Monday, June 18, 2018

OCMA Blog

Thank Goodness for a Good TPA


Michael I. Gorelick, APR
President
Accredited Pension Representative

Have you ever used these words?  If you have, you know the value that a good TPA brings to your practice.

I received a call from a CPA friend a few months ago.  He was telling me about a medical practice that had 5 Doctors and 20 employees.  Each Doctor had set up their own SEP IRA or 401(k) or Profit Sharing Plan, many years ago.  They merged their individual practices into one group, but the employees were never included in any of the doctor’s plans and a plan was never established for the employees. No one had asked the question, “What should we do for our employees or Do we have to do anything for our employees”?  

They wanted to do things right but no one was giving them advice. Finally, their CPA advised them to get a TPA involved. Thank goodness they called me before the government stepped in.

I explained the government’s rules that require employers to cover their employees if the owners have plans for themselves.  They quickly figured out that they had a liability and what was at stake and proceeded to add a new 401(K)/ Profit Sharing Plan for their employees.  Additionally, each Doctor was able to keep their own plan in-tact and some of the doctors were able to increase their savings. 

It is not unusual for employers to overlook the myriad of governmental rules if their advisors do not bring issues or the rules to their attention. Most 401k/profit sharing record-keepers do not see it as their job to probe into how employers run their businesses’. This means either running afoul of the rules or missing out on law changes that can benefit them.

If you haven’t reviewed the operational and design aspects of your retirement plan, you may be violating rules or missing out on increased contributions for yourself or reductions in the overall cost to cover your employees. 

Benefit Equity is a premier local Third Party Administrator who has proudly participated in the Business Partnership program with the OCMA for the past 6 years.  Contact us for a no-cost plan review today!

Michael Gorelick, Accredited Pension Representative (APR)
President
Benefit Equity, Inc

mgorelick@nenefitequity.com
(714) 480-1364 x220



California’s Physicians Proudly Endorse Gavin Newsom for Governor

Today, the California Medical Association (CMA) formally endorsed Lieutenant Governor Gavin Newsom’s 2018 bid to become California’s next governor. 

“California’s physicians are proud to support Gavin Newsom for Governor,” said CMA President Theodore M. Mazer, M.D. “Gavin is a lifelong champion for health care in California, and we know he will continue to fight for pragmatic solutions to our most crucial health care challenges, including working to achieve universal access and tackling our state’s physician shortage.”

As Mayor of the City and County of San Francisco, Newsom worked with health care providers to bring the nation’s first universal access health system to all residents, regardless of income or immigration status. He fought alongside CMA to restore hundreds of millions of dollars in harmful statewide cuts to Medi-Cal services and vowed to protect access to care for all Californians. Newsom was also the first statewide official to support Proposition 56 and its full state budget allocation to health care delivery.

More recently, he has reaffirmed his support for a comprehensive legislative approach that creates a pathway to universal health access, renewed investment in prevention and wellness, and bold reforms that bend the cost curve without exacerbating the provider gap. Newsom has long advocated that any strong and successful universal access plan must address California’s critical physician shortages and expand medical residency programs so patients can access timely and affordable health care, as well as standardize and reduce administrative burdens so physicians can spend more time on patient care than paperwork.

He will also continue working to protect Medicare and raise Medi-Cal reimbursement rates – currently among the nation’s lowest –  to help increase access for the nearly 14 million Californians, including half of the state’s children, currently covered by the program.

“After more than a decade of partnership working side-by-side with California’s physicians to expand health access and improve health outcomes for every Californian, it is a high and humbling honor to receive their endorsement for Governor,” said Newsom. “The promise of universal health is within our grasp, and we need everyone at the policy table working in common cause to achieve it, especially the physicians Californians depend on day in and day out to deliver high-quality patient care.”  

For more information on Gavin Newsom’s candidacy, please visit https://gavinnewsom.com/




Survey: How would the AB 3087 price fixing proposal affect your practice?

Assemblymember Ash Kalra (D-San Jose) last week announced a radical physician rate setting proposal (AB 3087) that would increase patient out-of-pocket costs, create state-sanctioned rationing of health care for all Californians and force physicians out of state or into early retirement.

The California Medical Association is asking physicians to answer a few questions about how AB 3087 will impact their practices. The survey is anonymous and the results will help in our legislative efforts to fight this dangerous and irresponsible legislation.

Take the survey now at: www.surveymonkey.com/r/ab3087

And, if you are among California's physicians that will be forced into early retirement or out of state if AB 3087 passes, we want to tell your story. Drop us a line at communications@cmanet.org.


Dr. Bennet Omalu Supports S.B. 1303 to require physician-conducted autopsies

Senate Bill 1303 (authored by Dr. Richard Pan & Senator Cathleen Galgiani), says Dr. Bennet Omalu, is about moving our state forward, applying best practices & protecting the public trust. Hear more from Dr. Omalu on this important legislation to create an independent medical examiner's office at www.cmanet.org/sb1303.

California Medical Association Applauds CDI and DMHC Probe into Aetna’s Practice of Denying Medically Necessary Care

This week, the California Department of Insurance (CDI) and the Department of Managed Health Care (DMHC) announced an investigation into Aetna Inc.’s coverage denials that appear to put profits before patients. The investigations were launched, in part, after a former Aetna medical director admitted he never looked at patients’ records when deciding whether to approve or deny health care. Denying coverage without a physician ever reviewing medical records is a potential violation of law.

“California physicians are increasingly concerned with the growing trend of for-profit insurance companies adopting policies that restrict access to care while their profits soar,” said California Medical Association (CMA) President Theodore M. Mazer, M.D. “We applaud the CDI and DMHC for investigating whether health insurers are using their market power to unjustly and illegally deny medically necessary care recommended by the treating physician. The burden of proof should rest with insurers to prove – with an expert medical and thorough review – why treatment should be stopped, not on treating physicians or patients.”

What’s more, nearly 60 percent of the total Independent Medical Reviews (IMR) filed against Aetna with DMHC in 2016 were overturned or reversed. This follows a growing trend of the regulator denying or reversing health plan decisions by almost 20 percent over the last three years (51 percent in 2014 to 69 percent in 2016).

“The growth of IMR reversals is troubling and suggests that for-profit insurance companies are inappropriately denying care without evaluating the specific clinical issues,” said Dr. Mazer. “For-profit insurance companies should not be allowed to set aside the decision of a treating physician without demonstrating that the treatment in question conflicts with scientific evidence, professional standards or expert opinion.”

CDI Commissioner Dave Jones has asked Californians who believe they may have been adversely impacted by Aetna’s decisions to contact the agency: http://www.insurance.ca.gov/
 

Winter 2018 OC In+Care Newsletter

In+Care Newsletter Issue 11 Winter 2018 for providers serving people living with HIV in Orange County:

InCare Newsletter Issue 11 Winter 2018.pdf

 


Paul Lubinsky, M.D. - 2018 Orange County Physician of Excellence

OCMA is proud to recognize our incredible members who are leaders in medicine here in Orange County.  This year, we want to spend time honoring our 2018 Physicians of Excellence and sharing more information on what makes them so excellent.  

                                                                        

Name: Paul Lubinsky, M.D.

Specialty: Pediatric Critical Care

What is the most rewarding thing about practicing medicine?

Helping Kids set the course for the rest of their lives. Children are resilient and tend not to dwell on the past, it is a privilege to care for them.

Why did you choose to practice in Orange County?
From the first day I started my American Medical career as a CHOC intern I could not think of any institution I would rather work at. I have been at CHOC for 34 years and we provide care to whomever needs it.

What’s a great experience you had through your OCMA Membership?

The advocacy work that OCMA is involved in provides a voice for the physicians, that helps to direct and ensure their patients care. As a Pediatric provider we have enhanced Pediatric Board representation and established a Pediatric workgroup to specifically focus attention on Children’s needs 

Do you have a word of advice for today’s students and residents?

If I had it to do over I would choose a career in medicine, and once again Pediatric Critical Care. There are tough days but we can make a positive difference in every patients life story and I cannot think of a more fulfilling career.

Social Media:
Facebook: https://www.facebook.com/CHOCChildrens/
Twitter: https://twitter.com/CHOCDocs 
Instagram: https://www.instagram.com/chocchildrens/


OCMA is Moving!

As of February 1, 2018, OCMA’s new address will be:

5000 Campus Drive
Newport Beach CA  92660

Our phone number will remain the same:  (949) 398-8100

The week of January 29 is a transition week, so please be patient if the staff does not respond to calls or E-mails as quickly as usual.

We look forward to seeing you at our new location.  



Connie Bartlett, D.O. - 2018 Orange County Physician of Excellence

OCMA is proud to recognize our incredible members who are leaders in medicine here in Orange County.  This year, we want to spend time honoring our 2018 Physicians of Excellence and sharing more information on what makes them so excellent.  

Name:  Connie Bartlett, DO

Specialty:  Pediatrics
  
What is the most rewarding thing about practicing medicine?  The relationships I’ve been able to build with my patients and their families is extremely rewarding – it’s the best thing about practicing medicine for me. As a pediatrician, I’m able to take a special part in “raising" the children who have seen me since birth – watching their development and seeing them transition into adulthood is the best gift.
 
Why did you choose to practice in Orange County?
Besides the great weather, I chose Orange County because it’s home for me and my family, which always comes first for me. It’s also a great benefit to be surrounded by reputable academic institutions and hospitals. I feel blessed to be part of a health system and medical group that takes such great care of me and my patients. 
 
What’s a great experience you had through your OCMA Membership?  I really appreciate the various advocacy efforts from OCMA – championing important issues for our medical community. I also really enjoy the various lectures and workshops available to help me keep up with clinical decision-making and practice management. 
 
Do you have a message for the rest of your POE honoree colleagues? I am humbled and honored to be selected. I hope we can spread the word for next year and recruit more of our colleagues to participate in this great tradition. Congratulations to all.  
 
Do you have a word of advice for today’s students and residents?  It is a gift and a privilege for us to be in the healing profession.  I encourage all students and residents to study hard the science of medicine, but not to forget to learn the art of medicine as well.  It's the compassion, empathy and connection to others that will bring joy to our days and comfort to our patients. 

Follow Dr. Bartlett on Social Media!
Facebook: www.facebook.com/sjhmg
Twitter: @stjoehealth



Eric Ball, M.D. – 2018 Orange County Physician of Excellence

OCMA is proud to recognize our incredible members who are leaders in medicine here in Orange County.  This year, we want to spend time honoring our 2018 Physicians of Excellence and sharing more information on what makes them so excellent.  Our staff spent some time interviewing honorees to bring you this series, and we hope you enjoy this series as we kick off the New Year!

Name: Eric Ball, M.D.

Specialty: Pediatrics
            
What is the most rewarding thing about practicing medicine?
I chose to become a pediatrician because I am drawn to preventative medicine.  I enjoy the ability to educate parents and families about healthy lifestyles in an effort to prevent diseases in the future.  It is a true privilege to be able to play a small role in the life of a growing child, and I am grateful every day for this opportunity.

Why did you choose to practice in Orange County?

My wife grew up in Orange County and we always knew that we would come back here to practice and raise a family.  It is an ideal spot for our children and, as a pediatrician, southern Orange County is the perfect place to practice.

What’s a great experience you had through your OCMA Membership?
This year I had the opportunity to attend the California Medical Association House of Delegates meeting, where physician leaders from all over the state gather to discuss policy and set the priorities for the medical community.  At the HOD, we heard from medical and government leaders and had vigorous discussions about the future of medicine in California.  As Orange County physicians with OCMA, we had the ability to influence these discussions and help shape state policy.

Do you have a message for the rest of your POE honoree colleagues?
 
It is always an honor to be selected a Physician of Excellence.  In these times of upheaval and change in the medical community, it is refreshing to know that an organization like the OCMA is single minded in its efforts to advocate for the success of the physicians of this county.  I know that through the efforts of organizations like the OCMA, the future of the practice of medicine is bright.

Do you have a word of advice for today’s students and residents?

Choose medicine and choose your specialty because you love them.  I would have made more money, or worked fewer hours, in other professions or other specialties.  I chose pediatrics because I am passionate about the health and well-being of children.  When I leave the office every day, I have a sense of pride and purpose; each day, I feel that I made a small difference in the life of a child or a family.  To avoid burnout, you must love what you do, and your profession must be more than a ‘clock-in, clock-out’ job.  The act of making an impact in the lives of others will bring purpose and meaning to your own life.

Follow Dr. Ball on Social Media!
Facebook:  https://www.facebook.com/socpa/

Twitter: @DrEricBall (personal)  @socpa (practice)




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