ANNUAL MEETING COMMITTEE REPORT COMMITTEE MEMBERS …

CONSENT ITEMS – COMMITTEE REPORTS Page 1

ANNUAL MEETING COMMITTEE REPORT COMMITTEE MEMBERS: Chair: Dennis R. Frisch, DPM, BOT R. Daniel Davis, DPM, BOT Robert Frimmel, DPM, FL Erin E. Klein, DPM, IL, Young Physician Phillip E. Ward, DPM, BOT Staff Liaisons: Kathy L. Balderson James R. Christina, DPM Heather Palmer, MA, MBA Anne Martinez, CMP Beth Shaub DATE OF MOST RECENT MEETING: Conference call on September 9, 2014 COMMITTEE ACTIVITIES:

• Committee reviewed attendee and exhibitor evaluations from the 2014 APMA Annual Scientific Meeting (The National).

• Committee approved the preliminary educational program schedule for The National in Orlando, FL. The program will feature dedicated educational tracks for DPMs, pedorthists, and podiatric medical assistants.

• Committee discussed affiliated organization participation for the Orlando meeting. ACFAOM will hold its Annual Clinical Conference at The National. Select affiliated organizations will present small group/panel discussions on Friday afternoon.

• Committee discussed Podiatry Management’s Hall of Fame Luncheon being held at The National in 2015. The committee was supportive of holding the Hall of Fame Luncheon as long as Dr. Block meets all of the requirements of the Foundation.

• Next meeting will be held on November 21, 2014 at APMA headquarters.


CENTER FOR PROFESSIONAL ADVOCACY & ADVISORY GROUP REPORT Advisory Group Members Jeffrey Bowman, DPM, MS, Chair Laura Pickard, DPM, Board Liaison Derek McCammon, DPM, State Component Leader Joseph Strickland, DPM, State Component Leader Steve Schmid, DPM, Young Physician Candace Daly, ASPE Representative Kevin Kruse, JD, CAE, ASPE Representative Center for Professional Advocacy Staff Scott Haag, JD, MSPH, Director Natasha Pattanshetti, JD, MPH, Primary Policy Analyst Gail Reese, JD, Policy Analyst In Memoriam: Jeffrey Bowman, DPM, MS APMA and Center for Professional Advocacy staff is saddened to report the passing of Jeffrey Bowman, DPM, MS, CPAAG Chair. Dr. Bowman was a strong advocate for podiatric medicine both on the state and federal levels. Center for Professional Advocacy Activities Self-Assessment Survey Within the next month, CPA will ask state components to complete the 2014 Self-Assessment Survey. The purpose of this survey is to gain an understanding and to track state component advocacy activities and infrastructure. The survey will ask about a state component’s advocacy infrastructure on topics including lobbying and legal services, component structure, grassroots involvement, political action, established relationships, and public education and outreach. State eAdvocacy APMA and CPA staff continue to invite all state components to draft letters addressing state legislative activity for members to send their elected representatives. State component leaders can submit letters to CPA staff at [email protected], who will then upload the letters to the State eAdvocacy site. State Advocacy Assistance Delaware A member of the Delaware Podiatric Medical Association (DPMA) requested assistance from CPA concerning Highmark Blue Cross Blue Shield Delaware credentialing. The plan required that participating podiatrists be board certified by the American Board of Foot and Ankle Surgery (ABFAS) or American Board of Podiatric Medicine (ABPM). The member’s one-year residency does not deem her eligible for either board and the plan did not have a plan to grandfather previously participating providers. CPA provided DPMA and the member with the following:

• Suggested revisions to letter to plan from DPMA president; • Standards, Requirements and Guidelines for Approval of Residencies in Podiatric Medicine

document, for member’s residency years, obtained from CPME; and • APMA HOD Resolution No. 7-05 (Policy) on Board Certification, which states, in part, that

certification should not be a requirement to participate in a health plan.

mailto:[email protected]


Using this information, the plan continued to allow the member to be a participating provider and is reevaluating its board certification requirement for podiatrists. Massachusetts Massachusetts Podiatric Medical Society (MPMS) requested assistance from CPA when Massachusetts podiatrists received letters about Cigna’s new product LocalPlus and not being included on the panel for this product. CPA asked MPMS to determine whether podiatrists are outright excluded or a narrow network is in place. CPA advised that in other metropolitan areas where LocalPlus is available, podiatrists are included as in-network providers. If podiatrists are outright excluded, MPMS should use the ACA provider non-discrimination provision as well as the state law non-discrimination to advocate for inclusion. Michigan Michigan Podiatric Medical Association sought guidance from CPA, HPP, and Scientific Affairs concerning a “Diabetes Pilot Project,” funded by the Michigan Department of Community Health. These departments provided guidance on study methodology to show cost savings when a podiatrist is involved in the care of Medicaid beneficiaries with diabetes, using the Thomson Reuters and Duke studies as a basis. Minnesota Minnesota Podiatric Medical Association asked about group practices limiting podiatrists’ ability to practice within state scope of practice. Though state law does not appear to prohibit this limitation, CPA advised for the members to review their employment agreements. MPMA also asked a question about the Mayo Clinic requiring board certification to perform rearfoot surgeries and not grandfathering podiatrists who completed one-year residencies and are not eligible for board certification. CPA provided MPMA with APMA HOD Resolution No. 7-05 (Policy) on Board Certification, which states, in part, that board certification should not be a requirement to be a provider in a hospital setting. In addition, CPA recommended that podiatrists at this hospital seek assistance from hospital and provider allies to remove this requirement. West Virginia An orthopedic surgeon employed by a VA Medical Center in West Virginia, contacted CPA for information on admitting privileges for podiatrists. She stated that this VA hospital is looking to allow podiatrists to admit patients. CPA provided the APMA issue brief on Hospital Privileging and Credentialing for Podiatric Physicians, which includes information on podiatric medical education and training, national testing, and board certification. ACA Provider Non-Discrimination Provision APMA continues to advocate for protecting the integrity of the provider non-discrimination provision and following Congressional intent when both federal and state governments are creating implementing laws, regulations and guidance. With HPP, CPA will be sending a letter to Multiplan and its health plan business associates, stating that Multiplan is in violation of the provision because of the lower fee schedules it offers podiatrists relative to allopathic and osteopathic colleagues. CPA will also be assisting the New York State Podiatric Medical Association in drafting a letter to a health plan, which has recently significant cut the fee schedule for “podiatric services,” using the provision. Healthgrades Letter CPMA brought to APMA’s attention that Healthgrades, an online resource for comprehensive information about physicians and hospitals, does not provide podiatrists with the option to update


their profiles with their relevant certifying boards. Currently, Healthgrades does not provide the option to select any certifying boards for podiatric medicine. CPA is working with CPME to determine the best response to correct these actions, whether it be a letter from JCRSB, CPA, a combination of the two, or some other action requesting that Healthgrades add JCRSB-recognized boards to its list of boards that podiatrists can select to be eligible for the recognized doctor list. Class Action Lawsuit against Blue Cross Blue Shield Association and Blues Plans APMA and CPA staff was in recent contact with representatives of WhatleyKallas, a law firm which is currently engaged in an antitrust class action lawsuit against the BCBS association and related local Blues plans with respect to their contracting issues, including fee schedules. WhatleyKallas has asked for assistance in identifying additional potential plaintiffs for its class. Information about the lawsuit was shared through the APMA Weekly Focus. State Advocacy Forum The 2015 State Advocacy Forum will be held on May 16, 2015, at the Courtyard Marriott in Philadelphia. The APMA State Advocacy Forum is a biennial conference providing an opportunity for state component leaders to discuss ongoing state legislative issues with other component leaders and to interact with state medical and osteopathic leaders and policymakers.


CLINICAL PRACTICE ADVISORY COMMITTEE (CPAC) REPORT COMMITTEE MEMBERS: Chair: Jeremy J. Cook, DPM, MA K. Kyle Ballew, DPM, TX Paul D. Dayton, DPM, IA Roy R. DeFrancis, DPM, NY Adam E. Fleischer, DPM, IL Kittra T. Owens, DPM, FL, Young Physician Tracey C. Vlahovic, DPM, PA Patrick A. DeHeer, DPM, IN, Diabetes Liaison Scott M. Neville, DPM, IN, Arthritis Liaison Sylvia Virbulis, DPM, BOT Liaison Staff Liaison: James R. Christina, DPM COMMITTEE MEETINGS: Committee has not had a conference call since the last report, although they have been communicating by e-mail. COMMITTEE ACTIVITIES:

• The committee continues to review research requests for funding as they are received. • The committee approved Transitional Research Grant programs at TUSPM and KSUCPM

and is monitoring their progress. They did not approve a request from RFUCPM but did offer feedback for a possible resubmission.


CODING COMMITTEE (CC) REPORT COMMITTEE MEMBERS: Members: Paul Kinberg, DPM (Chair) Ira Kraus, DPM (BOT Liaison) Lawrence A. Santi, DPM (BOT, Special Expert) Barbara Aung, DPM. Animesh S. Bhatia, DPM David J. Freedman, DPM Jon R. Goldsmith, DPM Mitchell P. Hilsen, DPM Sahani C. Howie, DPM (YP) Richard E. Horsman, DPM Michael G. Warshaw, DPM Michael J. King, DPM Advisors: Phillip E. Ward, DPM (Current Procedural Terminology advisor) Tim Tillo, DPM (RUC Liaison) Staff Liaison: Scott L. Haag, JD, MSPH Harry Goldsmith, DPM DATES OF MOST RECENT MEETINGS:

Annual Coding Committee Meeting, May 1, 2014 Coding Committee Conference Call, August 28, 2014

1. ICD-10 a. Changes to the CC Webinars. On the Coding Committee (CC) conference call in August,

the CC determined to make these programs more meaningful to membership. The change in plans involves teaching ICD-10 by means of the use of appropriate podiatric vignettes. We felt membership would better understand the correct ICD-10 coding usage in this way. We will still bring in the applicable coding conventions, GEMs, related codes, and coding issues, but utilize the vignettes as the teaching tool to do so. In this way, membership can be taught ICD-10 by using scenarios found in our day-to-day office and hospital practices. They will still learn such specifics as which codes are used in which order, the Excludes1 and Excludes2 codes, the included terms, the 7th character additions, and the ways the APMA CRC can be utilized to find the most appropriate code structure all within a podiatric-specific vignette.

b. Webinar Schedules and attendance. The CC has resumed monthly “ICD-10 Is Here” webinars in September 2014. To date, twelve webinars have been presented. Attendance at these reinstituted webinars has declined since we began the series last winter, but more noticeably after the announcement of the ICD-10 delay in April and after members learned that they could go back and view the webinars at a later date. The CC is not overly concerned at this time about the lower attendance figures as we recognize the delay has impacted attendance, that the CC has taken the approach as already noted of focusing on topic and vignette-specific coding so that some topics are going to be more popular than


others, and that we have prioritized the more popular topics earlier. The CC anticipates that attendance will go back up as we near the new effective date, as membership may just wait until they feel a greater sense of urgency. Other factors contributing to reduced attendance might include a false sense of security that Congress may (or could) legislate another delay. Assuming no further delay from Congress or CMS, then we feel the interest from membership will start to pick up probably in February or March 2015 as they start to realize their learning time is running out.

As the BOT can tell from the viewed recording numbers, members have come to realize that they or their staffs can go back at any time and view the archived presentations. Our understanding is that the members have come to recognize these webinars as a portfolio of ICD-10 educational materials that can be digested in individual segments.

The CC strongly suggests that APMA make an attempt to include mention something about our CC webinars.as reasonable in most Weekly Focus and APMA News editions.

Overall, we have had 2571 unique live attendees or views of our webinars, for a number equivalent to approx. 21% of our membership (including almost 1000 total recording views). We peaked initially with almost 600 total views of our first webinar (and that number keeps going up as members go back to view the recording).

Of particular note is that membership feedback continues to be very positive on the quality and value of the webinars

Current Statistics Attended Viewed Recording Total

9-Jan 259 339 598 23-Jan 238 180 418 6-Feb 265 153 418

20-Feb 238 96 334 6-Mar 160 56 216

20-Mar 134 76 210 3-Apr 84 26 110

17-Apr 41 29 70 8-May 33 17 50 19-Jun 29 12 41 18-Sep 51 13 64 16-Oct 40 2 42

Attended Viewed Recording Total Total 1572 999 2571

Average 131 83.25 246.5 • 5.0% of membership attended or viewed first webinar • 21.4% of membership attended or viewed any webinar

c. Continued ICD-10 Issues with CDC and WHO. As previously report, ongoing issues with ICD-10 implementation continue. Some of these are related to:

1. Neuroma 2. Sesamoiditis


3. Bunion/bunionette code request 4. Plantar plate repair (traumatic v spontaneous) 5. Depth of ulceration coding to remove the word “necrotic”

CC representatives met with Donna Pickett, CDC regarding laterality and gaps in ICD-10, and Ms. Pickett indicated that many initiatives have been pushed back by the delay.

d. ICD-10 Stand-Alone Seminars: CC is working with APMA staff to identify cities and dates when stand-alone meetings can be scheduled in 2015. APMA outreach to ASPE and states leadership has generated some interest and requests for joint CC / state meetings on ICD-10.

e. ICD-10, coding and ASM. The CC’s discussions have led to some recommendations for the upcoming ASMs, particularly in Orlando in 2015. CC recognizes that timing is short for any changes to 2015 but requests that these recommendations be considered for the future. CC recommends three separate coding tracks. The first two would be ICD-10 tracks suitable for the ASM (ideally Orlando in 2015 due to timing prior to the current implementation date). The first 4-hour track would be a repeat of our basic ICD-10 coding seminar. The second would be a hands-on workshop spanning 3-hours, utilizing the CRC to present live lecture materials in a question and answer format. This session would require internet access to accommodate approximately 50 – 75 computers all tuned to the APMA CRC. A third track would be our regular coding clinic running 3-4 hours for membership. This basic coding clinic has not been presented in several years at the ASM and the CC feels membership needs an updated basic coding lecture on all aspects of the podiatric practice. The CC also recommends that ASM planners consider offering an APMA branded CSFAC / AAPC certification test as well as a preliminary advanced coding workshop preparatory session. These have been offered at previous ASMs (Las Vegas 2013)

e. Review of ICD-10 LCDs, NCDs, and Medical Policies. The CC has offered to assist the CAC / PIAC members in their review of the revised LCDs, NCDs and medical policies. An ICD-10 lecture was held at the most recent CAC-PIAC meeting in November 2014 and the offer was repeated.

f. APMA Leadership Role in ICD-10. APMA staff is developing a one-page document for APMA senior staff and BOT members regarding the deletion of the 7th character and the laterality codes in ICD-10. This document could be used by BOT, APMA senior staff , and other representatives to discuss our recommendations with other medical associations and with Congress. Our advocacy for these two changes to ICD-10 could, we feel, start a ground swell and lead to significant traction of our positions with the other medical associations and Congress. Those two issues are:

1. The ability to dual code claims in either ICD-9 or ICD-10 for a period of up to a year after the stated transition date of October 1, 2015. If there are issues, either actual or perceived with ICD-10 then we would advocate for a delay in ICD-10 and the ability to continue using ICD-9 until such time as those issues and problems have been resolved to everyone’s satisfaction.

2. The elimination of the 6th character or laterality code and elimination of the 7th character extension.


2. Young Physicians. a. Power Points. The CC has begun to provide to Dr Salvo, the Director of the YP program, PowerPoints presentations and other materials that CC members have already developed, for the use by YPs. We will let the YP Director determine how these power points can best benefit YP membership.

b. Fees. The CC repeats its recommendation to reduce the tuition to the stand-alone meetings for YPs. The CC welcomes feedback from the BOT on one suggestion, which is that once the seminar has been completed by the YP, APMA could consider refunding that tuition.

3. Coding Resource Center. The CRC remains the preeminent foot and ankle coding resource on the web and is completely ICD-10 ready. Based on staff reports, there are now almost 1400 current subscriptions to the CRC with approximately 84% coming from renewals. This is slightly down from the previous high but should pick up due to targeted marking efforts and approaching ICD-10 effective date and price change in Sept 2015. Subscription history for the past rolling twelve months is as follows:

Number of Subscriptions Revenue

Online Subscription Renewal 1,080 $ 191,766.50 Online Subscription 207 $ 47,871.00 Grand Total 1,287 $ 239,637.50

4. Global Surgical Services Report. The GSSR review has stagnated as no progress has been made since our last report. One final push by a small subcommittee workgroup should be enough to complete the GSSR and allow it to be posted to the member’s-only side of the APMA web site. 5. Coding Issues. There remain a few other coding issues of concern to the CC chair and staff liaison. To that end, these issues will be brought up at our next annual CC meeting, if not sooner, for review and discussion. Once a determination has been reached by CC, we will disseminate our conclusions to membership.


COMMUNICATIONS COMMITTEE REPORT COMMITTEE MEMBERS: Chair: Jacqueline M. Sutera, DPM, NJ Leslie Campbell, DPM, TX Alex Kor, DPM, MD Megan R. Leahy, DPM, IL Roderick C. Hunter Jr., DPM, TX, Young Physician Edison K. Picklesimer, DPM, NC Ami A. Sheth, DPM CA Wenjay Sung, DPM, CA Grace E. Torres-Hodges, DPM, FL Cary M. Zinkin, DPM, FL Jeffrey R. DeSantis, DPM, BOT Liaison Jean Kirk, VA, ASPE Liaison Marlene Reid, DPM, IL, Special Expert (Shoe Gear) Staff Liaison: Peggy S. Tresky, MA DATE OF MOST RECENT MEETING: September 6, 2014 (in person) COMMITTEE ACTIVITIES: 2014 Diabetes Campaign The committee directed staff to retain the “outsmarting diabetes” theme for the 2014 campaign, now underway. Committee members supported the creation and early distribution of a digital toolkit for components and affiliates to use in implementing their own diabetes campaigns; the digital toolkit was disseminated to states in October. APMA Mobile App The committee discussed preliminary plans for an APMA mobile app. This app would be different from the current app used for The National. Discussion focused on the features members would find most useful, including a news feed, event calendar, e-Store, and practice management information. APMA staff currently are in the research and planning phase. Development of the app will begin in the summer of 2015 at the earliest. Online Resources The committee also discussed enhancements to practice promotion tools available on apma.org, as well as resources designed to assist members in local media outreach. They also suggested enhancements for other areas of the site, including resources for state components. Strategic Communications Plan/ Young Physicians The committee reviewed APMA’s Strategic Communications Plan. Because the BOT and senior staff will meet in July 2015 to create a new Strategic Plan for the organization, the committee will not make any updates at this time. APMA News The committee members reviewed recent issue of APMA News. The publication is in the process of undergoing a minor refresh. Committee members expressed the desire to see more graphics, lists,


and snippets of information and less pages of all text. Additionally, members would like to see more variety from month-to-month but recognized the importance of consistency. The committee also questioned the necessity of publishing 10 copies a year. 2014/2015 Spring Foot Health Campaign The committee brainstormed ideas for the 2015 Spring Foot Health campaign. Discussion gravitated toward a focus on sports medicine, with the suggestion that the campaign should convey that a sprained ankle or injured foot should be treated by a podiatrist, not an internist or orthopedist. Social Media APMA continues to enjoy tremendous penetration with the public through Twitter, while members tend to connect through our Facebook and LinkedIn accounts. The committee suggested social media workshops at The National, as well as dedicated space/staff to assist members who want to learn more about social media. Brochures The committee continues to work on updating patient foot health brochures and suggested all brochures be made available in Spanish.


DEVELOPMENT COMMITTEE REPORT COMMITTEE MEMBERS: Chair: R. Daniel Davis, DPM, BOT David Edwards, DPM, BOT Matthew G. Garoufalis, DPM, BOT Sylvia Virbulis, DPM, BOT Phillip E. Ward, DPM, BOT Glenn B. Gastwirth, DPM, APMA Executive Director Dennis R. Frisch, DPM, BOT, AMC Liaison Staff Liaison: Heather E. Palmer, MA, MBA DATE OF MOST RECENT MEETING: July 23, 2014 COMMITTEE ACTIVITIES:

• 2014 APMA National Meeting Results: Total grant and sponsorship was approximately $917,750 which included speaker revenue, grants and sponsorship from 28 companies. This total net revenue exceeded our 2014 goal by approximately $92,750. The revenue goal was set at $825,000 and reflects the increased uncertainty of support from one year to the next. Many factors play a part in this uncertainty including new rules and regulations surrounding giving and a decrease in loyal established donors. The exhibit hall for the 2014 hosted 99 exhibitors and generated $243,300 in revenue. Additional income from pre/post-meeting registrant data sales totaled $4,500. Total revenue for exhibit and sponsorship combined was $1,165,550.00. Support fell short of the combined goal of $1,175.00 by $9,450 or less than 1%.

• 2015 APMA National Meeting Proposal Status - report to-date: Currently we have commitments from Valeant, PICA, Bako, HealthFusion, Asics, Crealta, MediUSA, Upsher-Smith & New Step Orthotics for a total of $330,000. An additional 25 proposals have been submitted and are pending totaling approximately $850,000.

2015 Annual Meeting Prospects

Grant/Sponsor

PENDING Grant/Sponsor

Committed Diamond ($125,000) Merz (BS, and Gen. Sess x2) $79,000.00 Merz - (coding wkshp/non-cme breakfast sponsorship) $17,000.00 Merz - (Opening session) $25,000.00 Merz - (Faculty Reception) $20,000.00 PICA - Risk Management $ 50,000.00 Valeant (LS w/ Plenary, BS and GS) $100,000.00 Valeant (non-CECH Program) $ 50,000.00


Valeant (Key Cards - $8,000 w/ net of $2,500.00 - in 2014…. 2015 WILL COST MORE …. Awaiting printing costs from new vender via Anne and WCM)

$10,000.00 Valeant (Meter Boards - Exclusive for all 8…. Will not do exclusive die to availability of more meter board signage… should offer up to 16 to min of 2 sponsors)

$15,000.00 Platinum ($100,000) Bako Integrated Physician Services (Plenary) $ 50,000.00 HealthFusion (GOLD - General) $ 75,000.00 HealthFusion (YPP Title sponsor) $ 25,000.00 Gold ($50,000) PharmaDerm - NON-CECH (WE need to propose non-CECH programs for total of $50,000) $50,000.00 Sandoz - (CECH Grant for BS, Plenary and GS) $50,000.00 Organogenesis (Wound Care Track and non-Cme lunch) $25,000.00 Smith & Nephew (Plenary) $57,500.00 Smith & Nephew Ortho - LONG SHOT for BS or plenary Smith & Nephew (In-Kind donation of use of towers)

Hollister $50,000.00

Vionic (GS track TITLE and PFA track TITLE) 50,000.00 Crystal ($35,000) Mallinckrodt Pharmaceuticals $35,000.00 Silver ($25,000) Aetrex (GS on DPM and GS on PFA) 25,000.00

Asics $ 25,000.00 BioVentus - LONG SHOT for BS or Plenary Crealta (Formerly Savient) $ 25,000.00 DJO/Dr. Comfort 25,000.00 MediUSA (General Session, YPP Reception) $ 25,000.00 Mimedx (GS 12,500 and YPP track and reception 12,500) 25,000.00 Acelity/KCI 25,000.00 RTI Biologics (BS) 25,000.00 Spenco (General SILVER for closing reception and Assistants' Program) 25,000.00 Bronze ($15,000) New Balance 15,000.00 Pewter ($10,000) ACell (General Session) 12,500.00 BioMet (YPP) 10,000.00 BSN (GS track) 12,500.00 Cutting Edge Laser (GS track) 12,500.00 Stryker Foot & Ankle (General Session) 10,000.00


Universal Ultrasound (In-Kind for U-S workshop) 2,500.00 Vasamed (GS Track support) 12,500.00 Copper ($5,000) ABPM 5,000.00 ICS Software 5,000.00 Medline 5,000.00 New Step Orthotics $ 5,000.00 SureFit 5,000.00 The Tetra Corporation 5,000.00 Upsher-Smith $ 5,000.00 Total 846,000.00 $ 330,000.00

• Corporate Membership: We have 7 companies that have renewed or joined APMA in 2014 as a

basic corporate member. Corporate membership of $2,500 is our basic/entry level sponsorship. These companies have provided nearly $14,000 in support of the podiatric profession. The companies include: Gebauer Company, Histology Associates, Inc., Osiris Therapeutics, Inc., Pedag USA/Schelchen GmbH, ProLab Orthotics/USA, Straight Arrow Products, and SISA Spa. Companies such as ICS Software, Ltd. and Vasamed bumped their membership level up to $5,000 as a copper sponsor for the National meeting in 2014.

• Special project sponsorships are as follows. (Several are still pending.) REdRC – The following sponsors have renewed for year III; KCI, Bako, PICA, MediTouch, and Merz. We are awaiting confirmation from Organogenesis however this is unlikely for year III.

APMA On-line Coding Resource Center – A proposal has been submitted to Merz for renewal consideration for the 7th year in a row as the exclusive sponsor of CRC.

APMA Young Physicians’ Program Institute – A proposal has been submitted to Merz for

funding consideration for the 4th year in a row for support of the YPP Institute. APMA Weekly Focus – Exclusive sponsorship renewal by UPSHER-SMITH LABORATORIES,

INC. in progress for 2015. YPP News Insert in APMA News – Looking for a new exclusive sponsor. A proposal has been

submitted to Valeant Pharmaceuticals for exclusive sponsorship. Lecture Series Program – Formal signed agreement pending a non-CECH lecture lunch

program by Valeant Pharmaceuticals for National and 4 major regional sites. Verbal approval received. Logistics and requests to regional sites is in the works.

CECH Lecture Series Program – A proposal is pending with Hollister for an unrestricted

educational grant for wound care lecture series program in 2015 for National and 4 major regional sites.


“Footprints” custom newsletter, walking campaign and Career Center sponsorship – A proposal is pending with Spenco at Partner level for multiple projects. Their sponsorship also includes support for the APMA National. Social Media Sponsor – A proposal is pending with Valeant Pharmaceuticals. A second Matching Grant at HOD for Scholarship Launch – A proposal is pending with Valeant Pharmaceuticals.


FINANCE COMMITTEE REPORT COMMITTEE MEMBERS: Ira H. Kraus, DPM, Chair R. Daniel Davis, DPM Dennis R. Frisch, DPM Andrew Shapiro, DPM Patrick DeHeer, DPM Barry E. Wesselowski, DPM Richard Bloch, ASPE Observer Staff Liaison: John A. Lieske, CPA DATE OF MOST RECENT MEETING: The Finance Committee’s most recent meeting was held on November 12, 2014 via conference call. COMMITTEE ACTIVITIES: Various topics were discussed at the committee’s November meeting. The most recent fiscal year’s audit as of May 31, 2014 was reviewed in detail and all questions were answered. We once again received an “unqualified” opinion. Net assets increased by $428,000 for the fiscal year, mostly due to the return on investments. From an operations perspective, APMA ended the year with a small net gain of $17,000. The budget statements thru September 2014 were also reviewed by the Director of Finance and questions were answered regarding the most recent ASM activity and results from Hawaii. Finally, the 3rd quarter investment report was summarized by the Director of Finance and two action items were brought before the committee regarding recommended changes from our advisors to replace specific investment managers due to performance/turnover issues. The committee voted on these changes and they were approved unanimously. The first five months of budget statements thru October 2014 have been distributed. Information needed to complete the 990 tax returns for the latest fiscal year is being accumulated for submission to the auditors. Insurance policies for the upcoming year have been updated and renewed.


HEALTH POLICY AND PRACTICE COMMITTEE REPORT COMMITTEE MEMBERS: Mark Block, DPM (FL), Chair Bruce Blank, DPM (OH) Jeffrey Crowhurst, DPM (IL), Chair, APMA Carrier Advisory Committee Kirk Geter, DPM (DC), Chair, Private Insurance Subcommittee Scott Hughes, DPM (MI) Franklin Kase, DPM (CA) Luke Kovatch, DPM (IL) Frederick Mechanik, DPM (CO) Edward Prikaszczikow, DPM (IA), Chair, Medicare Subcommittee Robert Russo, DPM (NY) Jeffrey DeSantis, DPM (CA), Board Liaison Phillip Ward, DPM (NC), President-Elect, CPT liaison Paul Kesselman, DPM (NY), DME Special Expert Jondelle Jenkins, DPM (IL) Dual Eligible Special Expert Don Blum, JD, DPM (TX), Medicare Subcommittee Special Expert Barron Elleby, DPM (GA), Private Insurance Subcommittee Special Expert Paul Kinberg, DPM (TX), Chair, APMA Coding Committee Laura Pickard, DPM (IL), Board Liaison, CPAAG Josh White, DPM (NY), DME Workgroup Staff Liaisons Scott L. Haag, MSPH, JD, Director, Health Policy & Practice/Center for Professional Advocacy Natasha Pattanshetti, JD, MPH, Policy Analyst, Health Policy & Practice/Center for Professional

Advocacy Gail Reese, JD, Policy Analyst, Health Policy & Practice/Center for Professional Advocacy DATE OF MOST RECENT MEETING: In-Person Meeting: May 2 – 3, 2014 Leadership Call: November 12, 2014 COMMITTEE ACTIVITIES: DPMs, Scope of Practice Under Siege from Numerous Fronts As we enter the fall of 2014, APMA is responding to challenges to DPM scope of practice on a number of fronts, from MACs and DME MACs with respect to hyperbaric oxygen therapy (HBOT) supervision and pneumatic compression device (PCD) prescribing respectively. The merger of the Health Policy and Health Systems committees into the Health Policy and Practice committee (HPPC) continues to progress smoothly. The committee has been conducting monthly calls for HPP leadership to refine our strategic direction on a regular basis. Physician Payment Sunshine Act (Open Payments) CME Speaker Payment Reporting Exemption CY 2015 MPFS Final Rule released October 31 removes specific reporting exemption for CME speaker payments for CME programs run by certain accrediting/certifying organizations, which omitted CPME. All accrediting/certifying organizations are now on equal playing field (DPM, MD, DO, etc.) The Final Rule appears to clarify that CME speaker payments where the industry sponsor


does not select the physician speaker are not reportable. This clarification is a large advocacy win for APMA due to our focused and relentless efforts to address the inequality in excluding CPME and therefore DPM-related CME meetings run by CPME-approved sponsors from the reporting exception. Alternative Payment Models and Reimbursement Reform CMS and other payers continue to focus on participation in alternative payment models. These reforms are designed to help alleviate cost pressures and incentivize efficient and quality care. HPPC notes that identification and creation of these models will be crucial for member participation in incentive opportunities under the current and future CMS reimbursement structures, where participation in PQRS, meaningful use, alternative payment models, qualified clinical data registries, etc. will determine in which compensation bucket Medicare physicians will be placed. 14th Annual Joint National Podiatric CAC-PIAC Representatives’ Meeting The CAC-PIAC meeting took place in Washington, DC on November 7 – 8, 2014. Meeting attendees included CAC and PIAC representatives, state component leaders, APMA leadership, HPP leaders, and APMA staff. Kathy Bryant, JD, Director, Division of Practitioner Services, CMS, HHS, and Henry Demarais, MD, MPA, Health Policy Alternatives (APMA Consultant) addressed Medicare policy issues, including the Medicare Physician Fee Schedule for CY 2015, change from 10-day and 90-day global periods to 0-day, value-based modifier, and Medicare physician payment reform. Erika Williams, MPA, Medicare National Supplier Clearinghouse presented on “Understanding Physician Supplier Enrollment and Related Issues.” William Rogers, MD presented on physician regulatory issues, including Medicare RAC reform and Medicare Advantage. Attendees heard federal legislative and ICD-10 updates from Seth Rubenstein, DPM, Trustee, Chair, Federal Legislative Committee and Harry Goldsmith, DPM, APMA Consultant, respectively. J. Kevin West of Parsons Behle & Latimer explained leading sources of audits and how to protect practices and then participated in a DME panel with Paul Kesselman, DPM Chair, APMA DME Workgroup, Mark Block, DPM, and Harry Goldsmith, DPM, where panel members showed a preview of the APMA documentation guide for Medicare’s Therapeutic Shoe Program for Patients with Diabetes (discussed later). David Freedman, DPM, Former Chair, CAC Subcommittee explained BMAD analyses relevant to podiatric physicians. Phill Ward, DPM, APMA President Elect, and Laura Pickard, DPM, APMA Trustee presented on APMA HPP Initiatives. One of the highlights was and continues to be the CAC and PIAC breakout sessions, which HPP leaders moderated. Jeff Crowhurst, DPM, Chair, CAC Subcommittee and Ed Prikszczikow, DPM, Chair, Medicare and Other Public Payer Subcommittee stressed to meeting attendees the importance of sharing information from this meeting and in general with their state components and members. Meeting materials can be found at www.apma.org/CACPIAC. Member Education / Reimbursement Webinar Series APMA once again hosted its Reimbursement Webinar Series. This webinar series ran from January through June and covered such topics as Affordable Care Act, SGR, Medicare Incentive Programs, Medicare Advantage, and provider enrollment. Webinars are available at www.apma.org/webinars. HPPC plans to renew the webinar series in the winter and spring of 2015, with such topics as ACA update, alternative payment models and VBM, correct coding of routine foot care, and so on. Medicare and Public Payer Subcommittee The Medicare and Public Payer Subcommittee, formerly the Health Policy Committee, is engaged in policies, programs and other activities to position the DPM as the recognized foot and ankle care specialists within public healthcare delivery and financing systems and to work for appropriate reimbursement for podiatric physicians.

http://www.apma.org/CACPIAC

http://www.apma.org/webinars


Membership Assistance / Regional Issues The Medicare and Public Payer Subcommittee has assisted PPMA and NYSPMA on issues related to pending legislation expanding fitting privileges to pharmacists and with prepayment audits for homecare E&M codes respectively.

• With respect to PA, APMA determined that the pending state legislation should have no impact on a PA member’s ability to order, dispense, and fit DMEPOS under federal law.

• In NYS, APMA working alongside NYSPMA with NGS better to understand the impetus for prepayment audits directed at DPMs. With NYSPMA taking the lead, APMA and NYSPMA will follow up with member education and communication.

Other examples of assistance the Medicare and Public Payer Subcommittee provided:

• In Novitas states (JH and JL) CAC representatives were successful in having a draft LCD limiting DPMs’ ability to supervise HBOT withdrawn. APMA’s HPPC provided over the shoulder advice and support.

• HPPC working with Novitas CAC representatives on skin substitute LCD to clarify DPMs' ability to establish medical necessity and correct improper guidance on product wastage.

• AZ: HPPC recommended to AzPMA an amendment to DMEPOS state legislation that references federal exemption from accreditation for DPMs and other physicians dispensing/supplying to their patients.

Strategic Priorities Diabetic Therapeutic Shoes: On April 25, HR 1761, the HELLPP Act, was introduced in the 113th Congress by US Rep. Lee Terry (R-NE). As you are aware, the HELLPP Act will clarify and improve coordination of care in Medicare’s Therapeutic Shoe Program for Patients with Diabetes. As part of this effort, APMA’s HPPC and APMA’s health policy consultants helped create a provision that would clarify the role of a prescribing podiatric physician in terms of establishing medical necessity, and consequently ease the reporting burden on all physicians involved in the TSD program. To highlight the need for a federal legislative fix, APMA met with CMS in September and the meeting was a bit contentious and had overtones of real resistance on the part of CMS. APMA and CMS reached a consensus that:

1) There is a problem with this program, particularly in the area of documentation; and 2) The problem largely exists at the interface between supplying DPMs, MDs and DOs

and certifying MDs and DOs.

In an effort to address the documentation issues associated with this program, APMA, including the DME Workgroup, partnered with J. Kevin West of Parsons Behle & Latimer to create a documentation guide for this program, which will be released to the membership in the near future.

RAC Activities: HPPC worked with LA to provide support to pending RAC reform initiatives. In a letter of support on July 18, APMA endorsed the “Medicare DMEPOS Audit Improvement and Reform (AIR) Act of 2014” (HR 5083) legislation recently introduced by US Rep. Renee Ellmers (R-NC). The bill would reform the Medicare audit process for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) claims and make it more efficient, consistent, and equitable in a number of ways. It would increase transparency by Medicare Administrative Contractors (MACs) and Recovery Audit


Contractors (RACs), require more education and outreach on the part of these auditing bodies, set new limits on how far back auditing bodies could search claims, and would reward suppliers that have low error rates on audited claims.

Payment Reform: HPPC is curious to see what the recent election results mean for meaningful physician reimbursement reform. Will Congress act to reform Medicare physician payment in the near future? APMA previously responded to the House Ways & Means and Senate Finance Committee Discussion Draft (Spring 2014), which was a bi-cameral and bi-partisan discussion draft to repeal SGR and reform Medicare physician payment. HPPC seeks to ensure fair and adequate payment and the inclusion of DPMs in all alternative payment models (APMs). HPPC and the Legislative Departments have been actively involved in SGR repeal and Medicare physician payment reform advocacy efforts, writing comment letters to congressional committees, and attending Q&A sessions.

Alternative Payment Models / ACOs: HPPC will be taking the lead on identify DPM services that may lend themselves to establishing alternative payment models, where DPMs will be willing to take on risk in exchange for preferential CMS reimbursement. APMA’s ACO resources, located at www.apma.org/ACO, include recorded webinars, policy briefs, and contact information. HPPC is currently assessing podiatrists’ involvement in ACOs, and is soliciting additional information from participating DPMs.

Qualified Clinical Data Registries and Quality Payments: HPPC continues to support efforts to develop a data registry for podiatrists. At the HPPC meeting in May, Dr. James Christina discussed the new Qualified Clinical Data Registries and APMA relationships with US Wound Registry (USWR). The primary goal of APMA’s relationship with USWR is to provide data to APMA for its clinical practice improvement initiatives and research functions, and secondary goal is to assist APMA members in complying with CMS incentivized reporting requirements including stage 2 and meaningful use, PQRS and value based purchasing under the Affordable Care Act. APMA continues to communicate the value to members of participating in the registry. The Medicare and Other Public Payer subcommittee recommends creating hypothetical examples (cost and time investment, return on investment, other effects on practice) be provided to the membership. Consequently, more information on cost, process, and penalties will be shared on the HPP leader calls.

TRICARE: HPPC awaits publication of the final rule to allow DPMs to prescribe and dispense DME under TRICARE programs. On August 8, 2013, the Department of Defense (DoD) released a proposed rule that would allow DPMs to prescribe and dispense DME to TRICARE patients. TRICARE reports to APMA that the final rule is in coordination at the Washington Headquarters Services Legal Counsel Office, after which it will be sent to the Regulatory Policy Office (RPO) for final coordination. TRICARE also indicated that there are no significant oppositions to the proposed amendments.

Skin Substitutes: APMA remains vigilant on the issue of skin substitutes through CAC efforts as well as participation in the Alliance for Wound Care Stakeholders. The Medicare and Other Public Payer subcommittee recommends that members advocating for certain products do so on their own behalf, and indicate that their opinions are independent from APMA. APMA maintains a position of broad inclusion reflective of DPM needs. HPA has

http://www.apma.org/ACO


warned APMA that the packaging/bundling policies could be adopted in the outpatient/office setting.

Private Insurance Subcommittee The Private Insurance Subcommittee, formerly the Health Systems Committee, is engaged in several areas to further APMA’s mission to gain equitable reimbursement by private payers for podiatric physicians. APMA Resource Promotion: PIRG

The APMA Private Insurance Resource Guide (PIRG) is an underutilized resource guide with a wealth of materials for members. The Private Insurance subcommittee worked with communications to promote the PIRG through the APMA News and Weekly Focus. Additionally, APMA consultant Kelli Back, JD is updating the PIRG. PIRG is available at www.apma.org/PIRG. Member Assistance The Private Insurance Subcommittee has assisted a number of states on issues related to state legislation and regional payer issues:

• OR: Oregon’s state legislature passed physician definition legislation. As a result, large insurer will reimburse DPMs under physician fee schedule.

• TN: Private Insurance Subcommittee and the Center for Professional Advocacy (CPA) are providing assistance to TPMA on CIGNA fee schedule and other policy concerns.

• LA: Private Insurance subcommittee is assisting state members in working to obtain ability to perform H&Ps.

• NE: Private Insurance subcommittee provided assistance to the state resulting in successfully obtained ability to perform H&Ps.

• OH: APMA assisted Ohio members with continued denial by Humana Medicare Advantage plans. APMA reviewed several claims and recommended that the members review their coding and documentation procedures and continue to work with Humana to resolve the issue.

• OH: Private Insurance subcommittee worked with Ohio PIAC representative to address Aetna Medicare Advantage plans denying claims or requesting for medical records for routine foot care. APMA and OHFAMA spoke with Aetna’s national medical director, Chris Jagmin, MD, and theses issue have either been resolved or are being addressed by the members involved, state leadership, and Aetna.

Private Insurance Advocacy and Outreach APMA Provider Non-Discrimination Provision APMA responded to a request for information on the ACA Provider Non-Discrimination provision, issued by CMS, IRS, and the Employee Benefits Security Administration. In this comment letter, APMA asks that these agencies implement the provision in accordance with congressional intent. The comment letter addresses:

• defining discrimination; • discriminating with respect to coverage by excluding based on service type, not

provider type;

http://www.apma.org/PIRG


• discriminating with respect to participation, meaning plans cannot uniformly exclude specific types of providers from their networks or vary reimbursement solely based on provider type;

• prohibiting health plan policies with discriminatory impact; • prohibiting health plan downstream entities from engaging in discrimination; and • reporting to enforcement agencies in order to monitor compliance.

HPPC is awaiting proposed rules and other guidance from the agencies tasked with implementing the provision.

Multiplan APMA, with legal assistance, drafted a letter addressed to the general counsel of Multiplan and the general counsels of major plans that contract with Multiplan This letter informs these plans that Multiplan is discriminating against DPMs with lower fee schedules than MD/DO colleagues, based solely on DPMs license, in violation of the ACA provider non-discrimination provision Outreach Efforts At its most recent meeting, the Private Insurance subcommittee decided that its next outreach target is Humana. APMA last met with Humana in 2009. Humana has a new Medical Director, Philip Painter, MD who referred us to Worthe Holt, MD, Vice President Clinical Innovation and Regional Lead, Humana. HPPC is in the process of setting up a meeting with Humana to discuss a number of national member issues.


LEGISLATIVE COMMITTEE REPORT October 2014 — Second Session, 113th Congress COMMITTEE MEMBERS: Chair: Seth A. Rubenstein, DPM, APMA Board of Trustees W. Cabell Adams, DPM Richard A. Altwerger, DPM Barney A. Greenberg, DPM, Chair, APMAPAC Randy K. Kaplan, DPM Margaret “Maggie” Kreutter, APMSA Liaison Terrence D. McDonald, DPM Eugene L. Nassif, Jr., DPM Priya Parthasarathy, DPM Ami A. Sheth, DPM Frank A. Spinosa, DPM, APMA President Staff Liaisons: Peter J. Stein, Director, APMA Legislative Advocacy Benjamin J. Wallner, Associate Director, APMA Legislative Advocacy Anita Elder, Legislative Advocacy Associate DATE OF MOST RECENT MEETINGS: The committee convened via conference call on:

• January 27, 2014 • February 17, 2014 • April 21, 2014 • May 19, 2014 • June 16, 2014 • July 21, 2014 • September 15, 2014 • October 20, 2014


COMMITTEE ACTIVITIES: The Committee and Legislative Advocacy Department continue to be active on a number of fronts, with a primary focus on promoting and advocating support for our signature federal legislation to recognize DPMs as physicians under Medicaid (the HELLPP Act), and also pursuing a remedy to our VA pay scale inequity problem. Also figuring prominently into our advocacy agenda are the preservation of and appropriate implementation of the “provider non-discrimination” provision in the health reform law, and appropriate modifications to the regulations implementing the Physician Sunshine Payments Act. APMA LEGISLATIVE PRIORITIES Medicaid Recognition of DPM as Physician The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act (HR 1761) was introduced in the US House of Representatives by US Reps. Lee Terry (R-NE) and Diana DeGette (D-CO), and in the Senate by US Sens. Charles Schumer (D-NY) and Chuck Grassley (R-IA) (S 1318). The bill retains the same essential legislative language as previous years’ bills, would recognize the services of podiatrists as physician services in the Social Security Act’s Title XIX/ Medicaid statute, and would specifically identify podiatrists as physicians. The HELLPP Act also contains two additional important provisions:

• Budgetary Offset: By closing a loophole that allows tax-delinquent Medicaid providers to still receive full Medicaid reimbursements, this provision will save the Medicaid system money and more than offset any additional federal budget costs associated with the recognition of podiatrists as physicians under Medicaid. Such a mechanism already exists in Medicare so this could save billions of dollars for the public health-care system.

• Broader Patient Access Appeal: We heeded the suggestion of our Capitol Hill sponsors to include a discrete, targeted MEDICARE provision to remove confusion and regulatory inconsistencies in the provision of Medicare therapeutic shoes for patients with diabetes.

As of October 15, 2014 HR 1761 has 114 bipartisan cosponsors, and S 1318 has 10 cosponsors. APMA’s Legislative Advocacy Department has been actively working with Hart Health Strategies on more than 200 Capitol Hill meetings urging cosponsorship. This has included meetings with all Republican Senate offices.

We continue to share periodically lists and summaries of these meetings with the Legislative Committee members and ASPE leaders urging that they complement these meetings through their grassroots membership mobilization to ask for similar cosponsorship. The provisions of the HELLPP Act were included in the main Senate Medicare SGR permanent reform bills (S 1871, S 2110, S 2122 and S 2157). Unfortunately, these bills have been held hostage to a partisan stand-off where Republicans and Democrats cannot agree on a method to pay for the SGR overhaul.


We continue to work to garner cosponsors in both the House and Senate, and are laying the foundations to retain the HELLPP Act in any final SGR legislation, and to seek other moving legislative vehicles to which we may attach the HELLPP Act provisions. Additionally, through Legislative Committee Chair Dr. Seth A. Rubenstein’s “Concierge Lobbying” campaign, we invited presidents from TX, OH and PA have come to Washington, DC to lobby on the HELLPP Act to their respective congressional delegations, and had their grassroots membership follow-up accordingly. We hope to engage in additional states soon. CMS Meeting on Therapeutic Shoes for Persons with Diabetes (TSD) Most recently, regarding our issues with therapeutic shoes for persons with diabetes (TSD), on September 10 APMA Legislative Advocacy department helped set up a meeting with CMS – at the suggestion of congressional staff – to see if there was any guidance or direction that CMS could provide to the DME MAC medical directors,

1) if any regulatory pathway for solutions was available, or 2) if they could provide technical assistance with the legislative language in the HELPP Act to address the inconsistency between interpretation of statutory policy and the documentation requirements related to the TSD program which are inconsistent across DME MACs.

The meeting was somewhat uneventful, a bit contentious and had overtones of real resistance on the part of CMS. If nothing else, we were able to gain consensus with CMS that:

1) There is a problem with this program, particularly in the area of documentation; and 2) The problem largely exists at the interface between supplying DPMs, MDs and DO’s and certifying MDs and DOs

We ended up with two potential solutions, one workable and one likely not: 1) Implementation of Prior Authorization (according to CMS, this process would take about 2 weeks) – this seemed like a losing proposition, especially for the impact it would have on beneficiary care; 2) Development of a “template” or “Form” (CMS stated that they do not like to use the “F” word, form) to educate certifying MD-DO’s about proper necessary foot exams, but which would also insulate DPMs from ordering shoes that weren’t sufficiently documented on the certifying MD-DO’s part. This may be accomplished through “e-clinical templates” or other means.

Medicare Physician Payments APMA continues to urge Congress to repeal Medicare’s flawed SGR payment formula and eliminate the uncertainty it creates for physician practices. We have been part of stakeholder policy discussions with Congress on ideas for what a reformed Medicare physician payment system should look like. APMA has submitted public comments to the US Senate Finance Committee, and the House Energy & Commerce and Ways & Means Committees on this important health-care delivery issue. APMA has also been invited to stakeholder discussions with congressional staff. In some early legislative drafts of the main House and Senate bills on SGR reform we were successful in beating back language that would have bifurcated Medicare’s “physician” definition, and created a provider classification for update incentives that would not be available to non-MD/DO specialist providers. Working in concert with coalition allies we were able to strike the offending language.


US Department of Veterans Affairs (VA) and Podiatry Federal Advocacy department staff have been meeting with targeted congressional offices on our VA / DPM recruitment and retention issues. We continue to provide updates on these Hill activities to Federal Services component leadership, and communication has been ramped up between APMA and US House and Senate VA and Armed Services committees (over 40 congressional visits conducted since June 2014) seeking speedy resolution to our VA issues. The ultimate goal is to put pressure on VA to request from Congress that changes be made in statute to recognize podiatrists under the VA's Physician & Dentist Pay Band.

113th Congress – Cross Section of Federal Bills Monitored/Addressed by APMA

Updated October 15, 2014 Medicare / Medicaid S 1180/ HR 2843 Claims Data Publication Bill; APMA opposes; Sponsors – Sen. Grassley (R-IA);

allows CMS to publish information about individual physicians’ [“any provider or supplier of services” under Title XVIII (Medicare) which includes podiatrists] claims and payments; 4 cosponsors; Introduced 6/18/2013; House companion introduced 7/25/2013 by Rep James Sensenbrenner (R-WI); 2 cosponsors; Official Title: Medicare Data Access for Transparency and Accountability Act. [After a court ruling lifted a decades-old ban, on April 9, 2014 CMS released to the public a data set of physicians’ Medicare claims—including billed charges and total payments]

HR 1250/S 1012 Hospital Medicare RAC/Audit Improvement; APMA supportive; Sponsors – Rep. Sam

Graves (R-MO) and Sen. Roy Blunt (R-MO); aims to introduce health care provider clarity on problematic areas of the RAC program, and improve auditor performance by introducing penalties for those auditors that do not comply with basic program requirements; 231 cosponsors; Introduced 3/19/2013; Senate companion bill introduced 5/22/2013; has 16 cosponsors; Official title: Medicare Audit Improvement Act of 2013

HR 1310/S 236 Private Contracting Bill; APMA supports; Sponsors – Rep. Price (R-GA) and Sen.

Murkowski (R-AK); allows all Medicare physicians [1861(r) which includes podiatrists] to contract privately with individual patients for certain services without incurring penalties of the current Medicare opt-out law; HR 1310 introduced 3/21/2013; 25 cosponsors; S 236 introduced 2/7/2013; 5 cosponsors; Official Titles: Medicare Patient Empowerment Act (additional similar bills introduced; none as viable as HR 1310/S 236)

HR 1331 Electronic Health Records Penalty Relief; APMA supportive; Sponsor – Rep. Diane Black

(R-TN); Introduced 3/21/2013; 37 cosponsors; would allow EHR/Meaningful Use exemptions from penalties for failure to adopt in specified time for solo medical practices and those practitioners near retirement; would also allow providers to meet meaningful use quality reporting requirements through participation in specialties’ disease or practice registry programs recognized by HHS, and require CMS to establish an appeals process for those providers penalized under Medicare for not meeting meaningful use; Official title: Electronic Health Records Improvement Act

HR 1761/S 1318 APMA Physician Recognition/Definition in Medicaid Bill; US Reps. Lee Terry (R-NE)

and Diana DeGette (D-CO) introduced the House bill on April 25, 2013; 114 cosponsors; Official title: Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act; Senate companion bill introduced on July 18, 2013 by US Sens. Charles Schumer (D-NY) and Chuck Grassley (R-IA); 10 cosponsors; On 12/12/13, HELLPP provisions (without the budget offset section) adopted as an


amendment to the Senate Finance Committee’s SGR Repeal and Medicare Beneficiary Access Improvement Act (S 1871); HELLPP provisions also included as part of the following permanent SGR overhaul bills: S 2110, S 2122 and S 2157

HR 2375 DMEPOS Competitive Bidding; APMA has no stated position, would prefer to see program

disappear; Sponsor – Rep. Glenn Thompson (R-PA); delays indefinitely Medicare’s competitive acquisition program for DME until an outside auction expert review of Round 1 takes pace and a Round 1 rebidding takes place based on the outside panel’s review; DPMs exempt from competitive bidding except for DMEPOS for their patients; few products DPMs provide require competitive bidding; DPMs also exempt from DMEPOS supplier accreditation requirement; awaiting House committee action; 36 cosponsors; Introduced 6/14/2013; Official Title: Transparency and Accountability in Medicare Bidding Act.

[Similar House bill introduced to halt current DME competitive bidding program and replace it with specific market-oriented metrics; Sponsor – Rep. Tom Price (R-GA); HR 1717 Introduced 4/24/2013; 157 cosponsors; Official title: Medicare DMEPOS Market Pricing Program Act of 2013]

HR 2545 Medicare Relative Update Committee (RUC); APMA closely monitoring; Sponsor – Rep.

McDermott (D-WA); loosely based on MedPAC recommendation, changes the way CMS sets fees with a likely emphasis favoring primary care physicians; issues of concern expressed by APMA and other organizations participating in the RUC process; not expected to move out of House committee; 2 cosponsors; Introduced 6/27/2013; Official Title: Accuracy in Medicare Physician Payment Act of 2013; a version of this bill was passed into law in the Protecting Access to Medicare Act (P.L. 113-93)

HR 2914 Repeal of Certain Stark Law Exemptions; APMA monitoring; Sponsor – Rep. Jackie Speier (D-

CA); would prohibit under Medicare self-referral for four complex services—advanced imaging, anatomic pathology, radiation therapy and physical therapy; would increase penalties for improper referrals and create new compliance review procedures, and would clarify that physician groups participating in Accountable Care Organizations in the Medicare Shared Savings Program can continue to provide integrated services; introduced 8/1/2013; 13 cosponsors; Official Title: Promoting Integrity in Medicare Act of 2013

HR 5083 DMEPOS Audit Reform; APMA supports; Sponsor – Rep. Renee Ellmers (R-NC); would establish

education and outreach program for DMEPOS suppliers and auditors; sets forth structure for audits of DMEPOS suppliers, requiring a contractor to give priority to activities under the DMEPOS payment outreach and education program that will reduce improper Medicare payments based on technical errors, medical necessity, and fraud; requires the HHS Secretary to: (1) increase the maximum record requests made by Medicare DMEPOS contractors in auditing claims of suppliers with a relatively high audited claims error rate for DMEPOS payments, and (2) decrease the maximum record requests for suppliers with a relatively low error rate; limits the audit documentation review period for MACs to 3 years; introduced 7/11/2014; 36 cosponsors; Official Title: Medicare DMEPOS Audit Improvement and Reform (AIR) Act of 2014

HR 5481 EHR Meaningful Use Relief; APMA supports; Sponsor – Rep. Renee Ellmers (R-NC); would

allow providers to report their Health IT upgrades in 2015 through a 90-day reporting period as opposed to a full year; introduced 9/16/2014; 5 cosponsors; Official Title: The Flexibility in Health IT Reporting (Flex-IT) Act of 2014

Practice of Medicine / DPM and “Other” S 44 Malpractice Reform; APMA supports; Sponsor – Sen. Rob Portman (R-OH); introduced 1/22/2013; 2

cosponsors, not likely to move in the Senate; Official Title: Medical Care Access Protection (MCAP) Act


HR 1427 Bucshon Truth in Health-Care Marketing; APMA opposes; Sponsor – Rep. Bucshon (R-IN); passage not expected; AMA lobbying for it; APMA coalition letter of opposition sent on basis that bill is redundant and not necessary; working with PARCA to offset influence of AMA and AOA; 23 cosponsors; introduced 4/9/2013; Official Title: Truth in Healthcare Marketing Act

HR 1761/S 1318 APMA Physician Recognition/Definition in Medicaid Bill; US Reps. Lee Terry (R-NE)

and Diana DeGette (D-CO) introduced the House bill on April 25, 2013; 114 cosponsors; Official title: Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act; Senate companion bill introduced on July 18, 2013 by US Sens. Charles Schumer (D-NY) and Chuck Grassley (R-IA); 10 cosponsors; On 12/12/13, HELLPP provisions (without the budget offset section) adopted as an amendment to the Senate Finance Committee’s SGR Repeal and Medicare Beneficiary Access Improvement Act (S 1871); HELLPP provisions also included as part of the following permanent SGR overhaul bills: S 2110, S 2122 and S 2157

HR 911 Health Insurer Antitrust Reform; APMA supports; Sponsor – Rep. Gosar (R-AZ); would remove the

exemption from antitrust law that health insurers currently have; 17 cosponsors; Introduced 2/28/2013; Official Title: Competitive Health Insurance Reform Act (additional similar bills introduced; none as viable as HR 911)

HR 969 Medical Practice Freedom; APMA supportive; Sponsor – Rep. Tom Price (R-GA); passage not

expected; would prohibit HHS or any state from requiring any health care provider to participate in any health plan as a condition of licensure; 14 cosponsors; Introduced 3/5/2013; Official title: Medical Practice Freedom Act of 2013

S 1188/HR 2575 Definition of Full Time Employee / Employer Mandate Penalties under ACA;

APMA monitoring; Sponsors – Sen. Susan Collins (R-ME) and Rep. Todd Young (R-IN); Senate bill introduced 6/19/2013; House bill introduced 6/28/2013; would change the definition of “full time” under ACA to 40 hours per week (from current 30 hours), and the number of hours counted toward a “full time equivalent” employee to 174 hours per month; Senate bill has 19 cosponsors; House bill has 210 cosponsors; House Ways & Means reported the bill favorably 23-14 on 02/04/14; passed full House 248-179 on 04/03/14; Official titles: Forty Hours is Full Time Act of 2013; Save American Workers Act of 2013

HR 2817 Repeal of ACA’s Provider Non-Discrimination provision; APMA opposes; Sponsor – Rep. Andy

Harris (R-MD); would repeal Affordable Care Act’s health insurance prohibition of discrimination with respect to participation under a plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law; “0” cosponsors; Introduced 7/24/2013; Official Title: Protect Patient Access to Quality Health Professionals Act of 2013

HR 3303 The SOFTWARE Act; APMA supportive; Sponsor – Rep. Marsha Blackburn (R-TN); would

provide regulatory clarity regarding mobile medical applications, clinical decision support, electronic health records, and other health care related software; focuses FDA authority onto the products that pose a potential risk to human health.; 38 cosponsors; Introduced 10/22/2013; Official Title: Sensible Oversight for Technology which Advances Regulatory Efficiency Act of 2013

HR 4077 Physician Antitrust Reform; APMA supportive; Sponsor – Rep. John Conyers (D-MI); Exempts health care professionals, including individuals and entities, from federal and state antitrust laws in connection with negotiations with a health plan regarding contract terms under which the professionals provide health care items or services for which plan benefits are provided. Declares that this Act: (1) applies only to health care professionals excluded from the National Labor Relations Act; and (2) does not apply to such negotiations relating to Medicare or Medicaid programs, the Children's Health Insurance Program (CHIP), medical and dental care for members of the uniformed services, veterans' medical care,


the federal employees health benefits program, or the Indian Health Care Improvement Act; 4 cosponsors; Introduced 02/25/2014; Official Title: Quality Health Care Coalition Act of 2014

Affordable Care Act HR 45/S 177 Healthcare Reform Repeal; House sponsor – Rep. Bachmann (R-MN); passed in U.S. House;

APMA takes no position on overall repeal but seeks to retain non-discrimination language in the Affordable Care Act (ACA); introduced 1/3/2013; 128 current cosponsors; HR 45 passed the House 229-195 on 5/16/13; US Senate sponsor – Sen. Ted Cruz (R-TX); introduced 1/29/2013; 41 cosponsors; Senate action not likely. Official Senate title: ObamaCare Repeal Act

HR 351 /S 351 IPAB Repeal; APMA supports, as do the AMA, AOA, and the majority of organizations

representing Medicare participating health care professionals; APMA sent its own letter to Congress and signed a coalition letter supporting repeal; Sponsors – Rep. Roe (R-TN) and Sen. Cornyn (R-TX); HR 351 has 227 cosponsors, introduced 1/23/2013; S 351 has 36 cosponsors, introduced 2/14/2013; Official Title: Protecting Seniors' Access to Medicare Act

HR 762 Repeal Title I of ACA/Provider Non-Discrimination Provision; APMA opposes; Sponsor –

Rep. Blackburn (R-TN); repeals Title I of the health reform law which contains APMA non-discrimination provision; puts in its place various market-oriented health insurance reforms, including the allowance of health insurance sales across state lines; one of several ACA “repeal or replace” bills in the US House; 23 cosponsors; Introduced 2/15/2013; Official Title: Health Care Choice Act of 2013

Related bills: HR 2300, the Empowering Patients First Act of 2013 (Rep Tom Price [R-GA]) with 59 cosponsors; HR 3121, the American Health Care Reform Act of 2013 (Rep David Roe [R-TN]) with 130 cosponsors

HR 2328/S 650 Medical Loss Ratio; APMA opposes; Sponsors – Sen. Mary Landrieu (D-LA) and Rep.

Rogers (R-MI); would alter the ACA’s medical loss ratio (MLR) requirement and allow insurance companies to spend larger percent of premiums on plan administration (specifically, allow insurers to exclude health insurance agent/broker commissions from medical loss ratio calculations), and less on medical care / patient benefits; one of several ACA “repeal or replace” bills in the U.S. House; HR 2328 has 105 cosponsors; Introduced 6/12/2013; Official Title: Access to Professional Health Insurance Advisors Act of 2013; Companion Senate bill (S 650) introduced 3/21/2013; has 12 cosponsors

HR 2575/S 1188 Definition of Full Time Employee / Employer Mandate Penalties under ACA;

APMA monitoring; Sponsors – Sen. Susan Collins (R-ME) and Rep. Todd Young (R-IN); Senate bill introduced 6/19/2013; House bill introduced 6/28/2013; would change the definition of “full time” under ACA to 40 hours per week (from current 30 hours), and the number of hours counted toward a “full time equivalent” employee to 174 hours per month; Senate bill has 19 cosponsors; House bill has 210 cosponsors; House Ways & Means reported the bill favorably 23-14 on 02/04/14; passed full House 248-179 on 04/03/14; Official titles: Forty Hours is Full Time Act of 2013; Save American Workers Act of 2013

Medical Student / Education HR 702 Frontline Provider Act; APMA supports; sent letters of support; Sponsor – Rep. Braley (D-IA); new

loan repayment program to incentivize certain providers including podiatrists to practice medicine for agreed-upon time in underserved areas; awaiting House committee action; APMA sent letter of support; students continue to lobby for it, as well; 42 cosponsors; Introduced 2/14/2013; Official Title: Access to Frontline Health Care Act

All federal bills are available for viewing on line through the Library of Congress website at http://thomas.loc.gov/


Legislative Committee Staff Meeting October 24, 2014

Reston, VA

Legislative Advocacy department staff; Peter Stein (Director) and Ben Wallner (Associate Director) met with Seth Rubenstein, DPM (Legislative Committee Chair) to discuss strategic plans for the Legislative Committee during the 114th Congress.

Discussion Points

1. Should we maintain or change the language of the HELLPP Act? Consensus: Maintain the language Discussion: There is no compelling reason for significantly changing the current legislative language of the HELLPP Act. The current HELLPP Act made significant progress in the 113th Congress in being included in the main US Senate SGR reform bills. Educating APMA members and congress about the content of a new bill requires significant time. It will be easier to gain co-sponsorship in the 114th congress from a congressman or senator who supported our bill in the 113th congress if the bill contains the same language. Co-sponsor numbers should increase which is critical for our bill’s success. A bill addressing the permanent SGR fix will likely be reintroduced in 2015. We have a better chance of amending the HELLPP Act to that bill if the language remains the same. In addition, changing the language will create a bill which will have to be vetted, scored and championed by a sponsor willing to amend the bill to a larger piece of legislation and protect it from removal during subcommittee review. We explored alternative Medicare issues to replace the Diabetic Therapeutic Shoe portion. Discussion included legislative and regulatory issues such as ICD-10, pneumatic compression devices, routine foot care certification by MD/DO’s and hyperbaric oxygen provider licensing. It was our opinion that the profession would benefit most from correcting the Diabetic Therapeutic Shoe regulatory issue. We also discussed simply removing the Diabetic Therapeutic Shoe section from the HELLPP Act. Not only do we still need a “hook” to make our bill germane to a Medicare / SGR package, but Senate staff believes this accounted for only 25% of the CBO score of $1.3 billion over 10 years.

2. Should we maintain outside consultants? Consensus: Yes Discussion: Heart Health Strategies (HHS) has been an indispensable part of constructing our legislative message and the content of our bill, opening doors for lobbying in support of the bill, as well as being valuable eyes and ears on all things legislative. They have produced additional value by assisting on regulatory matters like the Physician Sunshine Act and helping prepare for and attend regulatory meetings with CMS.


HHS is currently employed on a month to month retainer. Funding is due to expire after the next payment in early January. The annual budget is $100,000.

3. Status of the HELLPP Act support material

Consensus: Support material for the HELLPP Act is in place. Discussion: The Legislative Committee reviewed on-line Issue Briefs, White Papers, landing pages and the e-Advocacy web site. Minor modifications of content need to be updated and will be addressed by staff. Recommend working with APMA’s PR Department to promote introduction of the HELLPP Act in the 114th congress including press announcements, social media posting and ads in Hill news outlets to coincide with the Legislative Conference. The advertising component will require additional budgetary resources. Consider request for a “Surge Budget” to be used for high dollar short term projects such as an ad campaign.

4. What is the status of a VA Podiatry Pay Disparity bill for the 114th Congress?

Consensus: We will not introduce a bill at the onset of the 114th congress. Discussion: Rep. Brad Wenstrup’s office recommends exploring procedural remedies before legislation is introduced to address this issue. Rep. Wenstrup will work with members of the House Veteran’s Affairs Committee and others to request a copy of the VA white paper on Podiatric Pay Disparity, authored by Jeff Robbins, DPM. The white paper is proprietary to the VA. Copies supplied to congress from outside the VA cannot be used as reference source. With support documentation in hand, congress can modify the definition of “physician” in statute for the VA which will place podiatrists in the same pay band as Physicians and Dentists. Staff did not feel a letter writing campaign by MD/DO’s in support of this initiative would yield a high response rate. In case procedural remedies fail, a VA parity bill is prepared and ready for introduction.

5. Review responsibilities of the Legislative Committee Members

Consensus: The legislative Committee needs to develop a more robust nationwide communication network to disseminate information to, and request support from, component societies. Discussion: Legislative Committee members will request designation of a Key Contact/Legislative Representative from their assigned states. This person will act as a liaison with state component leadership. Note: this may be the same person as the APMAPAC Coordinator.


Legislative Committee members will encourage component states to develop relationships with peer medical associations to support legislative advocacy messages of mutual interest. Legislative Committee members will be asked to target 50% congressional co-sponsor participation from their combined assigned states. We propose requiring members of the Legislative Committee to attend the APMA Legislative Conference, effective in 2015. Pending budget approval, Committee members will receive reimbursement for travel, room and a per diem for their participation in the conference. Committee members qualifying for expense coverage must be appointed by the APMA President, must serve on the Legislative Committee in the year following the current House of Delegates and Legislative Conference, and must fully engage and participate in all activities related to the annual Legislative Conference. The Legislative Committee chair will a. Work with staff and committee members to implement the strategic goals of the

committee b. Work with staff to provide educational material for distribution in APMA publications,

blast e-mails and other forums on a regular basis and urgently when needed. c. Organize and run monthly committee conference calls. Provide a short summary of

discussion points and tasks for the following month. d. Inspire APMA leadership to engage in legislative advocacy.

6. Review draft plans for the 2015 Legislative Conference Consensus: Plan a more robust Legislative Conference for 2015 Discussion: The 2015 Legislative Conference will have an extra half day, beginning with the close of the APMA HOD at noon on Monday. Staff reviewed a draft program and various locations for debriefing participants after lobbying on the Hill. Proposal was made for component Key Contact/Legislative Representatives to attend the APMA Legislative Conference in addition to APMAPAC Coordinators, pending budget approval. Note: The APMAPAC covers expenses for the PAC Coordinator and the APMA covers expenses for one state representative (Component President or alternate state officer) to attend the APMA Legislative Conference.

7. Review the Strategic Charge of the Legislative Committee Consensus: Maintain

a. Review federal legislation and its impact on podiatric medical practices and patients b. Advise the Board of Trustees concerning federal legislative priorities and

recommends related policy and actions to the Board c. Ensure implementation of public policies and legislative actions d. Facilitate partnerships with other health care organizations for the advancement of

APMA’s legislative agenda


e. Update APMA membership on federal legislative issues and activities in order to further engage members in the political process.

8. Operational Goals for the Legislative Committee Staff (Draft)

Consensus: Approve

a. Define a “Tactical Plan” b. Define expectation for committee members work c. Set target “goal” for number of co-sponsors for a bill d. Develop and provide instructions on how to access support material


MEMBERSHIP AND STUDENT LIAISON COMMITTEE REPORT COMMITTEE MEMBERS: Donald Feldman, DPM, Chair Bradley C. Haves, DPM Biff Kramer, DPM Rebecca A. Moellmer, DPM Angela Savage-Davis, DPM (Young Physician) Ms. Tonda Wooten (APMSA) BOT Liaison: Phillip Ward, DPM Staff Liaison: Beth Shaub Advisor: Mr. David Higgins, Executive Director, FPMA DATE OF MOST RECENT MEETING: April 2014 COMMITTEE ACTIVITIES: Miscellaneous Fall College Visits The fall 2014 visits have been completed. APMA is not invited to attend orientation at Des Moines and CA-Merritt. Due to the budget cuts to this function, APMA had to solicit participation from members who reside near a podiatric college. All presenters did a fantastic job of collecting hard copy opt in forms for APMA student membership from the first year students. This was greatly appreciated as a few of the colleges are no longer willing to share student data with APMA. If data is not shared it is very difficult for APMA to create records in the APMA database for student membership recruitment. Scheduling of the 2015 spring visits are in process. Dates are as follows:

COLLEGE DATE ARIZONA Dates not confirmed BARRY Dates not confirmed CA – SAMUEL MERRITT Dates not confirmed CA – WESTERN Dates not confirmed IOWA January 22 & 23 KENT Dates not confirmed NEW YORK February 3 & 4 SCHOLL March 9 & 10 TEMPLE Dates not confirmed

State Licensure Tracking Staff continues to collect data from 25 percent of the state licensing boards each year. This allows for new data to be collected, on a rotating basis, every four years. Tracking indicates approximately 17,500 licensed DPMs in the country. APMA Direct Dues Collection At present APMA directly collects dues for 28 components (AK, AR, AZ, CO, DE, FS, HI, ID, LA, ME, MN, MS, MT, NE, NV, NC, ND, NM, OK, OR, SC, SD, UT, VA, VT, WI, WV, and WY).


With a membership base of just under 12,500 (excluding students), these 28 components represent approximately 2,310 members or 18.48 percent of the membership base. Staff continues to market this service to other components when the opportunity arises. Payments through the on-line dues payment option through the APMA website continues to increase. This is available only to those members in the components allowing APMA to handle their dues collection process. Reporting to Components APMA continues to send all monthly reports automatically via e-mail. This allows the components to receive their reports on a more timely basis and saves a great deal of APMA staff time. A quarterly report is in place which lists the young physician members in each component. This is done to encourage the components to enfranchise young physicians into leadership roles. Membership Recruitment Membership Counts The membership base at year end May 31, 2014 was 12,528 (excluding students) which represent a 2.00 percent growth over year end May 31, 2013 (12,282 excluding students). If students are included the count as of May 31, 2014, the membership base rises to 14,595 which represent a 5.86 percent growth over year end May 31, 2013. As of October 6, 2014, the APMA membership base was just over 12,348 (excluding students). Membership numbers have recently dropped slightly due to the first round of suspensions for non-payment of dues. State Recruitment Campaigns At present APMA sponsored membership recruitment campaigns are being conducted by the Arizona Podiatric Medical Association, Florida Podiatric Medical Association, Indiana Podiatric Medical Association, Texas Podiatric Medical Association, Alabama Podiatric Medical Association, Mississippi Podiatric Medical Association and the Utah Podiatric Medical Association. Student Membership Student membership was launched in June of 2012. Marketing has occurred through various methods and continues. Overall results are improving. Out of the student population base of 2,430, 2,269, or 93 percent, have opted in. 161, or 6 percent, have NOT opted in. The fourth year students have the lowest rate of opting in at 85%. This is expected as the students rotate into their third and fourth years it is more difficult to make contact. National Resident Recruitment Campaign The national resident membership recruitment campaign was launched at the beginning of the 2007-2008 APMA fiscal year and targeted DPMs in their first year of residency by providing membership at no fee. Due to the initial success of this program and the desire to complete further tracking, the APMA Board agreed to extend the program until the end of the 2012 - 2013 APMA fiscal year. During the 2012 APMA House of Delegates meeting the APMA board announced that this campaign would be expanded to include membership at no fee to all DPMs in residency training. The campaign is now due to expire on May 31, 2018.


As of November 3, 2014, 64 percent (342 out of 533) of the 2014 graduating class has joined as first year resident members. Marketing of membership to the 2014 graduates continues. Total resident member counts as of early November 2014 was 1,205, while as of early November 2013 the count was 1,195. This represents an increase of 40, or 3.34 percent. In total, 1,515 DPMs have joined though the expanded campaign. Of this 1,515, only 131, or 8.64 percent, have allowed their membership to lapse. As this expanded campaign has been in place since June of 2012, many are still in a residency program thereby limiting the tracking of continued membership after the member rotates into a dues paying category. It should be noted that 70 (or 53.43 percent) of the 131 whose membership has lapsed were in OH and PA which charges state dues of $40.00 and $100.00 respectfully after the DPM completes their 1st year of training. The remaining 61 of the 131 (or 46.56 percent) allowed their membership to lapse at the conclusion of their program. These were all members whose program ended in spring of 2013. Tracking of those that completed their program in the spring of 2014 cannot be measured until early January 2015, as APMA continues to provide member services to these DPMs until early January 2015. Marketing to these DPMs is ongoing. Dues Waiver Campaign The one year pilot program to waive past dues of any former member was launched June 1, 2012. This was in response to some components indicating that the collection of past dues owed was an impediment in getting former members to re-join. In response to the positive feedback received from ASPE in the spring of 2013 and spring of 2014, the APMA Board agreed to twice renewing the pilot program for another fiscal year (now through May 31, 2015). For calculations of the past dues waived, a blended quarterly dues rate of $125.00 is considered. During the 2012 – 2013 APMA fiscal year, 270 DPMs joined under this pilot program and calculations indicate that APMA waived approximately $33,750.00 in past dues. During the 2013 – 2014 APMA fiscal year, 217 DPMs joined under this pilot program and calculations indicate that APMA waived approximately $27,125.00 in past dues. So far, during the 2014 – 2015 APMA fiscal year, 66 DPMs joined under this pilot program and calculations indicate that APMA waived approximately $8,250.00 in past dues. Of the 585 total memberships activated through this program (32 were allowed to participate late in the 2011 – 2012 APMA fiscal year), 154, or 26.32 percent, have allowed their membership to lapse. Considering that 431 who activated through this program have continued with their membership, total dues revenue of approximately 172,400.00 has been received. This more than compensates for the past dues written off of $69,125.00. This calculation considers a blended annual dues rate of $400.00 Membership Retention New Member Resource/Welcome Kit The New Member Resource/Welcome Kit launched in June 2006 is updated on a regular basis. This mailing provides details of member benefits in a brief easy to read format. Newsletters are e-mailed to all members during their first 12 months of membership. The newsletters focus is on current news and areas that could not be included in the kit mailing. Surveys have been e-mailed to members as they complete their first twelve months of membership to determine satisfaction with


the kit and newsletters. To date the responses to the survey have been positive. Of the respondents, approximately 80 percent found the kit informative and felt the information is not overwhelming. Approximately 78 percent have responded that the monthly newsletter is informative. It is anticipated that this Welcome Kit will be sent electronically after we have depleted the supply of Welcome Kit three ring binders. Member Affinity Programs Affinity program usage by members continues to be slow. Marketing efforts continue through the APMA website, APMA News, and the E-News Brief. While staff continues to evaluate viable additions to the member affinity program, no real focus is put towards this due to lack of member participation.


PUBLIC HEALTH AND PREVENTIVE PODIATRIC MEDICINE COMMITTEE (PHPPMC) COMMITTEE MEMBERS: Chair: Janet Simon, DPM, NM Tracy L. Basso, DPM, CA Emily A. Cook, DPM, MA James J. DiResta, DPM, MA Virginia E. Parks, NY, APMSA Representative Christian A. Robertozzi, DPM, NJ Dyane E. Tower, DPM, IL, Young Physician Crystal M. Holmes, DPM, MI, Liaison Brooke A. Bisbee, DPM, BOT Liaison Jeffrey Robbins, DPM, IL, Special Expert (Federal Services) Staff Liaison: James R. Christina, DPM DATE OF MOST RECENT MEETING: October 28, 2014 (Conference Call) COMMITTEE ACTIVITIES:

• Committee has recommended and is directing a listserve for students at colleges of podiatric medicine interested in Public Health. The listserve is up and running and is designed to let Public Health clubs at the colleges of podiatric medicine discuss and feature projects that they are working on.

• The committee is working on a Falls Prevention Toolkit to be available to APMA members. • The committee is developing a proposal for the APMA Annual Meeting Committee for a

track including public health and health care disparities topics. • The committee is working on a resolution for the 2015 APMA HOD encouraging

components to designate a board position as chair of public health committee and to sponsor a minimum of 2 POD section APHA members annually.

• The committee continues to work on encouraging membership in the POD section of APHA to preserve the section status.

• The sub-committee on health care disparities is working on two power point presentations with regards to health care disparities—one for APMA members and one for students at colleges of podiatric medicine.

• The sub-committee on health care disparities had Dr. Jondelle Jenkins attend the AMA Commission on Health Care Disparities meeting in Chicago.

Documents

ANNUAL MEETING COMMITTEE REPORT COMMITTEE MEMBERS …