SENATE MEDICARE VOTE FAILS. NO SOLUTION TO 10.6% CUT AS SENATORS HEAD HOME. EXTENSION ANNOUNCED BY CMS
Following another six months of inaction, the hoped-for prevention of the July 1st 10.6 percent cut to physicians’ Medicare payments died Thursday evening when Senate Democrats fell one vote short of forcing cloture on a motion to bring the House bill (HR 6331) to the floor for action.  It was a bitter moment – on all sides. 

But CMS has announced a 10-day payment freeze at the current level.  And, reports the Washington Post in its Saturday edition,  “If the legislative dispute lasts beyond the new deadline…(HHS Secretary)… Leavitt said he hopes to retroactively pay doctors once the dispute is resolved.”

MEDICAID CUTS TO ILLEGAL IMMIGRANTS
Somewhere between 3,000 and 16,000 adults in Washington State likely will lose Medicaid medical coverage July 1, 2008, because they can't prove they are U.S. citizens. 

On Tuesday, Washington will start complying with federal rules that were put into place two years ago after Congress passed a law requiring Medicaid recipients and new applicants to show proof of citizenship to get coverage.

Since July 1, 2006, DSHS has been providing medical coverage as long as applicants declare they are U.S. citizens.  However, federal officials want Medicaid recipients to show a birth certificate or other document to prove both identity and citizenship.

It will be up to federal auditors - not state auditors - to decide whether Washington has to pay back any federal funds for spending the money on non-citizens (perhaps a couple of hundred million).

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FY 2009 LABOR-HHS-EDUCATION APPROPRIATIONS
On Thursday, June 19, 2008, the House Labor-HHS-Education Appropriations Subcommittee approved by voice vote its $626 billion fiscal year 2009 draft bill.  The measure provides $153 billion in discretionary spending for the three departments plus some independent agencies, which is $8 billion more than President Bush requested and $8 billion more than FY 2008.  President Bush has promised to veto any spending bill that exceeds his budget request.
Of note, the bill provides:

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SENATOR MURRAY SIGNS ONTO ACEP LEGISLATION
Senator Patty Murray was one of the recent members to join the ACEP sponsored legislation, “Access to Emergency Medical Services Act of 2007,” (H.R. 882/S.1003).  She joins Senator Maria Cantwell and Representative Rick Larsen from the Washington Congressional Delegation in supporting this legislation.

There are currently 150 co-sponsors in the House and 21 in the Senate.  For a complete list, please go to the ACEP Website.

You can also check our Co-Sponsor Map on the ACEP Website.

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CMS COVERS PQRI BONUSES
On its fourth PQRI provider call of the year, CMS confirmed that incentive payments for satisfactory 2007 reporting will be issued in mid-July.  Feedback reports on 2007 PQRI participation will be available separately at that time.  To access the reports, each tax identification number (TIN) will need to be registered as an “organization” in “IACS” – Individuals Authorized Access to CMS Computer Services.  Registration is free, but will take some time, particularly for providers registering large groups.  CMS also announced that individuals may access reports for their own use as early as June 30.  Providers can refer to the IACS helpdesk for additional information at 1-866-484-8049.

US COULD FACE SHORTAGE OF 44,000 PRIMARY CARE PHYSICIANS BY 2025
The MU School of Medicine, found that the U.S. could face a shortage of up to 44,000 family physicians and general internists in less than 20 years, due to a skewed compensation system that rewards specialists increasingly more than primary care practitioners.

During the past decade, the number of generalist graduates has fallen by 22 percent and declines continue as medical school graduates enter other specialties. At the same time, the U.S. population is increasing by about one percent each year, and the baby boomer generation will significantly increase the number of Americans older than 65 by 2025.
In the study, the U.S. Health Resources and Services Administration and the University of Missouri, used data from the National Ambulatory Medical Care Survey to estimate the future demand for generalist care. The Census Bureau predicts that the number of adults will increase 21 percent by 2025, and the number of Americans older than 65 will rise by 73 percent.

MEDICARE CONTRACTOR SWITCH UPDATE:  NORIDIAN FILES PROTEST
The WSMA has been advised by the Centers for Medicare and Medicaid Services (CMS) Region 10 office in Seattle that Noridian has filed a formal protest over the selection of National Heritage Insurance Corporation (NHIC) for our (the J-2) contract region.  The protest will be heard by the Government Accountability Office (GAO).

LICENSING RENEWAL TIPS FROM DEPARTMENT OF HEALTH
The Washington Department of Health recently notified license holders that some renewal notices for credentials that expire in August may arrive later than in past years.  Typically the renewals are sent out about 60 days in advance; this year some physicians will only get 30 days notice.  The Department reports this is a temporary delay due to changes in fees and the new legislative process for approving the fees.

The DoH recommends the following steps in order to assure that your license is renewed promptly:

Avoid the need for a manual renewal.  The agency reports that its automatic renewal system is working smoothly, with renewals processed in a day or two.  To take advantage of this, physicians are urged to send in the bar-coded renewal card, submit the correct fee, and provide all required information including continuing education.  Name or address changes in your renewals may cause delays.

Submit address changes separately.  Name or address changes can be submitted prior to renewal.  Send any changes in name or address to the department’s email box or fax machine.  The email address is hpqa.csc@doh.wa.gov and fax is 360.236.4818.

Don’t wait to send in your renewal.  Returning your renewal card and fee shortly after receiving it will help avoid a gap without a current license.

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EMERGENCY ROOM 911 CALLS
The emergency room staff at Northfield City Hospital in Minnesota thought an obviously disturbed patient was about to turn violent, so they did what many hospitals do in that situation: They called the police.

In this instance, officers used a Taser to shock the man. The patient dropped to the floor, was injected with medications and transferred to the psychiatric unit at another hospital, according to an official report about the February incident.
Now federal and state health officials have cited the Northfield hospital for violating the patient's rights.

The Minnesota Department of Health, which investigated the incident, cited the hospital for failing to protect the patient's safety. Under federal law, the hospital could lose Medicare funding if the problem isn't corrected.

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FIGHT THE BITE: PROTECT PATIENTS FROM WEST NILE VIRUS
No matter whether you’re a patient or a health care provider, the facts are clear: West Nile virus really is as bad as experts say it is, and we should work to prevent exposure to it in Washington. Factor in that an especially wet summer could mean more mosquitoes than usual, and the importance of protecting your patients by educating them about the risk grows even more.

Patients should know that West Nile virus:

Health care providers should empower patients to protect themselves by:

Please help your patients understand mosquito bites are more than just a nuisance. West Nile virus is real, it’s in Washington, but it’s easy to avoid.

More information is available online (www.doh.wa.gov), or call 866-78-VIRUS.

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BOARDING SOLUTIONS REPORT RELEASED
ACEP’s Boarding Solutions Task Force recently completed a new report, “Emergency Department Crowding: High-Impact Solutions.” The beauty of the report’s recommendations is that there is little or no-cost solutions that will have a positive impact on our patients and the amount of time they are boarded in the emergency department.

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HEROES OF EMERGENCY MEDICINE CAMPAIGN
The Heroes of Emergency Medicine campaign -- which recognizes emergency physicians for their contributions to the specialty, their community and their patients – continues to have a significant impact. This important tool drives our messages of the essential community service provided by our members to the local level as we honor members in local markets on radio, in community newspapers, on Web sites, and hospital newsletters.

We know there are Heroes all across the United States. Please help us by identifying those in your area -- anyone can submit a nomination online.

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Elizabeth M. Dorn, MD – Seattle
Francisco A de le Fuente, MD – Seattle
Fiona Elizabeth Gallahue, MD, FACEP – Seattle
Richard Kwun, MD – Seattle
Brooks T. Laselle, MD – Tacoma
Garrick Stride, MD - Poulsbo

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JOB POSTINGS

Yakima Regional Medical Center-FT and PT Physician Openings
Yakima, WA – Yakima County - 214 Bed Hospital / 21-bed ED including 10-bed Fast Track and designated trauma bays- Estimated Annual Volume of 29K, 2.38 PPH - BC/BE Emergency Medicine, PALS required - 12 hr shifts with 24 hrs of physician coverage + 8 hrs Family Nurse Practitioner coverage in ED - Additional 8 hrs physician assistant coverage in Fast Track - Competitive Fee For Service Incentive Plan - “A” Rated Malpractice Insurance Program with No Tail Obligation upon departure! Yakima is located in the heart of Washington State, only 2 hours from Seattle. The beautiful agricultural settings include national forests, wildlife viewing, lakes, streams, rivers, skiing and hiking. The Yakima Valley is also the state’s most densely populated wine region. For more information, please contact John Torres, Physician Recruiter at 800-230-5160 ext 3025, email: john_torres@emcare.com, fax: (805) 564-5087. Please visit our website at www.EmCare.com.

Full-time position, possibly also part-time position, for BC/BE EM, FP, or IM physician with minimum 4 years full-time ED experience. Join our private, single hospital group at the foot of the Olympics, overlooking the Strait of Juan de Fuca. ED volume 27K. Excellent pay and benefit package. Schedule is flexible, allowing a great lifestyle in the most beautiful part of Washington. Please send CV and questions to James Wallace, M.D., at jamescwallace@msn.com, and/or call 206-349-7627 for more information.

Abrupt retirement of a full partner for health reasons has caused us to have immediate opening for a board el/cert emergency physician at Stevens Hospital, Edmonds, Wa. at 42K ED staffed by Edmonds Emergency Physicians, a democratic, single hospital group. Please contact Richard McClelland MD FACEP at richard.mcclelland@comcast.net or at 425-742-3708.

Immediate FT Locum position and PT position available with Associated Emergency Physicians, Inc. at Valley Medical Center. Potential for FT continued employment. Stable independant democratic group, staffing a single hospital with over 72,000 visits. Level III trauma center. New 56-bed ED under construction. Competitive compensation and benefits. Must be residency trained and board eligible or board certified. Send CV or contact Pattie Giuliani:425/228-3440x2975. Fax: 425/656-5016 email: pattie_giuliani@valleymed.org.

Seattle - Highline Emergency Physicians is democratic independent group of physicians currently seeking full-time ABEM prepared/certified physician. We are a one hospital, two facility group with 8 hour shifts triple coverage in our high volume facility (45 K visits annually) and single coverage in our low volume facility (15 K visits annually). Friendly work environment with rapid patient turnaround and a planned construction of a new department on the horizon. Flexible scheduling allows for ample free time to enjoy the Northwest's abundant opportunities for outdoor recreation. Great nurses! We provide competitive compensation and paid malpractice, health and dental. We are a well established group (contract held for 25 years), respected by the medical staff and community. Send CV to Carter Hill MD; e-mail: carterhill@comcast.net or Fax 206-236-8063, Mobile # 206-409-7598. Position is available summer of 2008 for qualified and credentialed candidate!

Wenatchee Emergency Physicians seeking a BC/BE emergency physician for full time employment and partnership. We see 30k patients per year at a level III trauma center. We offer superb recreational opportunities, excellent physician and nursing staff, a growing community, and affordable housing. Contact Tom Ettinger MD FACEP morsno@charter.com 509-679-9708, Scott Stroming MD FACEP 509-679-3635, or one of our partners at Central Washington Hospital 509-665-6163.

Are you considering a change of employment? If so, don't make a move until you give us a call. At any one time we have physician openings across, Washington, Oregon, Idaho, Montana and Wyoming. Northwest Emergency Physicians-TEAMHealth is the largest employer of emergency medicine physicians in the Northwest. Contact: Emily Simpson (800) 336-8614 x 2115 or email: emily_simpson@teamhealth.com or Lynn Benson at (800)336-8614 ex 2123/fax (253)838-6418 or lynn_benson@teamhealth.com

CRAssociates, Inc. (CRA) is a national healthcare management company that is committed to the delivery of high-quality health care services. We have a need for full-time Emergency Medicine Physician to support the Naval Hospital Bremerton. Requirements include:
· Board Certified as an Emergency Medicine Physician
· Min one year exp in last 3 years
CRA is proud to offer you a team environment, excellent compensation and benefits, as well as company-paid professional liability insurance. Please send your resume to Human Resources at one of the following: Fax: 866-550-1476 (Toll Free) Email: ckm@crassoc.com CRA is proud to be an equal opportunity employer.

Washington, Kitsap Peninsula: We staff two brand-new ED's seeing a total of 60,000 pts/annually and seek a full-time BC EM Physician to expand coverage. Established, progressive, democratic group with excellent compensation and benefit package. Mountain and Ocean recreation opportunities abound. One-hour ferry ride to Seattle. See Website: www.harrisonmedical.org E-mail CV to: Gail Donavan at gdonavan@harrisonmedical.org

Longview- Cascade Emergency Associates is looking for BC/BP emergency physicians. Stable and growing practice in a Level III trauma center. Usually one of the busiest practices in the state, with a census in 2005 of 49,500. Brand new ED under construction. Wonderful family-oriented community located on the Columbia River close to a myriad of recreational opportunities. Democratic scheduling and compensation. Contact Holly Liberatore MD, PO Box 2404, Longview, WA 98632, or email liberatoreh@comcast.net

Immediate Full-Time Position for BC/BE EM Physician with Kennewick Emergency Physicians, a Democratic Group staffing a single hospital, 30,000 annual visits with moderate acquity on the banks of the Columbia River. Generous Competitive Package, Guarantee plus Incentive Compensation, Liability Insurance included, Relocation Expenses included, Full Partnership Tract in 18 months, 8-11hour shifts, Double coverage during peak hours, average 12-14 shifts/month with 3 weeks off/quarter built into schedule. Enjoy a peaceful lifestyle in this friendly community of approximately 200,000. Take advantage of hundreds of miles of waterways- fishing, water sports and beautiful sunsets- all near the mountains, over 300 days of sunshine annually, over 40 local wineries. Contact Louis K. Koussa DO, FACEP; 509-521-3396 or 509-627-1798 and email your CV to loukoussa@yahoo.com

WANTED: Emergency physicians for bipolar company. Quark (www.quarkexpeditions.com) leases Russian Icebreakers for 10 to 25 day voyages to the polar regions. We are in need of ED physicians willing to serve as ship’s doctor. On any ship, there at most 110 passengers and 50 crew members. No dressing up and no night life except the scenery and animals. Contact Dr. Dan Zak at zak38@aol.com. Please let your colleagues know about this as well.

Looking for FT & PT physicians in Central WA. (180 miles from Seattle). Enjoy this desert garden with the finest fruits and vegetables as well as the home to award-winning wineries! Washington State designated Level-4 Trauma Center with a 17K estimated annual patient volume. Efficient support staff with a great pace & good mix of patients. Medium to low acuity. Qualifications: BC/BE EM or IM and FP accepted with significant ED experience. We offer an A-rated malpractice insurance program with no-tail obligation upon departure. This is an Independent Contractor facility with a competitive hourly rate and generous sign-on bonus! For more information, please contact John Torres, (800) 230-5160 ext. 3025, john_torres@emcare.com Visit our website at www.emcare.com

To have your job posting included free in future WA/ACEP NewsWatch transmissions, send your information to WA/ACEP