Spring magazine 2016 by Knoxville Academy of Medicine

Volum e L X X III, No . 1 • S p r in g 2 0 1 6

Se r ving the Gr e ate r M e tr opolitan Knoxvi l l e Area

KAPA’S BOOT SCOOTIN’ BALL FEATURING RODNEY ATKINS APRIL 8, 6:30 PM KNOXVILLE MARRIOTT

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Academy Officers

PRESIDENT’S MESSAGE By: Thomas Pollard, MD

Thomas Pollard, MD PRESIDENT

Neil Coleman, MD PRESIDENT ELECT

Ceeccy Yang, MD SECRETARY

Jack Benhayon, MD TREASURER

Pat O’Brien, MD

IMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees David Harris, MD Ed McBride, MD Clifton Tennison, MD Tim Wilson, MD

Ex- Officio Board Members Randal Dabbs, MD Richard Briggs, MD Richard DePersio, MD John W. Lacey, III, MD Robert Page, MD Cynthia Gash - KAMA Rep.

Publisher Kim Weaver, PhD

Editor Jonathan Weaver

Production Coordinator Margaret Maddox

Advertising David Caudill

ADVERTISING: For advertising information, call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in the publication.

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As I begin my second year as President of the Knoxville Academy of Medicine, I realize that I have been given a unique opportunity. I think that many of our past Presidents would agree that a one year term passes pretty quickly, and I for one have found it difficult to achieve all that I set out to do in that period of time. Although I am very proud of the Academy’s accomplishments this past year, I look forward to the many challenges we face in 2016. Several of our Academy members participated in our annual “Day on the Hill”. On March 1, physicians from our community and from around the state were given the opportunity to meet one-on-one with legislators and other government officials. The House and Senate addressed several bills this session of critical importance to East Tennessee physicians, the most important of which deals with the integrity of our practices. Recent proposals to allow advanced practice nurses to practice independent of physicians threaten to undermine the quality of primary care in Tennessee. The Tennessee Medical Association has introduced its own bill, The Tennessee Healthcare Improvement Act, which allows nurse practitioners and physician assistants to practice to the full extent of their training as a part of a physician-led team. We feel that this approach will achieve the goal of improving access to medical care while maintaining safety and quality. I encourage you to contact your own representatives and voice your opinion on this very important topic. Like many societies, our Academy also faces the challenge of maintaining a vibrant and involved membership. I am proud of the progress we have made this past year, both in increasing our number and our participation in Academy and Alliance events. This February saw another successful Doc Rock which benefitted several health-related charities. Our Poker League is off the ground and has provided a unique opportunity to get to know other members. And, don’t forget to dust off your boots and mark your calendars for April 8th. The Boot Scootin’ Ball has become one of Knoxville’s most anticipated social events and this year will feature Rodney Atkins. Tickets will likely

KAM

KNOXVILLE ACADEMY OF MEDICINE sell out, so, reserve your tables now! The Foundation has also set its goals for the coming year. As you know drug abuse has taken its toll on our community and has been the focus of Academy and Foundation projects over the past few years. We have seen impressive success in our work with addicted mothers and in our efforts to close disreputable pain clinics. This month, we met with physicians representing all of the hospital systems in Knoxville in an effort to confront the growing problem of IVDA-related endocarditis. I will be seeking your help as we strive to reverse the human and financial costs related to this epidemic. Once again, I am honored to serve as your President for another year! I thank all of you for your commitment to the Academy and to our community!

Tommy

Calendar of Events APRIL KAPA’S BOOT SCOOTIN’ BALL 8

Knoxville Marriott, 6:30 pm - 11:00 pm

KAM Poker Tournament, Casual Pint Farrgut, 6:30 pm

Spring OSHA Seminar,Knoxville Marriott, 8:00 am-10:30 am or 6:00 pm-8:30 pm

MedTenn16, Embassy Suites, Murfreesboro, April 28 - May 1

MAY 17

Roane-Anderson County Medical Society Spring Meeting, Riverside Grille, Oak Ridge, 6:30 pm

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KAM Drug Czar Visits the KAM By: Kimberly Weaver, PhD

The Knoxville Academy of Medicine was honored in January to host a private meeting for KAM physician leaders with Michael Botticelli, Director of the White House Office of National Drug Control Policy. Mr. Botticelli was in Knoxville as part of a multi-city fact-finding tour to discuss ways to prevent and treat prescription drug abuse. KAM physician members who attended the private session were Drs. Tom Pollard, Elise Denneny, James Choo, Richard DePersio, Randal Dabbs, Pat O’Brien, and Matt Mancini. AMA Representative Patrice Harris, MD and TMA

BME Update

By: Reeves Johnson, MD Failure to Renew – It is against the law to practice medicine on an expired license. It is the individual’s own responsibility to maintain an active license. Any reminder from the Board is a courtesy and failure to receive one is not an excuse. Once you recognize you are practicing on an expired license, you must cease practicing immediately. In order to obtain an active license, you must submit a Reinstatement Application which is more detailed than a renewal application. You will have to submit a detailed work history since the expiration, which, by the way, if you have not been actively practicing in the preceding 2 years, you will have to prove you are competent to practice. Also, you will need to submit proof of the required CME including the 2 hours relating to prescribing practices. If it has been less than 60 days since expiration, there will be no penalty. However, if you have practiced more than 60 days but less than 6 months beyond expiration, you will be assessed a penalty of $1000 for each month in which you practiced beyond the 60 days. This will also be reported to the National Practitioner Data Bank (NPDB). If you practice more than 6 months on an expired license, you will be referred for formal disciplinary action, including fines, investigative costs and a reprimand which also is reported to the NPDB. Continuing Medical Education – In the 2 calendar years preceding the renewal year, unless exempted, you are required to complete 40 hours of CME including 2 hours related to prescribing practices. If audited, you must provide documentation of completion which must be a copy of the certificate or letter verifying attendance and completion. However, if you are a member of the AAFP, documentation from the CME part of their website will suffice. These hours must be from an organization accredited by the ACCME and be either Category 1 AMA or AAFP prescribed credits. Your documentation must be kept on file for 4 years and your

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Representative Richard Soper, MD were also on hand to meet the Director. KAM physicians presented information regarding the KAM Drug Task Force and the successes the initiative has achieved. The Knoxville Academy of Medicine Drug Task Force is in its 2nd year of existence and includes physicians, legislators, the Metropolitan Drug Commission, law enforcement and pharmacists to collaboratively approach the prescription drug abuse problem in East Tennessee. For more information on the KAM Drug Task Force, contact Margaret Maddox at mmaddox@knoxvillemedicine.org.

hours do not roll over to the next renewal cycle. Prescribing practices CME – Vanderbilt University now offers a free online course that will satisfy this CME requirement. Go to: http:// cme.mc.vanderbilt.edu/tennessee-chronic-pain-guidelines-and-controlled-substance-efforts You will need to register; but please note this offering is set to expire 11/24/2016. Medical Spas – By statute (T.C.A. § 63-1-153), the definition of a Medical Spa exempted an individual physician’s office or practice that is owned by the physician. However, last year a law was passed that effective 1/1/2016, all Medical Spas have to register with the BME and the above exemption did not apply. There is proposed legislation to delete this requirement for physician offices, but for now, any physician that provides cosmetic services that could include treating asymptomatic skin tags, moles, etc. would have to register. For more specific information, please review the FAQ’s at https://www.tn.gov/assets/entities/health/attachments/Med_spa_FAQs.pdf Telehealth – Two years ago, the Legislature amended the insurance section of the law to require most commercial insurance companies to provide coverage for telehealth services if they are provided under certain guidelines. Last year, they amended the general provisions section as it relates to medicine to further clarify the definition of telehealth and called it synonymous with telemedicine. It also holds telehealth to the same standard of care as an in-person encounter and does not apply to pain clinics and treatment of chronic nonmalignant pain. The BME has developed proposed rules regarding Telemedicine and they are currently being reviewed by the Attorney General’s Office. NEEDED: Expert Medical Witnesses - The BME is seeking expert medical witnesses to review cases involving disciplinary actions brought before the Board. Please contact Andrea Huddleston at 615-741-8221 if interested.

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ACADEMY NEWS New Members A big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine. ELLEN FARINA LIUZZA, MD

DAVID CROUCH MD

PAMELA BULLOCK, MD

________________________________________________

JAMES BECKHAM III, MD

JAIDEEP SOOD, MD

DEANNA NELSON, MD

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BRETT CAMPBELL, MD

SAMUEL T. MCILRATH, MD

STEVEN HAMILTON, MD

________________________________________________

ELIZABETH DRISCOLL, MD

RILEY S. SENTER, MD

JAMES GOODIN, MD

________________________________________________

DOUGLAS WELLONS, MD

JARED KRAVITZ, MD

EMILY BURDICK, MD

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BRET ROGERS, MD

JOHN-PAUL NEWPORT, MD

AYAZ RAHMAN, MD

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THOMAS J. CHRISTIANSON, MD

BRIAN PARKER, MD

JASON J. HALL, MD

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MARY GRAHAM, MD

LAUREN L. HARRIS, MD

INTERNAL MEDICINE Summit Medical Group Healthcare Services 501 20th St Ste 404 Knoxville, TN 37916

PEDIATRIC ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy # U-109 Knoxville, TN 37920

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy # U-109 Knoxville, TN 37920

ANESTHESIOLOGY American Anesthesiology of Tennessee 900 E. Oak Hill Ave Knoxville, TN 37917

CARDIOLOGY University Cardiology 1940 Alcoa Hwy Ste E310 Knoxville, TN 37920

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy # U-109 Knoxville, TN 37920

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FAMILY PRACTICE Summit Medical Group at Farragut 11808 Kingston Pike Ste 160 Knoxville, TN 37934

PULMONARY MEDICINE Statcare Pulmonary Consultants 2240 Sutherland Ave Ste 103 Knoxville, TN 37919

ANESTHESIOLOGY American Anesthesiology of Tennessee 9352 Park W Blvd Knoxville, TN 37923

INTERNAL MEDICINE Knoxville Integrated Healthcare 9051 Executive Park Dr Ste 401 Knoxville, TN 37923

PULMONARY MEDICINE University Pulmonary and Critical Care 1940 Alcoa Hwy Ste E210 Knoxville, TN 37920

UROLOGY Tennessee Urology Associates 7557A Dannaher Way Ste 230 Powell, TN 37923

OPHTHALMOLOGY University Eye Surgeons PC 1928 Alcoa Hwy Ste 324 Knoxville, TN 37920

PATHOLOGY,ANATOMICAL/CLINICAL PATHOLOGY, CYTOPATHOLOGY Knoxville, TN 37919

VASCULAR SURGERY Premier Surgical Group 1819 W Clinch Ave Ste 200 Knoxville, TN 37916

ANESTHESIOLOGY American Anesthesiology of Knoxville 501 20th St. Ste 606 Knoxville, TN 37916

CRITICAL CARE SURGERY University General Surgeons PC 1932 Alcoa Hwy Ste 270 Knoxville TN 37920

RADIOLOGY, DIAGNOSTIC Vista Radiology 2001 Laurel Ave Ste 304 Knoxville TN 37916

CARDIOLOGY Cardiology Associates of East Tennessee 9320 Parkwest Blvd Knoxville, TN 37923

SURGERY, PLASTIC Knoxville Plastic Craniofacial 9239 Park West Blvd. Ste 202 Knoxville TN 37923

ACADEMY NEWS

KAM KNOXVILLE ACADEMY OF MEDICINE

Doctors “Day on the Hill” This year members of KAM, BCMS and KAMA joined TMA members from across the state to participate in the annual “Day on the Hill” event. Physicians were able to sit in on meetings as well as speak one-on-one with legislators to make sure that the issues that impact them were heard. The bus trip up and back provided members with another opportunity to get to know one another. We look forward to next year’s trip and encourage all our members to get onboard with us.

KAM Kicks Off Year Two with President’s Bash This year the Knoxville Academy of Medicine celebrated the start of the second year of Dr. Pollard’s two year term with the President’s Bash. The Foundry location was only enhanced by the popular Doc Rock band Remedy. Congratulations Dr. Pollard and we look forward to another year of your leadership.

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Friday, April 8, 2016 6:30 pm, Knoxville Marriott

The evening will be packed with great country music by award-winning country artist RODNEY ATKINS, line dancing, a western-themed dinner, a variety of beers in your own bottomless souvenir glass, and a large silent auction. All proceeds to benefit Knoxville Area Project Access (KAPA). For more info & tickets visit kapabootscootin.com or call (865) 531-2766

KNOXVILLE AREA

A Program of the Knoxville Academy of Medicine

ACADEMY NEWS

KAM KNOXVILLE ACADEMY OF MEDICINE

Legislative Report By: Elise Denneny, MD

The 2016 legislative session is in full gear and I wanted to give you an update on TMA’s bills as of press time. The Health Care Provider Stability Act (SB0937/HB0963) continues to work to hold payors accountable for contractual agreements. The insurance companies have responded with an actuarial report that places a large fiscal note on its implementation which diminishes its support. The Tennessee Health Care Improvement Act SB0521/HB0861, as you recall, champions the Physician-led team-based health care model, encouraging all health care providers at all levels to work together to provide value-based care and reign in runaway health care costs. Dr. Hale testified before the House health subcommittee February 16th. TMA’s Silent PPO bill (SB 1758/HB1720) was heard by the Joint Advisory council. The bill holds the silent PPO’s of worker’s compensation accountable; making them more transparent and provides a mechanism to process complaints about these Silent PPO’s. TMA’s in-office dispensing bill (SB 2060/HB2126) establishes requirements for the dispensing of opioids and benzodiazepines by physicians and other healthcare providers. It will have been heard by the Senate Health and Welfare Committee (2/24/2016) by the time you read this. TMA Day on the Hill was held March 1, 2016. Physicians and other providers joined in Nashville to meet directly with state lawmakers to advocate for their practice, their profession and their patients. If you have never attended this event before I encourage you to consider attending in 2017. Physicians and many of their spouses convened in Nashville to share their problems and explain the challenges of delivering quality health care to their legislators. As you know, many legislators have little idea of the daily challenges of EHR, Tennessee Payment reform, battling PBM (patient benefit managers) and rapidly changing CMS regulations. Day on the Hill is well invested time. You meet first hand with the legislator’s personal staff who are always ready to help

and hear your concerns in the event the legislator is tied up in committee. TMA’s position on other bills filed in 2016 can be accessed on the TMA website. Senator Briggs continues to champion the field of medicine with SB2025/HB208 Office-Based Opiate Treatment Act, and SB 1761/HB2043 Charges for persons providing prayer instead of medical treatment, and SB 2060, which was described above and provides regulations for the in-office dispensing of opioids. Other bills filed of interest are SB 1579, 1580, 1704, 2027 and 2057. They can be accessed at: http://wapp.capitol.tn.gov/apps/sponsorlist/default. aspx?id=s070&ga=109. Last but not least remember that April 28 -May 1 is MedTenn 16. The full agenda can be found at http://www.tnmed.org/Documents/ MedTenn2016%20Agenda%20REVISED%2011516.pdf and includes almost 20 hours of CME covering • Team-Based Healthcare Delivery Models • Death with Dignity • Telemedicine • Physician burnout • A NEW proper prescribing of pain medication course KAM can present concerns you may have as resolutions to be debated on the floor Sunday. Contact Kim Weaver at kweaver@knoxvillemedicine.org with your concerns. I encourage you to reach out to your peers attending as delegates. The delegates for 2016 are: Blount County - Dr. Robert Proffitt and Dr. Aaron Bussey Roane Anderson Counties – Dr. Kenneth Luckmann and Dr. George Smith Knox County – Dr. Matt Mancini, Dr. Timothy Wilson, Dr. Leonard Brabson, Dr. Rob Page, Dr. Roy King, Dr. Elise Denneny, Dr. Will Gibson, Dr. Walter Chiles, Dr. Melissa Chiles, Dr. Jeffrey Ollis, Dr. Thomas Pollard, Dr. Neil Coleman, Dr. Pat O’Brien, Dr. Keary Rob Williams and Dr. Keith Gray. Respectfully, Elise C. Denneny

50 Year of Service Recognized

The Knoxville Academy of Medicine was honored to present 50 year service pins to the following physicians. Congratulations and thank you for your many years of service to the community and your profession. Monte Biggs, MD

James I. Hilton Jr., MD

Charles I. Huddleston, MD

Kenneth Christenberry Jr., MD

William M. Hovis, MD

Carl Leslie Mathews, MD

R. Kent Farris, MD

Robert G. Howard, MD

Hiroshi Toyohara, MD

KAM Member since 1972

KAM Member since 1974

KAM Member since 1973 *Past KAM President

ROA Member since 1973

KAM Member since 1975

ROA Member since 1977

Member since 1974

KAM Member since 1974

KAM Member since 1976

Catherine Gyurik, MD KAM Member since 1985

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ACADEMY NEWS Resident Article

By: Niva Misra-Sammons, MD PGY3 (Third Post-graduate Year) IM Resident UT Graduate School of Medicine, Dept. of Medicine One aspect of a career in medicine is managing stressful situations. This may include concerns regarding a very ill patient, anxiety dealing with other staff members, or even personal matters. Resident physicians worry about doing their best, both as young physicians in training and for their patients. Stress is a part of life no matter the medical field. Each person chooses how to deal with it individually. This ability may be learned from our parents or family members. I am continually learning from both my mom and husband how to better manage my daily stress. As my mom always says, “there is a solution for everything”. In addition, our colleagues are good examples. I learn from both other resident physicians and those attending physicians who exemplify calmness. Dr. Mike McCormack, a pulmonologist at UT, stated, “I have learned that addressing potential stressful situations with a clear head and a calm mind consistently leads to better outcomes than those that result from anxiety and haste. The more I practice this habit, the easier it becomes to exercise in the future”. The key is stopping to think about a situation and not allowing oneself to be negatively influenced by the situation. Dr. McCormack also said,

“In our profession, we deal with many crucial decisions, and we do best when we aspire to keep our heads and hearts tranquil.” In a hypothetical example, imagine a sick patient’s family member is angry when you come in for your shift in the morning. He states the “hospital and staff are incompetent”. Although it is easy to think about this situation on paper, it is more difficult to act in the best manner when it is happening in real life. Rather than raising your voice, this is a situation to take a step back and stay calm before responding. To properly deal with situations at work, we must manage stress outside of work. Dr. Lands, a Hematologist at UT said, “One hour of quiet time in the early morning before my work day starts is therapy for me. Sometimes I read and other times I write.” Other ways to manage stress include spending adequate time with significant others, family, friends, and co-workers that will listen with an open mind. Activities may include exercising, playing with a pet, volunteering to help others, working in the garden, taking a relaxing walk, or using religious practices to help. Some may enjoy traveling to new places on days off and others may enjoy relaxing at home. We each have the ability to positively affect others by managing our own personal stress. Dr. McCormack further stated, “We can influence others to achieve a more comfortable and secure state in all aspects of our lives by setting an example”. Special thanks to Dr. Mike McCormack and Dr. Ronald Lands for calmly giving me good advice for this article.

Blount County Medical Society Report Congratulations to Jerome Heiny, MD who was recently elected President of the Blount County Medical Society. Former President, Dr. Robert Proffitt, passed the gavel to the new BCMS President at the Annual Meeting. Dr. Heiny is a physician with East TN Medical Group and began practicing in 1983 as a Family Practice Physician in Blount County. He attended the Doctor’s Day on the Hill on March 1st to represent Blount County physicians with area legislators. Aaron Bussey, MD and Robert Proffitt, MD were also elected as TMA Delegates for BCMS and will attend the MedTenn Meeting in April representing Blount County.

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TECHNOLOGY NEWS etHIN Surveys Healthcare Community Participants Learn what peers are saying about using etHIN by: Leigh Sterling etHIN Executive Director

etHIN has provided numerous educational articles in the KAM Magazine about the products and services it offers, and we thought it might be helpful for you to learn what users of etHIN’s services are saying about how they use etHIN and the benefits they have seen. etHIN surveyed a representative sample of physician practice clinical portal users in January 2016 and was very pleased to receive responses from 63% of those surveyed. Replies were overwhelmingly positive, with suggestions for additional functionality along with more and additional data types to be added to the HIE. Following are just a few of the responses to the survey questions related to time savings, type of data used, and benefits of using etHIN. How much time does using etHIN save versus your former process? Cancer specialty – “etHIN helps me turn around records on a patient in a matter of a few minutes, as before, I would have been waiting 2-48 hours+ for local providers/facilities to respond to my requests.” PCP – “Average 10-15 minutes per patient, looking up probably 30 patients per day.” Pediatric – “Staff save 5-10 minutes per request each time etHIN is used when compared to (finding information) in other portals. I would guestimate (waiting) 10-30 minutes (per request) for faxes, return calls, etc. (using our former process).” PCP Care Coordination – “Basically, etHIN is the only place I can find (where else patients have received care) in a timely manner. So I would say in that regard, etHIN saves me approximately an hour or

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more of time a day.” What types of data are you using from etHIN? PCP – “ADT, lab, discharge summaries, plus reports. For HEDIS reporting, we save an hour each time we file if the information we need is in the system.” Pediatric – “etHIN is used mainly for labs and x-rays, sometimes reports.” Surgical Specialty – “Lab reports, op notes, imaging reports and images.” Billing – “I am in etHIN every day and find it very helpful for finding addresses, phone numbers and insurances.” Cancer Specialty – “I look for pathology reports, imaging reports, doctors’ notes, labs, consults and anything else our doctors might need for the patient.” What are the benefits of using etHIN to physicians and patients? Pediatric – “Speed of obtaining lab results and ability to view xrays” PCP – “It provides the physicians with more patient information than they would have otherwise, plus it provides the information the staff needs to build case management codes.” Cancer Specialty – “(As a case manager,) I can get answers more quickly, get patients in to see our physicians more quickly, and reduce the amount of time I spend working on each case, allowing me to help more patients.” etHIN provides patient information through its services to numerous practices in the local community, enhancing office efficiency and providing additional medical data, which can positively impact the bottom line. Now more than ever, these are critically important factors in the success of your practice and the quality of care provided to your patients. To learn more, visit www.ethin.org, or call us at 865-691-8433.

Eighth Annual Stroke Symposium: Providing Care Accross the Continuum

On Tuesday May 3, 2016 at the UT Conference center in Knoxville there will be the Eighth Annual Stroke Symposium presented by University of Tennessee Medical Center Brain and Spine Institute and the University of Tennessee Graduate School of Medicine. The topics covered during this session will include NETSMART-APNs Improving Stroke Care, Neurosurgical Management SAH, Hemicraniectomy, Neuro Critical Care Management of Hemorrhagic Stroke, Endovascular Guidelines Update, Integrative Review of the Stroke, Coordinator Role, Triaging Stroke/Mimics & Chameleons and Developing Regional Systems of Care. This symposium is approved for AMA and TPTA credit. For more details or to register, visit http://gsm.utmck.edu/cme/Stroke2016 or call (865) 974-0280

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Spring 2016 OSHA Annual Compliance Training for Healthcare & Dental Workers Two Seminars from Which to Choose: Thursday, April 21, 2016

To Register:

Visit knoxvillemedicine.org Call Andrea Brown at (865) 531-2766 Email at abrown@knoxvillemedicine.org Only $99 per person

8:00 am - 10:30 am Breakfast will be served or 6:00 pm - 8:30 pm Dinner will be served

Convenient Location

Knoxville Marriott 501 Hill Avenue SE Knoxville, TN 37915

New information for this seminar: Increase in fines and changes in reporting to OSHA!

Spring Meeting Tuesday, May 17, 2016

Riverside Grille 100 Melton Lake Peninsula Oak Ridge, TN 37830 Special Guest Speaker Dr. Roland Gray with the Tennessee Medical Foundation

Monday, April 18, 2016 6:30 pm Casual Pint - Farragut $50 Entry fee All KAM Physicians and invitational guests are welcome to join us for a Texas Holdem Poker Tournament. Tournament slots are limited so reserve your slot today! Entry fee is $50.00 and will benefit Knoxville Area Project Access (KAPA), with the top 3 tournament players receiving prize winnings! Dinner starts at 6:30 pm Tournament starts at 7:00 pm Register at knoxvillemedicine.org or email Margaret Maddox at mmaddox@knoxvillemedicine.org 12

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LEGAL NEWS 60-Day Report and Return Rule: The Clock is Ticking

By: Kourtney Hennard, London Amburn, P.C. At long last, on February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published the final 60-day report and return rule (the “Rule”). The Rule, originally proposed in February 2012 (two years after the Affordable Care Act mandated the reporting and return of overpayments received under Medicare and Medicaid), applies to providers and suppliers receiving funds under Medicare Parts A and B. Generally, the Rule requires a person receiving an overpayment to report and return the overpayment by the later of either (1) 60 days after it was identified, or (2) the day any cost report is due, if applicable. “Overpayments” are funds that a person receives or retains to which the person, after applicable reconciliation, is not entitled. The failure to report and return an identified overpayment within the 60-day timeframe can result in liability under the False Claims Act, including significant monetary penalties and other detrimental consequences. Though there are many important aspects of the Rule, this article will focus on (1) what it means to “identify” an overpayment, (2) the lookback period, and (3) the importance of a robust compliance program. Under the Rule, a person has identified an overpayment when “the person has, or should have through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment.” Reasonable diligence is “demonstrated through the timely, good faith investigation of credible information, which is at most 6 months from receipt of the credible information, except in extraordinary circumstances.”

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Even if an overpayment is retained inadvertently, False Claims Act liability can result if the provider fails to exercise reasonable diligence. As the commentary to the Rule makes clear, overpayments must be returned “regardless of the reason it happened – be it human or system error, fraudulent behavior, or otherwise.” And “otherwise” even includes errors made by CMS. What’s more, providers must report and return overpayments received at any point during the past six years. Providers may use statistical sampling and extrapolate overpayments owed rather than reviewing each individual claim; however, the provider must explain the sampling methodology when reporting the overpayment. The key takeaway here is the importance of robust internal compliance programs for providers. The Rule clarified that “reasonable diligence” includes both proactive compliance activities and reactive investigative activities. In fact, CMS specifically stated that “undertaking no or minimal compliance activities to monitor the accuracy and appropriateness of a provider’s…Medicare claims would expose a provider…to liability.” Efficacious compliance programs, including internal audit procedures, will be key to complying with the Rule’s tight timelines and avoiding False Claims Act liability. The clock is ticking, and the stakes are high. Kourtney Hennard is an attorney with London Amburn, a law firm based in Knoxville, Tennessee, which represents providers in the area of healthcare law, including regulatory, compliance, HIPAA, malpractice and nursing home defense, employment, mergers and acquisitions, corporate and business matters. For more information, you may contact Ms. Hennard at (865) 637-0203 or visit www.londonamburn.com. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

Don’t Miss the Boot Scootin’ Ball! Friday, April 8, 2016 6:30 pm Knoxville Marriott With Rodney Atkins!

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KAMA CORNER By: Lorraine Johnson, KAMA President Doc Rock was held at NV in the Old City on Saturday, February 20th. This was the 11th year for the event and co-chairs Jacque Prince and Jennifer Ollis did an outstanding job making this event so successful! The proceeds from the event were divided among three health-related charities represented by three bands: “Missing Chords” for KAPPI; “Remedy” for Interfaith Health Clinic and “STD –Spinal Tappin Docs” for St. Mary’s Legacy Clinic. KAMA also hosted a “Pre-Doc Rock Gathering” at Barley’s for resident physicians that same night. March is a busy month for KAMA! We started the month off with several members attending Doctor’s Day on the Hill on March 1st. It was wonderful to have the opportunity to go to Nashville and meet with some of the legislators and have a dialog about upcoming bills pertaining to the practice of medicine in our state. The 4th Annual KAMA Retreat was held at the Buckhorn Inn in Gatlinburg, TN on March 6-7. The retreat gives us the opportunity to reflect upon this year, set goals and discuss ideas for next year. Once again KAMA/KAM will honor retired physicians at the Doctor’s Day – Emeritus Club Luncheon on March 28th at Lakeside Tavern.

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On this day, we celebrate these physicians for their many years of valuable service to our community! The 88th TMAA Annual Meeting and Convention will be held in Murfreesboro, TN on April 28-May 1. Our own Gail Brabson is President this year and will be presiding over this meeting. More details can be found at www.kamalliance.org. KAMA will be participating in the 5th “Let’s Move Knoxville” event on May 7th at Victor Ashe Park. We will have a booth with the theme “I Can be Healthy’ which will focus on activities to ensure making healthy food choices. On Thursday, May 5th KAMA will host a Past President’s Luncheon along with the Installation of Officers at Cherokee Country Club. We will be recognizing the past presidents and welcoming the new leadership for 2016-2017. If you would like to learn more about KAMA: visit us on Facebook (Knoxville Academy of Medicine Alliance), follow us on Twitter (KAM_ Alliance), Pinterest (Knoxville Academy of Medicine Alliance) and on our website (www.kamalliance.org).

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