Tuesday, March 20, 2018


State Offering Webinar on Coordinated Care Initiative

The California Department of Health Services is offering two more educational webinars on the Coordinated Care Initiative (CCI) in July. It is important to note that these webinars will NOT be recorded or available for on-demand playback.

Physicians and their staff in affected counties are encouraged to participate in one of the live webinars, Tuesday, July 23 or Tuesday, July 30.


The initiative, also known as "CalMediConnect," was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state's low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that will transition more than 450,000 of the state's dual eligible beneficiaries - those eligible for both Medicare and Medi-Cal - into managed care plans.


Enrollment begins no sooner than January 2014 in 8 counties (Alameda, San Mateo, Santa Clara, Los Angeles, Orange, San Diego, Riverside and San Bernardino).


Physicians, other providers and their staff are invited to participate in one of the July webinars:

  • Tuesday, July 23 at 6:00pm (Click here to register)
  • Tuesday, July 30 at 5:00pm (Click here to register)

Each webinar will include a 30 minute overview of the program, including continuity of care provisions, and 30 minutes of Q&A. Note that the content of the overview will be the same on both dates. Additional webinars will be scheduled as enrollment nears.

For more information on the initiative, please visit http://www.CalDuals.org

OCMA Specialty Spotlight: Specialty Care for Hernia Repair

Specialty Care for Hernia Repair


About Hernia Surgery

Hernia surgery today is much more advanced than even five years ago. The use of laparoscopic surgery techniques and the newest, lightweight meshes (if needed), often allow patients to heal faster, in less pain, and have a more cosmetic outcome. Healthcare providers who are deciding on where to refer hernia patients should make sure that their surgeon has all the tools available to offer the most state-of-the-art techniques and mesh to their patients.


About Hernia Symptoms

Hernia symptoms vary dramatically from one patient to the next. One of the most common symptoms of a hernia is therapid onset of pain at the hernia site. When internal fat or internal organs press through a hole in the muscle, a hernia develops. These internal organs and fat cause the skin over the hernia to 'bulge' out. In rare cases, a piece of intestine can become trapped inside a hernia causing strangulation (see image). This is a rare, but serious concern. 

Open versus Laparoscopic Hernia Repair 

The two major types of hernia surgery are traditional open surgery, and laparoscopic surgery. No one approach is suitable for every patient. Patients with certain types of hernias may benefit from open hernia surgery while another similar patient may need laparoscopic hernia repair. The size of the hernia, the location, and whether it is unilateral or bilateral influences the best approach (see comparison chart). At California Hernia Specialists, we develop treatment plans for individual patients to suit their medical needs, their overall medical condition, and their preference when possible. 


Open Hernia Repair

Laparoscopic Hernia Repair

Most common technique

used for hernia repair.

Techniques vary widely from surgeon to surgeon

Less common approach for hernia repair. Requires advanced training

Can be done under local

anesthesia with sedation

Requires complete general anesthesia

Hernia is fixed on the

outside by opening the

muscles over the weakness

Hernia is fixed from the inside, behind the muscles where the weakness is located

Requires standard surgical equipment.

Requires advanced

laparoscopic equipment

Recurrence rates of 1-2% and infection rates of <1%

Recurrence rates of 1-2% and infection rates of <1%

Basic preoperative workup is required

Occasionally requires more advanced workup because general anesthesia is used

4-5 cm incision in the groin or bikini area

1-2 cm incision next to belly button, and 2 small punctures below the belly button

Mesh is placed behind the muscle and above the muscle. The mesh is sutured in place

Mesh is placed only behind the muscle, and is secured in place with dissolvable sutures

Tension Free Repair 

The term 'tension free' hernia repair is commonly used to describe hernia surgery. Hernias are caused by a weakening of the abdominal muscles. Some surgeons choose to sew the muscles back together, thus causing 'tension' on the muscles around the hernia. However, the muscles around a hernia are already weak, and over time those muscles tend to pull apart and the hernia can recur, or come back. Therefore, most hernia specialists today utilize a mesh to help strengthen the muscles. When using a mesh, the muscles themselves are not sewn together (see image). Instead, a mesh is placed over or under the hole in the muscle to prevent anything from pushing through the abdominal wall. 

For Referring Physicians

Patients and providers can learn more by visiting our website at www.CaliforniaHerniaSpecialists.com. We work with a large number of primary care, internal medicine, and other physician specialties for hernia care. We take your referrals as the highest compliment we can receive. By choosing to have treatment at California Hernia Specialists, patients and their healthcare providers can ensure the most consistent and highest quality hernia care.

 Todd S. Harris, MD

Dr. Todd S. Harris is board certified in general surgery as well as highly experienced in hernia surgery. Dr. Harris is a Fellow of the American College of Surgeons, one of the highest distinctions for a general surgeon. He is the medical director of California Hernia Specialists and coordinates all clinical functions of the office and surgical center for hernia patients.

Dr. Harris was born and raised in South Carolina and is a graduate of The Medical University of South Carolina. He completed his general surgery training at St. Vincent's Hospital and Medical Center in New York City. After completing his surgical residency, Dr. Harris returned for a cardiovascular and interventional radiology (CVIR) fellowship at the University of Minnesota. After completing his fellowship in 2008, he relocated to Orange County to develop his hernia practice.

Outside of work Dr. Harris enjoys a variety of recreational activities. He is an avid runner and swimmer. He has competed in several triathlons, including the 2012 Malibu International distance race. He balances cardiovascular activities with core and strength training. His interest in fitness allows him to appreciate getting patients back to what they enjoy as quickly and pain free as possible after their hernia surgery.

Orange County Medical Association Welcomes Dr. Kockinis as New President

Article written by Physicians News Network,  


Last Saturday, July 13, OCMA welcomed doctors to a special installation of OCMA’s new president, Dr. Thomas Kockinis.

Members and guests had a chance to meet and talk to Orange County public officials and members of California legislature, network with each other, and hear about the history of Orange County Medical Association, organized in 1889, back when an increase from two to six beds was considered a major hospital expansion.

Dr. Kockinis said a lot of positive changes during the last year at OCMA were in big part due to the leadership of Dr. Standiford Helm who worked hard during his term as the president of OCMA to take the organization to the next level.

“Membership”, Kockinis said “is now growing at a rapid pace, infused by a new generation of doctors eager to make a positive impact”. Advocacy, according to him, has never been stronger, and OCMA has excellent working relationships with legislators.

Dr. Dennis Jordanides, who is not a member of OCMA but attended the event for the first time as a guest, said that from his perspective “OCMA is becoming increasingly relevant in this era of unprecedented health care reform, and President's dinner was an excellent venue for physicians of all specialities to engage in discussions regarding future collaboration”.

He added that  “the community support of OCMA was clearly evident by the presence of a number of high-profile state and national political representatives."

The main message from the legislators attending the event was that they need to hear from physicians in order to understand the issues that physicians are concerned about. Assembly woman Diane Harkey went as far as give the audience her cell number saying “Call me, text me! Contact me any time, any time at all. I will look into it, we will take care of you because we need you!”

Eric Handler, Orange County Health Officer, told PNN that “partnership of his organization with OCMA has flourished under the current OCMA administration, and OC Health will continue to collaborate with physician community over public health issues, such as hunger, homelessness and prescription drug overdose.

He encouraged physicians to reach out to him and use him as a resource when they have any requests or concerns.

The event was attended by over 200 OCMA members and guests, and was held at the Center Club Costa Mesa.

See pictures from the event on OCMA's Facebook page

Announcement: Noridian Transition Dates Set

The Centers for Medicare and Medicaid Services (CMS) recently announced that the cutover to the new Medicare Administrative Contractor (MAC) for Jurisdiction E (including California) will begin in August. The Part A cutover will be August 26 and the Part B cutover will be September 16.


CMA has and will continue to work closely with CMS and the new contractor to ensure a smooth transition.


Jurisdiction E (previously called Jurisdiction 1) covers California, Nevada and Hawaii, as well as the U.S. territories of American Samoa, Guam and the Northern Mariana Islands. Jurisdiction E includes over 3.5 million Medicare fee-for-service beneficiaries, 500 Medicare hospitals and 86,500 physicians. MACs process Part A and Part B claims and perform other critical Medicare operational functions, including enrolling, educating and auditing Medicare providers.


To help physicians understand what is changing, Noridian is offering a series of Implementation 101 and EDI Support Services web-based workshops. Noridian is also holding in person "Meet and Greet" workshops throughout the state.

 Important Dates:

August 26, 2013 - Part A implementation

September 16, 2013 - Part B implementation

Orange County Meet and Greet:

July 9 - July 11

Embassy Suites Anaheim South

11767 Harbor Blvd

Garden Grove, CA 92840

Registration is required to attend these workshops. Specific times and registration information are available on the Noridian website: 



Other programs will be added as they progress through the transition. CMA encourages physicians to join the Noridian mailing list to stay apprised of changes.

If you have any questions or concerns on how this might impact your practice, members may contact OCMA's Physician Advocate, Mitzi Young:

Phone: 888-236-0267

Email: myoung@cmanet.org 

MICRA ALERT: Trial Lawyers Start Voter Mail Program

The trial lawyers and their front group "Consumer Watchdog" are taking the MICRA battle up another notch. With the start of their direct mail campaign to registered voters, it is clear they are looking to score a victory this year. Below is a photo of their mailer including a "38 Is Too Late" story card and an ever-so-subtle "morgue toe tag." Over the top tactics are to be expected.

Your help is critical to our continued success. Share the details of the trial lawyers efforts with your colleagues. Also, donating to CALPAC to your fullest ability and asking your colleagues to donateCMA/OCMA membership is crucial, so please consider becoming a member to help us with this fight. If you are already a member, we sincerely thank you for your membership.

CMA and our MICRA coalition members at Californians Allied for Patient Protection (CAPP) are fully engaged. With increased legislative visits and the preparation of our own mail and updated materials, we are telling the full story of MICRA and its important role in maintaining access for all. We completed our field poll testing and just received the results. This crucial data will help guide our campaign and ensure we deliver the strongest defense of MICRA at both the legislative level and to the voters of California.

Share this email with others and follow up to join and donate. We don't win unless the physicians of California are united and committed to beating back the trial lawyers. You have the strongest possible message to urge your fellow physicians to join the efforts to protect MICRA. And have no doubt, the fight will get more intense over the coming days and months.

We will win this fight once again because MICRA is a nationally-respected best-practice with overwhelming bipartisan support that has worked successfully in California for decades and, if changed, would result in higher health care costs for every Californian. Your commitment and efforts motivate our incredible staff at CMA. Thank you for all you do and will do. We will be back to you shortly with an update on our latest efforts.

Orange County Medical Association Selects Solution21 as Preferred Business Partner

Irvine, Calif., May 21, 2013 - The Orange County Medical Association is pleased to announce another benefit of membership. The OCMA has designated Solution21 Inc., as its Business Partner for physicians seeking to generate more patient leads through custom design websites and internet marketing.


OCMA members may receive complimentary consultations and discounted rates on a wide range of internet marketing and website development services, including  custom built websites that are search-engine friendly, Search Engine Optimization (SEO), Social Media Marketing, and internet marketing solutions (Google Adwords and remarketing).


"We are knowledgeable about medical and dental practices and have streamlined the process to minimize the amount of time you need to spend on each website and marketing project. Our focus is on bringing the maximum number of new patients to your medical or dental practice by developing the best websites and marketing programs." said Fred Parvini, CEO at Solution21. "We look forward to offering our services to OCMA members through this special arrangement with OCMA."


Solution21 Inc., now celebrating its 10th year, provides service from its office in Irvine, California. The company is known for its support of local college graduates, graphic designers, web developers, and internet marketers. The Solution21 design team is known for its ability to develop websites that are comprehensive, state-of-the-art, and search-engine friendly, fulfilling both the professional and personal needs of its clients. The firm is focused solely on medical and dental practices and business with the medical community.


The strategic business partnership with Solution21 Inc. reinforces OCMA's commitment to bring added value to its members by aligning with companies that offer business practice expertise, allowing physicians to focus their attention on patient care.



About Solution21

Solution21 was established to fulfill a worldwide demand for cost-effective medical and dental custom website solutions and marketing services. The company is staffed by experienced healthcare, medical professionals, website designers, computer programmers, and marketing specialists who combine their talents to create an unrivaled lineup of products that will enable any practice to increase its production. For more information, visit www.solution21.com.

Upcoming Fundraising Event for Dr. Richard Pan, Assemblymember

Please Join the OCMA Board of Directors

for a Dinner Reception in Support of



Friday, June 28, 2013

7:00 - 8:30 p.m.

Orange County Medical Association Conference Center

17322 Murphy Avenue
Irvine, CA 92614

$1,000 Host * $500 Co-Host $250 Supporter 

* $100 Friend * $50 Ticket

Dr. Richard Pan, a pediatrician and former UC Davis educator, currently represents the people of Sacramento and San Joaquin counties in the California State Assembly and serves as Chairman of the Assembly's Committee on Health.  He also continues to practice medicine. Dr. Pan has served in numerous capacities for his county, state, and national medical associations. He is past-President of the Sierra Sacramento Valley Medical Society and past-Chair of the CMA Council on Legislation. He is also the past-Vice-Chair of the California American Academy of Pediatrics (AAP) as well as past-Chair of the AMA Council on Medical Education and has served on the board of the Accreditation Council on Graduate Medical Education.  For a full bio, please see: http://www.asmdc.org/members/a09/biography. 

Please RSVP to Linda Johansen at: 

949-398-8100 Ext. 102 or ljohansen@ocma.org

Click here for the RSVP/Donation form

Please make checks payable to:

Dr. Richard Pan for Senate for 2014

915 L Street, Suite C415 Sacramento, CA 95814


You may also contribute on line at rally.org/panmd/donate


Department of Defense authorizes temporary waiver for TRICARE authorizations and referrals

As previously reported, since the transition of TRICARE managed care services from TriWest to United Health Military & Veterans (UMVS) on April 1, 2013, physicians are reporting significant delays in processing of authorizations and referral requests, which is affecting patient care.

The California Medical Association (CMA) recently surveyed members about the transition, and 30 percent of physicians surveyed reported significant delays in the processing of authorization and referral requests for TRICARE patients. While the standard timeframe for processing of authorization and referral requests is two business days for urgent request and five business days for routine requests, the payor has been weeks behind in processing of these requests. CMA has been working closely with UMVS to seek a resolution to this issue as soon as possible.

To address the delays, the Department of Defense (DoD) has waived authorization and referral request requirements for all TRICARE covered services April 1 through May 18, 2013. Physicians will not be required to seek or wait for an approval from UMVS for any covered services.

However, according to the UMVS Frequently Asked Questions (FAQ), if a practice received a denial from UMVS for a previously submitted request for a referral or authorization, the previous denial will remain in effect.

In a May 3 letter announcing the waiver, Lori McDougal, Chief Executive Officer of UMVS, directs physicians to provide a copy of the letter to patients at the time of referral to ensure the specialty physician knows the request is authorized.

CMA continues to work closely with UMVS to ensure the difficulties physician’s have experienced since the transition are resolved quickly.

For more information on the TRICARE transition, see CMA's TRICARE Transition Guide, available free to members in CMA's online resource library at www.cmanet.org/resource-library.

Questions about the waiver should be directed to UMVS Provider Services at (877) 988-9378.

Contact: CMA’s reimbursement helpline (888) 401-5911 or economicservices@cmanet.org.

2013 CalOptima Circle of Care Award Request for Nominations

About CalOptima and the Circle of Care Award

CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner.

The CalOptima Circle of Care Award recognizes health care professionals, community groups and individuals who demonstrate excellence in the delivery of accessible and high-quality health care services to CalOptima members. The award honors those who go above and beyond in serving their profession, patients or clients. Since the award’s inception in 2000, CalOptima has recognized more than 230 distinguished people or groups whose dedication to our members and community is extraordinary.  

Nomination Criteria and Deadline

Please join CalOptima in recognizing outstanding health care professionals, community groups and individuals who, in the past 12 months, went above and beyond to serve our members by submitting the attached Nomination Form. Award recipients will be selected based on:

  • The nominee’s service to CalOptima members
  • The nominee’s accomplishments during the past 12 months

Nominators, please note the following criteria:

  • A nominee may only be a Circle of Care Award recipient a total of five times
  • Only one Nomination Form per nominee is needed
  • Self-nominations are welcome
  • Completed Nomination Forms must be submitted by: Friday, June 7, 2013

Mail, deliver, fax or email Nomination Forms to:   

CalOptima: Network Management Department

Attention: Maria Wahab

505 City Parkway West, Orange, CA 92868

Email: mwahab@caloptima.org

Fax: 714-796-6679   

Award recipients will be invited to attend the Circle of Care Award luncheon on Friday, September 20, 2013. 



If you have any questions, please contact Maria Wahab at 714-796-6143. Please allow adequate time before the nomination deadline for CalOptima to respond to any inquiry.


Please click here for the nomination form

Malpractice Claims Consume Years of a Physician’s Career

Risk Tip by The Doctors Company

On average, each physician spends 50.7 months, or approximately 11 percent of an average 40-year career, on resolving medical malpractice cases—the majority of which end up with no indemnity payment. That’s the conclusion of a recent study1 by the RAND Corporation based on data provided by The Doctors Company, the nation’s largest medical malpractice insurer. Researchers found that 70 percent of the time physicians spend on claims is spent defending claims that end in no payment to the plaintiff.

Key findings of the study include:

  • Physicians experience additional stress, work, and reputational damage from the time spent defending claims.
  • Fighting claims takes time away from practicing medicine and from the opportunity for the physician to learn from his or her medical errors.
  • The lengthy time required to resolve claims also negatively impacts patients and their families.
The effect of malpractice claims on physicians’ careers is discussed further by Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company, in two short videos that can be viewed at www.youtube.com/doctorscompany.

To help prevent claims that can take up years of your career, follow these key tips to promote patient safety:

1.    Communicate with Patients

·         Understand the new vital sign: health literacy.

·         Do not ask patients if they understand—instead, ask them to repeat back the information.

·         Document patient understanding of instructions.

·         Provide the patient with written instructions.

·         Use a translator when necessary.

2.    Document Carefully and Objectively

·         Do not point fingers at other staff or providers.

·         Do not impeach the integrity of the medical record by altering it.

·         Use only approved abbreviations.

·         Review patient information that is automatically populated in the EMR.

3.    Monitor Handoffs and Ensure Follow-ups

·         Establish a formal tracking system for missed appointments.

·         Follow up with patients to reschedule.

·         Document missed appointments in the patient record.

·         Send a letter to patients who repeatedly miss appointments.

·         Explain the importance of follow-up care.

·         Refer the patient to another physician, if necessary.

4.    Avoid Medication Errors

·         Keep prescription pads secure.

·         Document samples in the medical record.

·         Check allergies at every visit and document in the same place in the record.

·         Review and reconcile medications at every patient visit.

·         Be aware of LASA (look-alike/sound-alike) medications.

5.    Follow HIPAA Regulations

·         Avoid unauthorized release or breaches of PHI (protected health information).

·         Safeguard against lost or stolen PHI through laptops or drives.

·         Examine office practices and layout that may compromise confidentiality.

·         Assess your methods to protect electronic communications.

·         Follow federal requirements and know your state regulations, which may be stricter.


1. Seabury SA, Chandra A, Lakdawalla DN, Jena AB. On average, physicians spend nearly 11 percent of their 40-year careers with an open, unresolved malpractice claim. Health Affairs. 2013;32(1):1-9. 

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