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

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/

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