Oregon MGMA, State Affiliate

What's New:

Kudos to 4 New FACMPEs!

New 2008-2009 Executive Committee!

2009 Spring Meeting: May 17 – 19, 2009
Portland, Oregon (Washington/Oregon Joing Meeting)

OMA Proposed Legislation

4 New Oregon Fellows...

Barbara Tauscher, FACMPE

Barbara Tauscher, FACMPE
Gastroenterology Specialists of Oregon

Since 2004, Barbara Tauscher has enjoyed the role of Executive Director of Gastroenterology Specialists of Oregon (GSO). GSO has offices in Tualatin and Oregon City, Oregon.

Barbara began her practice management career in 1986. She began by managing a five physician family practice office in Reedsport, Oregon, through a management contract with Medical Management Inc. She served as the Director of Clinic Operations for Providence Medical Group in Portland, Oregon. From 2001- 2004, she worked as a practice management consultant supporting various specialty offices in Portland, Corvallis and Eugene.

Barbara earned her Bachelor's degree in Healthcare Adminstration from Oregon State University in 1985, and her Master's in Healthcare Administration from the University of Minnesota in 2000.

Kathie Oriet, FACMPE

Kathie Johnson Oriet, FACMPE
Willamette Valley Clinics, LLC

Kathie is employed by Willamette Valley Clinics, LLC in McMinnville, Oregon as Director of Physician Clinics. She oversees the operations of 15 clinics, 26 employed physicians, 4 non-physician providers and staff. Kathie has over 24 years in medical practice management and received her FACMPE in September 2008.

Among her other interests, Kathie serves as Mayor of Carlton, Oregon and enjoys working in her flower and vegetable gardens. She and her husband Greg have two grown sons.

Susan Curtis, FACMPE

Susan Curtis, FACMPE
Oregon Neurology, PC

Susan Curtis, FACMPE is the administrator of Oregon Neurology, PC in Tualatin and Oregon City. She has worked for Oregon Neurology for over 14 years. Oregon Neurology has been named a Better Performer by MGMA in Accounts Receivable for five of the last six years. Susan has been active in the Portland Medical Community Managers group for many years, and served as president in 2004 and 2005. Susan submitted three case studies to fulfill her Fellowship requirement: “Developing Ancillary Services to Improve Patient Care”; “Options When An Electronic Medical Records Vendor Eliminates Support and Upgrades”; and, “Evaluating Tools to Assess and Validate Perceptions of a Practice.”

Scott Kenyon, FACMPE

Scott Kenyon, FACMPE
The Maple Street Clinic, P.C.

Scott and his wife Kelly reside in Forest Grove, Oregon with their five children. Together, they spend time as a family enjoying the wonderful outdoor opportunities afforded to all Pacific Northwesterners. For the past four years, Scott has been the clinic administrator at the Maple Street Clinic in Forest Grove.

A native of Washington, Scott grew up in the suburbs of Seattle. After graduating Lake Washington High School in Kirkland, Washington, Scott enrolled in Brigham Young University, Provo, Utah. Scott worked at Sears to put himself through school and after obtaining his Bachelors degree in Business Administration, he was offered a position in the Sears executive training program. Scott accepted this position and moved back to the Seattle area.

After four years at Sears, Scott and his family relocated to the East Coast and settled into a busy new life at Merrill Lynch. Following the terror attack of September 11, Merrill Lynch lost access to the World Financial home office located across the street and connected to the World Trade Center. Scott helped his department implement trading floor contingency plans allowing the division to function as close to normal as possible after the terror attacks.

The hustle and bustle of the Manhattan area lifestyle didn’t fit the model Scott and Kelly wanted for their family life. The year following the terror attacks, they relocated to Forest Grove, Oregon. Scott secured a position with a small Oregon banking institution as a Registered Investment Advisor, a hobby he still enjoys to this day.

A few years after relocating to Forest Grove, one of the doctors at the Maple Street Clinic approached Scott about some management issues at the Clinic. This simple act set the wheels in motion for Scott to take over administration of the Clinic. During that time Scott became active in the MGMA and the ACMPE. He found a strong network of people in the Portland area and with their mentoring assistance; he became Certified and ultimately a Fellow of the American College of Medical Practice Executives.


Achieve your career goals with board certification in medical practice management through the American College of Medical Practice Executives (ACMPE), the certification and standard-setting body of the Medical Group Management Association (MGMA). First, earn the respected Certified Medical Practice Executive (CMPE) designation. After you become board certified, attain the highest distinction in the profession — Fellow in the American College of Medical Practice Executives (FACMPE).

Find out more about the American College of Medical Practice Executives at the MGMA National web site, or contact our chapter's ACMPE liaison, Kathleen Hennricks, FACMPE

ACMPE

OMA Proposed Legislation...

Summary of OMA Proposed Legislation for 2009 Session
From OMA Health Care Finance Committee
Provided by Marilyn Happold-Latham, MBA, FACMPE

I. PPO Panels (including silent PPO issues)

Prevents covered entities that purchase access to preferred provider panels from further selling access to such panels. Requires covered entities to comply with the terms of the contract between the physician and contracting agency. Requires contracting entities to give notice to physicians of material changes to physician contracts. Requires contracting entities to maintain web-based records of all covered entities to which panel access has been sold. Preauthorization information provided to physicians regarding benefit coverage or eligibility shall be binding if services provided are within 72 hours of preauthorization. Allows DCBS to issue fines and penalties of not less than $1,000 per violation.

II. Quality Profiling

Requires health insurers who profile physicians to use statistically valid data for both quality of care and cost efficiency. Measures have to be based on nationally recognized evidence-based medical standards or consensus-based guidelines endorsed by recognized health care organizations. Required to give notice to consumers of physician profiling. Requires disclosure of methods used to profile. Permits physicians to appeal profiling determinations.

III. Credentialing

Requires health insurers to approve or reject a preferred application within 30 days for services provided until approval or rejection. Reimbursement for services provided to health plan patients will begin after the 30th day.

IV. Worker’s Comp carriers accessing PPO panels

Casualty insurers or self-insured employers may not access health care services under a contract with a preferred provider organization. Establishes penalties for non-compliance of not more than $5,000 per violation.

V. Overpayments by health plans

Prohibits health insurers from requesting refunds of payments made to physician more than 12 months after payment was made. Requests must be made in writing. Practice has six months to refund the insurer after receipt of the request.

VI. Prompt Payment

Insurers shall pay a clean claim not later than 30 days after receipt of the claim. Health plan contracts cannot include provisions that relieve the plan of this obligation. DCBS shall issue fines and penalties of not less than $100 per day that the claim is not paid after the 30th day. ERISA plans are now included.

VII. Access to Eligibility information

Requires health insurers to create a web-based or telephone access method to determine enrollee coverage and eligibility. Prohibits health insurers from denying coverage if enrollee coverage and eligibility is confirmed 72 hours prior to treatment. Violation is subject to penalties of up to $1,000 for each offense.

OMGMA/WSMGMA Joint Meeting
Mark Your Calendars! May 17 – 20, 2009
Portland, Oregon

Information will be coming soon! Mark your calendars for the Spring Conference Oregon/Washington Joint Meeting in Portland, Oregon.

 

OMGMA/WMGMA Joint Meeting

 

 

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ACMPE Certification

Find out more about the American College of Medical Practice Executives at the MGMA National web site, or contact our chapter's ACMPE liaison:

Kathleen Hennricks, FACMPE
Director of Billing Services
Oregon Medical Group
1580 Valley River Drive, Suite 210
Eugene, Oregon 97401
(541) 242-4348
Request InformationE-mail Kathleen