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Progress Notes
December 2014
MSMA Reporting the Progress of Missouri’s Medicine
www.msma.org
A Short Course on the 2015 Legislative Session
The 2015 legislative session is less than a month away.
The Republicans will control 117 of 163 seats in the House of
Representatives and 25 of 34 seats in the Senate. Of the 197 seats
in the 98th General Assembly, four will be held by physicians. We
introduce them on page 2 of this issue, and are incredibly happy
to have four doctors in the legislature, protecting the practice
of medicine from outside forces. Your MSMA lobby team looks
forward to working with them this coming year.
Here are some of the issues we anticipate working on during
the 2015 legislative session:
Tort Reform
Back in 2012, the Missouri Supreme Court overturned our
successful $350,000 cap on noneconomic damages. The past two
legislative sessions, MSMA has led a large coalition of organizations
attempting to reinstate the cap. In both 2013 and 2014, our bill
passed the House of Representatives only to get bogged down
in the Senate. Opposition has been from Democrats and a few
of
the
Volunteer to spend a day in the Capitol
as MSMA’s Physician of the Day in 2015!
This excellent program is warmly received by the
General Assembly and participating physicians.
One physician per day is needed every Tuesday,
Wednesday, and Thursday during the legislative session.
Plan to arrive in the Capitol around 9:00 or 9:30 a.m.,
and stay until 2:00 or 3:00 p.m. (except Thursdays,
when the House and Senate typically adjourn around
noon).
If you are interested in serving in this worthwhile
project, please contact MSMA’s Kenny Jackson
at 800-869-6762 or by e-mail at kjackson@msma.org.
stalwart Republican attorneys. The Show-Me Tort Reform
Coalition will hold its White Coat Rally on Tuesday, February 24,
2015. We hope you can join us at the Capitol that day to lobby in
favor of re-establishing the cap. Save the date and look for more
information on the rally at www.ShowMeTortReform.com
Nurse Scope of Practice
For the past few years, the nurse lobby has unsuccessfully
lobbied for an expanded practice authority. We’ve made efforts
to compromise with them in the past, but they seem to want all
or nothing. We anticipate this issue to resurface yet again this
year. In addition to the nurses themselves, CVS and Walgreens will
be champing at the opportunity to allow APRNs to see patients
in their pharmacies. So we foresee their involvement, as well
as newcomer BJC HealthCare, who also sees nurses as a viable
primary care option to physicians.
Board Opinions
A few years ago the state Supreme Court ruled, in part, that
any opinion of general applicability issued by a state board is
an administrative rule, and needs to be properly promulgated
under the law. The ruling has hamstrung the Board of Healing
Arts’ ability to answer simple licensure questions and interpretive
inquiries raised by physicians. Presently, the Board routinely
answers physicians’ questions with, “a state agency cannot make
a statement of general applicability, including answering general
questions or interpreting or clarifying statutes, without going
through a formal rulemaking process.” The potential legislation
to fix this problem will allow the Board of Healing Arts - as well as
the other professional boards - to offer non-binding opinions when
licensees ask questions.
Medicaid Expansion
This will be an interesting topic this coming year. With even
more Republicans in the Capitol in 2015 than in the prior General
Assembly, it seems it will be difficult for anything remotely related
to the Affordable Care Act (ACA) to pass. Just like 2013 and
2014, we predict a number of different bills that would give the
state’s MO HealthNet program a facelift. Some of those bills will
propose full expansion under the ACA, and others will attempt
to “fix” the program by offering to make things transparent or
rein in fraud and wastefulness. As we’ve seen in the past, some
of these ideas will benefit physicians and some will make it more
difficult for you to practice medicine. We’ll do our best to make
it beneficial to you and your patients, rather than the government
and insurance companies.
continued on page 2
Page 2 / December 2014
Greet Your Physician Legislators
Representative Keith Frederick, DO (R)
House District 121 (Rolla)
Rep. Keith J. Frederick, DO, represents parts of Pulaski County
and parts of Phelps County in the Missouri House of Representatives.
He was elected to his first two-year term in
November 2010.
In addition to his legislative duties, Rep.
Frederick is a practicing orthopedic surgeon in
Rolla at the Phelps County Regional Medical
Center, where he is also chair of the Department
of Surgery. He received his BS from St. Louis
College of Pharmacy in 1976 and his DO from
the Chicago College of Osteopathic Medicine
in 1981. He also attended the University of
Missouri for graduate studies.
Contact: keithjfrederick@gmail.com
Representative Jim Neely, DO (R)
House District 8 (Cameron)
Rep. Jim Neely, DO, a Republican,
represents Clinton and Caldwell counties and
parts of Clay and Ray in the Missouri House
of Representatives. He was elected to his first
two-year term in November 2012. Rep. Neely
is a graduate of the University of Missouri and
received his DO from the Kansas City University
of Medicine and Biosciences. In addition to
his legislative duties, Rep. Neely is a physician at Cameron Regional
Medical Center and a veteran of the US Army.
Contact: jim.neely@house.mo.gov
Bob Onder, MD (R)
State Senate District 2 (St. Charles)
Bob Onder, MD, graduated from
Washington University School of Medicine
in 1987 and St. Louis University School of
Law in 1994. He is a physician and small
businessman who founded his private medical
practice in 1992, specializing in allergy and
asthma.
In 2006 he was elected State
Representative, representing western St.
Charles County, and was elected to the
Missouri Senate in 2014. Contact: rfonder@charter.net
Senator Rob Schaaf, MD (R)
State Senate District 34 (St. Joseph)
Robert Schaaf, MD, graduated from
Saint Louis University School of Medicine
in 1983. A family practice physician, he is
also the director of the Missouri Doctors
Mutual Insurance Co.
He was first elected to the Missouri
House of Representatives in 2002,
winning reelection in 2004, 2006, and
2008. He has represented the 34th
district in the Missouri Senate since 2011. Dr. Schaaf also
represents District #1 on the MSMA Council.
Contact: rob@schaaf.com
A Short Course, continued from front page
Licensing Compact
The Federation of State Medical Boards is championing an
interstate compact for physician licensure. Many other health
professionals have similar licensing compacts. The compact would
make it quicker and easier for qualified physicians to apply for
licensure in multiple states. It would eliminate the state-specific
nuances in licensure while ensuring states retain the ability to
discipline independently when necessary. The FSMB indicates that
only six percent of physicians hold licenses in multiple states, which
hampers the ability of physicians to practice across states lines or
on digital platforms. As with all legislation, much is determined
once we see the actual bill language.
Other Issues
We anticipate having our yearly discussions over the worthiness
of state’s motorcycle helmet law. We’ll find ourselves advocating
for stricter texting-while-driving laws and seat belt enforcement.
The insurance companies will probably get an earful over narrow
networks and prior authorization. Telemedicine will likely come
up; as will the pharmaceutical industry and their numerous
endeavors. We’ll have to watch some public health groups that
will attempt to offer solutions to their own issues for their select
set of patients. We’re the only state without a Prescription Drug
Monitoring Program (PDMP), so that will be in play. Plus, the
chiropractors, optometrists, midwives, etc., never seem to go away.
And on and on and on…
Be sure to read MSMA’s weekly Legislative Report during the
2015 session. It will keep you in the loop on all the above and
then some. And don’t forget to volunteer as the MSMA Physician
of the Day at the Capitol. If you have any questions about our
advocacy efforts on your behalf, feel free to give me a call anytime
at 573-636-5151, or email jhowell@msma.org.
December 2014 / Page 3
Around the State: Membership & Meetings
Contact Haley Wansing at hwansing@msma.org / Member names in bold
The Saint Charles-Lincoln County Medical Society ninth
annual Dr. William Jones McElhiney medical school scholarship
was presented to Paul Hempel, fourth year student at University
of Missouri School of Medicine on Dec. 2 at Saint Joseph Health
Center. Below, from left is Carson Agee, MD, St. CharlesLincoln County Medical Society president, Kevin Weikert, MD,
MSMA #2 District Counselor, Paul Hempel, Martin Willman,
MD, scholarship chair, and Jeffery Copeland, MD, MSMA
Fewer than 11 Months to ICD-10
CMS has released a new webcast with information on clinical
documentation and coding from the “Road to 10” tool, which was
designed to help small physician practices transition to ICD-10.
Accessible through the “Road to 10” link on the CMS website
(www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html),
the webcast discusses how ICD-10 will impact documentation
and coding in small physician practices. Visit the CMS website at
www.roadto10.org for the latest news.
October 1, 2015 is the implementation deadline for ICD-10
compliance. Watch the CMS website for testing opportunities in
March and June 2015. The MSMA Insurance Conference (July 16,
2015 in Columbia) will have payors present to discuss how to get
claims paid and transition to ICD-10.
Washington University School of Medicine and MSM
Foundation Scholarship Recipients, below, from left: Seth
Howdeshell, Taleff Khan, Ron Evens, MD, Miriam Ben
Abdallah, and
Daniel Weisel. Not
pictured is Rowland
Han.
Congratulations
to the following
raffle winners whose
names were drawn
from each medical school’s pool of new first-year students. They
signed up for four-year MSMA memberships during their school’s
recruitment period, and are the lucky recipients of $150 raffle
awards and MDpocket WhiteCoat Clipboards: Bruce A. Wallace,
ATSU; Elizabeth York, KCUMB; John D. Flo, SLU; Cale
J. Roberts, UMC; Siddhant Thukral, UMKC; and Angus
Toland, WU.
Help a Vet with MSMA Registry
www.msma.org/VeteransAffairsRegistry
Scores of doctors representing more than 30 medical
specialties have signed up to a provide care for
military veterans outside the U.S. Department of
Veterans Affairs system. MSMA’s Veterans Affairs
Registry at www.msma.org/VeteransAffairsRegistry
was created to improve timely access to care for
those who have served our country.
Renew Your Medical License by January 31, 2015
Physicians obtaining a Missouri license to practice medicine must renew their license by January 31, 2015. Here are the requirements:
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Missouri law requires all physicians to obtain 50 hours of CME during the CME reporting period (every two years).
The current CME reporting period ends on December 31, 2015.
It is the responsibility of the physician, not his/her employee or employer, to submit the renewal application and fee to the Board.
A licensee who fails to obtain 50 hours of CME during the reporting period shall not engage in the practice of medicine unless an
extension has been granted by the Board.
An application for an extension must be made prior to December 31, 2015, along with a $50 processing fee.
Extensions are only granted through February 28, 2016.
Failure to obtain the CME or failure to request a CME extension by December 31, 2015, is cause for disciplinary action against your
license.
The next CME reporting period will be January 1, 2016 through December 31, 2017.
Notify the board of any name/address changes to assure their renewal is sent to the proper address.
Visit https://renew.pr.mo.gov/renew-default.asp for renewal information. For CME opportunities, visit www.msma.org/CMEOpps.
Page 4
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Progress Notes
www.msma.org
Progress Notes is published monthly for
the physician members of the Missouri
State Medical Association.
Lizabeth R. S. Fleenor, Editor
Missouri State Medical Association
113 Madison P.O. Box 1028
Jefferson City, Missouri 65102
800-869-6762 Fax: 573-636-8552
lfleenor@msma.org
@momedicalassn
December 2014
RALLY DAY
Tuesday, February 24
8:00 a.m. - 3:00 p.m.
MISSOURI CAPITOL in JEFFERSON CITY
201 W. Capitol Dr., Jefferson City, MO 65101
RSVP Today at www.ShowMeTortReform.com
Questions? Contact Becky Green with the Gate Way Group at
(314) 275-0884 or email bgreen@gogateway.org