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Orleans Parish Medical Society eNews:
Update: 10-10-05
 Post-Hurricane Resource Center
 

Message from Pat Breaux, MD, OPMS President

Dear Colleagues:

Katrina has dealt medicine in New Orleans a terrific blow; however, we can overcome the challenges that it has presented. Orleans Parish Medical Society, which has been in existence for 127 years, has been a major force in disaster preparedness and response during our organization's entire lifetime, and as been active on your behalf since the disaster occurred.

Starting with yellow fever, continuing through Betsy and Camille, and now Katrina, OPMS recognizes its role in supporting and assisting your efforts to care for your patients - even during and after a crisis. Because of Katrina, you may have relocated temporarily as may have your patients or you may have already returned to New Orleans to begin caring for your patients again. We assure you that we are working to develop the infrastructure and find the funding to help you and our colleagues rebuild this medical community.

Please let me or Susan D'Antoni, OPMS Executive Director, know what help you need most. You can call me at 504-220-9600, or Susan at 504-523-2474, ext. 3011 or cell: 504-453-8562, or email pbreaux1317@aol.com, or dantoni@opms.org.

Thank you for your continued commitment to caring for New Orleanians.
Pat Breaux

 

Message from Susan D'Antoni, OPMS Executive Director

Dear Doctors:

On behalf of the leaders and staff of Orleans Parish Medical Society, we wish to express our concern for you, your families, your patients, staff and practices. We understand that this is a difficult time for everyone. It also represents an unprecedented opportunity for physicians.

If you haven't already, I would like to encourage you to visit the Louisiana State Medical Society website: www.lsms.org. It has valuable information and resources to help you inform us of your whereabouts, locate your patients, and help you find answers to your questions about your malpractice coverage. To be able to assist you further, we must hear from you.

This is the first issue of OPMS E-News. We will continue to update you on the efforts of the leadership and staff on a regular basis, and provide you updates on resources that could be helpful to you personally or professionally. I, and the staff, will do everything possible to assist you.

Susan D'Antoni
Executive Director


Physicians' Voices are Being Heard in the Post-Katrina Rebuilding Effort

Within a few days after Katrina, OPMS became active on many fronts making sure that physicians' voices are being represented in the dialogue to rebuild New Orleans' medical community. Dr. Patrick Breaux, OPMS President, & Dr. Roberto Quintal, OPMS President-Elect, on a local level, and many physician leaders, including Floyd A. Buras, Jr., M.D. who will be installed as LSMS President on 10/14/05, have been making sure that doctors' needs are becoming known. OPMS has become active in the daily U.S. Public Health Service-led discussion where many strategic issues regarding New Orleans health care infrastructure are being discussed, beginning each day with an update on the status of health care facilities and public health care. OPMS leaders are also in frequent contact with local, state and national elected officials, including attending meetings with Senator Vitter and Representative Jindal. Meetings are also being scheduled with Senator Landrieu, Representative Jefferson, and Mayor Nagin. Dr. Breaux and Dr. Tony Sun of the PRO have discussed re-establishing medical practices with even better technology infrastructure. The listing of resources in this eNews is also information gained through this dialogue as we represent your concerns and interests in the coming days and weeks.

Concerns regarding Hospital Credentialing Issues Addressed:

In the last few weeks, physicians have raised concerns about questionable practices in Jefferson Parish hospitals regarding processing of applications for hospital privileges. Questions arose about whether the concerns possibly related to temporary privileges or permanent privileges, whether hospital medical staffs were attempting to use traditional credentialing processes as a barrier to timely credentialing. Contact was made by Dr. Mike Ellis with AMA Board member, Rebecca Patchin, who contacted Dr. Richard Frankenstein, AMA representative on JCACHO. He said that a separate set of standards for Disaster situations had been established, and that any effort to "close" a staff in such a circumstance would be grounds for possible antitrust and other concerns for such an institution.

He offered to help anyone who encounters such difficulties and gave his number 1-714-534-2897, and further indicated that he would attempt to have such a policy statement placed in AMNEWS, etc, as well as our state society websites. The link below provides a detailed account of those standards:

http://www.jcaho.org/about+us/news+letters/this+month+/for+physicians/index.htm#Joint#Joint

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OPMS to Request Waiver of 2006 Dues for Members of LSMS and AMA

At the LSMS Board meeting on October 14, 2005, and by letter to the AMA, OPMS will request a waiver of dues for all current members' dues for LSMS and AMA. It will be recommended to those organization that anyone who has already paid for 2006, should be credited to 2007.

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OPMS to Expand Physician Referral Program & Medical Records Locator Service

In a desire to provide helpful information to the public and ensure continuity in care, OPMS will be providing an expanded physician referral service to area residents. This expanded physician referral program will begin as soon as OPMS is allowed to re-occupy its office at 400 Poydras Street in the Texaco Center. Please watch your email for more details about this service.

Again, in an effort to assist those physicians who are relocating outside of New Orleans, OPMS will offer a service to track the location of patient medical records. This service is expected to begin on October 17, 2005.

OPMS Obtaining Hospital Medical Records Information

OPMS staff are making contacts with area hospitals which have closed to determine their plans for medical records access and/or storage. We will keep you updated. Here is the information we have so far:

Universal Health Services (for Methodist and Chalmette Medical Center)
Medical Records Inquiry
email: medical.records@uhsinc.com
phone: 1-877-777-7762

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From Medicare: Advance Payment Requests are Possible with Completion of Hurricane Katrina Disaster Recovery Information Form

In light of Hurricane Katrina, Medicare Services is offering an option to provide temporary financial relief for the provider community during this difficult time. Part B providers (see criteria below) may request advance Medicare reimbursement based on past payment patterns by completing the attached Advance Payment Request Form. Please fax the completed form to Arkansas Blue Cross and Blue Shield, Attn: Medicare Financial Services at (501) 210-9151.

The potential for an advance payment applies to Physicians/Suppliers whose place of business was not affected, but have seen an increase in the number of patients due to Hurricane Katrina; Physicians/Suppliers whose place of business was damaged, but are still able to render services; and, Physician/Suppliers whose place of business was destroyed, but they have moved to another location and are beginning to provide services to Medicare beneficiaries. Download Advance Payment Request Hurricane Katrina Disaster Recovery Information Formhttp://www.lamedicare.com/provider/AdvPayFrm.pdf

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Helping Physicians Rebuild Medical Practices:
Donations Encouraged to the Greater New Orleans Medical Foundation

The Foundation was created last year to improve access to health care services in New Orleans, to enhance public and physician education, and to increase Medicine's involvement in disaster preparedness and response. The Foundation, created by Orleans Parish Medical Society and the Alliance, is a 501c3 organization, and has been approved by the IRS to receive tax-deductible donations.

If you have contacts within professional organizations, health care corporations, or other entities which you think would like to make sure their contributions stay in New Orleans to help you and your colleagues rebuild your practices to improve your ability to care for the patients of New Orleans, please forward this contribution information to them.

Contributions should be made payable to:

Greater New Orleans Medical Foundation
c/o Hibernia National Bank Baton Rouge Main Office
440 3rd Street
Baton Rouge, LA 70802
In the memo line write: "Deposit to GNOMF, Acct # 2080558964", or enclose a note with this information.
For tax records, the Tax I.D. # of the Foundation is 20-1650323. We appreciate everyone's support during this trying time.

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Resources for Physicians & Patients

We have compiled the following list of resources and information. We apologize for any redundancy in the information. If you know of websites or other resources which would be of interest to physicians throughout New Orleans, please email Susan D'Antoni at dantoni@opms.org.

From the American Medical Association

The AMA has worked with David J. Brailer, MD, PhD, National Coordinator for Health Information Technology, and numerous other groups to expand KatrinaHealth.org to provide physicians access to prescription records of patients displaced by Hurricane Rita in addition to those affected by Hurricane Katrina. If you are a licensed physician and are treating a Hurricane Katrina or Rita evacuee, you may be eligible to use the medications network. To complete the process necessary to obtain a login and password, please contact the AMA's Unified Service Center at (800) 262-3211. The AMA's website includes information about the following information and can be accessed via _blank>www.ama-assn.org.

Locating Physicians & Resources for Doctors

Louisiana State Medical Society: www.lsms.org

Employment Portal for Displaced Louisiana Physicians: The Louisiana State Medical Society is establishing a database of available in- and out-of-state employment opportunities for displaced Louisiana physicians.

Displaced Louisiana Physician and Patient Tracking System can help physicians and patients.

Louisiana State Medical Society has established a "Hurricane Katrina Disaster Recovery Center," which offers an array of services, including tax and legal guidance; a small business administration fact sheet; a SBA disaster business loan application; a link with the state Medicare Web site for updates on provider issues; and links from other various providers offering information.

Other Medicare Information 

Medicare Patient Information Poster

http://www.lamedicare.com/provider/HelpIsOnline050915.pdf

To Update Your Medicare Provider Information if You Have Changed Locations

http://www.lamedicare.com/provider/dreUpdateFrm.pdf

The CMS provides answers to questions about Medicare fee-for-service issues on its Web site (PDF, 64KB; requires Adobe® Reader®).

Other Health Plans' Procedures & Information re: Hurricane Katrina

http://www.ahip.org/hurricaneresponse/

From LAMMICO re: Malpractice & Other Coverage Issues

http://www.lammico.com/resources/news-detail.asp?news_id=21

Louisiana Economic Development Activities related to Rebuilding Business in New Orleans

Information related to http://www.ledforward.louisiana.gov/

Local information on the disaster response

Local information on the response is available through the Louisiana Department of Health and Hospitals, Louisiana State Office of Homeland Security and Emergency Preparedness

FEMA Publication re: Individual Assistance and Housing

http://www.fema.gov/pdf/about/process/help_after_disaster_english.pdf

From the Small Business Administration

United States Small Business Administration
To obtain general program information or to receive a status update on your disaster loan request, please call our customer service line at 1-800-659-2955 from 6AM to 11PM, 7 days a week, or email us at disastercustomerservice@sba.gov.

U.S. Department of Labor - http://www.ldol.state.la.us/

Financial help for those employed and self-employed impacted by a declared major disaster. (225) 342-3111

Louisiana State Economic Development Corp. - http://www.lded.state.la.us/

IRS Disaster Site for Hurricane Victims - http://www.irs.gov/newsroom/article/0,,id=148488,00.html

Women in Entrepreneurship - http://www.women-21.gov/

SBA Women's Business Center - http://www.sba.gov/onlinewbc/

U.S. Department of Commerce Office of Small and Disadvantaged Business Utilization - http://www.osec.doc.gov/osdbu/

National Women's Business Council - http://www.wbenc.org/

Minority Business Development Agency - http://www.mbda.gov/

Hurrican Katrina Assistance Links - http://www.inc.com/criticalnews/katrina.html

http://www.sba.gov/disasterarea2/LA10176factsheet.pdf

http://www.sba.gov/sbaforms/Form-5(01-05).pdf

http://www.sba.gov/disasterarea2/LA10176factsheet.pdf

From CMS: Emergency steps to ease health care access

The Centers for Medicare & Medicaid Services (CMS) has announced a series of emergency policy changes to accommodate the needs of displaced Medicaid and State Children's Health Insurance Program (SCHIP) beneficiaries who have fled Hurricane Katrina and need urgent medical attention in their new host states.

Special evacuee status has been granted to all those who fled states because of Hurricane Katrina. This designation allows those persons to apply for the full range of federal benefits administered by the states without having to produce the normal forms of documentation to verify eligibility. These programs include Medicaid; SCHIP; temporary assistance for needy families; child care; mental health services and substance abuse treatment; food stamps; housing; foster care; women, infants and children nutrition; school lunch; unemployment compensation; and job training. Visit the HHS Web site to view these and other changes by CMS.

Medicaid template agreement for assistance to states

HHS Secretary Michael Leavitt announced a template agreement for use by states making it easier for eligible evacuees to receive services through the state's Medicaid and State Children's Health Insurance Programs (SCHIP). The template agreement creates an uncompensated care pool to help compensate physicians, hospitals and other health care entities who provide needed medical treatment to evacuees who do not currently have health insurance and are ineligible for Medicaid or SCHIP.

To learn more, access the Alabama fact sheet (PDF, 68KB; requires Adobe® Reader®) or the Florida fact sheet (PDF, 68KB; requires Adobe® Reader®).

Medicare, Medicaid and SCHIP providers

Health and Human Services (HHS) Secretary Mike Leavitt has also declared a public health emergency in Alabama, Florida, Louisiana, Mississippi and Texas. He has also temporarily waived several regulations of the Social Security Act, including one that requires physicians treating patients in the emergency areas to hold licenses in the state in which they provide services, in most cases. Other waivers affect preapproval requirements, privacy regulations, transferring of patients between facilities and patients cared for out-of-network under Medicare Advantage plans. Visit the HHS Web site to read the waiver.

The Centers for Medicare and Medicaid Services (CMS) has relaxed normal operating procedures to speed provision of health care services to the elderly, children and persons with disabilities. Because of hurricane damage to local health care facilities, many beneficiaries have been evacuated to neighboring states where receiving hospitals and nursing homes have no health care records, information on current health status or even verification of the person's status as a Medicare or Medicaid beneficiary. The CMS is assuring those facilities that the normal burden of documentation should be waived and that the presumption of eligibility should be made. Visit the CMS Web site to view other forms of immediate relief by CMS.

Louisiana Medicare: Visit the Louisiana Medicare Services' Web site for hurricane disaster assistance updates.

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Answers to frequently asked questions

HHS: On its Web site, HHS is continuously providing answers to hundreds of questions on a variety of issues related to the disaster, including volunteering in groups, length of deployment for volunteers, and many other topics related caring for patients in the aftermath of the disaster.

Logistical assistance

HHS has established an e-mail address where physicians, medical societies and clinics can get logistical help if, for example, a shelter experiences a shortage of a particular drug, or if patients experience problems in using Medicaid cards in states to which they have been evacuated.

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Victims' insurance issues

AMA Insurance Agency

AMA Insurance Agency has worked with underwriters of AMA-sponsored plans to assist customers who have been affected by Hurricane Katrina. Agency customers who are residents of Mississippi, Louisiana, Alabama and Florida now have:

A 90-day grace period extension for premium payments

A priority customer-care telephone line at (800) 458-5736 (Press "6" when prompted.)

The ability to call to submit an address change, change or stop electronic payments, and other customer services without written confirmation

The Agency is considering additional ways to assist customers. View AMA Insurance Agency's Web site for more information.

America's Health Insurance Plans (AHIP): AHIP has created an online resource to explain how several insurers' policies are being amended to regarding patients affected by the disaster. Visit the AHIP Web site to view this resource. Victims of Hurricane Katrina who have questions about their health insurance or do not know how to contact their health insurance plans should call toll-free (800) 644-1818 for assistance.

National Association of Insurance Commissioners (NAIC): The Mississippi insurance commissioner has asked all insurance companies, including health, auto and home, to suspend cancellations for nonpayment of premiums for at least 90 days. View the NAIC Web site for more information.

Public health and safety issues

HHS Declaration: As a consequence of Hurricane Rita in the states of Texas and Louisiana, Health and Human Services (HHS) Secretary Mike Leavitt issued a Determination that a Public Health Emergency exists as of September 20, 2005. As in the case of Hurricane Katrina, he has also temporarily waived several regulations of the Social Security Act, including one that requires physicians treating patients in the emergency areas to hold licenses in the state in which they provide services, in most cases.

Crisis hotline: HHS has established a toll-free hotline for people in crisis in the aftermath of Hurricane Katrina. By dialing (800) 273-TALK or (800) 273-8255, callers will be connected to a network of local crisis centers across the country that are committed to crisis counseling. Callers to the hotline will receive counseling from trained staff at the closest certified crisis center in the network.

The Centers for Disease Control and Prevention (CDC): The CDC has wide range of updated resources, ranging from infectious diseases and immunizations to food and water safety. Daily updates are provided. Visit the CDC's Web site to access this resource.

Relief worker/volunteer health: Because of their potential exposures, relief workers are at increased risk for developing illness and injuries. Relief workers should plan for travel with the knowledge that there may be shortages of electricity, safe water, or food distribution systems in areas affected by the hurricane. The Centers for Disease Control and Prevention (CDC) recommends bringing a travel health kit as well as specific toiletry and personal items. The CDC also details efforts volunteers/relief workers should take to prevent injury, electrocution and foodborne illness and to avoid health risks from contaminated flood waters. The CDC Web site also provides links to mental health resources to help relief workers cope with stress. Visit the CDC Web site to view these recommendations.

Immunization: Interim immunizations are available for people who have been displaced by Hurricane Katrina, but requirements for certain age groups vary, depending on whether their immunization records are accessible. Children and adults with available records should be vaccinated according to the recommended child, adolescent, and adult immunization schedules, according to the Centers for Disease Control and Prevention (CDC).

For those whose records are not available, children age 10 and younger should be forward vaccinated and treated as if they were up-to-date with recommended immunizations and given any doses that are advised for their age. In addition, children and adolescents 11 to 18 years old and adults should receive their own specific immunizations.

Visit the CDC Web site for immunization information for Hurricane Katrina.

Medical student, resident and research issues

Medical students: Tulane University School of Medicine has resumed its medical education program at Baylor College of Medicine. Temporary housing for all relocated students is being provided in the Houston area, and Tulane officials are collecting money for students through donations and the university's financial aid office. Classes for Louisiana State University at New Orleans students are being held at the Pennington Biomedical Research Center in Baton Rouge. The Web site of the Association of American Medical Colleges has detailed information about arrangements for students at these schools, as well as how the schools will handle residency applications.

Residents: Residents may visit the Accreditation Council for Graduate Medical Education's Web site for information on residency issues.

Researchers: The National Institutes of Health, Office of Extramural Research, has published answers to frequently asked questions for grantees/grants/applications affected by Hurricane Katrina.

Hospital issues

AHA: The American Hospital Association has created a centralized hospital relief Web site to help HHS set up, staff and manage emergency shelters.

Emergency medical staff credentialing - Joint Commission: Element of Performance 20 under MS.1.20 requires that medical staff bylaws include "a description of the privileging process (including temporary and disaster privileging)." MS.4.110 states that "Disaster privileging may be granted when an emergency management plan has been activated and the organization is unable to handle the immediate patient needs." The Elements of Performance permit disaster privileges to be granted on the presentation "of a current picture Hospital ID card," or current license to practice and a valid picture identification issued by a government agency, or identification from the Disaster Medical Assistance Team, or identification from a government entity establishing that the individual has authority to render patient care, or simply upon current staffs' presentation as to the provider's competence to treat patients.

AHRQ: The Agency for Health Research and Quality (AHRQ), part of U.S. Department of Health and Human Services, has created a new tool to help public health officials and hospital and health facility staff in Louisiana, Mississippi, Alabama, Texas and surrounding states determine how to best choose and use a formerly closed hospital or health facility to care for patients in the wake of the disaster. Visit the AHRQ Web site to access this tool.

Pharmaceuticals

Affected states: Most, if not all, state pharmacy board regulations contain emergency refill provisions that permit a pharmacist to dispense an emergency refill in limited quantities without a prescription if, in the pharmacist's professional judgment, the medication is essential to the maintenance of life or the continuation of therapy, and the interruption in therapy would result in undesirable health consequences. Check the appropriate state pharmacy board for detailed guidance.

Alabama: The Governor of Alabama has issued a Proclamation authorizing pharmacists to refill prescriptions for evacuees only, and have 30 days to contact a physician instead of 72 hours.

Uninsured, underinsured, and low-income individuals may be eligible to receive free or nearly free drugs through the Partnership for Prescription Assistance, organized by leading pharmaceutical manufacturers in partnership with more than 1,200 health care providers and community groups nationwide.

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From Senator Vitter's Office: Individual assistance programs

The U.S. House and Senate reached agreement on the "Katrina Emergency Tax Relief Act of 2005," which provides much needed tax relief to affected individuals, provides tax breaks for individual and corporate charitable giving, and other debt relief. The bill was signed into law by President Bush on Sept. 23.

The U.S. Dept. of the Treasury and the Internal Revenue Service are allowing victims of Hurricane Katrina to make withdrawals and take loans from their retirement plans. To qualify for the relief under this announcement a hardship distribution must be made on or after September 29, 2005 and no later than March 31, 2006. Taxpayers affected by Katrina now have until February 28, 2006 to file tax returns and pay any taxes due. See the Katrina Tax Relief Act of 2005 (HR3768) signed on September 23. The IRS will abate interest and late filing, late penalty or failure to deposit penalties that would otherwise apply. This relief includes the September 15 and January 15 due dates for estimated taxes for individuals, and the September 15 and December 15 due dates for estimated taxes for corporations; the September 15 due date for calendar-year corporate returns with automatic extensions; the October 17 deadline for individuals who receive a second extension for filing their individual income tax returns; the October 31 and January 31 deadlines for filing quarterly federal employment and excise tax returns; and employment and excise tax deposits due on or before February 28, 2006. The postponement of deadlines, interest suspensions and waiver of penalties apply to any tax returns, tax payment or tax deposit with an original or extended due date falling on or after August 29, 2005. In Florida, when Katrina hit first, the date is on or after August 24, 2005. Visit the IRS Web site for the geographic areas covered by the Katrina tax relief. Relief is available through March 31, as detailed in this document. (PDF, 15KB)

FEMA and other federal, state and local agencies offer disaster assistance in several forms, including assistance for individuals and households, low-interest loans, veterans benefits, tax refunds, excise tax relief, unemployment benefits, crisis counseling and free legal counseling. Visit the FEMA Web site for more information. Call (800) 621-FEMA (621-3362) or apply online for FEMA assistance. If you are seeking legal help because of the disaster, the ABA Young Lawyers Division/FEMA toll-free hotline is (800) 310-7029 for Louisiana residents.

The Disaster Unemployment Assistance program--funded by FEMA--is designed to help those whose employment was interrupted by the disaster. Eligible persons include self-employed business people, business owners unable to provide services, and other unemployed workers who are out of work because of the disaster, and who do not otherwise qualify for unemployment benefits. For claim information in Louisiana contact (225) 342-3111 or visit the Louisana Works: Department of Labor Web site; Louisiana Small Business Administration provides information about low-interest loans for homes, business and economic injury.

Independent Doctors of New York will provide information on available positions to any New Orleans physician seeking relocation assistance. Physicians should contact the IDNY at IDNYMDAssist@aol.com.

In addition to the employment portals cited above, displaced physicians may wish to contact their specialty society and/or the state/county medical society where they are considering relocating for further information regarding employment opportunities both within and outside the affected disaster areas.

From the IRS re: Katrina Tax Filing Issues

If you know of other resources which would be helpful information for your colleagues, please forward them to dantoni@opms.org. Thank you.

 

 

 

 

 
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