Tuesday, August 21, 2018


Avoiding Medical Board Discipline when Prescribing Opiates

There are a host of new, ever changing, and conflicting guidelines from a multitude of regulators and academic societies.  This evolving and uncertain landscape is making the life of a practicing pain physician in the midst of today’s nationwide opiate epidemic…painful.  

Here are 10 Tips to help you avoid Medical Board discipline when prescribing opiates:

1.  Don't Prescribe Opiates Unless . . . 

  • The patient has exhausted all reasonable alternatives.
  • There is medical indication

o   Recently documented objective evidence of/consistent with Patient's Pain Complaints

  • You have conducted a comprehensive history, initial exam, imaging, UDT's, CURES, ORT's, have a signed Pain Contract, and have provided Informed Consent.

2.  Treat the 2014 MBC Guidelines as Dictating the Standard of Care (i.e., rules you must follow) - Deviations from these Guidelines must be justified and documented.

Click here to read the remaining tips.  

Welcome to CMA's Next Generation

Earlier this week, CMA launched its new branding initiative along with its updated website. The initiative called, “Next Generation of CMA,” has been in the planning process for over a year.  You can check out information on it by clicking here.

OCMA was one of the early adopters at the county level and we released our new logo at the same time.  

As you can see, the logo is consistent with CMA other than its color, and the new logo design will soon be adopted by all the county medical societies in California.  Each will have its own color.  Over the next few months, OCMA will be upgrading its website making it easier for our member physicians to navigate and get the information they need.  Stay tuned. 

OCMA partners with Carr Healthcare Realty to encourage Orange County Physicians to capitalize on their highest negotiable expense - real estate.

FOR IMMEDIATE RELEASE                                                       Contact: Katie Tomarchio, OCMA

25 June 2018                                                                                Phone: 949-398-8100

                                                                                                      Email: ktomarchio@ocma.org


OCMA partners with Carr Healthcare Realty to encourage Orange County Physicians to capitalize on their highest negotiable expense - real estate

[Newport Beach, CA] - OCMA has officially approved Carr Healthcare Realty as business partner.  To level the playing field between landlords and sellers, Carr Healthcare Realty is committed to only representing the interests of physicians with their leasing or purchasing needs.   They are the nation’s leading provider of commercial real estate services for those in the healthcare industry, and only represent tenants and buyers. By not listing properties or representing landlords they assure their clients that their interests are always protected, resulting in the most favorable terms possible. 

“Our only goal at CARR Healthcare Realty is to protect the interest of our doctor clients in their real estate endeavors.  We are excited that the OCMA has recognized that our core value aligns with their mission.  This is a great partnership that will provide another benefit to OCMA members with unparalleled results.”  – Tricia McCarroll, Orange County Agent

Real estate is the second highest expense for most healthcare practices.  The difference between a properly or poorly negotiated transaction can benefit or cost a practice hundreds of thousands of dollars.  With this much at stake, maximizing every opportunity is paramount to increasing profitability.  Achieving the most favorable terms goes far beyond just lease rates or purchase price; there are many substantial concessions available when a doctor is properly represented.

“The services Carr provides are critical to our members as they take major steps with their practices.  We’re excited to work with Carr’s professional and dedicated Orange County team to better the experience of our Members.” – Katie Tomarchio, Director of Public Affairs & Strategic Partnerships, OCMA. 

Services Provided:

  • Start-ups
  • Lease Renewals
  • Additional offices
  • Expansions
  • Purchases
  • Relocations
  • Practice Acquisitions

These services are always free to clients. In both residential and commercial real estate, the industry standard is for landlords and sellers to pay commissions to both their agent as well as the buyer’s or tenant’s agent. Commissions are being paid out regardless, so it is in the best interest of the doctor to put that money to good use and have their own representation. 



Thank Goodness for a Good TPA

Michael I. Gorelick, APR
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)
Benefit Equity, Inc

(714) 480-1364 x220

10 things you could buy with the money your practice is leaving on the table.


Patient bills. Sitting in your AR.  Dollars left on the table.

It’s one of the top problems we hear about from our members at OCMA, and one that we can help you fix through our Business Partner Universal Financial Systems.

Most docs are leaving $150,000 on average on the table PER YEAR…what could you do with your extra cash?  Well, we took it upon ourselves to find out!

1.       A Jet Pack - $100,000

By Seg9585 [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

This is Orange County, you can get some real use from a water jet pack!  Wouldn’t the 10-year-old version of you be furious to know you have the ability to purchase a jet pack and haven’t yet flown through the sky?


2.      Duffy Boats - $52,000/each


See page for author  [Public domain], via Wikimedia Commons

You and 36 of your friends could be out on the water brunching and cruising every weekend!  Call UFS now and get out there this summer! 


3.        The Permits, Guides, and Gear for THREE Everest Climbs ($40-80,000/person)

By Mount_Everest_as_seen_from_Drukair2.jpg: shrimpo1967derivative work: Papa Lima Whiskey 2 [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

Even if Everest isn’t on your bucket list, imagine what bucket list items your savings could help you cross off!


4.           A litter of California’s most expensive dogs ($50,000/each)


By danny O. (Flickr) [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0)], via Wikimedia Common

French bulldogs are some of the most expensive dogs on the planet, especially when they come from a top breeder – why not ensure you get the best?


5.      Team up with another doc and you could control the Bellagio Fountains ($250,000)

By Adam Jones from Kelowna, BC, Canada (Bellagio Fountain - Las Vegas, CA - USA - 02) [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

If it’s money you were leaving on the table, why not do something fun with it?  You’ve been living without it for years!  Seriously, stop leaving money on the table and reach out to our trusted partner UFS today!


6.      Tickets to Game 7 of the NBA Finals ($50,000/each)


By Eric Kilby (originally posted to Flickr as Tangle Underneath) [CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

NBA Finals Game 7 tickets have gone for up to $90,000/ticket.  With the money your practice leaves on the table, you could be sitting court-side every year…


7.      Live at the Versace Mansion for 2 Months ($1600/night)

By Daniel Di Palma [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

OC can get taxing, why not take a break living in luxury at one of the most infamous mansions in South Beach?  What’s $100k for two months of high fashion luxury?!

8.      Hire an up and coming celeb for a party ($100K)

By glenjamn [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

Sorry, an act like Elton John will set you back millions, but if your son of daughter wants to hire a new artist like Fetty Wap (ask them who he is), your $100K savings from hiring UFS could come in handy…


9.      You could eat nearly 30 pounds of European White Truffles ($3600/pound)

By Mortazavifar [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

You’ll never have to go out to dinner again if you can freshly shave white truffle on every meal!  Once you start, you won’t be able to stop…and you won’t have to with that new $100K truffle budget…


10.      And for the practical folks, a one-bedroom Condo in Sacramento ($104,000)

OCMA encourages our members to be vocal about the rights of physicians and patients, with your very own condo in Sacramento you can be in on the action at your home away from home in Sac Town!

Ready to get started?  Call UFS today!

OCMA members receive a complimentary Insurance & Patient Collection Performance Analysis ($300 value), as well as bundled pricing for billing and collection services. 

Contact: George Christidis, 310-502-3580, georgec@ufsworks.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.

Long-time OCMA Member Nick Anas, M.D. Has Passed Away

In Memoriam

Nick G. Anas, M.D.

June 14, 1950 - April 3, 2018

It is with great sadness that we announce the passing of Nick G. Anas, M.D., long-time member of OCMA.  Dr. Anas passed away peacefully on April 3, 2018.

To read the entire tribute, please click here.  

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


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