Gasline Newsletter March 2010

Volume 11, No. 11

CSA/CMA vs. Schwarzenegger

The Governor’s response to CSA’s complaint was received by CSA legal counsel on March 25. Below is a brief synopsis from legal counsel explaining what the response contains and what our next steps are:

I have reviewed the Governor's answer to our petition in some detail. Basically, it denies virtually all of the allegations of our petition (it does admit that Arnold Schwarzenegger is the governor, that he is sued in his official capacity, and that venue is proper in San Francisco), which was not particularly surprising. At this point we will need to move forward with our motions, and a motion for summary judgment requires 75 days notice of the hearing, so we will not be able to have that motion heard right away.

CSA and CMA legal counsel as well as CSA lobbyists have been working on the motions referenced above and hope to have them submitted to the court sometime next week.

Some members have reported activity within their hospitals that administrators claim would permit hiring or contracting with CRNAs to practice independently. However, state law still prohibits independent practice by CRNAs and members are encouraged to use CSA resources to educate hospital administrators and medical staffs that state law supercedes the federal opt-out. Members may share the opinion to this effect by the California Legislative Counsel, the office responsible for drafting state laws.

Chiropractic Manipulation Under Anesthesia

The Office of Administrative Law recently approved regulations put forward by the Board of Chiropractic Examiners allowing chiropractic manipulation under anesthesia in California. This occurred despite written and oral testimony from the CSA opposing the adoption of such regulations. The CSA Board of Directors considered this issue at its meeting on March 20, 2010. At that time we reviewed the “ASA Statement on Chiropractic Spinal Manipulation under Anesthesia,” and the BOD has affirmed and adopted this as a CSA statement of policy as well:

Chiropractic Spinal Manipulation Under Anesthesia

RESOLVED, that the American Society of Anesthesiologists declares that the use of general anesthesia for chiropractic spinal manipulation has no scientific basis and that there is no evidence to support a claim that its use is either safe or beneficial for patients.

ASA HOD Action: Approved 2007

In addition the CSA is interested in learning to what extent this procedure is performed in California. If you provide anesthesia for MUA, please complete the brief survey on this issue by following the link:

National Health Care Reform Update
In the aftermath of the vote and signing of the bills on Health Care Reform the ASA has provided, the following resources:

Remarks of ASA President Alexander Hannenberg, M.D. on the Final House Health Reform Votes

ASA releases primer on implementation of new health care reform law.

CSA will continue to work closely with ASA on these issues.

Congress Adjourns Without Taking Action on SGR Fix

Congress adjourned for a two-week break without taking action to stop the Medicare cut of 21% from taking effect on April 1. Medicare carriers were instructed to hold claims for the first 10 business days of April. See for more information.

CSA Elections are Complete

The CSA district director, delegate and alternate delegate elections are complete and are posted on the elections page.

CSA Annual Meeting and Clinical Anesthesia Update

Do you wonder what the future holds for anesthesiology? How will new government regulations affect your practice? What new technologies and practices will influence perioperative safety? These and many other fascinating topics will be explored at the CSA Annual Meeting and Clinical Anesthesia Update, May 14 – 16, 2010 at the Hilton Costa Mesa/Newport Beach.

Program Chair Zeev Kain, M.D., will kick off the program on Friday, introducing a series of lectures on The New World of Medicine as Related to Anesthesiology, a peek into the year 2030, predicting clinical, political and business changes we can expect.

Take advantage of the special CSA room rate of $129. Reservations for the Hilton Orange County/Costa Mesa should be made by contacting the hotel at 1-800-HILTONS.

Call for Submission of Resolutions to the House of Delegates

Any CSA member may submit a resolution to the House of Delegates (your elected representatives) on any issue that he or she deems important to the membership. A resolution is a proposal that the CSA undertake an activity related to a current issue of concern to anesthesiologists. For example, a resolution might recommend that the CSA develop social networking capabilities for the members. For assistance in formulating a resolution, please contact Johnathan L. Pregler, M.D., Speaker of the House of Delegates. The deadline for submissions is April 15, 2010.

The House of Delegates will meet on Saturday, May 15, 2010, as part of the CSA Annual Meeting at the Newport Beach/Costa Mesa Hilton, Orange County, California. An Issues Discussion Forum (formerly the Reference Committee) meets prior to the House of Delegates to hear testimony on all matters to be considered by the House. For more information, contact the CSA office 650-345-3020 or 800-345-3691.

District 7 Symposium

Uday Jain, MD, PhD, Director District 7, cordially invites all anesthesia providers to the District 7 Symposium on Saturday Morning, April 10, 2010. The speakers will be Tong Gan, MD, Professor &Vice-Chair, Duke University, and Adrian Gelb, MBChB, Professor & Vice-Chair, University of California, San Francisco. The Symposium will take place at the Park Plaza Hotel, 150 Hegenberger Road, Oakland, CA 94621; Parking is free. The Symposium is supported by Baxter Healthcare. Please contact Garrett Lee ASAP at 408-364-6286 or

Winter 2010 CSA Bulletin Online

The Winter 2010 CSA Bulletin is now online. It can be accessed from the Home Page for three months from the date of mailing until the next issue of the Bulletin is published. Click on the PDF link on the Bulletin icon on the left-side navigation. The Bulletin is also archived on the Web site by individual article. You can find current and archived issues under Publications on the left-side navigation of the CSA Web Site.

Linda B. Hertzberg, M.D.

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