Louisiana Medical News August 2015

YOUR PRIMARY SOURCE FOR PROFESSIONAL HEALTHCARE NEWS JULY/AUGUST 2015 / $5

SOU TH LOU ISIANA ED ITION

UMC New Orleans Hospital Complex Set to Open in August

On Rounds Physician Spotlight Dr. George Chimento Well-traveled Physician Calls Ochsner Home Growing up in Rhode Island, George Chimento’s role model was his uncle, Dominic Chimento, a firstgeneration Italian immigrant who came to the U.S. and became a general surgeon.

“My uncle didn’t speak English when he was growing up, and he somehow managed to put himself through medical school driving a taxi,” Chimento explained ... page 2

Louisiana Medical Society Offering Physician Leadership Training

Healing, Training, Research

BY BARBARA MCCONNELL

University Medical Center New Orleans, unique for design features, art and technology, is a $1.1 billion teaching and research architectural marvel of a hospital complex slated to open this August in the emerging Bio-Medical District of downtown New Orleans.

In partnership with UMC New Orleans are Tulane University School of Medicine and LSU Health Sciences Center. Nursing and allied health education affiliates include, LSU Health Sciences Center, Xavier University, Delgado Community College, Dillard University, Nunez Community College, Our Lady of Holy Cross and the University of New Orleans.

The project encompasses a 2.3 million square foot state-of-the-art hospital, clinic and three patient towers and 1800 parking spaces, in a 34-acre square of (CONTINUED ON PAGE 6) PHOTO: NBBJ/SEAN AIRHART

Health Systems, Hospitals Form New Statewide Network

BY TED GRIGGS

A few years from now, when communities, schools, and hospitals regularly see younger physicians helping shape their policy and organizations, the Louisiana State Medical Society (LSMS) will be able to credit its new leadership program.... page 5

The Ochsner Health Network (OHN), a partnership of five organizations and 25 facilities, is part of a growing trend where hospitals form affiliations rather than acquiring additional assets.

Ochsner Health System, St. Tammany Parish Hospital, Lafayette General Health, Christus Health and Terrebonne General Medical Center are the founding partners.

By building on each member’s strengths, sharing best practices, the partners believe they can improve quality, safety and access to care, and reduce healthcare costs.

“The hospital industry is seeing lots of mergers and acquisitions, especially the smaller guys, but a number (CONTINUED ON PAGE 9)

From left: David Callecod, President, Lafayette General Health; Phyllis Peoples, President and CEO, Terrebonne General Medical Center; Warner Thomas, President and CEO, Ochsner Health System; Kathy Kliebert, Secretary of the Department of Health and Hospitals; Stephen Wright, Senior Vice President, Group Operations, Christus Health; and Patti Ellish, President and CEO, St. Tammany Parish Hospital

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Louisiana Medical News

Physician Spotlight

Dr. George Chimento Well-traveled Physician Calls Ochsner Home

BY LISA HANCHEY

Growing up in Rhode Island, George Chimento’s role model was his uncle, Dominic Chimento, a first-generation Italian immigrant who came to the U.S. and became a general surgeon. “My uncle didn’t speak English when he was growing up, and he somehow managed to put himself through medical school driving a taxi,” Chimento explained. “So, I thought that what he accomplished was pretty neat.” The young Chimento was so impressed that he decided to follow in his uncle’s footsteps.

After obtaining a BS degree in biology at Providence College in his home state, Chimento headed to Georgetown University School of Medicine in Washington, D.C. During his third year, he decided to focus on orthopedic surgery. “My last rotation during my third year was in orthopedics,” he recalled. “Until that point, I thought I wanted to be a cardiologist. But, when I saw the variety of cases that orthopedics entailed, and the fact that you could definitely improve the quality of someone’s life, it made me decide that orthopedics was what I wanted to do.”

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Chimento then migrated South for his internship and residency in orthopedic surgery at Tulane University School of Medicine and Charity Hospital in New Orleans. While at Charity, he met his future wife, Leslie Thomas, a medical student from New Orleans.

Following his residency, Chimento served four years in the U.S. Air Force at Barksdale Air Force Base in Bossier City, La., where he was a staff surgeon for two years, then promoted to Chief of Orthopedic Surgery. He also served as chairman of the Medical Ethics Committee. It was during his stint in the military that he decided to focus on total joint replacement. “You had some people who were very, very de-

bilitated,” he recalled, “but by replacing a knee or a hip, you could give them a quality of life that they hadn’t had in a long period of time. I think that’s what drew me to joint replacement.”

For his contribution to Air Force personnel, he was awarded the Meritorious Service Medal. After finishing his military commitment, he became a fellow at the Hospital for Special Surgery in New York City. Then, he and his wife decided to return South to practice in her hometown.

For five years, Chimento worked in a private orthopedics and joint replacement practice. After Hurricane Katrina hit in 2005, he found Ochsner Medical Center needed a full-time joint replacement surgeon. “I realized that was what I wanted to focus on,” he recalled.

In 2006, Chimento started at Ochsner’s main campus, where he currently serves as Chairman of the Department of Orthopedic Surgery. His practice focuses on primary and revision hip and knee replacement surgery. Leslie, an anesthesiologist, serves as the Director of Regional Anesthesia at Ochsner.

Last year, Chimento’s department, in conjunction with the anesthesiology department, launched the Perioperative Surgical Home Program, which changed the process of care for total joint replacement patients. “We manage patients along with the anesthesia team throughout the hospital stay,” he explained. “It’s a surgical home, but it’s a type of accelerated rapid recovery program where the idea is to get the patient moving soon after surgery. Once that’s accomplished, it allows patients to go home sooner.”

The PSH program benefits patients by reducing the length of stay without increasing complications. “The patients have less pain, they are moving quicker, they get to go home quicker, and there’s really no increase in complications or readmissions afterwards,” he said. “More people get to be discharged home, not a skilled nursing facility or rehab unit.”

PSH’s multidisciplinary team of orthopedic surgeons, anesthesiologists, nurses, social workers, case managers and physical therapists meets weekly to discuss current and upcoming patients.

“We meet just to make sure that we are all on board,” he explained. “It takes a lot of work to get this done from a lot of different people.”

A respected surgeon, Chimento has been featured as one of the top Orthopaedic Surgeons in America by U.S. News and World Report, Castle Connolly’s Top Doctors (2013), Patients’ Choice Award (2011, 2014), Compassionate Doctor Recognition (2011, 2013-2014), Top 10 Doctor – City (2014) New Orleans, LA, and Top 10 Doctor – Metro Area (2014).

After hours, Chimento spends family time with Leslie, son Christopher, 16, and daughter Alexandra, 15. He also enjoys exercise, bike riding and traveling. He has presented at conferences in Beijing, China, Sydney, Australia and Kyoto, Japan. Next on his bucket list is South America.

Aside from being a serious surgeon, Chimento says that people would be surprised to know that he has a humorous side. “When you get to meet me, I’m not as serious as people think, and I have a goofy sense of humor,” he said with a laugh.

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JULY/AUGUST 2015 • 3

Lafayette Community Health Care Clinic: New Leadership, New Vision

BY LISA HANCHEY

Celebrating its 23rd year, Lafayette Community Health Care Clinic (LCHCC), a nonprofit providing healthcare to the working uninsured, is now under new leadership with a new direction. Last year, attorney Nicholas Gachassin, III, assumed the helm as board chair. On June 8, Skyra Rideaux, a Lafayette native with more than 10 years of professional experience in Nicholas public relations, market- Gachassin, III ing, strategic planning, and policy/procedure development, became LCHCC’s new executive director.

The Gachassin Law Firm has a long-standing relationship with the clinic. The firm’s office Skyra Rideaux manager, Phena Guidry, helped spearhead LCHCC’s major fundraiser, the Silverbell Soiree. Since the first event, annually held in December, the soiree has raised nearly $1.1 million. In 2014, the event raised $117,000.

LCHCC provides medical, dental, and pharmaceutical services to more than 600 working uninsured patients, solely through volunteers and donations.

Within the clinic facility are the LSU Dental Hygiene Program and the Community Pharmacy, a collaboration between LCHCC, Our Lady of Lourdes (OLOL) and Lourdes Foundation. LCHCC’s services include general medical, standard gynecological, preventive healthcare, education, pharmaceuticals (prescribed medi-

cations at no charge), dental, eye clinics (for diabetic and hypertensive patients), general nutrition, lab and x-ray referrals, sub-specialty referrals and breast cancer screening. Community partners providing in-kind services include Lafayette General Health Systems, LabCorp, Regional Medical Center, Women’s & Children’s Hospital, OLOL, Heart Hospital of Lafayette, Lafayette Specialty Surgical Hospital, Lafayette Surgical Imaging, Preferred Anatomic Pathology Services, University Hospital and Clinics and individual physicians, nurses, pharmacists, and lay volunteers.

For the last 21 years, the clinic has opened its doors to patients on Tuesday and Thursday evenings. Now, under its new leadership, LCHCC’s goal is to expand those services to more days. “Our ultimate goal is to provide services seven days a week,” Gachassin said.

To boost its fundraising efforts, the clinic formed the Committee of 1000. The goal of this project is to get 1,000 people to make a donation of $1,000 payable by cash, check, credit card or PayPal, or pledge a gift of $1,000 payable over three years, equating to $27.77 monthly for 36 months. These funds will help LCHCC continue to deliver the highest quality healthcare services to the working uninsured.

For over a year, LCHCC’s executive director position remained vacant.

Because LCHCC relies solely on donations, the 14-member board wanted to fill the job with someone having extensive fundraising experience. After months of searching, the committee found the ideal candidate in Rideaux.

A graduate of the University of Louisiana at Lafayette, Rideaux most recently served as the events and public relations

manager for Louisiana Immersive Technologist Enterprise (LITE) and served seven years in the United States Navy. She is actively involved in several nonprofit organizations, including the705, One Acadiana, Greater Southwest Louisiana Black Chamber of Commerce, Junior Achievement, Public Relations of Louisiana – Acadiana Chapter and Lafayette Public Education Stakeholders Council. “The Board is thrilled that Skyra has joined the clinic and we believe she will inject some great energy, new ideas, and strategic processes that will ensure lasting success,” Gachassin said. “The Board’s goal is to work directly with Skyra to set strategic processes and plans and guide her through her transition into her new role.”

Rideaux’s goal is to provide healthcare to the working uninsured to make them more productive employees. “Given LCHCC’s mission to serve the working individuals in our community without essential healthcare, we envision a future where health will not get in the way of people’s livelihoods,” she said. “Both acute conditions and complications from chronic diseases like diabetes can cause people to miss work and, for the working uninsured, that can be detrimental to their family’s financial stability. Recent studies have also shown that given decreased productivity or absenteeism in the workplace due to illnesses, companies are also losing money. Helping one adult pursue a future of better health could result in significant financial improvements and productivity for employers and help maintain a family’s financial stability.”

For the clinic’s continued operations, donations are essential. A major source of funding is through community partnerships. Patients are referred from clinic night to a community partner for the

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needed services (labs, x-rays, tests, eye doctors, specialists, etc.). “It is also our vision that through collaborative partnerships with the local business community, we can be a mecca for healthcare, programs and training to ensure that everyone in our community has the ability to work and take care of their families without having to worry about their health,” Rideaux explained.

The clinic was founded in 1992 by Dr. Terry A. Cromwell, a prominent plastic surgeon who was then president of the Lafayette Parish Medical Society.

During his term, he and other medical society members organized a communitywide effort to establish a healthcare clinic to serve the needs of working families with no health insurance. Through a private donation of $200,000 matched by the community, the clinic purchased the old St. Anne’s Infirmary in 2000.

LCHCC was the first clinic of its kind in the State of Louisiana and has been the mentor for five other communities in establishing their own clinics. Since its inception, the clinic has provided healthcare services valued at over $8 million to more than 11,000 working residents of Lafayette Parish. “We want to provide a healthcare safety net for working families who fall through the cracks due to high premiums and deductibles for the ACA (Affordable Care Act) and not qualifying for Medicaid due to income,” Rideaux said.

To make a donation, visit LCHCC at lchcc.net or call (337) 593-9208.

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Louisiana Medical News

Louisiana Medical Society Offering Physician Leadership Training

By TED GRIGGS

A few years from now, when communities, schools, and hospitals regularly see younger physicians helping shape their policy and organizations, the Louisiana State Medical Society (LSMS) will be able to credit its new leadership program.

The program’s major focus will be the changing economics, business and practice of medicine, said LSMS CEO Jeff Williams. Doctors are among the brightest individuals when it comes to academics and training, but typically their educations provide little in the way of business training.

“Most of them major Jeff Williams in undergrad in some sort of science or liberal arts degree, and then they go to medical school,” Williams said.

“So what’s funny is that while the practice of medicine has changed dramatically over the years, the business of medicine is changing exponentially faster.”

A few of the recent issues physicians have had to tackle or are tackling include the changes wrought by the Affordable Care Act; a rapidly escalating push to shift from fee-for-service payments to outcome-based reimbursement; and government mandates such as electronic health records/meaningful use and the ICD-10 coding system.

Williams is hoping the leadership courses will balance physicians’ training.

It’s not just the payment systems that are changing, Williams said. Doctors are going to have to understand managing population health, data analytics and what that means for their practices.

Physicians will also have to adjust to changing roles, as more and more doctors move to either larger groups or hospital employment, Williams said. Part of their time will be spent practicing medicine and treating patients, and part of the time will be spent as managers and directors.

This is the training piece that LSMS feels physicians are really missing, Williams said.

The Medical Society is working with LSU Executive Education to create the program. The society is using a $146,000 grant from Physicians Foundation, a national nonprofit organization that seeks to empower practicing physicians, to cover the cost of the training.

LSMS president Dr. Dolleen Licciardi said the participants can apply fundamental skills from the leadership classes in their personal and professional lives.

The training will help physicians better represent the needs of their patients as well as potential partners Dr. Dolleen and/or employers at the Licciardi

local, state and national level, Licciardi said.

The first training program will consist of five weekend sessions spread out over several months at LSU. There will be online homework assignments between courses.

“It’s going to be a really in-depth, allinclusive program,” Williams said.

LSMS is still developing the selection criteria, but the group hopes to train 50 physicians over the first two years. The evaluations of the first year’s class will be used to further refine the second class’s courses.

Williams said already at least 25 physicians have inquired about the training, despite limited publicity.

“I would love to have a problem where I have four to five times that many people wanting to go through the program,” Williams said.

The classes will be limited to what LSMS is calling “emerging leaders” or young physicians, which includes medical students and people who have been practicing medicine for 10 years or less, Williams said. Those people are the future of the profession.

The program has its roots in the national physician leadership academy launched a few years ago by the Physicians Foundation, Williams said. Only one doctor from each state was allowed to take part in the first training class.

But the program was wildly popular, and participants came back asking how they could implement the training in their states.

LSMS has been working for the past 18 to 24 months on the Louisiana program with LSU’s EJ Ourso College of Business, which drew on the University of Florida’s experience.

After working out the Louisiana program, all LSMS needed was a way to pay for the training, Williams said. The Physician Foundation grant took care of that.

The foundation came about after physicians, 19 state medical societies and three county medical societies filed a class-action lawsuit against private, third-party payers and agreed to a large settlement. The settlement led to the Physicians Foundation, which awarded more than $31 million in grants since 2005.

Future funding for the Louisiana program may be available from the foundation, Williams said. LSMS is hoping to use an additional grant or its own funding to offer the training online.

That way people who don’t have time to commit to a full course or who aren’t interested in the full course can pick and choose the modules they want, either through webinars or virtual learning, Williams said.

The inaugural class is scheduled to begin February 2016. Interested physicians should contact Sadie Wilks at 225-763-8500 or sadie@lsms.org for more information.

Louisiana Medical News

JULY/AUGUST 2015 • 5

UMC New Orleans Hospital Complex Set to Open in August, continued from page 1

between the patient towers, and hanging art on the walls, were all selected to reflect the area’s color and ambiance.

Mackenzie Skene, NBBJ partner and lead architect said, “We design hospitals all over the world, but here we wanted to re-create the essence of New Orleans, so we’ve used courtyards for shade, views of nature, a place to cool off, breezeways, and water everywhere.”

Disaster Planning Skene said that even before they got P1LAMN03/15

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to aesthetics, disaster preparedness ogy is state-of-the-art including 3D mamwas the most important thing on mography, advanced oncology imaging everyone’s mind. and dual energy CT scanning, videostro“All the critical functions are boscopy for speech therapy, and soon inon the second floor; the first floor traoperative MRI. is built up so it is actually above “My department purchases and mainthe Katrina line, and then even tains the medical equipment and we are higher in case of a 22 foot storm very proud of the totality of our inventory. surge. If the first floor was totally For the all new equipment we have spent flooded, the hospital would keep the last six months making sure our emon functioning above it. That’s ployees understand how to operate it, and why the Emergency Department it wasn’t always easy,” he added.

(ED) is on the second floor and is designed for boat connections Building Stats from I-10,” he explained.

Three patient towers have a capacity Taking even more lessons of 446 private inpatient rooms; 60 behavfrom Hurricane Katrina, the faioral health rooms; 40 ICU beds, many cade was designed using stormwith overhead patient lifts; pressurized resistant technology to withstand units for infectious disease isolation; prihurricane-force winds and flying vate consultation rooms in each unit; large objects. The complex can survive patient rooms; and the Cancer Center with for seven days with enough food, private oncology infusion bays. water, pharmaceuticals and power The Ambulatory Care Building without any outside support or (Clinic) has 277 exam rooms, pulmonary backup supplies. function lab, OP radiology, and a rehabili“It doesn’t have the look, sound and tation gym. smell of a hospital,” Skene pointed out.

The Diagnostic and Testing Building “In typical hospitals, the staff, public and (Hospital) ED has 56 stations, nine “Rapid patients move together – there’s no sepaTreatment” rooms, resuscitation area with ration. But by controlling the flow and five trauma rooms, hyperbaric unit, radiolseparating them to different levels and ogy within the ED, and it is the only Level 1 pathways, the public space here doesn’t feel Trauma Center in southeastern Louisiana. like a hospital. It feels like a quality civic Operating Rooms: 19 with video infacility.” tegration and an area with intra-operative Instead of big, impersonal patient MRI capability, 76 pre and postoperative waiting areas, all throughout the hospital bays. campus there are smaller, cozier spaces, Operating Labs: invasive lab with a each grouped around specific treatment hybrid operating room, combining the latareas with comfortable seating and artwork est in imaging, as well as electrophysiology, for contemplation. interventional radiology and cardiac cath Yet all the buildings are spacious: long labs. and extra wide hallways with consultation CEO Cindy Nuesslein, a registered rooms grouped on either side, large patient nurse who trained at Charity Hospital and rooms with enough space for families to a New Orleans native, “As a University room-in, and private ED rooms.

Medical Center, we have a tripartite misNot only is it larger sion: patient care, educato accommodate patients tion and research done To date cost of UMC New and their friends and famin collaboration with our Orleans ily, it’s larger for the sheer academic partners. In traffic of 2000 employees, essence, this facility alState $278.5 million 600-700 physicians, sevlows us to do all three of FEMA $641.7 million LCMC $143.0 million eral thousand residents those functions incredTOTAL $1.063 billion and other students, as ibly well.” well as research associShe pointed out that Source: Greg Dupuis, press secretary, Louisiana Office of Administration ates. their Conference Center “We want to imis an educational asset; prove the city, opportunities within the classrooms and conference rooms are pepcommunity, and create a special place pered all over the organization; and there here. We want UMC New Orleans to be are physician teaming rooms whereby the a good neighbor. It’s the big picture of physicians and students can talk over their the biomedical district and the economic cases together. engine we’re creating – there’s incredible Their nationally renowned Level I synergy,” Skene added.

Trauma Center was recently re-certified and the consensus from the American ColBuilding lege of Surgeons team was, ‘It doesn’t get Scott Landry, senior vice president better than this.’ of facilities, LCMC Health said, “It took “New Orleans has something to be 12,000 very proud construction workers proud of and it’s tremendous for the State and 42 months to complete construction. of Louisiana. We will be educating a lot of “Anything that is critical to hospital providers and the majority of these graduoperations is located 22 feet above the base ates stay in-state, which is going to allow us flood level…We have 18 megawatts of to recruit the best and the brightest. This generators so we could run 100 percent of is the culmination of years of sweat equity the buildings for seven days, and 250,000 and passionate people who have brought gallons of fuel on site.” us to this point in time,” Nuesslein added Throughout the hospital the technolproudly.

PHOTO: NBBJ/SEAN AIRHART

land bordered by Tulane, Canal and Galvez Streets.

UMC New Orleans is the private partner of Louisianabased, not-for-profit LCMC Health, which also manages Children’s Hospital, Touro, Interim LSU Hospital, New Orleans East Hospital, and soon West Jefferson Medical Center.

Architectural services were provided by NBBJ, Seattle and Blitch Knevel, New Orleans.

It took eight years and several hundred architects and engineers to complete.

The complex is impressive.

Large window/walls let in natural light in the common areas and patient rooms; atriums, natural lighting and plantings combine in a sleek, modern design creating an atmosphere of comfort and reflection.

The Louisiana Percent for Art Program states that 1 percent of the money spent by the state on projects over $2,000,000 must be spent on art, and it’s everywhere in evidence here.

The main lobby is a bright pavilion with soaring glass walls connecting the hospital and clinic buildings. A huge, multitiered glass mobile representing the map of New Orleans floats overhead, “River Spirit” by Ray King.

Glass sculptures by Chihuly set in outdoor fountains and pools in the courtyards

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Louisiana Medical News

Legislative Affairs

BY CINDY BISHOP

The 2015 Regular Session of the Louisiana Legislature convened at noon on Monday April 13 and adjourned at 6:00 pm Thursday June 11. This was one of the most challenging sessions for the healthcare industry yet.

The deadline for Governor Bobby Jindal to act on bills has passed. This is the final legislative report for selected actions of the 2015 Legislative Session.

Last Action Taken HB 6, Honore Authorizes the use of medical marijuana in Louisiana No position 4/13/2015 - Referred to committee on Health & Welfare HB 159, Hoffmann Adds a fee at license renewal for pharmacists and pharmacies and dedicates proceeds to certain pharmacy education programs No position 6/29/2015 - Becomes Act 298; Effective August 1, 2015

Legislative Wrap 2015 HB 165, Anders Provides relative to fees collected by the Louisiana State Board of Medical Examiners No position 4/28/2015 - Returned to the calendar subject to call HB 186, Montoucet Requires that mammography and ultrasound reports provide information regarding supplemental breast cancer screening No position 7/1/2015 - Becomes Act 378; Effective January 1, 2016 HB 194, Moreno Provides relative to the examination, treatment, and billing of victims of a sexually-oriented crime No position 5/5/2015 - Substitute bill adopted: HB 835 HB 210, Moreno Authorizes the prescribing or dispensing of naloxone to third parties No position 6/23/2015 - Becomes Act 192; Effective August 1, 2015

HB 247, Huval Provides relative to the disciplinary proceedings of the Louisiana Physical Therapy Board No position 6/23/2015 - Becomes Act 195; Effective August 1, 2015 HB 257, Seabaugh Provides relative to healthcare provider credentialing No position 6/5/2015 - Becomes Act 63; Effective June 5, 2015 HB 304, Hall Provides relative to sharing of prescription monitoring program information with equivalent programs of other states No position 5/29/2015 - Becomes Act 22; Effective August 1, 2015 HB 307, Jackson Provides relative to coverage and payment for services rendered to a person admitted under an emergency certificate No position 7/1/2015 - Becomes Act 390; Effective August 1, 2015

HB 319, Simon Provides relative to the dispensing of interchangeable biological products No position 7/1/2015 - Becomes Act 391; Effective August 1, 2015 HB 329, Armes Requires the state Office of Group Benefits to cover bariatric surgery techniques for the treatment of morbid obesity No position 4/27/2015 - Recommitted to committee on Appropriations HB 342, Gisclair Provides relative to vaccinations required prior to enrolling in an educational institution No position 7/1/2015 - Becomes Act 394; Effective August 1, 2015 HB 375, Harris Exemption for certain ophthalmic drugs administered in a physician’s office No position 4/13/2015 - Referred to committee on Ways and Means

HB 381, Jackson Exempts certain providers from licensure as behavioral health services providers No position 5/29/2015 - Becomes Act 23; Effective May 29, 2015 HB 416, Barrow Provides relative to advanced practice registered nurses No position 4/13/2015 - Referred to committee on Health & Welfare HB 436, Johnson, R. Provides for insurance reimbursement of certain provider fees paid by pharmacies No position 7/1/2015 - Becomes Act 399; Effective August 1, 2015 HB 440, LeBas Prohibits certain fees relative to the adjudication of pharmacy benefit claims No position 4/30/2015 - Engrossed, recommitted to committee on Appropriations

HB 450, Schexnayder Creates the Home Health Agency Trust Fund and provides for the deposit of fines and penalties levied against home health agencies into the fund No position 6/19/2015 - Becomes Act 113; Effective June 19, 2015 HB 461, Simon Provides relative to the regulation of telemedicine and telehealth services No position 4/13/2015 - Referred to committee on Health & Welfare HB 486, Johnson, R. Provides relative to collaborative practice agreements between advanced practice registered nurses and physicians No position 4/29/2015 - Referred to committee on Health & Welfare HB 494, Willmott Requires ambulance services to establish protocols for transporting patients with cardiac and stroke emergencies

(CONTINUED ON PAGE 8)

Louisiana Medical News

JULY/AUGUST 2015 • 7

Legislative Wrap 2015, continued from page 7 No position 4/13/2015 - Referred to committee on Health & Welfare HB 498, Talbot Provides for transparency in health services pricing and health care quality measures No position 6/29/2015 - Becomes Act 338; Effective August 1, 2015 HB 517, Edwards Provides for expansion of Medicaid eligibility in conformance with standards provided in federal law No position 4/13/2015 - Referred to committee on Health & Welfare HB 552, Thierry Provides relative to the scope of practice of chiropractic No position 4/13/2015 - Referred to committee on Health & Welfare HB 560, Norton Requires that La. Medicaid eligibility standards conform to those established by the Affordable Care Act No position 4/29/2015 - Involuntarily deferred HB 573, Hazel Provides for the investiga-

tion and adjudication of violations by the Louisiana State Board of Medical Examiners No position 5/14/2015 - Substitute bill adopted: HB 843 HB 602, Johnson, R. Provides relative to collection of coinsurance and deductibles No position 4/13/2015 - Referred to committee on Insurance HB 652, Hunter Requires the Dept. of Health and Hospitals to implement an equitable system of Medicaid reimbursement among certain hospitals No position 5/14/2015 - Substitute bill adopted: HB 845 HB 683, Kleckley Requires the Department of Health and Hospitals to determine a methodology for reimbursement related to uncompensated care costs in Calcasieu Parish No position 4/13/2015 - Referred to committee on Health & Welfare HB 701, Whitney Prohibits abortion based on sex selection No position 5/19/2015 - Referred to committee on Judiciary B

HB 702, Thierry Requires health insurance issuers to cover contested healthcare services, including prescription drugs, during the appeal or review process No position 4/13/2015 - Referred to committee on Insurance HB 835, Moreno Provides relative to the examination, treatment, and billing of victims of sexuallyoriented criminal offenses No position 6/23/2015 - Becomes Act 229; Effective June 23, 2015 HB 843, Hazel Provides for the investigation and adjudication of violations by the Louisiana State Board of Medical Examiners Monitor 7/1/2015 - Becomes Act 441; Effective July 1, 2015 HB 845, Hunter Requires the Dept. of Health and Hospitals to implement a methodology for reimbursing uncompensated care costs incurred by hospitals in certain areas Monitor 5/26/2015 - Recommitted to committee on Appropriations HCR 4, Simon Expresses the intent of the

Physicians’ health Foundation oF louisiana

legislature regarding the standard of care prescribed by law for the practice of telemedicine No position 5/20/2015 - Enrolled in the House HCR 10, Burford Suspends rules of the La. Board of Pharmacy that invalidate prescriptions with computer generated electronic signatures No position 4/13/2015 - Referred to committee on Health & Welfare HCR 75, Kleckley Provides for a hospital stabilization formula No position 6/2/2015 - Enrolled in the House HCR 84, Simon Directs the La. State Law Institute to reorganize and recodify the Miscellaneous Health Provisions chapter of Title 40 of the La. Revised Statutes No position 6/1/2015 - Enrolled in the House HCR 132, Henry Requests a study on prospective implementation of a system to help health practitioners identify child abuse No position 6/1/2015 - Enrolled in the House HCR 133, Schexnayder Urges and requests the Traumatic Head and Spinal Cord Injury Trust Fund Advisory Board to study and make recommendations for providing services to persons with injuries arising from sudden internal medical conditions No position 6/1/2015 - Enrolled in the House HCR 165, Hunter Directs Department of Health and Hospitals to require by rule that obstetricians be on the premises of or on call for all free-standing birthing centers during the operating hours of those centers No position 6/7/2015 - Killed on final passage by vote of 32 to 63

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HCR 166, Burford Requests the Department of Health and Hospitals to study means to facilitate burial of a fetus or fetal remains resulting from a loss of pregnancy at less than twenty weeks’ gestation No position 6/10/2015 - Enrolled in the House HCR 170, Smith Creates a study committee to evaluate and make recommendations concerning Louisiana’s system of healthcare delivery

No position 6/10/2015 - Enrolled in the House HCR 186, Simon Requests a study to establish baseline data on access to health care in Louisiana and make recommendations concerning health system reforms that emphasize prevention and wellness No position 6/7/2015 - Enrolled in the House HCR 187, Johnson, R. Requests the Department of Insurance to study the effects on insureds and healthcare providers of the increasing amount of deductibles and coinsurance obligations required by many health insurance products being offered to Louisiana citizens No position 6/2/2015 - Enrolled in the House HR 151, Stokes Requests the Dept. of Health and Hospitals to update La. Administrative Code provisions as necessary to comport with federal regulations relative to dietitian nutritionists No position 6/10/2015 - Enrolled in the House HR 162, Willmott Authorizes the Dept. of Health and Hospitals to issue administrative rules concerning transportation of patients with cardiac and stroke emergencies No position 6/10/2015 - Enrolled in the House SB 10, Peterson Constitutional amendment to direct DHH to offer health insurance with essential health benefits to every legal resident of Louisiana whose income is at or below 138% of the federal poverty level No position 4/13/2015 - Referred to committee on Health & Welfare SB 40, Nevers Requires the Department of Health and Hospitals provide health care coverage with essential health benefits to every legal Louisiana resident whose household income is at or below 138% of the federal poverty level No position 4/13/2015 - Referred to committee on Health & Welfare SB 68, Buffington Extends moratorium on additional beds for nursing facilities No position 6/19/2015 - Becomes Act 139; Effective June 19, 2015 SB 80, Guillory Constitutional amendment

to provide that an unborn child is a human being from the moment of conception No position 4/13/2015 - Referred to committee on Judiciary A SB 115, Mills Provides with respect to the practice of physician assistants No position 7/1/2015 - Becomes Act 453; Effective July 1, 2015 SB 158, Heitmeier Requires the reporting of malpractice claims paid by insurers or self- insurers on behalf of certain health care providers in an annual report to the Senate and House committees on health and welfare No position 7/1/2015 - Becomes Act 454; Effective July 1, 2015 SB 163, Mills Provides relative to Medicaid managed care No position 6/4/2015 - Referred to committee on Health & Welfare SCR 18, White Authorizes and directs the Louisiana Emergency Response Network (LERN) to organize and facilitate a working group of healthcare providers who deal with victims of trauma to develop recommendations for a Level III Trauma Center in Northeast Louisiana.

Monitor 4/14/2015 - Referred to committee on Health & Welfare SCR 132, Claitor the Department of Health and Hospitals to conduct a study on access to psychiatric medications and the costs for nonaccess to such medications.

No position 6/10/2015 - Enrolled in the Senate SR 179, Murray Requests the Centers for Disease Control and Prevention sub-group Advisory Committee on Immunization Practices to recommend the Meningitis B vaccine for incoming college students.

No position 6/11/2015 - Enrolled in the Senate

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content © Checkmate Strategies and Louisiana Medical News, LLC. For more information, readers may contact Cindy Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to destiny362@aol.com. Our website is www.checkmatestrategies.com

Health Systems, continued from page 1 of looser affiliations,” said Jen Ewing, an analyst with Moody’s.

In Georgia, 30 different hospitals have banded together. A large number of hospitals have done the same in New Jersey and Pennsylvania. New Hampshire has an affiliation of six hospitals.

These sorts of arrangements allow the different hospitals to achieve economies of scale without going through the whole marriage, Ewing said. There’s a lot that goes on in putting together a merger or acquisition, and a lot of work that takes place post-merger. Those deals often take more time to arrange.

“But these things (partnerships) seem to be able to happen a little faster, and you can kind of pick and choose what you partner on,” Ewing said.

Some examples of the newly formed network collaborations include: • Ochsner helping St. Tammany Parish Hospital launch the Epic electronic health record in its clinics in early June.

The EHR improves the integration of care for patients as they move between systems.

• Lafayette General’s Neonatal Intensive Care Unit implementing Ochsner’s telemedicine program. The added support of Ochsner specialists, such as pediatric neurologists, allows Lafayette General to utilize technology like a Total Body Cooling System and so avoid having to move the most delicate patients elsewhere. The partnership will also help Lafayette General better manage chronic disease patients.

• Christus Health Louisiana working together with Ochsner on clinical research studies. Christus is also prioritizing its work on Medicare Advantage to increase cost savings for those patients. An early assessment on materials management for Christus has created more than $3 million in savings opportunities.

Ewing said Ochsner is expanding its reach in a couple of ways.

The health system has acquired some very small hospitals through mergers and acquisitions, helping support and maintain care in those communities. The more high-acute, complex cases are brought into Ochsner’s main facilities.

The new network is doing a little bit of the same thing, Ewing said. Ochsner is supporting its partners in their communities through telemedicine and other efforts, and moving the more complicated cases to Ochsner and its specialists.

Lisa Goldstein, associate managing director for Moody’s, said it’s unclear whether the more complex cases will be more profitable for Ochsner.

That depends on the kind of insurance resources the patients have, she said.

At the very least, the cases will boost Ochsner’s topline revenue.

Ewing said the more complex patients could require longer stays in the hospital, generating more expenses.

Moody’s doesn’t have statistics that show these patients are more lucrative, although generally Ewing said she thinks they could be.

In a news release announcing OHN, Warner Thomas, president and CEO of Ochsner Health System, said the new network will allow the partners, together, to make a number of advances.

Those include expanding services and solutions to improve care; using the most advanced tools and technology to support physicians and empower employers; and leveraging data to re-engineer cost structures.

These sorts of partnerships have another advantage: they generate less scrutiny from state and federal regulators.

Ochsner is partnering with community hospitals rather than acquiring them, so there’s not as clear a reduction in competition, said Matthew A. Schmitt, a PhD candidate in managerial economics and strategy at Northwestern University’s Kellogg School of Management.

Schmitt is currently researching whether hospital mergers reduce costs.

His preliminary findings, based on mergers from 2000 to 2010, show the cost reductions are limited. Schmitt found that the hospitals that were acquired realized cost savings of between 3 percent and 5 percent. The evidence suggests that the acquiring hospitals did not reduce their costs.

“So I think there is a question of whether these looser affiliations can be capable of generating cost savings as well,” Schmitt said.

Thomas said at the end of the day, it’s about taking care of patients and providing high-quality healthcare in Louisiana.

“The future of healthcare is all about collaboration and partnership, and the Ochsner Health Network partners and physicians are committed to the belief that no Louisianan should ever have to leave our state for the care they need,” Thomas said

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In the News

The ICD-10 Grace Period: What It Is and Is Not WASHINGTON, DC- On July 6, the American Medical Association and the Centers for Medicare & Medicaid Services (CMS) jointly announced elements of a “grace period” for the Oct. 1, 2015, implementation of the ICD-10 medical billing and coding system. This is good news but not the deliverance many physicians were hoping for.

Here is what the grace period is and is not: What this is not: It is not a delay of ICD-10. Starting Oct. 1, 2015, medical providers still must use ICD-10 codes on claims and an ICD-10 code from the right family of codes. Medicare — and other payers — will not pay if you don’t use ICD-10 codes as of Oct. 1. This means you must continue your ICD-10 preparation apace. You and your coding staff still need to learn how to use the codes, and your practice still must make system changes to accommodate the codes and test with Novitas Solutions to make sure your claims will process smoothly.

What it is: “A giant burden slightly eased,” in the words of Texas Medical Association President Tom Garcia, MD. The grace period gives practices and Medicare payers time to adjust to the new system and work out problems without threat of crippling payment delays or penalties for physicians.

CMS says grace period entails the following: For one year starting Oct. 1, 2015, Medicare will not deny claims denied solely on the specificity of the ICD-10 diagnosis codes as long as the physician submitted an ICD-10 code from an appropriate family of codes. In addition, Medicare will not audit claims based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes.

To avoid potential problems with midyear coding changes in CMS quality programs (Physician Quality Reporting System, value-based payment modifier, and meaningful use) for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores. CMS will continue to monitor implementation and adjust the duration 10 • JULY/AUGUST 2015

if needed.

CMS will establish an ICD-10 ombudsman to help receive and triage physician and provider problems that need resolution during the transition.

CMS will authorize advance payments if Medicare contractors such as Novitas Solutions are unable to process claims within established time limits because of problems with ICD-10 implementation.

More information is available at the CMS website www.CMS.gov.

New Law Expands Physicians’ Legal Rights BATON ROUGE- Governor Bobby Jindal signed House Bill 843 (Act 441)

by Rep. Chris Hazel (R-Pineville) July 1, marking a significant legislative victory for Louisiana physicians.

The Louisiana State Medical Society (LSMS) supported Act 441 which mandates that written due process rules must be established and implemented

by January 1, 2016, giving physicians basic, legal rights including: • Clarifying the definition of “unprofessional conduct” and “medical incompetency” • Requiring a majority vote of the Board of Medical Examiners before a formal investigation is initiated • Prohibiting the executive director from acting as the lead investigator • Requiring a notice of the investigation to be provided to the physician • Establishing that all charges shall be proven by a preponderance of evidence “The Board plays an important role in patient safety, and these changes will not impede their ability to protect patients. When a physician’s license is investigated, many lives hang in the balance. The LSMS believes a fair and timely adjudication of the matter is in the best interest of both patients and physicians,” wrote Dolleen M. Liccardi, MD, LSMS president.

“We are grateful to Rep. Hazel for leading the fight for the legislation, as well as to our champions in the legislature who helped shepherd it through the process including Rep. Katrina Jackson (D-Monroe), Rep. Scott Simon (R-Abita Springs), Sen. Danny Martiny (R-Metairie), Sen. Eric LaFleur (D-Ville Platte), Sen. John Alario (R-Westwego), and Rep. Julie Stokes (R-Metairie), wrote Liccardi. “The representation of legislative support across geographic, party and racial lines for this monumental legislation underscores the need expressed by physicians across the state’” she added.

Louisiana Medical News

UHC Physician Named “Master Pediatrician” LAFAYETTE- The Louisiana Chapter of the American Academy of Pediatrics (La AAP) is honoring Richard Howes, M.D., FAAP, as one of two “Master Pediatricians” selected in the state. The La AAP defines “Master Pediatrician” as a superb clinician who has Dr. Richard contributed to the health Howes and welfare of children in Louisiana for at least 30 years, through direct patient care and child advocacy. Pediatricians given this title are also recognized as having served as an educator and outstanding role model to students and young physicians.

Throughout most of his 39 years as a pediatrician, Dr. Howes has served on the faculty of the LSU School of Medicine in the Department of Pediatrics at the former University Medical Center, now University Hospital & Clinics (UHC). For 30 of those years, he served as Chairman of the Pediatric Department at UHC and continues to serve as President of the Medical Staff. (His ties to UHC go back to his days as a college student working as a blood bank technician at Lafayette Charity Hospital in 1968.)

Since the reopening of outpatient pediatric services at UHC under the new management of Lafayette General Health in 2013, Dr. Howes has treated children with ADHD, Autism, developmental disabilities, Pediatric HIV, Sickle Cell Anemia and other chronic illnesses.

President of the La AAP, Pediatrician Bryan Sibley, M.D., FAAP, says Dr. Howes has completely devoted himself to improving the health and well-being of children, specifically those with special health care needs. Board Certified in Developmental/Behavioral Pediatrics, Dr. Howes’ extensive work in this field earned him the “Bettina Hillman Award for Service to Special Needs Children” in 2006.

“So many children across the state with special health care needs do not have access to the kind of care that Dr. Howes provides,” says UHC CEO Jared Stark, FACHE. “We are fortunate and proud to have him at UHC.” Dr. Howes has chaired a variety of committees and mentored hundreds of medical students, residents and practicing physicians. “He represents the embodiment of everything we, as pediatricians, hold dear, and he is truly a ‘Master Pediatrician,’” says Sibley.

The “Master Pediatrician” award will be presented to Dr. Howes at the Louisiana Chapter of the American Academy of Pediatrics annual CME program, August 21-23, in New Orleans. Dr. Howes will, at that time, make a presentation on “Reflections on the Changes in Pediatrics from 1968 to Present.”

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In the News St . Elizabeth Hospital First in State to Achieve NICHE “Exemplar” Status GONZALES – St. Elizabeth Hospital has achieved “Exemplar” status for its NICHE (Nurses Improving Care for Healthsystem Elders) program. St. Elizabeth Hospital is the first hospital in the state to achieve this status. Three other hospitals in the Franciscan Missionaries of Our Lady Health System also achieved some level of NICHE certification. They include Our Lady of the Lake Regional Medical Center in Baton Rouge, Our Lady of Lourdes in Lafayette and St. Francis Medical Center in Monroe. NICHE is the premier designation indicating a hospital’s commitment to excellence in the care of patients 65-years-and-older.

The “Exemplar” status recognizes St. Elizabeth Hospital’s ongoing, high-level dedication to geriatric care and pre-eminence in the implementation and quality of system-wide interventions and initiatives that demonstrate organizational commitment to the care of older adults.

St. Elizabeth Hospital has been designated as a NICHE facility since 2012.

The “Exemplar” status — the highest of four possible program levels — was assigned following a rigorous program evaluation of the current state and future goals of the NICHE program at St. Elizabeth Hospital.

“The NICHE designation and the “Exemplar” status signal our resolve to provide patient-centered care for older adults,” says Yvonne Pellerin, RN, Chief Nursing Officer for St. Elizabeth Hospital.

“Through our participation in the NICHE program we are able to offer evidencebased, interdisciplinary approaches that promote better outcomes, positive experiences, and improved care for the older adults in our care. This leads to greater satisfaction rates for our patients, their families and our staff.”

The Annual Program Evaluation is used to determine the level of their NICHE program. The evaluation benchmarks program progress year-to-year, targets future care initiatives and provides data to use in gaining and sustaining support from institution stakeholders.

Through the hospital and its physicians group, St. Elizabeth’s Senior Services division provides many offerings to improve the lives of patients over 65.

Programs include geriatric medicine, House Calls, wellness exams, pulmonary rehabilitation, diabetes self-management, health and wellness education, screenings, and other supportive services.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.

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