark County Medical Society (CCMS) Regarding
Proposed Nevada State Board of Medical Examiners (NSBME) Physician Competency
Regulations for Re-licensure
This
statement represents the official position of the CCMS regarding the proposed
regulations that the physician licensee has demonstrated continuing competency
to practice medicine by accomplishing one of the following:
"1.
Holding current certification or re-certification by a member board of the
American Board of Medical Specialties; or
2. If
certified by a member board of the American Board of Medical Specialties and
not required to re-certify by the rules of such board to remain certified, have
maintained active or associate hospital privileges at the Joint Commission on
Accreditation of Healthcare Organizations (JACHO)-certified hospital or
hospital affiliated surgical/medical center for the two years preceding the
commencement of the biennial registration period; or
3. If not
certified by a member board of the American Board of Medical Specialties,
maintained active or associated hospital privileges for two (2) JACHO-certified
hospitals or hospital-affiliated surgical/medical centers for the two years
preceding the commencement of the biennial registration period; or
4. Pass a
Board approved peer review of the licensee's practice at the licensee's cost
during the ten (10) years preceding the biennial registration period; or
5. Within
the ten (10) years preceding the commencement of the biennial registration
period have taken and passed the Special Purpose Examination (SPEX) and/or one
of its specialty modules of the Federation of State Medical Boards of the
United States, Inc., with a minimum score of seventy-five percent (75%) or
passed such other formal examination at the licensee's cost as may be approved
at the board's discretion."
It is the
opinion of the CCMS that the above proposals will do nothing to improve the
quality of health care provided by the physicians of Clark County and the State
of Nevada. In fact, it may force some of
our most qualified physicians to leave Nevada leading to further erosion of the
once very good health care that the people of Clark County enjoyed as little as
two years ago prior to the medical malpractice crisis which continues.
In
addition:
- There
are no data to support the contention that competency testing of
physicians will improve the quality of health care
- There
are currently no uniformly established or accepted national standards for
the testing of physician competency
- These
proposed regulations will not uniformly apply to all physicians
- These
proposals will add to rising physician expenses
- These
proposals will increase the "Hassle factor" to physicians
already heavily burdened with ever-increasing regulations
- These
proposals will likely accelerate the "experienced physician
drain," defined by the
American Medical Association as the early retirement or severe curtailment
of the practices of physicians ages 50-55
The CCMS proposes the creation of a "blue-ribbon" panel of experts in the field of peer-review to explore alternative methods of improving the quality of medical care for the people of Clark County and the State of Nevada. There are, in the State of Nevada, individuals who have board certification in peer review and quality care medicine from whom this panel could be created. A pilot study could then be undertaken in this area to formulate recommendations for continuous physician development.
Minutes Synopsis
(Members can receive a full copy of meeting minutes by calling 739-9989.)
CLARK COUNTY MEDICAL SOCIETY BOARD OF TRUSTEES MEETING
Tuesday, April 15, 2003; 6:00 P.M.
Action Items
- The
minutes from the March 18th Board meeting were approved.
- Dr.
Ashton reported this year's expenses have been, and continue to be, lower
in every category compared to the previous fiscal year.
Committee Reports
- Deb
Barton reported Dr. Kingsley's installation dinner will be held at the
Green Valley Ranch Station Casino on May 31, 2003. Staff plans to send the invitations next
week.
- The
following applicant was approved for membership: Kayvan
Taghipour-Khiabani, MD
- Dr. Evins reported he was in Carson City last week when
SB97, the bill that mirrored the initiative, was deleted almost in its
entirety. The MICRA-like provisions
were replaced with provisions such as an insurance provision which would
punish the insurance companies if they did not settle within policy limits
early in the course of a medmal claim. Another provision would require medmal claims to have a pre-screening conference with
a district court judge. Dr. Evins noted the new SB97 no longer contains any of the
MICRA-like provisions. Also, Garn Mabey's bill to reconstitute the screening panel was
"declared exempt" which means that although it did not pass the
Assembly Judiciary committee, it is still in play until the end of the
session.
- Membership
is down around 100 paid members compared to last year at this time. CCMS is currently allotted 36 Delegates
to the NSMA annual meeting. As of
yesterday, only 9 Delegates had confirmed.
- The
deadline for receipt of petition ("write-in" candidate) ballots
was 5 p.m. today. Dr. Evins announced the official ballot candidates. The President-Elect position will be a
contested race; the candidates are Kevin Hyer and Michael Colletti. The Trustees at Large positions will
also be contested as there are 7 candidates for 5 Trustee positions
available.
- Dr. Evins appointed Ed Kingsley as the chairman of the ad
hoc committee to look at the proposed regulation for competency
testing. The committee was assigned
to write a position statement to present at the NBME workshop scheduled
for 11 AM April 30 at the Grant Sawyer building.
Alliance Report
- Karen
Schroeder reported the Alliance's third annual benefit luncheon was a huge
success. They donated $13,000 to
charity from the proceeds of the fundraising function. The Alliance will also be awarding three
nursing scholarships at their next luncheon. Ms. Schroeder asked for volunteers at
the Susan G. Koman breast cancer run benefit on
May 3. The Alliance continues to
collect books, preschool to grade 4 levels, and have almost reached their
goal of donating 500 books to needy students.
President's Report
- Congratulations
were given to Dr. Shreck for being selected as the new Senior Medical
Director of Health Insight.
- Dr. Evins had received a letter from Senator Bill Raggio in response to CCMS' request asking him to
consider doubling the nursing enrollment.
Senator Raggio thanked CCMS and promised
he would give it serious consideration.
Administrative Report
- Deb
Barton reported the CCMS pictorial directory is in progress and should be
to press by the end of May. The
advertising income, received and yet expected, exceeds the expenses needed
to produce the directory. Marlaina Burns announced the reinstatement of member
Maureen Mackey.
New Business
- Dr. Evins announced NSMA accepted CCMS' nomination of Dr.
Joe Hardy for the NSMA Community Service Physician of the year.
- A
suggested proposal to inquire into a discount for members with a physician
owned malpractice insurer was discussed and decided against.
- Dr.
Kingsley informed the Board of member Dr. Avron
(Bud) Genser's death this morning. Dr. Evins
requested a moment of silence in Dr. Genser's
honor.
- The
next meeting will be Tuesday, May 20, 2003 at 6 PM.
- There being no further business, the meeting was adjourned by Dr. Evins at 7:35 pm.
Clark County District Court Medical Malpractice
Filings Against Health Care Providers
Jan 2001 - Apr 2003
2001 2002
2003
Jan 39 33 80
Feb 20 14 72
Mar 35 30 75
Apr 37 34 74
May 37
35
Jun 27 24
Jul 19 100
Aug 54
51
Sep 20
65
Oct 37 83
Nov 38 184
Dec 9 170
Calendar of Events
- June
1 - “Growing Seeds of Survivorship,” featuring former Nevada
First Lady Sandy Miller for Cancer Survivors’ Day at Sunrise Hospital,
from 1:30 to 4 p.m. Call 731-8788 for reservations.
- June
12 - “Strategies on how to contain costs for medical/dental
benefits,” Nevada Medical Group Management Association meeting, 8 a.m. at
Sunrise Hospital. Call Judy Montgomery, 737-3808 ext. 134, for details.
- June
18 - Free “HIPAA Readiness Workshop” by the Centers for
Medicare and Medicaid Services, 8:30 a.m. to 5 p.m. at a location to be
determined. For further information, contact the Medical Association of Billers at 240-8519.
- June
26 & 27 - “Attorney General’s Conference on Aging and
Senior Protection” at the Rio All-Suite Hotel & Casino. For information
on the conference, call Marcie Jackson, CHES, Education
Program Manager at Southern Nevada Area Health Education Center at
320-4406.
- July 18 - “Adolescents with HIV and At-Risk Youth” workshop presented by the outhern Nevada Area Health Education Center and the Las Vegas AIDS Education & Training Center from 1-4:15 p.m. Call Yolanda Pitts, M. Ed., CHES at 318-8452 for registration information.
CME Calendar
Cardiovascular
Consultants 691-9154
Clark County Medical
Society 739-9989
7/19 - “The Physician as an Expert Witness,” 8:45 - 11 a.m.,
2 CME hours
Future Programs Planned
August - “Patient Consent and
Rights,”
“End
of Life”
September - “Health Care Fraud and
Abuse”
St. Rose
Hospital 616-5832
Southwest Medical
Associates 242-7347
6/12 - “Office Management of Knee and Shoulder Injuries”
7/10 - “Pain and Addiction Challenges and Controversies”
Sunrise Hospital 731-8210
UMC 383-2604
Valley Hospital 388-4847
6/10 - “Diabetes,” noon
6/24 - “Medical Specialty: Politics,” noon
7/8 - “Immunizations for Children and Adults,” noon
7/22 - “Osteoporosis,” noon
*Special Note: CCMS
members can receive free CME courses on the internet with World Medical
Leaders.
To have your CME courses listed on our calendar, please
contact Deborah Barton at 739-9989 prior to the deadline
of the 12th each month.
CLARK COUNTY HEALTH DISTRICT DISEASE STATISTICS* - APRIL
2003
DISEASE CASES REPORTED YEAR TO DATE
Apr. 2002
Apr. 2003 2002 2003
VACCINE PREVENTABLE DISEASES
DIPTHERIA 0 0 0 0
HAEMOPHILUS
INFLUENZA 0 0 3 2
(invasive)
HEPATITIS A 0 0 9 4
HEPATITIS B 5 4 12 21
INFLUENZA 6 17 57 45
MEASLES 0 0 0 0
MUMPS 1 0 1 0
PERTUSSIS 0 2 0 3
POLIOMYELITIS 0 0 0 0
RUBELLA 0 0 0 0
TETANUS 0 0 0 0
SEXUALLY TRANSMITTED DISEASES
AIDS 28 17 82 72
CHLAMYDIA 436 396 1546 1543
GONORRHEA 153 164 544 576
HIV 27 16 56 75
SYPHILIS 3 2 4 3
(Primary & Secondary)
SYPHILIS
(Early Latent) 0 1 3 11
ENTERICS
AMEBIASIS 2 1 8 8
BOTULISM-INTESTINAL 0 0 0 1
CAMPYLOBACTERIOSIS 12 2 32 23
CHOLERA 0 0 0 0
CRYPTOSPORIDIOSIS 0 0 2 2
E. COLI
O157:H7 3 0 4 0
GIARDIASIS 3 3 29 24
ROTAVIRUS 66 55 256 300
SALMONELLOSIS 11 4 51 20
SHIGELLOSIS 1 2 1 8
TYPHOID
FEVER 0 0 0 0
YERSINIOSIS 0 0 0 0
OTHER
ANTHRAX 0 0 0 0
BOTULISM
INTOXIFICATION 0 0 0 0
BRUCELLOSIS 0 0 0 0
COCCIDIOIDOMYCOSIS 4 2 10 11
ENCEPHALITIS 0 0 1 0
HANTAVIRUS 0 0 0 0
HEMOLYTIC
UREMIC 0 0 0 0
SYNDROME (HUS)
HEPATITIS C 1 0 1 0
HEPATITIS D 0 0 1 0
LEGIONELLOSIS 0 0 0 1
LEPROSY
(HANSEN'S DISEASE) 0 0 0 0
LEPTOSPIROSIS 0 0 0 0
LISTERIOSIS 0 0 0 0
LYME
DISEASE 0 0 0 1
MALARIA 0 0 1 0
MENINGITIS,
2 14 20 27
ASEPTIC/VIRAL
MENINGITIS,
BACTERIAL 2 0 11 10
MENINGOCOCCAL
DISEASE 2 1 10 3
PLAGUE 0 0 0 0
RABIES
(HUMAN) 0 0 0 0
RELAPSING
FEVER 0 0 0 0
ROCKY
MOUNTAIN 1 0 1 0
SPOTTED FEVER
RSV
(RESPIRATORY 140 129 1593 1256
SYNCYTIAL VIRUS)
TOXIC SHOCK
SYNDROME 0 0 0 0
TUBERCULOSIS 9 5 17 26
TULAREMIA 0 0 0 0
*Numbers include confirmed and probable cases
Alliance Message
By Karen Schroeder,
2002-2003 CCMS Alliance President
This
article from me is my last as President of the Clark County Medical Society
Alliance. It has been a tremendous year
and I would like to recap a "few" of the events from this year:
- Distribute
"Concerned Physicians of Nevada" Kits
- Voter
registration at booths in Galleria Mall
- Interviewing
candidates for office with members of the Medical Society
- Legislative
forum for members in the Foundation Room
- Collecting
support of our Holiday Greeting Card Project
- Protect
Nevada Medicine dinner with Dr. Palmisano as guest
speaker
- Member
recognition luncheon
- Third
annual Fashion Show Luncheon Benefit
- Book
collection for "Spread the Word: Kids to Kids"
I cherish
the strong alliances that I have formed this year and look forward to working
with many of you in the next few years.
Thank you for your comments, suggestions, and support during my year as
president.
The
Alliance was again pleased to give out three nursing scholarships at our April
general membership meeting/luncheon. It
was especially nice to have Dr. Michael Colletti join us. He came in the capacity of the chairman of an
ad hoc committee of the Clark County Medical Society; recruitment of people
into the nursing profession. Dr.
Colletti had the opportunity to meet nursing students, instructors, and share
with them and our group the concern that CCMS has in the diminishing numbers of
practicing nurses in our Las Vegas community.
Certainly this is an area that will affect all Las Vegans and the
Alliance will work with the CCMS on this issue.
As you read this article our May Installation luncheon will have been held and the Alliances' executive board will have new leadership. I look forward to working with Annette Mohs as Co-President of the CCMSA and her board. Planning sessions are in full swing and it looks to be another exciting, fun-filled year. If your spouse is not a member, please ask her/him to give me a call, 898-2595, to discuss membership. There are many areas of involvement and "Greater the numbers, the stronger the voice, stronger the voice, more powerful the message".
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