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Governor Appoints New Board MembersGovernor Jay Inslee recentlyappointed two new members to theBoard of Osteopathic Medicine andSurgery. Juan Acosta, DO and AlexSobel, DO each will serve a five-yearterm.Juan F. Acosta, DO, MS, FACOEPD, FACEP is a 1997 graduate of theNew York College of OsteopathicMedicine. After an OsteopathicInternship and Residency inEmergency Medicine at St. BarnabasHospital, Bronx, NY, he received aMasters in Clinical Investigation fromWeill Cornell Medical College and iscurrently in the process of obtaininga Doctorate Degree in HealthEducation from A.T. Still University.Dr. Acosta is also Board Certified inNeuromusculoskeletal Medicine(NMM/OMM).Dr. Acosta was the ProgramDirector at St. Barnabas Hospital forseveral years. He is presently theAssistant Dean for PostgraduateMedical Education, Director ofClinical Rotations, Regional Dean,Director of Medical Education atPacific Northwest University ofHealth Sciences College ofOsteopathic Medicine in Yakima,Washington. In 2009, Dr. Acostabecame the Medical ProgramDirector of the Yakima CountyDepartment of EMS and continues toserve as such. As President of theYakima County Medical Society, hehas been involved in unifying themedical community with theeducational community. Dr. Acostais very involved in the hospitalmedical executive committee andstill manages to work shifts in theemergency department. Presently,he is working with OPTI-WestEducational Consortium as aRegional Academic Officer.Dr. Acosta is actively involved inthe Washington Disaster MedicalAssistance Team (DMAT), a reviewerfor CECBEMS, Journal of EmergencyMedicine and a section editor for theWest-JEM. He is also an Oral Boardexaminer for American OsteopathicBoard of Osteopathic EmergencyMedicine (AOBEM). He is presentlyon the Board of Directors of theAmerican college of OsteopathicEmergency Physicians ( ACOEP) andthe Association of OsteopathicDirectors and Medical Educators(AODME).Washington D. O.Alex Sobel, DOJuan Acosta, DODr. Alex Sobel is a graduate of theUniversity of New England Collegeof Osteopathic Medicine. Hisinternship in General Surgery wascompleted at Doctors Hospital,Columbus, OH where he alsocompleted a residency inOtolaryngology/Facial PlasticSurgery. He received fellowshiptraining in Cosmetic Surgery at theAlderwood Surgery Center inLynnwood. He is certified by theAmerican Osteopathic College ofOtolaryngology-Head and NeckSurgery and the American Board ofCosmetic Surgery.He has been in private practiceexclusively in cosmetic surgery forover six years and has thousands ofaesthetic procedures to his credit.He is double board certified inGeneral Cosmetic Surgery andOtolaryngology/Facial PlasticSurgery and is a Fellow of theAmerican Academy of CosmeticSurgery. A past recipient of theWilliam K. Miles, M.D. award for thehighest written exam score inCosmetic Surgery, Dr. Sobel hasserved as an examiner and aneditorial committee member for theAmerican Board of Cosmetic Surgeryfor the past four years. In 2012, hewas elected to the Board of Trusteesof the American Board of CosmeticSurgery and in 2013, he became theChairman of the American Board ofCosmetic Surgery Oral Examination.Dr. Sobel has both lectured on avariety of topics, including facelifts,laser resurfacing, facial fat grafting,otoplasty, breast augmentation andbreast enhancement with fat graftingand has served as a panelist oncosmetic breast surgery as well asfacial plastic surgery at nationalmeetings for the American Academyof Cosmetic Surgery and theAmerican Osteopathic Academy ofOphthalmology and Otolaryngology– Head and Neck Surgery. He haspublished on topics including theintra-oral technique of injectablefillers – a method which drasticallyreduces inflammation and bruisingpotential, increases patient comfort,and leaves no injection marks. Forthe past three years, he has alsoserved as a reviewer for the AmericanJournal of Cosmetic Surgery.Committed to the education ofothers, Dr. Sobel is proud to havetrained other surgeons in the field ofGeneral Cosmetic and FacialCosmetic Surgery. Dr. Sobel is adjunctclinical faculty for Pacific NorthwestUniversity.Though he is proficient in generalcosmetic surgery, Dr. Sobel hasparticular interests in bodycontouring, including the aestheticenhancement of the breast andabdomen, fat transfer, face & eyelifting procedures, and rhinoplasty.His practice is in Bellevue.Summer 2014Page 3

Open PaymentsReview and DisputeProcess Opens forPhysiciansPharmaceutical and devicemanufacturers as well as grouppurchasing organizations (GPOs) havereported information to CMS onphysicians under the Open Paymentsprogram created by the PhysicianPayment Sunshine Act, and nowphysicians have 45 days to review anddispute the reported data before it isposted for the general public onSeptember 30.In order to review or dispute theinformation, physicians must beregistered in Phase Two of the OpenPayments program. Manufacturers andGPOs will review any disputessubmitted by physicians and work withthem to reach an agreement on anycorrections.CMS will host a National ProviderCall on July 22 to provide a detailedreview of the Open Payments process.To register please visit the MLN(http://Connects website.w w w . e v e n t s v c . c o m 69987100b99)For more information on OpenPayments program, please go to theAOA’s information page about -act.aspx)CBO Predicts noIPAB forNext Ten YearsBreeAppointmentGovernor Jay Inslee has appointedJeanneRupert, DO as theThe Congressional Budget Officeosteopathicphysician representative(CBO) released a new long-termontheRobertBree Collaborative.budget outlook last week that projectsThe2011Legislaturepassed Housethe Independent Payment AdvisoryBill1311,establishingtheBoard (or IPAB) created under theCollaborativetoprovideamechanismAffordable Care Act will not go intoeffect for the next ten years due to through which public and privateslowed growth in Medicare spending. health care purchasers, healthThe IPAB is a 15-member panel tasked carriers, and providers can workwith achieving specified savings in together to identify effective meansMedicare if spending growth exceeds to improve quality health outcomesa set target, without affecting coverage and cost-effectiveness of care.Although not included in the originalor quality.Unlike the Medicare Payment legislation, at WOMA’s request aAdvisory Commission (MedPAC), the position for an osteopathic physicianIPAB has the authority to directly make was added.The collaborative identifies andchanges to Medicare without needingreviewscertain high-variation or highan act of Congress. Congress wouldutilizationhealth care services inonly be able to overrule the IPAB’sWashingtonstate that produce betterdecisions through a supermajoritycareoutcomesfor patients. Itvote. The controversial panel has yetconsidersanddevelopstrategies thatto have any members appointed to it,and funding for it was cut by 10 million promote improved care outcomes,in the omnibus 2014 spending bill such as patient decision aids,enacted by Congress at the beginning provider feedback reports, centersof excellence or other providerof this year.qualification standards, and researchto improve care quality andSave the Date!outcomes. The Collaborative consistsof twenty members.102nd AnnualMost recently, WOMA membersNorthwestwere asked to provide feedback onOsteopathicthe Collaborative’s latest draft reportConventionand recommendations for a lumbarJune 25-28, 2015fusion surgical bundle supported bySemiahmoo Resortan evidence able, and a lumbar fusionBlaine, WAwarranty.Auction Supports WOFOn Saturday, June 21st, during theWOMA Annual Convention, membersrallied in support of the WashingtonOsteopathic Foundation, raising over 13,000 from convention attendees.We are grateful to the following forcontributing auction items and/orgenerous cash gifts to make theauction successful: Harold &Margaret Agner, Al Adatia, AlanThom, Amber Figueroa, BillDickinson, Dan Dugaw, DavidLemme, David Lukens, Ken andSharon Cathcart, John Allen &Maureen Rouse, Lindy Griffin,Kathleen Farrell, Loren H Rex, MarkPage 4& Ginny Hunt, Mischa Coleman,Monica Haines, Paul Emmans, Jr, PJEmmans, Phil Andress, RebeccaLocke, Richard Koss, Rick Reid, Scott& Jennifer Fannin, Sharelle & GeorgeLeick, Sheila Kennedy, Steve & KathieItter, Steven Leifheit, Nick Curalli,Suzanne Laurel, David Hofheins,David Tate, Tim Anderson and SherriDumont.Since 1971 the WOF has assistedmore than one hundred osteopathicmedical studentswho calledWashington their home state withscholarships and low-interest loans.Seventeen are currently in trainingSummer 2014programs and at least half of theremaining recipients stayed inWashington to practice uponcompletion of their training.Because of the rising cost oftuition and increase in osteopathicmedical schools and class sizes,there is an even greater need forassistance. If you would like to help,WOF is a 501 c 3 tax-exemptorganization and all contributions aretax deductible. A contribution formis included on the last page of thisnewsletter.Washington D.O.

Washington Seeks 92.4 MillionFor Health CareInnovationThe Health Care Authority hassubmitted the state’s application toremake the healthcare system inWashington with the goal of producingbetter health outcomes at lower cost.The grant application seeks 92.4million, in Governor Inslee’s words,“to help Washington’s seven millionresidents lead healthier lives andaccess the best quality of care at thebest price.”A few things about the grantprocess and Washington’s application:Successful applications are expectedto be announced in late October 2014with funding available in January 2015.Documents now available on s/default.aspx) include:Grant Application materialsGovernor’s News ReleaseHealthier Washington VideoWhile the State Health CareInnovation Plan is the foundation forthe grant application, the goal drivingour work is to achieve a healthierWashington. To keep us focused onthat goal, going forward we will referto all related work as part of theHealthier Washington project. We willcontinue to provide regular updateson project efforts, such as theAccountable Community of Healthinitiative, development of a statewidecore performance measures set, andthe Prevention Framework.Are pharmacists demandinga more detailed diagnosisfrom you to fill aprescription?The state requirements aremandated upon the physician andnot the pharmacist. It isappropriate for the pharmacist toverify that the prescription is for alegitimate medical need, butdiagnosis and the developmentof the comprehensive treatmentis the practice of medicine. Thistype of request is outside of thescope of practice of pharmacy.Washington D. O.Tramadol: Schedule IV ControlledSubstance as of August 18, 2014Effective August 18, 2014,tramadol (aka Ultram) will be a class4 controlled substance (Schedule IV)as a result of a decision by the DrugEnforcement Agency. This transferincludes all of the prescriptiverestrictions associated with acontrolled substance under thatSchedule. In addition, this transferremoves tramadol from naturopathicphysician prescribing scope ofpractice. For existing prescriptions,please see the information below.Effective August 18, tramadol andproducts containing tramadol will beclassified as Schedule IV controlledsubstances pursuant to 21 CFR 1308.INVENTORY: All pharmacies andany persons who handlemanufacture, distribute, dispense,import, export, engage in research,conduct instructional activities withor possess- tramadol, must take aninventory of their current stock oftramadol and other productscontaining tramadol on August 18,2014.REGISTRATION: Any locationpossessing tramadol or productscontaining tramadol that is notcurrently registered with US DrugEnforcement Agency (DEA) mustapply for and receive a DEAregistration prior to August 18, 2014.Alternatively, those locations notwishing to seek DEA registrationmust remove all tramadol productsfrom their possession prior to August18, 2014.PRESCRIPTIONS: All currentprescriptions for tramadol andproducts containing tramadol mustbe treated as controlled substanceprescriptions on and after August18, 2014.Prior to filling/refilling a tramadolprescription on or after August 18,2014, ensure that the prescriber hasa valid DEA registration, as requiredfor all controlled substanceprescriptions. All prescribers who donot have a valid DEA registration willnot be able to issue prescriptions orpersonally furnish tramadol ortramadol containing products.Summer 2014If a prescription for a tramadolproduct was issued prior to August18, 2014 and refills were authorized,as of August 18, 2014 those refillsmust be limited to no more than fiveand must be dispensed no later thansix months after the date theprescription was initially issued.No electronic prescriptions fortramadol or products containingtramadol may be sent to a pharmacyusing an electronic prescriptiontransmission system unless theprescriber’s and the receivingpharmacy’s systems meet the DEAauthenticated system requirementsaddressed in 21 CFR 1311.PMP: All pharmacies anddispensers must follow the federalregulations beginning August 18,2014. Because this drug isn’t includedin the Washington State rules, it isn’trequired to be reported to the PMPyet. The Pharmacy Commission willmove to schedule it in WashingtonState as a Schedule IV drug in rule bythe end of the year. While it may notbe scheduled in Washington Stateuntil the end of the year, you shouldensure all federal requirements arefollowed regarding Tramadolbecoming a Schedule IV drug.The Department of Health wouldlike all dispensers to voluntarilyreport any Tramadol dispensingstarting on August 18 so prescriptionsfor these medications can beavailable in the PMP for our providers.We think this is important for patientcare and for preventing prescriptiondrug misuse in our state. We’vereceived several communicationsfrom providers indicating howimportant they think it is to haveTramadol available in the PMP.Based on our current PMP law, alldispensers (except veterinarians)don’t have to report any dispensingof Tramadol or other controlledsubstances intended for a one-daysupply or less.If you have any questions, youmay contact the PMP at e 5

2014 Annual ConventionClockwise from upper right: Songwriter Dan Wolf onguitar, assisted by Sharon Cathcart and Lindy Griffin onvocals, leads the group in song for Osteopac supportwith new lyrics to Pink Floyd's "Money"; Dr. and MrsDavid Lemme visit with PNWU's Celia Freeman at theIcebreaker reception; Past President Marc Cote presentsScott Fannin with WOMA's Presidential Plaque; AOAPresident Norman Vinn, Woma Exec Kathie Itter andPNWU Dean Thomas Scandalis at the Icebreaker Reception; Trustee Dave Lukens reports on District 3 happenings at the annual meeting; Secretary Mark Hunt displaysa pair of paintings by Massai artists as they are preparedto be auctioned for the benefit of the WashingtonOsteopathic Foundation.Page 6Summer 2014Washington D.O.

HighlightsClockwise from top: President Scott Fannin provides his report at WOMA's annual meeting as Executive Director KathieItter, Immediate Past President Marc Cote, Secretary Mischa Coleman, Lobbyist David Knutson, Public Affairs ChairLindy Griffin and Treasurter Steven Leifheit prepare to give theirs; David Lukens requests a moment of silence at theannul meeting to remember pillars of the profession lost since the last meeting - Drs. Richard Koch, Lon Hoover, KarlJohnson, Charles Schuetz and former Executive Director Warren Lawless; Lynda Williamson has a lively discussion withDr. Larry Greenblatt and guest; Scott Fannin recognizes Dave Lukens for his 46 years of WOMA membership; StevenLeifhit converses with Alaska DO Janice Carrick, President Fannin presents Hugh Schuetz with his Life Membershipaward.Washington D. O.Summer 2014Page 7

In MemoriamLon Ahlers Hoover, DOLon Ahlers Hoover, D.O. quietlypassed away on May 8, 2014 with hisfamily nearby. Dr. Hoover was bornOctober 17, 1930 in Tacoma, WA. Hegraduated from Stadium High Schoolin 1948 and earned his BS from theCollege of Puget Sound in 1952. In1956 Lon, alongside his twin brother,graduated as a doctor from the ChicagoCollege of Osteopathic Medicine. Hisinternship was at Clare GeneralHospital, MI.Lon moved back to Tacoma andtook over his father, Harold V.Hoover’s family medicine and OBpractice. In 1977, he became a belovedassociate professor at Michigan StateUniversity College of OsteopathicMedicine,FamilyMedicineDepartment where he specializedwholeheartedly in manipulativemedicine. He was known for hiscommitmenttoosteopathicprinciples and practice, his easy styleof instruction, and his passion formountain-climbing (he’d train byrunning the stairs of Fee Hall with aheavy backpack). A faculty memberin MSUCOM’s Department of FamilyMedicine from 1977 to 1996, he alsoserved as a consultant in osteopathicmedicine for the MSU Division ofAthletic Medicine.During his career he was Presidentof both WOMA (’69-’70) and theAmerican Academy of Osteopathy(’73-’74), the AAOA Secretary (’75’81), and received the DistinguishedService Award from Michigan’sAssociation of Osteopathic FamilyMedicine. Until Parkinson’s limitedhim, he took his treatment table withhim everywhere, and laid healinghands on anyone who needed hisattention. He retired in 1996 andmoved to Vashon Island, WA.Outside of his profession, he wasa passionate vocalist, UPS Alumnitrustee, 1st Congregational Churchleader and an avid athlete(mountaineer, backpacker, skier andmower of lawns). After retiring, hetook up mountain biking in his mid70’s, successfully finishing the 3 day/3 summit Courage Classic race forTacoma’s Children’s Hospital. Alongtime hiker and mountaineer, heconquered Mt. Rainier six times, ledmore than 100 climbs, andparticipated in 50 others, includingthe treacherous Mt. Anyegaqen inChina at age 50.Page 8Dr. Hoover is survived by his wifeof55years,Carolyn(lonlynhoov@gmail.com), and twodaughters, Carol and Susan. He hasa 14 year old granddaughter, Jennifer,the apple of his eye and 11 nieces/nephews. He is preceded in death byhis sister, Regina Hoover PhD, and hisbrother, Larry Hoover, D.O.Richard Sayer Koch, DODr. Richard Sayre Koch Dr. RichardSayre Koch passed away peacefullyon June 16, 2014 in Olympia, WA, atthe age of 99. He was born onDecember 21, 1914 in Philadelphia,PA to Andrew and Mary Louise Koch.Dr. Koch received his pre-med degreeat the University of Alabama andgraduated from Philadelphia Collegeof Osteopathic Medicine in 1938. Hepracticed family medicine, physicalmedicine, prolotherapy and back/joint rehabilitation in Olympia WAfor 67 years. He retired in February of2005.Dr. Koch spent his professionallife advocating for medical researchand was a sought after lecturer onOsteopathic Medicine, spinalrehabilitation and prolotherapy. Inhis pre-med college years, Dr. Kochwas a champion light-heavyweightboxer, to help him pay his way throughcollege. He had a passion for scubadiving and went on many divingexpeditions all over the world,including his beloved Hood Canal. Hewas a scuba diving instructor for theYMCA. He was an avid Husky fan andenjoyed traveling the world with hiswife, Traudi. He made Hood Canaland his cabin his “home away fromhome.”Dr. Koch joined the WashingtonOsteopathic Medical Association in1951. He served WOMA as a memberof the Public Affairs Committee, theConference Committee, Chair of theState L&I Liaison Committee and asPresident in 1954-55.He is survived by his loving wifeof 36 years, Traudi, and his nephewRichard B. Koch (Wendy) ofPhiladelphia, PA.In lieu of flowers, donations may bemade in honor of Dr. Richard S.Koch’s name and sent to: WoundedWarrior Project PO Box 758517Topeka, KS 66675woundedwarriorproject.org orMilitary Order of the Purple HeartFoundation PO Box 49 Annandale,VA 22003.Summer 2014What isOSTEOPAC?The Washington OsteopathicPhysicians and Surgeons PoliticalAction Committee (OSTEOPAC) wasestablished in 1985 to give Washingtonosteopathic physicians a voice at theStateCapitolinOlympia.Contributions are used to support theannual DO Day in Olympia and otheradvocacy efforts for the osteopathicprofession as well as legislativecandidates supportive of theosteopathic profession and its issues.Why should you worry aboutpolitics? You don’t have time tomonitor every bill in Olympia and havea voice in the politics of the osteopathicprofession in Washington State. Thisis exactly why you should supportOSTEOPAC which helps members keepinformed in regard to what ishappening so when your efforts areneeded you will be prepared torespond.As a profession, we must be surethat those elected will have the bestinterests of the physicians, patientsand Washingtonians in mind.OSTEOPAC enables the profession toelect and re-elect pro-physician, propatient legislators through campaigncontributions providing networkingopportunities so when issues arise wehave legislators we can talk to.Our goal is to provide a constantpresence and voice in Olympia,advocating for the profession andpatients.OSTEOPAC supportscandidates who support 1) physiciansas the most qualified comprehensivehealthcare providers, 2) the physicianpatient relationship and public safety,3) medical liability reform, 4) apatient’s rig

Board of Osteopathic Medicine and Surgery. Juan Acosta, DO and Alex Sobel, DO each will serve a five-year term. Juan F. Acosta, DO, MS, FACOEP-D, FACEP is a 1997 graduate of the New York College of Osteopathic Medicine. After an Osteopathic Internship and Residency in Emergency Medicine at St. Barnabas Hospital, Bronx, NY, he received a