Alabama medicine : journal of the Medical Association of the State of Alabama

448 Pages·1992·31.4 MB·English

by  Medical Association of the State of Alabama

THE FMAM0BACQimWAYIWMEfOfMEDICINE
Msoie.u.iUBKAiiy-Boston MedicalLibrahv

Digitized by the Internet Archive
in 2017 with funding from
The National Endowment for the Humanities and the Arcadia Fund
https://archive.org/details/alabamamedicinej6119medi
.
THE
PREoErlT
K. Samuel Hippocrates, M.D.
777 Groves Drive
Payment=[(RVUwxGPCIw)+(RVUpexGPCIpe)+
Aesculapius, AL 00000
(RVUmxGPCIm)]xCF
Mw. J'C&f+tC'hr tf/ms
Work RVU(RVUw)=
0.52.
o. i/. 7 SO
u Practice expense RVU(RVUpe)=0.55.
3.00
RVU(RVUm)=0.04
Malpractice
.
Next, locate Birmingham in Addendum C.
Note that the GPCI values for work,
A. practice expense and malpractice as follows:
MA
Work GPCI(GPCI<w)=0.981
imw
Practice expense GPCI(GPCIpe)=0.913.
THE
RAJT
Malpractice GPCI(GPCIm)=0.824-
Finally, using 26.873 as the uniform national CF,
HCFA
Blinks
place the values into the formula provided
by William D. Lazenby, M.D., pg. 12
The 60s Medicare Debate Revisited Payment=[(RVUwxGPClw)+(RVUwxGPCIpe)
I by S. Lon Conner, pg. 4 + (RBUmxGPCIm)xCF
om Payment=[(0.52x0.981 )+(0.55x0.913)+
in bitter controversy 25 years ago, Medicare is once
^ain a bone ofcontention because ofHCFA's attempt (0.04x.824)]x26.873
) circumvent the government's own promises to the
rofession and the law itself in the 16% reduction in the Payment=[(0.51)+(0.50)+(0.03)]x26.873
onversion factor.
resident William D. Lazenby, M.D., looks at the present Payment=[l .04]x26.873
ontroversy while Executive Director, Lon Conner
;views the traumatic birth of Medicare.
(Full Fee Schedule Payment)
RARELYARE THERE EASY
ANSWERS,
YAWTHu-:;.
T THERE ARE
INTELLIGENT
BI
CHOICES.
The Keystone
of Your Protection
.Mutual
Assurance
100 Brookwood Place
Birmingham, AL 35209
205-877-4400
1-800-272-6401
8
Alabama
In This Issue
Medicine
JournaloftheMedicalAssociationoftheStateofAlabama
VOL.61.NO. JULY 1991 I.C. System Offers New Collection Programs ....2
1,
I.C. Systems, Inc.
(USPS284720)
ISSN0738-4947
OFFICEOFPUBLICATION:P.O. Bcm 1900,Montgomery Executive Director. ....4
Alabama36102-1900.SubscriptionPrices:member,$13.00,
non-member,$30.00peryear$2.50percopy.Secondclass The 60s MedicareDebate Revisited
postagepaidatMontgomery,Alabamaandatadditionaloffices.
PublishedmonthlybyTheMedicalAssociationofTheStaleof
Alabamaat19SouthJacksonStreet,Montgomery,Alabama
36104. President's Page ..12
POSTMASTER:SendaddresschangestoAlabamaMedicine,
P.O.Box1900.Montgomery,AL36102-1900. HCFA Blinks
Established1931,publishedbyandfarTheMedicalAssociation
oftheStaleofAlabamaforopenandresponsiblediscussionof
mattersrelevanttomedicineandotherfieldsofinteresttophysi- Congestive HeartFailure ..14
cians.Conclusionsandopinionsexpressedhereinarethoseofthe
individualauthorms.Noportionofthispublicationmayberepro- Michael A. Moore, M.D.*
ducedinanyfrg lDeludingelectronic,withoutwrittenconsent.
Publishersreservetherighttorejectanyadvertisingwithorwith-
outexplanation.
Copyright1991bytheMedicalAssociation FuturesIn YourFuture 1
oftheStateofAlabama George Kleinman y^E FRANCIS A. COUNTWAY
ECDlIaTudOeRL.Brown,Jr.,MB.,Mobile LIBRARY OF MEDICINE
AWSmS.1SHT.AMNcDToEnaDlIdT,OMRontgomery On BadDoctors B.QSTQN,..MA 22
ARDhVonEdRaTMIySeIrsN,GMAo.nDtEgoSmIeGrNy Michael A. LaCombe, M.D.
^
OFFICERSOFTHEASSOCIATION:President-WilliamD.
Lazenby,MX).(1992)**,Opelika;President-Electf^terW.
Morris,MX).(1992)**,Birmingham;ImmediatePastPresident- Classifieds ..25
T.RileyLumpiest,MX).(1992)**,Tuscaloosa;Vice-President-
JoelC.Pittard,M.D.(1992),Opelika;Speaker,Houseof
Delegates- RichardO. Russell,Jr.. M.D.(1994)***.
Birmingham;Vice-Speaker,HouseofDelegates-R. Bob Auxiliary ..26
Mullins.MX).(1994)***.Valley.
Guatemala!MedicalAuxiliary
DELEGATESANDALTERNATESAMERICANMEDICAL
ASSOCIATION(TermsexpiringDecember31 ofyearshown)
Y1o99h1n,DeMlXe)g.a,teBsuf•aJuloan.E.19S9a2nfoDredl,egMaXt)e.s,-FaJyueltitues;MKiecnhnaeetlhsoCn, Retirement Planning Needs ..29
MX).,Foley; WilliamT.Wright,MX),Mobile; CarlA.Grote, AMA
Jr.,MJ).,Huntsville. 1993Delegates-JonE,Sanford,MB., Investment Advisers
Fayette; KennethCYohn,MD.,Eufkula.1991Alternates- W.
EarleRiley, MJ).,Fairfield; EdgarW.Branyon,Jr.,MJ).,
AGanrnliasntdonC. 1Ha9l9l2.JArl..teMrXn)a.t,esMo•ulBtuornt;FR..TBaoylborM,ulMlXi)m.,,JrM.,obMiXl).e,; A TeenagerLooks atMalpractice ..31
VWa.llBerya.n1y9on9,3JArl.,teMrJn)a.t,esAn-nWi.stEoanr.leRiley,MB.,Fairfield;Edgar Brian Caveney
THESTATEBOARDOFCENSORS:JamesE.West,MX)..
Chairman(1992),3rdDistrict,Anniston; RichardH.Esham,
MX).,Vice-Chairman(1994)*,Mobile; W.EarleRiley,M.D.
(1992)*,Fairfield;EllannMcGory,MX)(1993).4thDistrict,PL
PWaiylnlei;amGaCrlaWnadllCer.HaMllB,.Jr,(M19B9.2)*(,19M9o3)n,tg3tohmeDrisyt;ricWt,ilMloiualmtoMn.;
Lightfoot,MX).(1994),1stDistrict,Mobile;PatrickB.Jones,Jr.,
M.D.(1994),2ndDistrict,Dothan;JonB.Sanford,M.D.
(1994)*,Payette;PinkL.Palmar,MB.,(1996),6thDistrict,
HB.irWmnalgbhuamm,;MXR)o.be,r(t19H9.6)S,to7rtyh,DMisBtr.i,ct,(1T9u9s6c)a*lo,oTsuas.kcgee;James COVER: This may be a nostalgia trip for older physicians, those who
•Atlarge remember how simple it was in the dear, dead days before the passage of
•••••MEexm-Obfefri,cBiooaMredmobfeCre,nBsoorasrdofCensors Medicare/Medicaid in the summer of 1965. At top left is a fairly typical doctor
STATB HBALTH OFFICBR: Claude Earl Fox. M.D., bill ofthe period; on the right is an actual exampleofMedicare fee computation
Montgomery. from HCFA’s proposed rule change in the Federal Register for June 5. On pg.
-STAFF- 12, President William D. Lazenby, M.D., comments on HCFA’s infuriating
ESX.ELoCnUCToInVnEerDIRECTOR attemptto impose a 16% cut in the Medicare conversion factor for 1992. On pg.
Secretary-Treasurer•EmmettWyatt 4, Mr. Conner uses the occasion to review the history of Medicare’s passage 26
DEPARTMENTS
Legal•WendellR.Morgan years ago. CoverbyBethAnnePalmer, Montgomery.
Education-GeorgeD.Getting
GovernmentalAffairs-RichardCWhitaker
PublicRelations-HalleyMidgley
Communications•Wm.H.McDonald
Alabama Medicine, The Journal ofMASA / 1
New
I.C. System Offers Collection Programs
I.C. System, Inc.
MN
St. Paul, . . . I.C. System, Inc., the collection directly in Phase 1, and no commission fees are
agency endorsed by MASA, has been providing ethi- chained. In Phase 2, the debtor pays I.C. System, and
cal, effective debt collection service since 1938. Until a commission fee is charged.
now, I.C. System has had one basic collection pro- You may submit Recovery Plus’ debts on the sub-
gram with optional features. However, as excellent mittal forms, computer printouts, tapes, disks or
and as flexible as that program is, it does not fit every copies ofledgercards.
creditor’s needs. Therefore, forthe first time in its 53- Premier Collect’ is the full service collection pro-
year history, I.C. System is offering three different gram that many of our members are already using
collection programs. successfully. If your debts are typically more than
I.C. System has just introduced two brand new $100 and sometimes over six months old, you may
products, Rapid Recovery’ and Recovery Plus’ need this highly effective, comprehensive program.
Collection Services. The company is also continuing With Premier Collect’, you pay an initial enrollment
to offer its familiar and very popular program, now fee plus commissions on the money that I.C. recovers
titled Premier Collect’ Collection Service. So it is for you.
possible for virtually all members of our organization With Premier Collect’, you are guaranteed that I.C.
to choose an affordable collection service that meets System will collect at least 10 times the amount ofthe
their specific needs. service enrollment fee.
If you have only a few accounts that are delin- Premier Collect’ uses intensive collection efforts
quent, or if your debts are typically under $100, that include letters, a demand letter from an indepen-
Rapid Recovery’ may bejust what you’re looking for. dent attorney, telephone calls from professional col-
It is also an excellent program when you want to lectors, listing ofdebts with the national credit report-
prompt debtors to make their payments. I.C. System ing agencies, limited skip-tracing and optional litiga-
sends yourdebtors fourcollection letters. A collection tion referral service.
letter from an independent attorney is also included in You may submit your accounts on easy-to-use
the service. Debtors pay you directly, and you don’t forms, computer print-outs, tapes, disks or copies of
owe any collection commission. There is a flat fee for statement/ledgercards.
the number of accounts you purchase. The larger the With all three programs you can submit both com-
package of accounts you choose, the lower the per- mercial and consumer debts. You also get these fea-
account price. tures:
Rapid Recovery’ is an easy-to-administer program • an indemnity agreement that protects you from
that lets you focus on your own business priorities legal consequences that might occur as the result of
while increasing your cash flow. Debts are simple to I.C. System’s collection efforts
TRACKDOWN®
submit on I.C.’s forms. • the options of using Debtor
If your typical debt is over $100 and less than six Locator Service and InstiCredit® Credit Reports
months old, you may want to choose Recovery Plus’. • the services ofI.C.’s Client Services Department,
Like Rapid Recovery’, you purchase the number of which can be contacted on a toll-free 800 telephone
accounts you think you’ll need, at a flat per account number.
fee. I.C. System has collected over $1 billion for its
Recovery Plus’ starts out with a series of four col- clients. Its collection services are endorsed by over
lection letters and a demand letter from an indepen- 1,100 trade and professional organizations, and it
dent attorney. That’s the first phase of the collection serves clients in all 50 states. If you would like more
process. However, if a debt is not collected in Phase information on how this national collection agency
1, it may be transferred automatically to more inten- can benefit you, contact the MASA office or call 1-
sive collections in Phase 2. The debtor pays you 800-325-6884.
2 / Alabama Medicine, The Journal ofMASA
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EXECUTIVE
DIRECTOR
S. Lon Conner
ExecutiveDirector,MASA
The 60s Medicare Debate Revisited
n the current rancor over HCFA’s crude arrogation even been called foolhardy; and it was even called
I
of legislative power in the conversion factor treason to the cause ofmedicine.
imbroglio, there are distinct echoes of the 1960s But the dissenters’ position was also prophetic. So,
debate leading up to the enactment of Medicare/ perhaps, was the overwhelming majority view that
Medicaid. government and medicine are as immiscible as oil and
AMA
In fact, re-reading the official history of the water.
on the subject, (in Frank D. Campion’s TheAMA and Although the antecedents to the fight go far back,
U.S. Health Policy Since 1940 ©1984, AMA, the battle was reallyjoined under President Kennedy.
Chicago) would, I am sure give, give some senior In November 1961, the White House staged 12
AMA
Delegates to frequent attacks of deja vu. Then, regional conferences on the health problems of the
as now, the central issue to physicians was a per- aged, featuring speeches by cabinet members and
ceived oxymoron, federal health care. other high administration officials in support of the
The rhetoric was similar in many ways, and differ- framework that was to become the King-Anderson
ent in many other ways. The first president to propose bill.
national health insurance, Harry S Truman, got Earlier, Senator Pat McNamara of Michigan had
nowhere. The idealistic President John Kennedy, taken a Senate Subcommittee on the Problems ofthe
although he embraced the concept of Medicare and Aging around the country to stage medical horror sto-
stumped for it, never really had his heart in it. All ries from people supplied by local labor organiza-
AMA
these efforts were beaten back by massive tions. AFL-CIO and its affiliates were by this time in
resistance, by instilling public doubt and by effective full mobilization behind the prototype of King-
lobbying in Washington. Anderson.
But the early battles, in which AMA found itself All the while, Health, Education & Welfare
slugging it out with organized labor forthe hearts and Secretary Abraham Ribicoff was using his office to
AMA
minds of the people, had taken a heavy toll. One broadside as obstructionist and coercive, a
could even characterize those early successes as medical tyranny that routinely whipped its members
Pyrrhic victories. That was, in fact, the way they were into line behind antediluvian policies. He called the
AMA
labeled by a small number of sincere, eloquent and President a “reluctant dragon.” and in general
concerned physicians. Led by Russell B. Roth, M.D., badmouthed doctors in much the same language as
this embattled minority persisted in the advocacy of we heartoday from thelikes ofPete Stark.
AMA
medicine’s making an accommodation with the feds very properly complained that federal
and with the Medicare movement. In the environment money and personnel were being wrongly employed
AMA
of majority sentiment ofthat period, their posi- in a partisan political cause. But the attorney general
AMA
tion was nothing if not courageous. If could have was Bobby Kennedy and the complaint was
4 / Alabama Medicine, The Journal ofMASA