Top Docs Radio

MAG 2015 Legislative Update This week we continued our ongoing series with Medical Association of Georgia to get the MAG 2015 legislative update.  MAG CEO, Donald Palmisano, Jr. and Director of Government Relations, Marcus Downs came by with Georgia Representative, Rick Jasperse.  We talked about several of the health-related issues Rick and his colleagues have […]

MAG 2015 Legislative Update

This week we continued our ongoing series with Medical Association of Georgia to get the MAG 2015 legislative update.  MAG CEO, Donald Palmisano, Jr. and Director of Government Relations, Marcus Downs came by with Georgia Representative, Rick Jasperse.  We talked about several of the health-related issues Rick and his colleagues have been and continue to work on in the Georgia legislature to promote and protect the health outcomes, safety, and access to care for the citizens of our state.

Rep. Rick Jasperse represents Georgia’s 11th district, which includes all of Pickens and parts of Gordon and Bartow counties. He serves on a number of committees in the House of Representatives – and he is the vice chair of the House Health and Human Services Committee. Rep. Jasperse graduated from UGA with a degree in food science. He retired in 2009 after 29 years as a county agriculture agent.

H.B. 416 by Rep. Carl Rogers (R-Gainesville) will require licensed health care practitioners to wear an ID on their “lab coats or similar distinguishing clothing or uniforms” that states their name and license or educational degree. The only exceptions include optometrists, dentists and chiropractors – except those who practice in hospitals and nursing homes. This has been one of MAG’s legislative priorities for the last two years as voted on by MAG’s Board of Directors. A number of other groups also supported the bill, including speech language pathologists, audiologists, respiratory therapists, marriage and family therapists, ophthalmic technicians, registered dieticians, and APRNs.

The FY 2016 budget (H.B. 76) includes some $23 million in additional funds to increase the reimbursement rate for select Medicaid primary care and OB-GYN codes. This included $17.1 million for primary care physicians (i.e., 90 percent of the 2014 Medicare fee schedule for the applicable codes) and $5.9 million for OB/GYN physicians (90 percent of the 2014 Medicare fee schedule for the applicable codes).

The FY 2016 budget also includes $199,000 to maintain the Prescription Drug Monitoring Program in the state.

H.B. 504 by Rep. Sharon Cooper (R-Marietta) extends the flu vaccine protocol that is in place between physicians and pharmacists and nurses for adults to pneumococcal, shingles, and meningitis. MAG’s Board Directors voted to support this kind of measure given strict limits and notification requirements. MAG worked with Rep. Cooper to ensure that appropriate sanctions are in place for any violations.

S.B. 158 by Sen. Dean Burke, M.D. (R-Bainbridge) would have addressed rental networks, all-products clauses, and other key issues. MAG’s Board of Directors voted to support this measure. The bill evolved into S.R. 561, which is a “study bill” – which means that a group of legislators will develop a report for the General Assembly’s consideration in 2016.

Special Guests:

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia     

* JD Law, Loyola School of Law

* Board of Directors, Physician Advocacy Institute

* Medical Payment Subcommitte Member, State Board of Workers’ Compensation

* Treasurer, Board of Directors,

Cholesterol Isn’t The Bad Guy In Heart Disease I recently read an article by a former heart surgeon that talked about the fact that cholesterol isn’t the bad guy in heart disease.  Instead, he argued that inflammation of the lining of the blood vessels caused by sugars and even the “healthy” oils we eat such […]

Cholesterol Isn’t The Bad Guy In Heart Disease

I recently read an article by a former heart surgeon that talked about the fact that cholesterol isn’t the bad guy in heart disease.  Instead, he argued that inflammation of the lining of the blood vessels caused by sugars and even the “healthy” oils we eat such as corn, canola (Omega-6 oils) is the real cause of what is still the #1 cause of death in America today.

I sat down with Dr. Ellie Campbell of Campbell Family Medicine in Cumming, GA to talk about the article and she was eager to discuss it.  She completely agrees with the premise of the article and shared how the ratio of Omega-3 oils  to Omega-6 oils has grown from ~1:1 or 1:2 to as much as 25:1 Omega-6 to Omega-3.

She also talked about the fact that higher levels of cholesterol in the blood don’t necessarily equate to plaque and heart disease/stroke.  It’s when cholesterol molecules are oxidized and corrupted by inflammatory substances we eat that they become “sticky” and attach to the irritated walls of the blood vessels.

Dr. Campbell shared numerous suggestions for basic changes we can make that will not only serve to reduce our risk for heart disease but in some cases can actually reverse damage already done.

I also brought back Leana Kart, a chiropractor whose practice, Northwest Chiropractic and a member of the Georgia Chiropractic Association to talk about the fact that May is National Posture Awareness Month.  She shared several tips on how to avoid “tech neck”, damage to the spine and neck caused by long periods of chin-down angles to look at a device in our lap.  She also talked about why good posture contributes to keeping us healthy.

Special Guests:

Special Guests:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine

    

* Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine

* Family Medicine Residency, Medical College of Georgia

* Board Certified Family Medicine

Dr. Leana Kart, DC, of NW Chiropractic 

* Doctor of Chiropractic, Life University

* Owner of NW Chiropractic for over 26 years

* Board Member, Georgia Chiropractic Association

 

  Dr. Rolf Meinhold MDVIP On this week’s show I was joined in studio by Dr. Rolf Meinhold MDVIP.  We were introduced to him by Justin Knott of Intrepy, LLC, a marketing firm with numerous local physician practices they serve.  He’s a family practice physician who’s been practicing in the Atlanta area for around thirty […]

 

Dr. Rolf Meinhold MDVIP

On this week’s show I was joined in studio by Dr. Rolf Meinhold MDVIP.  We were introduced to him by Justin Knott of Intrepy, LLC, a marketing firm with numerous local physician practices they serve.  He’s a family practice physician who’s been practicing in the Atlanta area for around thirty years.  He recently joined MDVIP to provide primary care services in their personalized healthcare program.  Through their service MDVIP and its doctors are able to include access to the physician 24/7, coupled with online resources that give patients access to their health information.  MDVIP offers a membership-based plan that provides such extended access to one’s physician with same-day or next-day appointments and 30 min appointment slots, Dr. Meinhold’s patients get significant time and access to their doctor.

Meinhold Family Practice is a MDVIP-affiliated practice utilizing the MDVIP Wellness Program to prevent little things from becoming big things…enabling patients to enjoy life and stay healthy. 
Patients that truly value their health will appreciate having an enhanced doctor-patient relationship. Our practice through MDVIP has dramatically decreased our practice size to closely work with you. Within our smaller practice, you will receive the comprehensive care and personalized service you deserve to keep you healthy.

Dr. Meinhold’s Approach to Your Wellness: Improving the quality of people’s lives one patient at a time, speaks to two essential elements: Quality and Personalization. Improving quality is all about wellness. The better someone is and feels the more possibilities of enjoying the richness that life has to offer. Being person-oriented means giving respect and reverence to the unique relationship that exists between a doctor and a patient. Only by optimizing trust and care can wellness be achieved.

Because of Dr. Meinhold’s specialized training, he is able to manage middle to late childhood, adolescent and adult patients. He has an ongoing interest in the primary prevention of diabetes and heart disease through nutrition and weight management. In addition,  he is a strong proponent of exploring the scientific basis for the mind-body connection in medicine.

Special Guest:

Dr. Rolf Meinhold, MD, Meinhold Family Medicine/MDVIP   

* Doctorate of Medicine, Vanderbilt University School of Medicine

* Internship, Riverside Regional Medical Center

* Board Certified, American Board of Family Medicine

* Fluent in English and German

Justin Knott, Co-Founder, Intrepy, LLC   

*  Previous VP Business Development, TAGin

* Former Director, Investments, I4 Capital Partners

* Previous Team Leader, B.A.S.E.

Chronic Lyme Disease This week, on Dr. Andrew Pugliese’s monthly special edition of Top Docs Radio we talked about chronic lyme disease.  Also known as post-treatment lyme disease syndrome, this chronic, debilitating condition is frequently overlooked outside of the Northeast, where it’s known to be prevalent. As we learned from David Baird, a patient experiencing […]

Chronic Lyme Disease

This week, on Dr. Andrew Pugliese’s monthly special edition of Top Docs Radio we talked about chronic lyme disease.  Also known as post-treatment lyme disease syndrome, this chronic, debilitating condition is frequently overlooked outside of the Northeast, where it’s known to be prevalent.

As we learned from David Baird, a patient experiencing chronic lyme disease, and Karen Huppert, the mother of a college-age student who dealt with the illness, its severe symptoms, and treatment for several years as well.  They both shared their poignant stories and described how they moved from specialist to specialist trying to find a diagnosis.  And they shared how they were told that, “Lyme disease doesn’t exist in Georgia,” leading to a significant delay in the diagnosis that allowed them to seek appropriate care.

David brought his wife, a local veterinarian, also talked about how comparatively easy it is to diagnose a canine, for whom there are straight-forward tests that identifies the infection, and treatment is also effective and readily available.  She talked about how frequently she treats pets for Lyme disease here in her local Atlanta office.

We strongly encourage patients to seek second opinions and to seek to learn all they can about their symptoms and diseases to facilitate timely treatment, which can affect outcomes.

I was also pleased to host Dr. Leanna Kart, DC, a chiropractor whose practice is located on Howell Mill Road in west Atlanta.  May is National Posture Awareness Month.  We talked about how technology has affected neck/back health through creating a tendency to sit with the head in a chin-down orientation for long periods of time.  This causes an increased strain on the connective tissues and muscles in the neck, which can lead to headaches, neck and back pain, and neurologic symptoms.

Special Guests:

Andrew Pugliese, MD, Infectious Disease Consultants        

* Doctorate in Medicine, St. George University School of Medicine

* Fellowship, Infectious Disease, Winthrop University Hospital

* Triple Board Certified in Internal Medicine and Infectious Disease

* Pioneer in non-surgical treatment of acute and chronic sinusitis

* President of Sinus Solutions

David Baird, Chronic Lyme Disease Patient

Karen Huppert, Parent of a young Chronic Lyme Disease patient

Dr. Leanna Kart, DC, of NW Chiropractic 

* Doctor of Chiropractic, Life University

* Owner of NW Chiropractic for over 26 years

* Board Member, Georgia Chiropractic Association

 

  Senate Bill 158 On this week’s show we continued our monthly series with the Medical Association of Georgia.  MAG’s CEO/Executive Director, Donald J. Palmisano, Jr. stopped by for a discussion on the state of Senate Bill 158, changes in the insurance contracting arena, and other topics on the MAG agenda.  Donald also shared how […]

 

Senate Bill 158

On this week’s show we continued our monthly series with the Medical Association of Georgia.  MAG’s CEO/Executive Director, Donald J. Palmisano, Jr. stopped by for a discussion on the state of Senate Bill 158, changes in the insurance contracting arena, and other topics on the MAG agenda.  Donald also shared how he and a colleague were able to raise over $40,000 to support the Think About It campaign to raise awareness and fight prescription drug abuse/addiction in Georgia, participating in a 100 mile race and completing it in under 24 hours.  In the days since Donald joined us on the show, Senate Bill 158 was passed.

MAG continues to take steps to enhance the relationship between health insurer Blue Cross Blue Shield of Georgia, Inc. (BCBSGa) and physicians in the state.

At the end of 2014, Georgia Insurance Commissioner Ralph Hudgens rescinded physician contract amendments that BCBSGa had put into place in Georgia following “numerous complaints from physicians (and their practices).”

First MAG/BCBSGa “Physician Advisory Group” meeting took place on February 12. It is forum for physicians to express their concerns, it will give Blue Cross the opportunity to disseminate information about new payer initiatives, it will be a venue for improving communications, and it will serve as a mechanism for physicians to weigh in on Blue Cross’ clinical policies, operations and contracting practices.

The advisory group consists of four MAG member physicians as well as MAG Health Policy and Third Party Payer Advocacy Department Director Susan Moore and BCBSGa Senior Clinical Officer Mark Kishel, M.D., and BCBSGa Director of Network Management/Georgia Provider Solutions Hayden Mathieson. They will meet a minimum of three times a year.

Rental Networks

 

MAG supports legislation that would limit rental networks in Georgia. A rental network involves a health insurer that rents or sells its network of physicians to another health insurer. These second-level insurers then include the physicians in their health insurance plans – and pay the physicians an even deeper discount – even though they don’t have a contract with the physicians.

 

It’s not uncommon for physicians to offer their services to a health insurer at a discounted rate because the higher patient volume offsets the costs. However, the aforementioned insurers rent or sell their networks without the physician’s knowledge – so the physicians often aren’t aware that they are in a given network or that they are contractually obligated to deliver patient care at a greater discount.

 

Rental networks result in mass confusion and higher administrative costs (e.g., the additional staff time that is required to verify a patient’s health insurance coverage and/or confirm the proper payment). Rental networks can also reduce the accessibility of care because physicians are forced to accept the lower (i.e., “re-priced” or “re-rented”) payment or refuse to see the patient for any follow-up or future care.

 

Rental networks are an inappropriate, profit-driven tactic that undermines the practice environment in Georgia that will exacerbate the physician shortage in the state. Sixteen states have now adopted laws that regulate or limit or prohibit rental networks.

 

Insurers are prohibited from using rental networks in federal employee health benefits plan contracts.

 

 

All-Products Clauses

 

Insurance companies use ‘all-products or all-or-nothing’ clauses as a cost-control tactic to force physicians to participate in every health insurance product that they offer or be blocked from ...