ALLEGHENY COUNTY MEDICAL SOCIETY BulletinNOVEMBER 2016 Prescription Drug Monitoring Program Update from the House of Delegates Care is Your Business, Change is Ours The healthcare environment is changing. Physicians must focus on providing the highest quality care with intense competition for their time. Medical practices face increased challenges tied to changes to regulation, insurance protocols, cost-management and revenue management. Houston Harbaugh has over 30 years of experience in helping physicians and medical practices manage change through contract negotiations with hospitals and payors; contract management; advocacy and new practice start-up counsel. We have provided critical support in practice mergers and acquisitions. And we have provided sound advocacy on issues ranging from HIPAA compliance to medical staff and peer review matters. Every challenge a medical practice can face, we have seen. We have helped practices of all size and structure meet these challenges. And we know what is ahead. hh-law.com Business • Employment • Estates and Trusts • Health Care Litigation • Oil and Gas • Public Finance • Real Estate ALLEGHENY COUNTY MEDICAL SOCIETY BulletinNOVEMBER 2016 / VOL. 106 NO. 11 ARTICLES PERSPECTIVES DEpaRTMENTS Materia Medica .................... 414 Editorial ............................... 398 Society News ...................... 403 Cabozantinib for renal cell carcinoma An exercise in gratitude • PAMED Foundation awards medical Melissa Blom, MD Deval (Reshma) Paranjpe, MD, FACS student scholarships • Medical Student Career Night Legal Summary ................... 416 Miller Time ........................... 400 • Pittsburgh Ophthalmology Society Pennsylvania Prescription Drug Just another day • Pennsylvania Geriatrics Society – Care is Your Business, Change is Ours Monitoring Program operational Scott Miller, MD, MA, FAAHPM Western Division The healthcare environment is changing. Physicians must focus on providing the highest quality care with intense Beth Anne Jackson, Esq. • Pittsburgh Urological Associates competition for their time. Medical practices face increased challenges tied to changes to regulation, insurance protocols, Perspective ......................... 401 • Pittsburgh Diabetes Club cost-management and revenue management. Materia Medica .................... 418 The ACA revisited before the arrival of Praxbind® (idarucizumab) MACRA and MIPS ACMS Alliance News .......... 409 Houston Harbaugh has over 30 years of experience in helping physicians and medical practices manage change through Nicholas R. Giruzzi, PharmD, Thierry Verstraeten, MD contract negotiations with hospitals and payors; contract management; advocacy and new practice start-up counsel. Nicole Payette, PharmD, BCPS In Memoriam ....................... 412 We have provided critical support in practice mergers and acquisitions. And we have provided sound advocacy on issues • Lowell G. Lubic, MD ranging from HIPAA compliance to medical staff and peer review matters. Special Report .................... 420 • Lawrence D. Ellis, MD Landmark initiative gets the green light • Walter Hiller Jr., MD Every challenge a medical practice can face, we have seen. We have helped practices of all size and structure meet from PAMED’s House of Delegates • Robert B. Wolf these challenges. And we know what is ahead. Pennsylvania Medical Society • Yvonne Bohatch Maher, MD Special Report .................... 422 Activities & Accolades ...... 413 Team up to tackle cardiovascular disease Feature ............................... 424 Ebensee: Recognition long delayed Fredric Jarrett, MD On the cover Hot Metal Bridge hh-law.com by Bruce A. Wright, MD Business • Employment • Estates and Trusts • Health Care Dr. Wright specializes in psychiatry. Litigation • Oil and Gas • Public Finance • Real Estate EDITORIAL/ADVERTISING OFFICES: Bulletin of the Allegheny County Medical Society, 713 Ridge Avenue, Pittsburgh, PA 15212; (412) 321-5030; fax (412) 321-5323. USPS #072920. PUBLISHER: Allegheny County Medical Society at above Affiliated with Pennsylvania Medical Society and American Medical Association Bulletin address. Medical Editor The Bulletin of the Allegheny 2016 PAMED DISTRICT TRUSTEE Deval (Reshma) Paranjpe County Medical Society welcomes Executive Committee John F. Delaney Jr. ([email protected]) contributions from readers, physicians, and Board of Directors Associate Editors medical students, members of allied COMMITTEES Charles Horton professions, spouses, etc. Items may President Awards ([email protected]) be letters, informal clinical reports, Lawrence R. John Donald B. Middleton Robert H. Howland editorials, or articles. Contributions President-elect Bylaws ([email protected])) are received with the understanding David J. Deitrick Robert C. Cicco Timothy Lesaca that they are not under simultaneous Vice President Finance ([email protected]) consideration by another publication. Robert C. Cicco David J. Deitrick Scott Miller Issued the third Saturday of each Secretary Gala ([email protected]) month. Deadline for submission Adele L. Towers Patricia Bononi Amelia A. Paré of copy is the SECOND Monday Treasurer Adele L. Towers ([email protected]) preceding publication date. Periodical William K. Johnjulio Nominating Gregory B. Patrick postage paid at Pittsburgh, PA. Board Chair Matthew B. Straka ([email protected]) John P. Williams Bulletin of the Allegheny County Primary Care Brahma N. Sharma Lawrence R. John Medical Society reserves the right to ([email protected]) edit all reader contributions for brevity, DIRECTORS Managing Editor clarity and length as well as to reject 2016 any subject material submitted. David L. Blinn Meagan K. Welling Robert W. Bragdon ([email protected]) The opinions expressed in the Thomas B. Campbell Editorials and other opinion pieces Douglas F. Clough are those of the writer and do not necessarily reflect the official Jason J. Lamb ADMINISTRATIVE STAFF policy of the Allegheny County 2017 Executive Director Medical Society, the institution with Peter G. Ellis John G. Krah which the author is affiliated, or David A. Logan ([email protected]) the opinion of the Editorial Board. Jan W. Madison Assistant to the Director Advertisements do not imply spon- Matthew B. Straka Amy G. Stromberg ([email protected]) ACMS ALLIANCE sorship by or endorsement of the Angela M. Stupi ACMS, except where noted. 2018 Bookkeeper President Patricia L. Bononi Susan L. Brown Kathleen Reshmi Publisher reserves the right to exclude William F. Coppula ([email protected]) First Vice President any advertisement which in its opinion Kevin O. Garrett Director of Publications Patty Barnett does not conform to the standards of Todd M. Hertzberg Meagan K. Sable Second Vice President the publication. The acceptance of advertising in this publication in no Barbara A. Kevish ([email protected]) Joyce Orr way constitutes approval or endorse- Amelia A. Paré Assistant Executive Director, Recording Secretary ment of products or services by the Raymond E. Pontzer Director of Member Relations Justina Purpura James D. Ireland Corresponding Secretary Allegheny County Medical Society of ([email protected]) Doris Delserone any company or its products. PEER REVIEW BOARD Treasurer Subscriptions: $30 nonprofit organi- 2016 Membership Relations Manager Josephine Martinez zations; $40 ACMS advertisers; $50 John G. Guehl Nadine M. Popovich Assistant Treasurer others. Single copy, $5. Advertising Rajiv R. Varma ([email protected]) Sandra Da Costa rates and information sent upon 2017 request by calling (412) 321-5030 or Donald B. Middleton online at www.acms.org. Ralph Schmeltz 2018 Sharon L. Goldstein COPYRIGHT 2016: Bruce A. MacLeod ALLEGHENY COUNTY MEDICAL SOCIETY www.acms.org POSTMASTER—Send address changes to: Bulletin of the Allegheny County Medical Society, 713 Ridge Avenue, Pittsburgh, PA 15212. Leadership and Advocacy for Patients and Physicians ISSN: 0098-3772 q ALLEGHENY COUNTY MEDICAL SOCIETY Leadership and Advocacy for Patients and Physicians ACMS selects vendors for quality and value. Contact our Endorsed Vendors for special pricing. Banking, Financial Medical and Surgical Printing Services and Leasing Supplies and Professional Services Allegheny Medcare Announcements Medical Banking, Michael Gomber, 412.580.7900 Service for New Associates, Office VISA/MC Service michael.gomber@henryschein. Offices and Address Changes PNC Bank com Allegheny County Medical Brian Wozniak, 412.779.1692 Society [email protected] Life Insurance Susan Brown, 412.321.5030 [email protected] Malachy Whalen & Co. Group Insurance Malachy Whalen, 412.281.4050 Programs [email protected] Auto and Home Employee Benefits, Disability, Insurance Dental & Vision Telecommunications Liberty Mutual USI Affinity and IT solutions 412.859.6605 Bob Cagna, 412.851-5202 connecTel, Inc. www.libertymutual.com/acms [email protected] Scott McKinney, 412.315.6020, [email protected] Member Resources BMI Charts, Healthy Lifestyle Professional Liability Posters, Where-to-Turn cards Insurance Allegheny County Medical NORCAL Mutual What does Society Laurie Bush, 800-445-1212, 412.321.5030 ext. 5558; lbush@norcal-group. ACMS [email protected] com membership do for me? EDITORIAL An exercise in gratitude was doing an exam on a cantanker- Internet. Everyone can exercise his or I ous inpatient with visual changes DEVAL her right to be a political commentator, during this election season and the (RESHMA) for better or worse. conversation went like this: PARANJPE, I am grateful for technology – even