Enjoy the April Update provided exclusively to members.

Do you have something to contribute to the next newsletter? Contact us.

Pennsylvania was well represented at last month’s House of Delegates meeting in Washington, D.C., at which Patrick DeHeer, DPM, was elected as President. Student representatives from TUSPM and LECOM were represented on Capitol Hill. The Diabetic Foot Health Access and Modernization Act was discussed to reduce the burdens we are experiencing with Medicare and to address what many consider dated legislation that needs reform.

Our board recently met and discussed several initiatives, including the need to add podiatry to the Fair Contracting Health Care Practitioners Act, enacted last year. We will provide you with updates on this legislation. PA House Bill 1391 (covering DME) continues to be a topic of discussion with our local representatives to ensure they understand the struggles we are facing and that we can meet the needs of our patients. These efforts include supporting Representative Joyce in Pittsburgh during the House of Delegates Meeting. Representative Joyce is one of the House champions of the Diabetic Foot Health Access and Modernization Act.

Our office notified you of updates to Medicare’s Skin-Substitute Reimbursements and the reversal of that decision. At this time, we do not expect any additional billing changes, but reimbursements may be impacted. In the event this occurs, we will keep you informed.

In addition to advocating on your behalf, PPMA continues to ensure that you receive valuable membership benefits you can count on. Preliminary results from our membership benefits survey indicate that our members appreciate the discounts we offer, including professional liability, education through the Goldfarb Foundation, and other discounts.

If you have benefited from PICA liability savings with The Yurconic Agency, won’t you consider telling a friend who would benefit from PPMA membership? We also remind you that OPEIU has a website and an app you can download to learn about everyday savings, including travel, prescription, and retail discounts, and much more. This will allow you to maximize your membership.

The Goldfarb Foundation is accepting registration for the third year of LESS CHAOS (Lower Extremity Surgical Symposium), scheduled to take place May 28-31st at The Loews Philadelphia Hotel. This is a must-attend event with well-known lecturers that residents, fellows, and attendings will want to participate in. Attendings who register for the event will receive a free Resident registration. Members who work with Residents should encourage their Residents to visit The Goldfarb Foundation’s website for more details about this event.

This year’s Clinical Conference is moving from the Valley Forge Casino Resort to the Hilton Philadelphia City Avenue, located between Valley Forge and Center City Philadelphia. The event was moved from The Valley Forge Convention Center. This year is a license renewal year, and we expect a big attendance. Members receive a deep discount on this conference, and when combined with any early-bird pricing, can really save big on licensing requirements.

Pennsylvania’s House of Delegates will take place in Pittsburgh this June, and division representatives will be on site to ensure that the entire state comes together as one voice on behalf of podiatrists in Pennsylvania. PPMA is now providing financial management support to many PPMA divisions throughout the state to reduce the burden on division leaders and allow them to focus on bringing members together for education and networking. Members who are considering getting more involved may want to attend a division meeting. If you are unsure which division you are in or would like contact information, please contact our office.

Establish your brand with Pennsylvania's podiatric community.

Take advantage of opportunities to engage in Annual Conference Sponsorship Opportunities and Marketing and Content Solutions.

Learn More about how your organization can becoming a PPMA Partner.

Learn more at  https://www.ppma.org/page/FamilyScholarship

After Medicare payments were cut again for the fifth year in a row, an effort is being made to stop the cuts and implement a payment raise. Reps. Greg Murphy, MD (R-NC) and Jimmy Panetta (D-CA), along with a bipartisan group of lawmakers, have reintroduced the "Medicare Patient Access and Practice Stabilization Act" (H.R. 879). This legislation would cancel the 2.83% cut and provide a 2% payment increase, stabilizing practices and ensuring Medicare patients can continue to receive care.

Visit the APMA's website now to encourage your representative to take action

Please feel free to contact the PPMA office with any questions or concerns.

With all the attention lately focused on how divided the country is, it seems like the right time to remind our members that PPMA represents one united voice with the goal of the greater good for our profession. There is tremendous comfort in knowing that our association has been here to support you since you began your career and will continue to be here through retirement, providing you with valuable benefits and advocating for all of us.

Last year, we announced a future scholarship at TUSPM in the name of Mike Davis. The scholarship was intended to be a bridge for those pursuing a podiatric education. In addition to this opportunity to support those pursuing podiatric study, we are excited to announce a future partnership with The John Yurconic Agency. The John Yurconic Agency has generously pledged $100,000 towards future education efforts of podiatry students. We are deeply grateful for this support, which will make a significant difference in the lives of these students and, ultimately, the future of our profession.

I would like to take this opportunity to thank the Yurconic family again for their generous pledge to support podiatry students' future education efforts. We are deeply grateful for this support, which will make a significant difference in the lives of these students and, ultimately, the future of our profession. Thank you.

One of the advocacy issues we are following is related to noncompete agreements in healthcare. The Fair Contracting for Health Care Practitioners Act, which currently does not impact podiatrists, will become law on January 1st. We have heard varied feedback in conversations with members and fielded a survey to get a full picture from our members about how these agreements are impacting them. Please take a moment to respond to this survey.

The Goldfarb Foundation is now accepting registrations for LESS CHAOS, which will be in Philadelphia this year. This unique interactive event provides didactic lectures and complementary sawbones workshops. It is expected to draw residents, surgeons, and fellows from Pennsylvania and other areas of the United States. Those interested in attending should register on December 1st, as some activities have limited seats available.

In 2025, The Montana Meeting, which Edwin Hart, DPM has chaired, will celebrate its 20th year. This is a unique educational event that many of us have appreciated the opportunity to participate in over the years. Let's take a moment to thank Dr. Hart for the time and effort he put into this event. If you have not attended in the past, consider attending this year, as I am confident that our board has something special in the works to commemorate the anniversary of this event.

To achieve our goals, we must work hard to retain and attract podiatrists across Pennsylvania. We appreciate your introduction to DPMs that have yet to experience membership and welcome opportunities to engage them with our valuable benefits. Let’s work together to grow our collective voice at this critical time.

As we wrap up 2024 and begin planning for a fantastic 2025, know that my door is open to ideas that could benefit our organization. Thank you again for the opportunity to serve you.

Many of our members have appreciated the opportunity to subscribe to health insurance plans through the affiliation of the OPEIU Local Plan, which has provided substantial savings over the years and the ability to access quality care for themselves and their family members.

• Members can choose the plan that best suits their needs with three PPO health plan options through Highmark.
• All plans include prescription benefits.
• Dental and vision options are available for members and their families, further enhancing the flexibility of our offerings.
• Members seeking Medicare Advantage plans can access plans for themselves and their spouses. These plans also offer the option to add dental and vision coverage.

Attached is a copy of the updated monthly premium rates effective September 1st.

Members that have questions related to health care coverage, including enrollment, are encouraged to call 1-877-578-8710.

Thank you for your membership in PPMA.

John Rahm went into graphic detail about his foot injury

Hart is one of five dedicated podiatrists on the State Board of Podiatry, which ensures the highest quality care through its licensing and continuing education requirements.

Hart is no stranger to these tasks. He has served as president of the state association, chaired a continuing education event for nearly 20 years, and was a board member for its educational component, The Goldfarb Foundation. Hart firmly declares, “It is an honor to serve the state of Pennsylvania in this capacity and support the quality care and dedication that the podiatric profession brings to the table every day.”

Hart practices out of his independent office (“Dr. Edwin S. Hart, Podiatrist”) in Bethlehem, PA, where he has treated patients with compassion since 1985.

Hart’s journey in podiatry has allowed him to learn and serve across the state. He graduated from Temple University School of Podiatric Medicine (TUSPM). Hart received his BA from both Temple University and the prestigious Central High School in Philadelphia, PA. He completed his residency requirements at the Podiatry Hospital of Pittsburgh.

PPMA represents its 800+ members by providing a unified voice for the podiatric profession, including advancement and advocacy. This allows the profession to continue providing quality care for Pennsylvania patients needing expert foot and ankle care. More information about PPMA can be found at www.ppma.org.

Podiatrists treating patients with neuropathy should Click Here to learn more about the recent update.

The Board of Directors of The Pennsylvania Podiatric Medical Association (PPMA) – a trusted resource for podiatrists practicing in PA – has announced its new Executive Director, Mike Barth.

The board searched for a new executive director in 2023 in anticipation of Mike Davis's retirement. PPMA President Jan Golden, DPM, states, “Mike’s background in working with state associations has made the transition smooth.”

Mike oversees the staff at the office headquartered in Camp Hill and has responsibilities related to membership benefits and advocacy for approximately 800 members, whom the association unites to form one voice in Pennsylvania. In his new role, Barth states, “I look forward to working with our board and the podiatry community-at-large to improve our value and strengthen our voice.”

CMS has issued a correction to the 2024 rates for outpatient hyperbaric oxygen therapy, reversing the 41.5% rate cut and increasing reimbursement from the 2023 rates!

• The CY 2024 HBO2 APC Rate is $132.21
• The APC Rate increased $7.14 or 5.7% over 2023 

The American Association for Women Podiatrists Welcomes PPMA Past President, Sabrina Minhas, DPM to speak to group of female podiatrists about leadership, inspiring others to advance to leadership roles.

APMA's Health Policy and Practice and Legislative Advocacy teams have been doing battle for members to ensure podiatrists can access the opioid education required under the MATE Act from a CPME-approved provider (and claim those hours toward state license renewal).

Watch and take action below to help make it happen!

• Visit www.apma.org/eAdvocacy today to send a prewritten letter to your legislators making them aware of the issue and encouraging them to support the bill!

Please review the following information from The Alliance of Wound Care Stakeholders

Medicare Coverage Policy on CTPS will Interrupt Patient Care

Clinician and Patient Call to Action 

We need your help in requesting a delayed implementation to January 2024.

Take action now to prevent disruptions to patient care.

Learn more..

WHAT IS THE ISSUE?

In early August, Medicare Administrative Contractors (MACs) Novitas, First Coast Service Options (FCSO) and CGS Administrators released highly problematic local coverage determinations (LCDs) and accompanying local coverage articles (LCAs) guiding use of Cellular and/or Tissue-based Products (CTPs, also known as skin substitutes) for the treatment of diabetic foot ulcers and venous leg ulcers. The new policies are scheduled to go into effect on Sept. 17, 2023, causing concerning interruptions to patient care. The policies impact wound care clinicians and patients across 15 states, Washington DC and Puerto Rico, as well as the Indian Health Service and Veterans Affairs nationally.

HOW DOES THIS IMPACT MY CLINICAL PRACTICE AND MY PATIENTS?

• CTPs which you are currently utilizing may be considered noncovered in these final policies. When issued as a proposed policies in 2022, the LCDs/LCAs had approximately 70 CTPs on its non-covered list. The final LCD/LCA released on Aug. 3rd, however, placed almost double that amount - 130 CTP products - on its non-covered list, removing coverage from a large number commonly used advanced wound care CTP products.  Insufficient evidence was provided regarding why coverage was removed. (See list of covered and non-covered CTPs) 

• Number of CTP applications will be capped at 4 versus the current allowable of 9. Beginning on the Sept. 17, 2023 implementation date, the number of CTP applications over a 12-week treatment episode will be limited to four, regardless of product labeling. This does not account for patients with wounds that are larger or more severe than those that were included in clinical trials, nor does it account for patients who are improving but not healed after 4 applications.

• Disruption of established patient plan of care. The removal of a significant number of products from Medicare coverage and the new utilization limitations are coupled with a tight implementation deadline of just six weeks after the final policy was released. This does not accommodate CTPs with standard 12-week instructions for use. This will result in problematic interruptions in patient care, such as described below:

• • • If the clinician is adhering to a product label and plan of care (POC) that requires more than 4 applications over a 12-week period of time, clinicians must stop a patient’s care mid-treatment after the 4th application of the CTP, regardless of the wound healing progress, on Sept.17.

• • • If a patient is currently being treated with a CTP that is currently covered but now listed on the new policies’ non-covered list, clinicians will need to stop utilizing that CTP on Sept. 17th regardless of the wound healing progress, to comply with the new policies.

HOW DO I KNOW IF THESE POLICIES APPLY TO MY PRACTICE/PATIENTS?

The coverage policies impact clinicians and patients in the states below: 

• Novitas: Arkansas, Colorado, Delaware, Louisiana, Maryland (Montgomery & Prince George’s counties), Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, Texas, Virginia (Arlington & Fairfax counties, Alexandria), Washington DC
  • • • see coverage policy LCD L35041 / LCA A54117
• First Coast: Florida, Puerto Rico, & U.S. Virgin Islands
  • • • see coverage policy LCD L36377 / LCA A57680
• CGS: Kentucky, Ohio
  • • • see coverage policy LCD L36690 / LCA A56696     

WHAT ACTION CAN I TAKE TO PROTECT MY PATIENTS?

1) EMAIL YOUR MACS AND REQUEST A DELAY IN THE POLICIES’ IMPLEMENTATION
THE ALLIANCE OF WOUND CARE STAKEHOLDERS AND OUR 20+ CLINICAL ASSOCIATION AND MEDICAL SPECIALTY SOCIETY MEMBERS ENCOURAGE WOUND CARE PROVIDERS IN THE IMPACTED STATES TO EMAIL THEIR RESPECTIVE MAC, SHARE REAL-LIFE SCENARIOS ABOUT THE PATIENTS THEY TREAT AND THE IMPACT THAT AN INTERRUPTION IN CARE WILL HAVE, AND REQUEST:

• A delay in the implementation date from Sept. 17, 2023 to Jan. 1, 2024 in order for clinicians to have enough time to complete patients’ POC that have already been or will be established prior to Sept. 17, based on the coverage permitted under the current LCD.

• Or, as an alternative, ask that the MAC enable a “grandfather clause” which would permit clinicians treating patients under current policy requirements to continue to the end of their 12-week POC (even if that extends beyond the Sept. 17 deadline) so that care - and wound healing - is not interrupted.

SEE SAMPLE EMAIL TO CUSTOMIZE AND SEND

2) ASK YOUR PATIENTS TO EMAIL YOUR MACS AND REQUEST A DELAY IN THE POLICIES’ IMPLEMENTATION
PATIENT VOICES ARE PARTICULARLY COMPELLING COMPONENET OF EFFECTIVE ADVOCACY. IF YOU HAVE PATIENTS WHO MAY BE WILLING TO SHARE THEIR STORY AND CARE IMPACT CONCERNS WITH THE MACS, WE'VE DEVELOPED RESOURCES TO FACILITATE THEIR DEVELOPMENT AND SUBMISSION OF EMAILS: 

• Patient "call to action" with summary of the policy issues and impacts
• Sample patient email template with instructions on how to customize and send

QUESTIONS? EMAIL MEMBERSHIP@WOUNDCARESTAKEHOLDERS.ORG

As a segue into this month’s message, concerning our transition, a member wrote an inquiry into a national blog this week inquiring into the “value” of APMA membership. The APMA President answered the question in the following way:

“From: Sylvia Virbulis, DPM

Dear Dr., We are sorry to hear that you have questions about the value of your national and state organizations. Please know that APMA has in fact undertaken significant research among both members and non-members to understand the value they derive (or do not derive) from their organizations. APMA conducts research among its members on a regular basis and most recently worked with a nationally known research firm in 2021 to complete research on our member value proposition. That research, which included qualitative and quantitative measures among nearly 1,000 physicians, demonstrated that advocacy was a top priority among podiatrists. APMA supports and defends members’ ability to practice every day. You can learn more about recent advocacy victories (including several in the reimbursement arena) at www.apma.org/victories. This page is an excellent resource for anyone asking the question, “What does membership do for me?”

Our research also demonstrated that members and non-members alike have varied priorities depending on their level of experience, practice setting, engagement with their associations, and more. Non-members often are unaware of the work organizations are doing on their behalf. We are working to communicate in a more targeted way with members and prospective members about their individual needs and how APMA and their state component organizations can meet them. Please expect to hear directly from your national and state leaders to address your concerns!

. . . .

Other messages in this thread:

Thank you to Dr. K for his explanation of the many ways APMA is fighting for equitable reimbursement for its members in response to Dr. D concerns. As a final clarification, I would also like to point out that in 2018, APMA led a national coalition to help avoid what would have been a roughly 30-percent reduction in code values solely for podiatrists. APMA met with employees at the Department of Health and Human Services to discuss the proposal to eliminate our ability to bill for E/M services (which would have been replaced with lower-paying G codes for podiatrists). We were victorious in that effort, and the result is that podiatrists nationwide have earned hundreds of millions of dollars over the past five years that otherwise would have been lost. These earnings alone offset the cost of member dues.”

As a state component president, I am adding to the answers in this blog discussion. PPMA is a linked component of APMA. We have a decades long history of working on behalf of our membership. All of this work has a single component, and that component is dedication and involvement of our Board members. Thirty years ago, Dr. Neal Kramer instituted purchasing group that he named PODIATRIC MEDICAL ASSURANCE of PENNSYLVANIA (PMAP). That is a purchasing group under the provisions of the 1986 Risk Retention Act. This has provided aggregate savings in the millions for our members. We have always held the “lowest responsible rates” as our PMAP guiding principle, and through several partnerships PICA has worked with us to allow Peer review of cases in order reduce all loss and cost trends.

In the same dedicated manner, Dr. John Mattiacci worked to establish the First National Guild, a local of the Office and Professional Employees International Union. This was so unique that its original charter was discussed on the front page of the New York Times. This guild has given us entre into State Federated AFL – CIO boards as well the Blue Cross Blue Shield Labor Committee, whose members sit on Blue Cross Blue Shield Boards in each of our states. Through the Guild we have offered, for the past five years, fully insured healthcare plans for our members and their families. These plans are “rich” in benefits and the rates have saved our members substantial sums as against the available group policies which had been available prior to this incredible advance.

Again, Dr. Thomas Ortenzio volunteered to become the chair of the Goldfarb Foundation which was established after the death of William Goldfarb. Dr. Goldfarb was one of the first surgeons to recognize the importance of certification and established educational programs in medicine and surgery which have developed into major national CME offerings that supply the biannual requirements to almost all of our members. These come to our members at a discount.

On the Hill, our Association has negotiated our position in Act 13, the MCARE statute, through which we each get the increased limit coverage of professional liability required to have our licenses in the state. Legislative accomplishments on a state level, most often relate to defensive victories. Protecting and extending our privileges often relate to issues raised by others which require us to appear and defend our state scope of practice. This requires interaction with the Medical Society, the Osteopathic Society and Associations representing home health, nursing and hospitals.

We have had success in many of these arenas because of our member and fiscal strength. This strength arises out of our volunteer Boards. Dr. Mark Pinker has guided our financial structure of over two decades, taking over those responsibilities from Dr. Paul LaFata, the preceding treasurer. That fiscal strength has allowed us to lead the national efforts to grow the profession, develop residencies and adopt sound management and personnel policies.

In summation, our Association provides the structure through which each licensed podiatric physician in Pennsylvania can pursue his or her practice either as a sole practitioner, group member or employee. Our peer services answer coding questions. Our staff fields all other concerns, be they minor or major.

We have a new Executive Director beginning his term this month. Michael Barth comes to us with a wealth of association and administrative experience, and we look forward to continuing our leadership, within the profession with his guidance.

• The script was written by Michael Lacey (Producer from Los Angeles), a Reading native.

• The team of talented actors has been recruited from throughout the state (Lancaster, Reading, and Philadelphia.

• The award-winning musical soundtrack is the brainchild of composer Perry Sachs (“Happy Madison”/Adam Sandler).

• The music was perfected by Tim Davis (Glee, Lady Gaga, Barbara Streisand).

• Santo D. Marabella has been brought on as The Stage Workshop Producer and Director. He has been involved with dozens of productions.

• Laura Bell Bundy, Tony-nominated Broadway and film star, is the show’s Creative Producer.

• The show’s Composer is the talented Kevin Guillaume (son of Robert Guillaume from the television show “Benson.”)

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