The Newsletter of the
Indiana Society of Anesthesiologists
Physician Leaders in Patient Safety
W I N T E R 2 0 1 0
F r o m t h e p r e s i d e n t
M A R K K Y K E R , M D , P R E S I D E N T
Dear ISA Membership:
Along those lines, do not get discouraged when you invest
I figured this would be the easiest, my time and money into the political system and it ultimately turns
last President's report for the ISA out against your wishes. Barry Glazer, ASA Past President
newsletter. All I have to do is look over and ISA DSA recipient, wrote in an email exchange,
the past two years, see what we have "unfortunately, as is often the case, our victories are often
done, pat myself on the back, and move measured in how little we lose; rarely do we have a win to
on. Instead, I think I will look at what I show. He went on to say,"while we might not agree with much
did not achieve and see where we can that's going on, we need to work within the system and the
improve. reasonable parameters of what we can practically get
accomplished (based on experience and expert advice),
My goals coming into office were to improve the ISA because "sticking to our guns" may feel good, and may even
electronic communication, create a grassroots lobbying be "right" - but won't get any results at all".
effort, improve our practices clinically through education,
and business wise through awareness, lobbying and if Although I badgered you, I am fairly certain I failed in obtaining
needed, legislation. All of this done so the patients in Indiana 20% of the membership to donate to the ASA PAC. Maybe you
will feel safe and know a physician is involved in their will prove me wrong!
anesthetic which includes perioperative care, pain
management, and critical care.
PRACTICE. Based on the evaluations and attendance, we
COMMUNICATION. Here we have actually improved. Our made some improvement in the Annual Meeting, moving to a
website is functioning quite well and the board just approved one day format with up to 8 CMEs. Libby Cierzniak's (our
a members-only section allowing us to post more sensitive lobbyist) presentation, a tradition started by immediate past
information and offer more electronic services. We now have president, Harriet Hamer MD, was well received and
over 85% of the members emails and hope to surpass 90% extremely informative. We had excellent speakers and
in 2010. Hopefully, the occasional letters or notices have not hopefully we are rekindling the importance of attending the
been too intrusive, and spurred some of you to call, email or Annual Meeting. This years meeting will be on April 24th with
visit your legislators or attend the annual meeting. We are the same format, so plan to come spend the day in
aware younger physicians expect electronic communication Indianapolis.
and most seasoned physicians are very comfortable with it,
so our goal is to be primarily electronic within 3 years. The decisions that affect our practices are easy if we keep the
Looking for improvement, the board is exploring video patient's safety as the primary concern. Has Medicaid become
conferencing to allow members not in central Indiana to join so poorly reimbursed that it affects access? Are there laws that
in from home, and we may offer electronic cme from our provide for truth and transparency about a health care
annual meeting in the future. We will continue to send email providers training and education? Are certain non physicians
reminders and legislative updates from our lobbyist during trying to diagnose, interpret, and treat patients with as little as
the legislative session. a weekend course or even worse, practicing medicine without
a license? These are issues that have been and are being
ACTIVISM/ADVOCACY. I was unable to achieve the dealt with and will be explained in greater detail with a
number of grassroots fundraisers I planned. One excuse members-only section.
was the long legislative session followed by the emergency
session, leaving lawmakers burned out on meetings. I was I am proud of our work that increased medicaid reimbursement
hoping to put together a dinner with key legislators and a to anesthesiologists for certain CPT codes this year. I am
number of geographically selected ISA members, but will unhappy that total reimbursement for Medicaid has not been
have to attempt this again in the summer. We did hold two addressed adequately for many years. I believe we made a
local fundraisers, and met multiple times with legislators at difference in exempting the public option in the health care
the state house. I do believe we improved individual activism reform bill, but were unable to communicate adequately with
and hopefully have learned the importance of trying to our Senators to prevent the passage of reform through
inform lawmakers of our interest. In fact, one non board financing based on across-the-board cuts to and new fees on
member already signed up for the ASA Legislative Confer- Medicare physician Part B services with no solution on
ence in April , I would urge you to do the same at some point Medicare SGR. (see the enclosed letter I sent via email on
in your career. Dec. 31).
F r o m t h e p r e s i d e n t 2010 ANNUAL MEETING
( c o n t i n u e d )
FUTURE. Looking over the past two years, I feel we have
accomplished significant improvements with our finances, MARK YOUR CALENDARS
administration and communication. I believe we have laid the The 2010 ISA Annual Meeting
groundwork for improving advocacy and awareness and will be held on Saturday April 24, 2010 at the IUPUI
establishing the importance of meeting and voicing our position Campus Center. Notice the new time and new venue.
to legislators. Our Annual Meeting has seen improved There will be excellent talks given by Drs. Robert
attendance. Our PAC contribution is still anemic. Our work on Stoelting, Armin Schubert, Brenda Fahy and Jerry
transparency, health care reform, and scope of practice is Cohen as well as our lobbyist Elizabeth Cierzniak.
ongoing. Our future as physicians providing excellent medical
The registration brochure will arrive the first week in
care is still bright, but will take awareness and activism in the
political process to navigate the turns and bumps that lay ahead. February and be on our web page at www.isahq.net
I believe the ISA is heading in a good direction and we have
young physicians and experienced physicians that will continue Hope to see you in April.
to serve the society at the state and national levels. I urge you to
stay involved, stay informed and stay active in the ISA and ASA.
Finally, I appreciate the opportunity to serve as President of the
Indiana Society of Anesthesiologists and look forward to helping
in the future.
2009 ISA Distinguished Service Award
Recipient….Dr Willard Albrecht!
Mark Kyker MD, President The ISA Board is pleased to announce the selec-
Indiana Society of Anesthesiologists tion of Willard Albrecht, M.D. to receive the 2009
ISA Distinguished Service Award at the April 24,
The 2010 ASA Legislative Conference will be held Mon- 2010 Annual Meeting in Indianapolis. Dr. Albrecht
day through Wednesday, April 26-28, in Washington D.C. at worked tirelessly as a teacher and mentor of many
the J.W. Marriott Hotel, 1331 Pennsylvania Ave, NW. Indiana physicians who trained in the Indiana Uni-
versity School of Medicine anesthesiology resi-
Further information (including hotel information) will be dency program. Please join us for the presenta-
available at http://www.asahq.org/government.htm tion at the Annual Meeting on April 24!
The previous ISA DSA recipients include 2008,
Dr. Gopal Krishna, and 2007, Dr Ken Haselby. All
previous recipients are listed on the ISA website.
ISA DSA Committee, Harriet Hamer, M.D., Chair
ISA DSA Committee requests Nominations for
2010 DSA Award
The ISA DSA Committee requests submission of
”Members Only” section on the ISA Website. This potential DSA Award nomination names to the
will allow the Society to post more sensitive infor- DSA Committee, no later than Aug 15, 2010, for
mation on the action and strategy of the final approval by the ISA September Board meet-
ing. Names of persons submitted should be per-
Board. We will be able to post information from sons who have made a significant impact on the
our Lobbyist that we would not post public. This practice of anesthesiology in the state of Indiana.
section will also allow you to directly update your Submission may be to the ISA office c/o Ms
contact information on our database. We will keep Wendy Gagnon at 450 E. 96th Street, Suite 200,
you posted on the status of the website. Indianapolis, IN 46240 or 317-607-9164 or email
firstname.lastname@example.org, or to the 2010 DSA Chair,
Dr. Mark Kyker at email@example.com.
January 2009- January 2010 District Director's Report
The ASA tries to navigate the Chaos
From the outset, let me say the state of the American Society of Anesthesiologists is strong. We have been
blessed with leaders of unique abilities in our last two Presidents. Roger Moore, MD, our 2009 President, is a man
of unique endurance who adopted a bunker mentality to defend our interests when no one else in medicine ap-
peared to care. He was stern and forceful when the situation required, and kept the principles of the ASA foremost
in his mind. He did a fantastic job of trying to communicate very complex topics and the ASA’s response to issues
to the leadership of the ASA and other ASA members. His common sense approach served us well. Alex Hannen-
berg, MD, our incoming 2010 ASA President, arguably has the keenest mind around when it comes to the intrica-
cies of health care financing and how the specialty of Anesthesiology as a whole is affected by any permutation in
the system. He is the leader we need as we move into the next phase of the continuing morass that has been
called Health Care Reform.
Looking back, Roger Moore, in his March 13, 2009 President’s message, described the initial Senate white paper
on health care reform, authored by Max Baucus, Call to Action: Health Reform 2009, as having 3 main points
A policy that ensures coverage and care to all Americans.
An insistence that any expansion be coupled with an emphasis on higher quality, greater value
and reduced costs.
A commitment to weed out waste, eliminate overpayments, and design a sustainable financing
system that works for taxpayers, and for recipients and providers of health care.
We now face a closed door negotiation process between the House and Senate Leadership (distinctly and openly
non-bipartisan) which is working on a bill that will arguably accomplish none of those three goals. We have had
significant victories in the process on behalf our patients and our specialty. In Indiana and nationally, our members
and our leadership continue to be active on our behalf; unfortunately our victories are often measured in how little
we lose. I encourage all members to sign up for the Grassroots Campaign, at the asahq.org website, to help us in
On other fronts, the ASA continues to remain the pre-eminent source for continuing education in Anesthesiology.
The ASA recognizes its responsibility to assist our members as they move through the MOCA process. I would
appreciate hearing from anyone who has ideas on how we can serve you better in that regard.
The issues facing the ASA are sizeable but not insurmountable. As we move forward we will continue to need the
help of all our members. Please let us know how we can help you help us. Please email me at ger-
The following is a weekly report that our Lobbyist, Libby Cierzniak provides to us
during the State legislative session. These will be posted weekly on the website.
Last week, both the House and Senate passed amendments The deadline for filing bills has now passed. Altogether,
to place the property tax caps in the constitution. The House 811 bills were filed this session - 420 in the Senate and
passed its amendment (HJR 1) on Monday, and the Senate 391 in the House, including 74 "vehicles bills" into which
passed its amendment (SJR 1) on Tuesday. Because the content may be inserted at a later date.
Senate acted swiftly on the House amendment, it is eligible
for final Senate passage Tuesday, just hours before Gover- State government offices will be closed tomorrow
nor Daniels gives his annual State of the State address. (January 18), so there will be no legislative activity until
Tuesday. However, the rest of the week will be very
The timing is no coincidence - House leaders pushed the busy, because most committees will meet only two more
governor's speech back one week later than usual while times before the Jan. 28 deadline to complete consid-
adopting the proposed amendment at breakneck speed so it eration of bills in the house of origin.
would pass both chambers before the governor's televised
address. (See page 4)
Legislative update . . Continued from page 3 gram's (INSPECT) data base to include information on a
controlled substance recipient's method of payment for
the controlled substance dispensed. The bill allows IN-
Last week, the legislature took action on several bills SPECT information to be released to the state toxicolo-
of interest to ISA. Following are highlights: gist and the Medicaid Retrospective and Prospective
Drug Utilization Review Program.
HB 1022 (open access) passed the House Public
Health Committee on an 8-2 vote, with Reps. On Thursday, the Senate Appropriations Committee will
Frizzell and Lehe as the sole dissenters. The pro- hear SB 294, which would require OMPP to amend the
posed legislation is being sought by the Indiana State Medicaid Plan to revise the distribution of funds
State Medical Association, and is aimed at non- within the DSH payment program, the Upper Payment
discrimination clauses in insurers' contracts that Limit (UPL) program, and the Medicaid Safety Net pro-
prohibit non-contracted providers from limiting the gram. The total amount of funding available to hospitals
number of patients they accept from certain insur- would not change; however, the additional funding pro-
ers. This issue was brought to the forefront in late vided to certain hospitals serving large numbers of indi-
2007, when a large physician practice in central gent patients would be spread around to other hospitals.
Indiana decided to stop accepting any more pa- The hospital lobby is divided in its support for this legisla-
tients insured by Anthem because of Anthem's tion.
relatively low reimbursement rates. Similar legisla-
tion was introduced last year but failed to gain Following is a tracking list of bills of interest to ISA. Please
traction; however, ISMA has been diligently work- note that legislation was not introduced this year to expand
ing the issue for the past six months and support the scope of practice for CRNAs, or to override the office-
among legislators appears to be growing. The bill based anesthesia rule, although we will keep watching
is expected to be eligible for second reading on throughout the session for amendments that include these
Both the House and Senate are working on om- Assignment of benefits legislation was filed this year (SB
nibus ethics legislation that - among other things 326), but has not been scheduled for a hearing. At this point,
- would impose additional restrictions and report- it's unclear whether the legislation will move forward this ses-
ing requirements on lobbyists and their clients. sion, given the controversy surrounding the issue and the fact
HB 1001 passed the House 97-2 on January 11, that the notice provisions of the 2009 legislation have been in
and SB 114, the Senate's version of ethics re- effect for less than four months. Under these provisions, in-
form, passed unanimously out of committee on surers are required to include a prominent displayed notice
the same day. Although the overarching goals of on all checks informing the recipient that failure to pay their
both measures are similar, the details vary provider could subject them to civil and criminal penalties.
widely. Both the Department of Insurance and the insurance industry
maintain that the new law should be given time to work before
The upcoming week will be hectic, with the following changing the law again.
bills set for hearing:
Please see website,www.isahq.net for
SB 356, the Indiana Professional Licensing the rest of the report and future reports.
Agency's bill, will be heard on Wednesday
morning in the Senate Health and Provider
Services Committee. Among other things, SB
356 clarifies and strengthens the authority of
the various professional boards (including the
Medical Licensing Board) over persons who
practice without a license. Currently, the only
way that the Medical Licensing Board can stop
the unlicensed practice of medicine is by work-
ing with the Attorney General to convince a
court to issue an injunction. Under the pro- CONTACT INFORMATION
posed language, the board is authorized to
hold a hearing and issue a cease and desist Indiana Society of Anesthesiologists
order if it determines an individual is engaged 450 E. 96th Street, Suite 200
in activities that are subject to licensure. Per- Indianapolis, IN 46240
sons who violate an order could be punished Phone: 317-607-9164
for contempt of court. Fax: 317-566-1700
SB 356 also requires the Indiana Scheduled Pre-
scription Electronic Collection and Tracking Pro-