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Digitized by the Internet Archive in 2017 with funding from The National Endowment for the Humanities and the Arcadia Fund https://archive.org/details/coloradomedicine9720colo 0 M OLORAB EDICINE "Advocating excellence in the profession of medicine" lary, 2000 Volume 97, Number 1 Doc Rocky Says: "O O, are we ready?" lecial I Medicaid Primary Care Physician Program - Important Message - Page 24 |ln This Issue: Are we ready? (for the first legislature of the century) by Dr. jack L. Berry, MD page 5 End-of-Life Care (Special Physician Education Program) page 1 Response to CMS "What can your medical society do?" by Dr. Clarence Kluck, MD page 11 Another Boom (and Bust) Time by Dr. John L. Lightburn, MD page 14 Consultation or Visit? Finally some clarification by HCFA page 21 2000 brings new coding; approach with care page 25 STRONG. RESOURCEFUL... SOUNDS LIKE COPIC. At Copic Insurance Company we putour strength to work foryou. We take care of the critical pieces of your business so you can do whatyou do best: provide high-quality health care to Coloradans. — For nearly 20 years, we've gone steadily about our business delivering what Colorado's healthcare community needs and planning for what they'll need next. From innovative disease state management programs and a flexible discount structure to legislative advocacy and industry-leading policy enhancements, Copic policyholders trust us to provide products and services that deliver solutions. Copic Insurance Company...the strength behind Colorado's healthcare community. Copic INSURANCE P.O. Box 17540 • Denver, CO • 80217-0540 (303) 779-0044Dept. 17 • (800) 421-1834 Dept. 17 • http://v/v/w.copic.com . Colorado Medicine january, 2000 Volume 97, Number 1 Qn This Cover Story 5 The Legislature and Medical Practice? - The Colorado legislature will consider a number of medically 2000 brings many changes, important issues. Are we ready? MD somegood,somenotsogood Jack L. Berry, Are we ready? Legislature; President, Colorado MedicalSociety coding; managed care and 10 Education for Physicians on End-of-Life Care - CMS collective negotiation, to Interim Session Educational program schedule and mention a few items. registration materials. Start on page 5 13 Letter to Leadership - It's a nice gesture, but what CMS intends to do about insurance contracts won't Departments get the job done. Who will step forward and take on the managed care giant? MD Clarence Kluck, Arapahoe MedicalSociety 14 ARCHIVES: From Boom to Bust - Medicine in the Roaring '20s was a different breed of cat, and it took some sturdy individuals to ride out the boom and survive the bust which followed. We have had boom 5 President's Letter times again at the end ofthe century; will there be a 9 Executive Director's Update bust to follow? MD 17 CMS Foundation John L. Lightburn 18 Copic Comment Historian 19 Colorado Physician Network 21 Health Care Financing 24 Special Notice to Medicaid Primary Care Physicians 26 Board Highlights Colorado Department of 30 Coalition for Medically Underserved Health Care Policyand Financing 31 Classifieds 38 Ruminations 27 Your Voice is Our Power - CMS Alliance "Legislative Day at the Capitol": January 28, 2000 Lynn Painter Colorado Medical SocietyAlliance Colorado Medicine, including Med Fax®, is printed entirely on recycled paper. Colorado Medical Society 7800 East Dorado Place, Englewood, Colorado 801 1-2306 1 (303) 779-5455 • (800) 654-5653 • http://www.cms.org \ o. \vf^ SEPi V* COLORADO MEDICAL SOCIETY OFFICERS, BOARD MEMBERS and AMA DELEGATES 1999/2000 Officers Board of Directors Board of Directors MD MD Stephen Batuello, James Simerville, Jack L. Berry, M.D. President JRoosbeeprht EB.roBocnkemlalin,n,MDMD JR.osDeopuhgJ.Rl.asTyYbaujrkcoz,y,MDJr., MD MD Richard Allen, M.D. John V. Buglewicz, President-Elect Roy E. Carlson,MMDD AMA Delegates Alfred N. Carr, Robert L. Kruse, M.D. John O. Cletcher, MD Richert E. Quinn, Jr., MD Treasurer Glenn T. Eoust, MD M. Ray Painter, Jr., MD MD MD Louise L. McDonald, M.D. Rod R. Holland, Mark A. Levine, MD MD Speaker ofthe House Mary Jo Jacobs, Joel M. Karlin, MD Sherri J. Laubach, M.D. PBaeunlKBu.rzJ,onMesS, Alternate Delegates Vice-speaker ofthe House Muryl L. Laman, MD Sandra L. Maloney Bonnie McCafferty, MD Robert D. McCartney, MD MD MD Secretary/Executive Director Nelson 1. MozMiDa, Jeremy A. Lazarus,MD W. George Shanks, M.D. Lynn Parry, MD Barbara R. Reed, MD Alan D. Rapp, Steven Thorson, (Immediate Past President) Barbara R. Reed, MD J. M. Eugene Sherman, MD Robert R. Montgomery Legal Counsel COLORADO MEDICAL SOCIETY STAFF Executive Office Division ofProfessional Services Sandra L. Maloney, Executive [email protected] Sandra M. Einney, [email protected] DebraM. )ones, ExecutiveAdmin. Asst. [email protected] Don Rutt, Manager, SupportServices [email protected] Genni Pearman, AdministrativeAssistant [email protected] Nancy L. Deter, Manager, Accounting [email protected] Division of Health Care Policy Chet P. Seward, Director [email protected] , Western Slope Office Lorraine K. Heth, Program Manager [email protected] DoloresM. Bennett, ExecutiveSecretary Suzi Shevell, Program [email protected] AnitaWesley, Program [email protected] Division ofMembership Information Services Timothy H. Roberts, Director [email protected] Division ofGovernment Relations Beth M. Crusha, MembershipCoordinator [email protected] K. Suzanne Hamilton, [email protected] Mary LeeJohnston, ExecutiveAdmin. Asst. Emeritus Kirsten Swart, Program Manager/Lobbyist [email protected] [email protected] Division ofCommunications Division of Health Care Financing William S. Pierson, Director [email protected] Edie K. Register, Director [email protected] JanetScardamaglia, CommunicationsAssistant Marilyn Rissmiller, Program [email protected] [email protected] Colorado Medical Society Foundation Anita M. Albrecht, [email protected] M54E5D5I.CIOCNuOtEs,LiOdP.eRODA.eDnBOvoexMrE1aD7reI5a5C,0I,cNaElDle(n1Iv-Se8Sr0N,0-0-C16O59498--507623514373.-)0Pi5es5rp0iuo.bdliAicdsadlhrseedspsomsoatlnaltgcheolrpyaraiesdsptaohtenEdonefgfnilcceeiwaloreojldoa,utriCnnagolltooorfsautdbhose,crCaionpldtoiroatnasda,oddaMidetvideoirntcaialslimnSagoicolirientagyd,dorf7fe8isc0se0sc.hE.aPnODgSoeTrs,MadAmoSaTnPuEI.sR,c,rEinspgtelsne,dwooarodgddar,neisCzsaOtcih8oa0nn1agl1ea1sn.tdToeoCltehOpeLhroOnnReewA(sD30iO3t)em7s79- regardingtheeditorialcontenttotheeditorialandbusinessoffice.Subscriptionsareavailablefor$35peryear,paidinadvance. a1d9v9a5ncbeCymOtehLnetO.CRoPlAuoDbrlaOidcoaMtEMiDeondIiCocIfaNalEnSyomcaaidgevateyzr.itnAilesleimmseatnthteeriionaflfCicsOiuaLbljOjeocRutArtnDoalOthoiMfsEtcDhoepIyCCrIoilNgohErtadadopoepseMaenrdoitincgiamlipnlSyCocOaineLtyeO,nRdaAonrDdsOeamsMesnEutDcIhoCriIssNaplEosnosmoaaruysthhbioepripnzhyeodtthtoeocCc^oairlerodyragfdeonroe(rMhaeeldinacodanvle-rctSoiomscimineegtr.ycCioafOltLhpOeuRrpprAooDsdueOcotMfoEerDdusIceCraIvtiNicoEeniasadnvcedorptsyicrsiieegndth.itfeidc PublishedarticlesrepresenttheopinionsoftheauthorsanddonotnecessarilyreflecttheofficialpolicyoftheColoradoMedicalSocietyunlessclearlyspecified. SandraL.Maloney,ExecutiveEditor;WilliamS.Pierson,ManagingEditor;janetScardamaglia.CommunicationsAssistant. htIpy/www.cms.org/ColoradoMedicine.html Member,ColoradoPressAssociation Member,ColoradoBroadcastersAssociation President's Letter MD jack L. Berry, President, 1999-2000 ColoradoMedicalSociety At the last Colorado Medical position is that 100% ofthese Society Board meeting, Dr. Robert funds should be allocated to Brockman, our resident health care programs. Last year we representative on the board, asked convinced some members ofthe ''Your direct me ifthere is a way the membership legislature this would be communication . ... is could be made aware of CMS's appropriate but they were not able imperative so we can best positions on legislative issues so that to reconcile this issue with the membership could have input state administration. A bill represent you." regarding those positions. This is a allocating these funds to tobacco great suggestion from an interested cessation, increased health care and involved young physician. We for children and other important visited about the possibility of a health related programs died. survey, but surveying in a timely CMS will work vigorously to manner would be difficult and preserve all these funds possible expensive, and physicians are for use in health care programs. surveyed excessively. thought a • A number of bills addressing the many women as possible. CMS I better strategy might be to use this myriad ills ofthe managed care continues to work on the details of space prior to the legislative session, system are likely to be introduced. this proposal. summarizing the issues being We will, of course, support those • Two bills regarding scope of addressed at CMS in preparation for which fix problems for physicians practice are expected, one representing all of you. Then we and patients, though they are regarding certified nurse can seek your input through the piecemeal. The CMS leadership is midwives, the other optometrists. CMS Legislative Council and our more interested in wholesale An arrangement between ACOG legislative personnel. overhaul of our health care and the Certified Nurse Midwives We are aware ofa number of delivery system. will discuss this Association will clarify current I important issues that are the subject further in next month's presidential contradicting statutes and enable of bills introduced this session and article. certified nurse midwives to work I will briefly discuss them here. More • We can expect some threat to tort within collaborative agreements in-depth discussion ofthese and reform and other legislation in the with physicians. This bill probably other issues can be found in an medical malpractice arena. We will be supported by the Council if article in this journal by Chris will work closely with Copic to it clearly outlines the Unrein, DO, your Legislative add our support to their efforts in responsibilities of both parties as Council Chair. this arena. they work together to provide • Prenatal care for undocumented care. A bill granting direct access • The Tobacco Settlement money women is a concept CMS certainly to optometrists without prior continues to be up for grabs and it supports. A bill providing funding approval or referral under seems every interest group in the for such a program includes a managed care contracts will state and many ofour state provision placing regional require careful scrutiny and agencies would like to get their administration of payment in the discussion. hands on at least part of it. One hands of a single managed care • Representative Brad Young from recent proposal we have seen entity. It is important for CMS to Lamar is introducing a bill that would leave on 37% for use in ensure that physicians providing would grant a state income tax health related programs with 63% labor and delivery services for this credit to physicians, nurse going to education, infrastructure, population are reimbursed while practitioners and physician et al. Your medical society's encouraging prenatal care for as (continued on next page) Colorado Medicinefor January, 2000 5 (continued from previous page) made available to finance communication with them, our implementation. Two things legislative staff, other staff or myself have changed since then. First, is imperative so we can best the financial status ofthe state is represent you in these legislative assistants who practice in a more sound and the mood arenas. genuinely rural area of Colorado. toward tax credits in the This concept has already been legislature and administration 1999-2000 Council on utilized to improve rural health more open. Second, CMS has Legislation Members: care access successfully in two greatly improved its credibility other states, Oregon and Georgia. in the legislature for itself and for Ben Galloway, M.D. It has increased the numbers of such rural access programs by David Hutchison, M.D. rural physicians, NP's and PA's in developing the CMS Foundation Mary Jo Jacobs, M.D. Oregon in the last four years by and its two programs, CROP and Brian Johnson, M.D. 500 + and largely alleviating rural the Coalition for the Medically Mark Johnson, M.D. shortages. This program required Underserved. Janak Joshi, M.D. significant investment of public Joel Karlin, M.D. funds and was to have been sunset Most important of all is your (all Pam Laman this last year but the Oregon members) input to, and support of, Jeremy Lazarus, M.D. legislature has chosen to continue our legislative efforts. Your Steven Lowenstein, M.D. it because of its success. legislative council determines our Darryl Thatcher, M.D. CMS proposed such a loan official positions as we go to the Chris Unrein, D.O. (Chair) repayment program to the State House and Congress to testify, Ben Vernon, M.D. Colorado legislature several lobby and develop legislation. Joyce Wilson years ago and it was felt to be a Below you will find a roster of our good idea but funds were not legislative council. Your direct No Sky’s Physicians You’re a successful physician. You’re continually looking for new ways to sharpen your expertise and expand your knowledge. 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