Association News

President's Column 

excerpt from August 2020 Heartbeat


Many thanks for extra efforts, but we must remain vigilant


We enter our annual change of leadership here at ASMA during unprecedented times, with challenges encroaching on the medical field from all angles: a global pandemic with COVID-19, public and private reimbursement changes, increases in scope of practice, and increased regulation and oversight, just to name a few. 

The strain and stress placed on our community has been tremendous.

But through it all, we have continued to persevere. Rising to the challenges as we demonstrate steadfast commitment to apply our compassion, breadth of knowledge, skills and an Alaskan “can do” attitude, we have provided exceptional care to the people of our state. 

Despite obstacles that last year would have seemed unthinkable – the pandemic, lack of PPE, shutting down operating rooms and surgery centers, travel restrictions, no cruise ships, no climbing season on Denali – we stayed strong to take care of Alaskans. 

Certainly, there were obstacles.

It wasn’t easy.

And it isn’t over.

But I wanted to take this time to say, “Thank you.” 

Thank you to everyone who worked so hard to keep your office open, some at your own expense.

Thank you to those who helped procure much-needed PPE during the early stages of COVID-19.

Thank you as you managed to figure out how to incorporate telemedicine in our massive state of Alaska, saving patients from having to travel or missing critical appointments because of pandemic fears.

Thanks to all of you who continued to treat patients, despite all the unknowns of coronavirus or appropriate PPE. 

Specifically, here at ASMA a big thanks to Dr. Eli Powell, our immediate past president, for his leadership during this hectic year. 

To the dedicated staff at ASMA – Communications Director Dave Rush and Office Manager Cassie Jeanes – who kept things running, helping to keep us all informed with Heartbeat, the website and many phone calls and Zoom meetings, thank you. To Mike Haugen, our former executive director who after eight years of leadership at ASMA is moving on to new challenges, thank you for your dedication and service to Alaska’s physicians. His role as executive director is, gratefully, being managed by Pam Ventgen, who brings many years of physician advocacy to our association as we move through this transition.  

Finally, I want to thank all the members of ASMA throughout Alaska. As a member-based organization, it is only through your support that we continue to function. 

Unfortunately, during these trying times, like so many other organizations, we have seen a significant decrease in our membership. People offer many different reasons for a lapse in membership or for never joining ASMA. 

Simply put, we need you and, as has been said in other materials and for the reasons mentioned here, I would argue that Alaska and all the physicians in the state need a strong medical society.

It is an election year, the state is quickly burning through what savings it had, and we physicians are continually viewed as overpaid and underworked – thus making us extremely attractive targets for legislators looking for revenue. Without ASMA and our lobbyist, Kevin Jardell, keeping constant vigil on the goings-on in Juneau, we would not stand a chance against the constant onslaught.

Every member makes our association stronger, and a stronger ASMA helps protect every physician practice. 

So please take the time to become a member of the Alaska State Medical Association. As the year is more than half over, we have dropped the membership price for 2020 by two-thirds. (See related story, Page 1.) We will be decreasing membership dues next year, making continued membership even easier. 

For those of you who are members, thank you. For those who are not, please go to and join today.

Thank you for your continued care, dedication and commitment to the people of Alaska. Stay safe, stay healthy, and take care.


Steve Sivils, DO, is a pediatric anesthesiologist in Anchorage and the president of the Alaska State Medical Association.


CMS proposes changes to physician fee schedule


The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Aug. 3 that includes updates to payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after Jan. 1, 2021. At the same time, the Administration issued an “Executive Order on Improving Rural and Telehealth Access.”

The American Medical Association has highlighted key points from an early analysis of the 1,355-page rule.

The proposed CY 2021 PFS conversion factor is $32.26, a decrease of $3.83 below the CY 2020 PFS conversion factor of $36.09. This represents an almost 11% decrease in the conversion factor. The proposed CY 2021 anesthesia conversion factor is $19.96, a decrease of $2.25 from the CY 2020 conversion factor of $22.20. The CMS proposed conversion factors include the budget neutrality adjustment.

Under the Medicare Access and CHIP Reauthorization Act (MACRA), the statutory physician payment update for 2021 is zero percent. Further, the proposed rule indicates that a steep budget neutrality adjustment will be required in 2021 to offset the payment increases for office visits and other services.


Telehealth Services

During the COVID-19 PHE, pursuant to authority granted in the CARES Act, CMS has waived the geographic and site of service originating site restrictions for Medicare telehealth services, allowing Medicare beneficiaries across the country to receive care from their homes. These flexibilities remain in effect as the Health and Human Services secretary recently extended the PHE declaration through Oct. 23.

Medicare telehealth services have been dramatically expanded during the COVID-19 PHE. CMS has proposed to permanently keep several codes that were temporarily added to the Medicare telehealth list, including the prolonged office or outpatient E/M visit code and certain home visit services. CMS also proposes to keep additional services, including certain emergency department visits, on the Medicare telehealth list until the end of the calendar year in which the PHE ends. There is also language about allowing physicians to supervise non-physicians in rural areas via telehealth.



CMS proposes to continue to gradually implement the Merit-Based Incentive Payment System in 2021 and postpones the MIPS Value Pathways participation option until 2022 at the earliest to allow additional time for stakeholder feedback about the MVP framework. CMS is also proposing a new MIPS pathway for participants in alternative payment models (APMs) called the APM Performance Pathway (APP). The performance threshold would increase from 45 points in 2020 to 50 points in 2021, a more gradual increase instead of the 60 points as had been previously proposed.

CMS also proposes to lower the weight of the Quality Category performance score from 45 percent to 40 percent of the MIPS final Score, and increase the weight of the cost performance category from 15 percent of the MIPS final score to 20 percent. In addition, CMS plans to add telehealth services to the existing cost measures, and to use performance period benchmarks rather than historical benchmarks for quality measures, as the 2020 data may not be accurate due to the pandemic.

More information is available at the CMS website,




Keep up with current events and issues that relate to health care in Alaska.


ASMA reorganizes staff, drops directory

PHC coordinator Ventgen takes over as association’s interim executive director


In the wake of budget shortfalls and declining membership, the Alaska State Medical Association has reorganized its staff and implemented a number of cost-cutting measures.

Michael Haugen, executive director for the past eight years, has left ASMA and was replaced July 16 by Physician Health Committee Coordinator Pam Ventgen. Her new title is interim executive director, and she is expected to serve at least through January.

The positions of administrative assistant and communications director are being permanently eliminated, and the Alaska Medical Directory will no longer be published. A Web-based version that is updated daily will continue to be available.

Paul Brusuelas, who had been the association’s administrative assistant for three years, has been dismissed. Dave Rush, who has handled publications and communications since 2009, will be terminated August 31. The decision to eliminate those positions was purely financial and in no way reflected the two men’s job performances.

Cassie Jeanes, the association’s office manager, becomes the lone full-time staffer and will assume many of Brusuelas’ and Rush’s duties.

The association expects to look for a long-term executive director, but details have not yet been determined.


Meet the interim executive director


Pam Ventgen has been working in the Anchorage medical community for more than 45 years. She began her Alaska career at Anchorage Community Hospital. She then moved to private medical practice management, working in general surgery, cardiology, obstetrics/gynecology and family practice. From there she was hired as the first executive administrator for the Alaska State Medical Board, where she spent five years. After her term with the board, she worked as committee support at ASMA before joining the University of Alaska as a professor in the medical assisting program.

When Ventgen retired from the university, Dr. Mary Ann Foland asked her to join the ASMA Physician Health Committee as committee coordinator. The purpose of the Physician Health Committee is to provide facilitation for physicians whose functioning is impaired because of alcoholism and/or drug abuse, or other emotional and cognitive impairments to receive assistance with the goal of restoring their function. During the past two years the PHC has seen a threefold increase in the number of physicians in monitored recovery. Most of these are voluntary participants, though a few are mandated to the PHC by the State Medical Board.

The value of the PHC is unquestioned. Without ASMA, the PHC could not exist. Ventgen’s commitment to the PHC and ASMA made her the logical choice to step in as interim executive director in these trying times.

Once we recover from the COVID-19 pandemic, Ventgen likely will seek to go back to retirement and travel, she says. But for now, ASMA is her focus, and the Board of Trustees has expressed appreciation that she is willing to support the association. Please welcome her when you have the opportunity