Washington, DC

LEGISLATIVE UPDATE

ACA UPDATE

The White House announced 7.04 million people signed up for health insurance plans under the Affordable Care Act by the March 31  deadline and 80 -90 percent have paid premiums (consistent with insurers’ reporting)

RAND survey covered by the Los Angeles Times found that about one-third of exchange sign-ups were previously uninsured, at least 4.5 million previously uninsured adults have enrolled in Medicaid, about 9 million--most of whom were previously insured--have bought plans directly from insurers, and fewer than one million who had plans last year are currently uninsured due to plan cancellations as a result of the ACA.  CMS announced that 3 million more people were enrolled in Medicaid as of the end of February, compared with the average total number enrolled in the several months prior to ACA open enrollment.

A Robert Wood Johnson Foundation and Urban Institute survey offers insight into the demographics of its estimated 5.4 million people who are newly insured under the Affordable Care Act. Some key points:

Of the 5.4 million, about 2.6 million were low-income adults through Medicaid expansion, 2.6 million were middle-income adults eligible for exchange subsidies, and 200,000 were higher-income adults.  Young adults ages 18-30, and nonwhite, non-Hispanic adults -- groups historically more likely to be uninsured -- made large gains in coverage.  States that expanded Medicaid saw significantly larger jumps in insured rate than those that did not.

With the end of ACA open enrollment, insurers have largely stopped selling plans that previously would have been available year-round. While companies are allowed to sell all year, most are choosing to do the limited open enrollment period since the ban on rejecting consumers because of pre-existing conditions makes year-round enrollment risky, as individuals could opt to buy an insurance plan only after becoming sick.

EPA on Monday, March 31, sent draft carbon-emissions standards for existing power plants to the White House Office of Management and Budget for review, by the deadline set by President Obama of June 1, 2014.

The fiscal year 2015 budget released by House Budget Chairman Paul Ryan blasts proposed emission regulations for power plants and criticizes the administration for making fossil fuels more expensive, while also slashing spending on climate-change mitigation largely by eliminating foreign efforts. The proposal would also zero out a clean-technology fund and a strategic climate fund offering that support energy-efficient technology and international climate-change work.

Supreme Court of the US voted 6-2 in favor of the State of Michigan to uphold the policy to not use race in admissions to higher education in that state. On April 22nd, Justices Sotomayor and Ginzberg voted against this or dissented – to maintain “race-sensitive admissions policies”.

The Following are excerpts from the Dissenting Opinion: The Constitution of the US, while it does not guarantee minority groups victory in the political process, it does guarantee them meaningful and equal access to that process. It guarantees that the majority may not win by stacking the political process against minority groups permanently,, forcing the minority aloe to surmount unique obstacles in pursuit of its goals – here, educational diversity that cannot reasonably be accomplished through race-neutral measures. Race sensitive policies further a compelling state interest in achieving a diverse student body precisely because they increase minority enrollment, which necessarily benefits minority groups. Under our Constitution, majority rule is not without limit.  The Fourteenth Amendment instructs that all who act for the government may not deny to an person the equal protection of the laws. We often think of equal protection as a guarantee that the government will apply the law in an equal fashion – that will not intentionally discriminated against minority groups.  But equal protection of the laws means more than that; it also secures the right of all citizens to participate meaningfully and equally in the process through which laws are created.

Political-process doctrine

Contrary to today’s decision, protecting the rights to meaningful participation in the political process must mean more than simply removing barriers to participation. It must mean vigilantly policing the political process to ensure that the majority does not use other methods to prevent minority groups from partaking in that process on equal footing.  She goes on to say about this case (of Michigan voters changing their constitution to delete race-based admissions) : What the majority could not do, consistent with the US Constitution, is change the ground rules of the political process in a manner that makes it more difficult for racial minorities alone to achieve their goals. In doing so, the majority rigs the contest to guarantee a particular outcome. That is the very wrong the political-process doctrine seeks to remedy.

Race Matters

Race matters in part because of the long history of racial minorities’ being denied access to the political process. And although we have made great strides, voting discrimination still exists.  Race also matters because of persistent racial inequality in society – inequality that cannot be ignored and that has produced stark socioeconomic disparities – in areas like employment, poverty, access to health care, housing, consumer transactions.

After California eliminated race-sensitive admissions, the University of California saw declines in minority representation – for example at UCLA, Hispanic freshmen declined from 23 percent in 1995 to 17 percent in 2011, and Black freshmen declined from 8 percent to 3 percent, even though the proportion of Hispanic college-aged persons in California increased from 41 percent to 49 percent  and the proportion of Black college-aged persons in California increased from 8 percent to 9 percent during that same period.

Today’s decision permits the decision of a majority of the voters of Michigan to strip Michigan’s elected university boards of their authority to make decisions with respect to constitutionally permissible race-sensitive admissions policies, while preserving the boards’ plenary authority to make all other educational decisions. Today’s decision eviscerates an important strand of our equal protection jurisprudence. For member of historically marginalized groups, which relay on the federal courts to protect their constitutional rights, the decision can hardly bolster hope for a vision of democracy that preserves for all the right to participate meaningfully and equally in self-government. (6th Circuit Case: Bill Shuette, Attorney General of Michigan, petitioner v. Coalition to defend affirmative action, integration and immigrant rights and fight for equality by any means necessary (BAMN), et al.)

The 2015 President’s Budget proposes major new investments to build the health care workforce and improve the delivery of health care services, particularly primary care services, across the nation.

Modernizing Graduate Medical Education: Create an updated approach to residency training by targeting $5.23 billion in mandatory funds to an innovative competitive grant program to create new residency slots with a focus on community-based ambulatory care. This program will be administered by the Health Resources and Services Administration (HRSA). It is expected to produce 13,000 physicians over the next ten years and advance key workforce goals, including the training of more physicians in primary care and other high need specialties, aligning training with more efficient and effective care delivery models, and encouraging physicians to practice in underserved areas including rural areas.

National Health Service Corps (NHSC): Expand the Corps to increase the availability of providers in those areas across the country most in need. Over the next 6 years, the Department will devote $3.95 billion in mandatory funds to the NHSC which will greatly expand the number of NHSC health care providers in underserved areas from fewer than 8,900 to an annual field strength of 15,000 for each year from 2015 through 2020.

Extend Enhanced Medicaid Primary Care Payments: Extend the Affordable Care Act’s (ACA’s) enhanced Medicaid primary care payments through Calendar Year (CY) 2015 to better target primary care and expand eligibility to mid-level providers practicing independently, at an estimated cost of $5.44 billion.  The ACA requires Medicaid reimbursement for primary care services furnished by eligible physicians to be increased to the Medicare rates for CYs 2013 and 2014.

Michelle Obama's push for better nutrition is bringing sweeping changes to agriculture, manufacturing, commerce, schools, and American homes.

By many accounts, the Obama administration is leading the most aggressive campaign to improve the nation's eating habits in many decades – calling for Americans to cut down on sugar and sodium and eat more whole grains, lean meat, low-fat dairy products, and fruits and vegetables by the end of 2016.

Many of those changes could result in multibillion-dollar shifts in how the government and consumers spend their money on food. Perhaps just as important, the efforts to reduce sodium, sugar, and fat will force companies to make changes in how they prepare, store, and ship food.

But a March House Agriculture Appropriations Subcommittee hearing on Capitol Hill, the opposition surfaced. The subcommittee's chairman, GOP Rep. Robert Aderholt of Alabama, told Agriculture Secretary Tom Vilsack that he is receiving complaints from schools and from the School Nutrition Association, which represents school food-service directors, that some schools are facing both a financial and logistical burden in implementing the new school-meals programs and are requesting a delay with a waiver, that the Secretary of Agriculture Vilsack reported he was prohibited to do by the National School Lunch Act .  Vilsack noted that about 90 percent of the schools have already complied with the new school meal menu patterns required under the Healthy Hunger-Free Kids Act, and that USDA is trying to help schools comply with the new rules. But more schools are concerned about implementing the healthy school snacks program by July. At the same hearing, Rep. David Valadao, a California Republican, noted that 67 House members had written Vilsack on Thursday expressing disappointment that USDA's Food and Nutrition Service ignored a request by Congress to add white potatoes to the list of eligible foods for beneficiaries of the Special Supplemental Nutrition Program for Women, Infants, and Children, known as WIC.  Vilsack said the average American eats nearly 90 pounds of potatoes per year and noted that WIC is a supplemental program that is encouraging the purchase of items that children need, such as dark, leafy green vegetables. USDA officials are following the recommendations of the Institute of Medicine, but in a bow to Congress have asked the institute to reexamine the WIC food package ahead of schedule, said Kevin Concannon, the Agriculture undersecretary for food, nutrition, and consumer services, when he announced that the package would provide for more purchases of fruits and vegetables.

The food and grocery industry also has to deal with a new nutrition labeling campaign that the first lady announced in the company of Food and Drug Administration officials. The back-of-package labels would reflect accurate serving sizes, list added sugars, and display calories more prominently. The industry has said it will work with FDA on the new labels, but has also announced its own front-of-package labeling system that would be more prominent but would not contain all the same information. There are clear winners in the food industry as a result of the administration's campaign. The fruit and vegetable industry is on Michelle Obama's side. But there are also food companies that will have to go to the expense of reformulating their products or lose government business entirely.

NHMA PROGRAM UPDATES

NHMA California Leadership Fellowship Class of 2014 – is the first program of its kind in a State in the nation. This is an executive leadership training program patterned after the highly successful NHMA Leadership Fellowship that has been a national program for mid-career physicians started by the US Department of Health and Human Services in 1999.  Government, and private sector leaders to discuss strategies to improve health policies that impact the health of Hispanics in California. The program is being sponsored by the California Wellness Foundation.  The public is welcome to meet the Fellows at a Reception on May 6th,  5:30 pm – 7:30 pm honoring Senator Lara, Chairman, California Latino Caucus, Peter Lee, Covered California, Lupe Alonzo-Diaz, OSHPD, at the Mayahuel Restaurant on K and 12st Streets, Sacramento. Please rsvp to This email address is being protected from spambots. You need JavaScript enabled to view it. by May 1.

NHMA 18th Annual Washington DC CME Hispanic Health Conference a Success!  With over 500 attendees, 35 exhibits and a great group of Speakers and Sponsors – we received much positive feedback on the high caliber sessions on medical care of Hispanic patients, business strategies for Latino medical physician practices; the importance of Hispanic focused programs from CMS, HHS, and national medical associations; the facuty development and publishing in journals; the  research on Hispanic health; and obesity and children’s health; chronic disease success stories and more ---over the March 27—30 weekend. Of note, the Board of Directors met with the Administrator of EPA interested in working more closely with NHMA in the environmental health – air quality/Asthma; water quality; pesticide safety and other chemical safety in our homes and other issues to help with climate change. The Board also discussed the new Journal of the NHMA project with one company, started a new Technology Committee with the founder of the Society of Physician Entrepreneurs, and discussed the Region Planning for 2014 on the ACA Prevention efforts.  All transcripts will be available from the conference this summer on the website www.nhmamd.org.

GE- NHMA Health Professional Student Mentoring and Leadership Program – We brought the Class of 2014 Mentees (48 or 50) and a dozen of the mentor physicians met with VP Physician from the GE Corporation to learn lessons about leadership and to network and learn about Hispanic health in our communities from the many health professionals at the NHMA Conference.

NHMA Leadership Fellows – Class of 2013 presented their policy recommendations on Prevention for Hispanics with Promotoras and on Healthcare Workforce Policy to increase Hispanics at HHS – with a closing ceremony where the Fellows received their certificates. Thank you to HRSA and the California HealthCare Foundation for their support of the year-long program.

NHMA 2014 Leadership Institute – with an outstanding line-up of speakers from the US DHHS Office of Minority Health, the Office of Personnel Management and the FDA Advisory Committees on the federal side, and the Korn Ferry, United Health Care and the National Hispanic Leadership Agenda on the private sector side – the 100 Hispanic health professional leaders participating this year, had a lively discussion on the skills needed to pursue and obtain high level C-Suite Leadership positions in the U.S.  NHMA is dedicated to nominating its members to these types of positions. Join NOW at www.nhmamd.org.

NHMA Congressional Visits – about 100 participants were debriefed on NHMA policy priorities including STEM Latino Recruitment Programs for Medical School, Telemedicine, Climate change and Asthma, Clinical Trials and Minorities, Access to ACA Prevention Programs and Medicaid Expansion, women’s health and child obesity and other issues.  Then they were coordinated to have key meetings with 50 Congress offices. The doctors and students were amazed and educated on the political process role and responsibility of NHMA and our networks to help educate about our concerns to help our community.

NHMA Medical School Recruitment Program, now in Year 02 of three, successfully motivated 200 Hispanic college and high school students and parents at our Recruitment Fair on March 29 in Washington, DC. Thank you to the George Washington University School of Medicine, AAMC, LMSA and NHMA leaders – Dr. Rios and other physicians who encouraged them to consider medicine as a career. Of note, NHMA has identified 90 students over the past 6 months interested in applying to medicine, has assigned mentors to about 50 of them, and is tracking and encouraging their progress to apply to medical school.  The program is supported by the US DHHS Office of Minority Health.

NHMA Portal - HispanicHealth.info – is live and starting online discussions on the ACA and other issues to encourage interaction among our members – the communications platform also has a Calendar of Events for the NHMA Networks – Regions, Council of Medical Societies, Council of Young Physicians, Council of Residents, LMSA and the National Health Professional Leadership Network (composed of national Hispanic health professional organization leaders).

W.K. Kellogg Foundation announces its support of the National Hispanic Health Foundation Early Childhood Obesity Education Campaigns, 2014-16.  NHHF and NHMA will educate the Latino Caucuses and Health Committees of the NY and CA State and the US Congress and their staff on the Recommendations from the NHHF Childhood Obesity and Hispanic Leadership Summits in 2013.  Next month, Dr Rios and Dr. Flores will be announcing the campaign in Sacramento, CA on May 6th at a Leadership Reception with California State Latino Caucus Chairman, Senator Ricardo Lara; and on May 16, Dr. Rios will be announcing the campaign during her remarks to the NY State Latino Health Summit in Albany, NY.  The Advisory Committee is being formed now with the NE and West NHMA Steering Committees and the Physician Leadership Team for the Obesity Project. If you are interested in participating – call John Aguilar at 202-628-5895 or This email address is being protected from spambots. You need JavaScript enabled to view it..

MEMBER UPDATES

NHMA announces 50,000 physician members – now we need to work to develop activities to engage our members in health policy, expert advisors for corporate and public health boards and commissions, and to participate in clinical trials and community-based research.  Any interested partners, please contact our new Executive Director, Teresa Chapa, PhD at 202.628.5895 or This email address is being protected from spambots. You need JavaScript enabled to view it..

NHMA Six Region Steering Committee Chairpersons met at the NHMA Conference to plan dates/locations and Region Forums on the ACA Updates in September – October 2014. Los Angeles meeting will be September 6; Chicago will be September 25, Washington, DC meeting will be Oct. 3. Atlanta, New York City TBD. Join NHMA and the US DHHS leaders discuss the latest changes to the ACA for Hispanic physicians, health experts and community leaders to learn about and share with their organizations. Thanks to Dr. Flavia Mercado, who will be leading the effort to coordinate this Committee of Region Chairpersons.

NHMA Members have long wanted a Journal of the NHMA – the Board of Directors under the direction of Dr. Sal Salcedo (long time journal editor from University of Pennsylvania) and Dr. Nellie Correa who has served as the first NHMA Journal Issues with AAFP, has started meeting with at least 3 publishers to determine who to work with to establish the Journal. Stay tuned for this very important project for the development of NHMA brand in the academic and health policy community. We hope to have a Journal in 2015.

We are proud to announce NHMA Corporate Members – GlaxoSmithKline, United Health Care, and Johnson & Johnson; and NHMA Institutional Members - UT Medical Branch Galveston

Hispanic Role Models for NHMA Members to know:

France Cordova, PhD has been appointed as Director, National Science Foundation. The oldest of 12 children, she earned a Bachelor's degree from Stanford University and a PhD in physics from the California Institute of Technology before starting her career as an astrophysicist at Los Alamos National Laboratory. She went on to become the first female chief scientist at NASA before returning to the academic world, first as vice chancellor for research at the University of California at Santa Barbara, then chancellor of the University of California at Riverside and later, as president of Purdue. Along the way, she became a champion of change for women, especially in STEM fields.  In 2008, she secured a $4 million grant for Purdue from the NSF's "ADVANCE" project to improve recruitment and promotion of women faculty at Purdue who teach and research in the STEM fields.  She also put more women in leadership positions at the university. During her tenure, the number of women in Purdue's senior administration team increased by nearly 60 percent (to 31 percent) and minority representation increased by 80 percent (to 25 percent), according to the publication "Diverse: Issues in Higher Education." She also started initiatives to increase the number of women faculty and graduate students at the university.

Francisco Fernandez, MD, professor and chairman of psychiatry and neurosciences at the University of South Florida College of Medicine in Tampa, will be the founding dean of the School of Medicine at The University of Texas Rio Grande Valley.  Fernandez is returning to the Lone Star State, where he was a faculty member at UT MD Anderson Cancer Center, Baylor College of Medicine, and UT Houston from 1984 to 1997. He joined Loyola University of Chicago in 1997 and the University of South Florida in 2002, serving as the chairman of psychiatry in each institution. In Tampa, he also directed the university’s Institute for Research in Psychiatry and Neurosciences. Fernandez is an expert in the brain’s relationship to behavior. He currently serves as first vice president of The American College of Psychiatrists and was the recipient of the Simón Bolívar award of the American Psychiatric Association for his work in Hispanic communities.

ANNOUNCEMENTS

Bridge Clinical Research Dinner Forums: “Diversity in Clinical Trials”

National Hispanic Medical Association (NHMA), National Medical Association (NMA) and the National Council of Asian American and Pacific Islander Physicians (NCAPIP) speakers – with FDA and others 6:00 pm Reception, 7:00 pm Dinner Program in DC Mar. 21, coming to Atlanta and Houston in May. See Bridge Clinical website for more information.

IOM Community-based Health Professions Education Workshop: May 1-2, 2014

The Global Forum on Innovation in Health Professional Education will be webcasting its next workshop on Scaling up Best Practices in Community-based Health Professional Education that aims to provide a framework for responsibilities of health professions, institutions, and students to the communities they serve; and to explore innovative models. A special 2-hour session for web viewers will take place on May 2 beginning at 8:45 AM ET. See IOM website for more information.

The October 1, 2014 deadline for ICD-10CM/PCS implementation is less than 8 months away. Whether your health centers ICD-10 preparations are on schedule, or if you are lagging behind, this article will provide useful information no matter what level of preparation your office has completed.

Have you completed an analysis of business impacts, to include the following areas?

• Coding training, billing, EHR (electronic health records), benefits and coding determinations, reimbursement, managed care contracts and auditing.

• Talk with your payers about how ICD-10 implementation might affect your commercial managed care contracts. Since ICD-10 codes are much more specific, payers may modify terms of contracts, payment schedules, reimbursement, and coverage determinations.

• Ensure the EHR system captures the correct ICD-10 code.

• Go to https://implementicd10.noblis.org/ for detailed planning guides.

Do you use billing software, clearinghouse, or billing service to submit claims? Or are you in the process of purchasing and/or contracting with a vendor? Is the vendor using HIPAA version 5010?

• Call the vendor to determine level of compliance to ICD-10 standards, when upgrades and testing will be completed(either at cost or no cost).

• Schedule internal testing with the vendor to ensure your practice is able to send and receive transactions with ICD-10 codes.

Review internal standard operating procedures and policies to ensure all practice documents are up-to-date.

Northshore Health System: Physician Recruitment

NorthShore University Health System (NorthShore), the principal academic affiliate of the University of Chicago Pritzker School of Medicine is a comprehensive, fully integrated, healthcare delivery system that includes four hospitals - Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital.  NorthShore is a member of the Mayo Clinic Care Network; Mayo’s only collaboration of its kind in the Chicago region.  NorthShore has been named one of the nation’s 100 Top Hospitals and Top 15 Major Teaching Hospitals by Truven Health Analytics more than any hospital in the United States.  NorthShore offers a state-of-the art EMR and ranks as one of the “Most Wired” hospital systems by Hospital and Health Networks.  NorthShore is committed to excellence in its academic mission and supports teaching and research.

The system has more than 2,100 affiliated physicians, including a multi-specialty group practice with over 125 office locations under NorthShore Medical Group. NorthShore Medical Group is a physician-led group with more than 870 physicians and growing.  It has been recognized by the American Medical Group Association for its innovation and demonstrated track record in providing patients with access to safe, efficient and patient-centered care.  NorthShore Medical Group offers many advantages, including competitive compensation and a solid platform of support that allows physicians to focus on patient care, free of the administrative hassles of running an office.

Current Physician Opportunities at NorthShore include:

-          Behavioral Neurology

-          Neuromuscular Neurology

-          Congestive Heart Failure Program Director

-          Palliative Care

-          Developmental & Behavioral Pediatrician

-          Pediatrics – Outpatient

-          Endocrinology

-          Physician Medicine & Rehabilitation

-          Internal Medicine- Outpatient

-          Psychiatry

-          Hematology-Breast Cancer

-          Psychology

-          Hospital Medicine

-          Pulmonary Critical Care Division Head

For additional information please visit our website: www.northshore.org/physicianrecruitment.

Qualified candidates should submit their CV and cover letter by contacting:

Physician Recruitment:  This email address is being protected from spambots. You need JavaScript enabled to view it.,  Phone: 847.663.8512

EOE Minority/Female/Disability/Vet

AHRQ Ad

 

Facts Up Front: The Nutrition Facts Panel, Simplified

Stroll the aisles of your local supermarket and you’ll see more and more products bearing the Facts Up Front label. Facts Up Front takes the most critical information from the Nutrition Facts Panel and places it on the front of food and beverage packages to help busy consumers – especially parents – make informed decisions when they shop.  Grounded in consumer research and developed by the Grocery Manufacturers Association and Food Marketing Institute, Facts Up Front labels display how much calories, saturated fat, sodium and sugars per serving are in a product. They may also provide information about fiber, vitamins, calcium and other nutrients that are essential for a balanced diet. Making this information more easily accessible helps shoppers quickly compare products on the grocery store shelf and identify the foods that best meet their family’s nutritional needs. 

Facts Up Front is supported with a robust consumer web site that includes a nutrition calculator, meal planning tips and recipes, available in English and Spanish and optimized for mobile devices.  The site also features a section for healthcare professionals.  To learn more about Facts Up Front, visit www.factsupfront.org.

 


1920 L St., NW, Suite 725
Washington, DC 20036
Phone: 202-628-5895
Fax: 202-628-5898
Email: nhma@nhmamd.org