Gasline Newsletter October 2009

Volume 11, No. 6

2009 ASA Annual Meeting

The CSA was well represented by the members of its delegation at the recent ASA Annual meeting and House of Delegates. Linda Mason, M.D., former CSA President and Director from California to the ASA Board, ran in a hotly contested election for Assistant Secretary of the ASA. The members of the delegation worked hard for Linda, and we are fortunate she was successful in the election against Jerry Maccioli, an experienced and well known Director from North Carolina. A message from Dr. Mason to the CSA membership is attached below.

To the Members of the California Society of Anesthesiologists:

As many of you may already know, I was elected Assistant Secretary for the American Society of Anesthesiologists during the recent ASA Annual Meeting in New Orleans. We did this together! I can't thank each of you enough for your help and support of my campaign. The commitment for my election from the CSA was beyond compare—you are the best! It will be a great pleasure for me to represent you as a member of the ASA Administrative Council.

We are also fortunate to have the dedication and talent of Mark Singleton who will now serve as your Director to the ASA from California. I wish Mark all the best in his new role.

Thank you again. I look forward to a bright future for our specialty of Anesthesiology.

Linda J. Mason, M.D.

In addition, two members of the California delegation, Michael Champeau, M.D., and Linda Hertzberg, M.D., served on the Reference Committees which hear the business of the House of Delegates. A number of members, either as individuals or on behalf of the CSA, were actively involved in bringing forward resolutions for the House of Delegates. Those involved included Edgar Canada, M.D., James Moore, M.D., Mark Singleton, M.D., and Kenneth Pauker, M.D. A full update on activity at the ASA meeting will be available in Dr. Singleton's Director's report on the Web site and in the next CSA Bulletin.

National Health Care Reform

With the so-called public plan or public option back in play, and its potential to tie payment rates for anesthesiologists to Medicare rates, the ASA has issued a call for members to contact their Congressional Representatives. As noted below, Representative Johnson of Texas has submitted an amendment to H.R. 3200 that would de-link anesthesia payments from Medicare rates. The full e-mail from the ASA is pasted below. If you click on the “Please call you Representative” link, it will take you to the ASA Grassroots Network and assist you in reaching your Congressman.

Urge support for anesthesiology-specific amendment to H.R. 3200
Rep. Eddie Bernice Johnson (D-TX-30) has introduced an amendment to H.R. 3200, health reform legislation in the U.S. House of Representatives, which would de-link anesthesia payments from Medicare rates under a public plan.

Under the “Johnson Amendment,” payments for anesthesia services would be based on the average of the payment rates of commercial insurers and health plans participating in the “Exchange.” This would level the playing field and ensure fair anesthesiology payments.

Please call your Representative and ask him or her to support the Johnson amendment.

Democratic leadership is involved in closed-door negotiations to craft the final House health reform bill. In the process, they must merge three separate Committee versions of the bill, two of which include a public plan based upon Medicare payment rates. ASA has consistently lobbied for negotiated payment rates, as included in a third Committee version of H.R. 3200.

The content of H.R. 3200 changes hourly. However, press reports and information from ASA lobbyists indicate that the House is leaning heavily toward including a public plan tied to Medicare rates.

Rep. Johnson is working with Speaker Pelosi's office in an effort to have her amendment language incorporated into whatever version of H.R. 3200 is ultimately brought to the floor of the House by the Democratic leadership. The precise mechanism by which the language would be incorporated has not yet been determined. Additionally, the specific date for full House consideration of H.R. 3200 has not yet been determined but could occur within the next 7-10 days.

Your Representative's support of the Johnson Amendment is extremely important at this point in the process. The addition of co-sponsors will strengthen Rep. Johnson's efforts. Please contact your Member of Congress (again, if necessary), and ask that he or she co-sponsor the Johnson Amendment.

Please use the following documents for additional information, and feel free to share these materials with Congressional offices.

Johnson amendment language
Rep. Johnson letter to Speaker Pelosi
Johnson amendment FAQ
Contact the ASA Washington office, 202-289-2222, with any questions.

California Opt-Out Update

At its September meeting, the CSA Board of Directors approved pursuing litigation on this issue. In late September, the CSA received the long-awaited letter from the Governor's attorneys, responding to our deep concerns about the legality of the opt-out and the manner in which it was done. Not surprisingly, the letter defended the Governor's position. Demands for documents under the Public Records Act have already been served on the Governor's office, the Board of Registered Nursing, the Medical Board of California, the Board of Chiropractic Examiners, and the State Health and Human Services Agency. This process provides a means for obtaining information similar to discovery during a lawsuit.

Moreover, this fight is far from finished. CSA is continuing to mount an active political and legal campaign. We will be going before the Medical Board of California at its next meeting later this month to discuss the manner in which information regarding the opt-out was withheld from that body. In the meantime, consultations are underway with CSA and CMA attorneys as to the timing and type of legal strategy that we will pursue. The ASA remains fully engaged in and supportive of these efforts.

Register Now! December 5 – Ultrasound Regional Anesthesia Workshop

A Hands-On Ultrasound for Regional Anesthesia Workshop (no more than seven per station), offered by the California Society of Anesthesiologists, will take place at the Renaissance Los Angeles Airport Hotel on December 5, 2009. To provide the best educational experience, CSA has limited the number of participants. Workshops fill quickly! If you plan to attend, register soon to ensure you'll get in. The cost for CSA members is $595.

CSA Winter Hawaiian Seminar

Beat the winter blahs! Attend the CSA's Winter Hawaiian Seminar, January 19-23, 2009, at the beautiful Hyatt Maui Resort & Spa. Visit the CSA Web site to learn more​.

Intraoperative Blood Pressure Management: Is the Standard of Care, Ideal Care$
Anesthetic Considerations for Spine Surgery
Perioperative Management of the Patient with Coronary Artery Disease
Analgesia for Routine Labor: What's Old, What's New, What Works
Concepts in Regional Anesthesia—Ultrasound and Nerve Stimulation
Our Evolving Practice: Oxygen, Vasopressors, Pre-Eclampsia and More
Book your sleeping room as soon as possible on the Hyatt's online CSA registration site at

Linda B. Hertzberg, M.D.

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