Sam Nussbaum, M.D.
Dr. Samuel Nussbaum is Executive Vice President and Chief Medical Officer for WellPoint, Inc. He oversees corporate medical policy, clinical pharmacy programs, health improvement and quality resources, transplant management program strategy, disease and care management strategy, and clinical informatics to optimize care for members. Dr. Nussbaum also has responsibility for the Health Management Corporation (HMC) subsidiary. His principal responsibilities include: serving as chief spokesperson on medical issues, guiding the corporate vision regarding quality of care and its measurements, leading efforts to assess cost of care performance and developing a strategy to foster further collaboration with physicians and hospitals to strengthen and improve patient care.
Dr. Nussbaum earned his medical degree from Mount Sinai School of Medicine. He trained in internal medicine at Stanford and Harvard and in endocrinology and metabolism at Massachusetts General Hospital, and Harvard Medical School, where he served on the faculty for 20 years. His clinical and basic research has led to new therapies to treat skeletal disorders and new technologies to measure hormones in blood. He is immediate Past President of the Disease Management Association of America, has served as Chairman of the National Committee for Quality HealthCare, and is professor of medicine at Washington University School of Medicine.
Robert Berenson, M.D
Robert Berenson, M.D. is a Senior Fellow at the Urban Institute. He is an expert in health care policy, particularly Medicare, with experience practicing medicine, serving in senior positions in two Administrations, and helping organize and manage a successful preferred provider organization. From 1998-2000, he was in charge of Medicare payment policy and managed care contracting in the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services.) In the Carter Administration, he served as an Assistant Director of the Domestic Policy Staff. He was also National Program Director of IMPACS—Improving Malpractice Prevention and Compensation Systems—a grant program funded by the Robert Wood Johnson Foundation, from 1994-1998.
Dr. Berenson is a board-certified internist who practiced for twelve years in a Washington, D.C. group practice, and is Fellow of the American College of Physicians. He is a graduate of the Mount Sinai School of Medicine. Dr. Berenson is also adjunct professor at the University of North Carolina School of Public Health. For ten years he was medical director of the National Capital PPO, a large rental PPO serving the Washington D.C. metropolitan areas and was co-author, with Walter Zelman, of The Managed Care Blues & How to Cure Them, published in 1998. Dr. Berenson’s current research focuses on modernization of the Medicare program to improve efficiency and the quality of care provided to beneficiaries.
David Bernard, M.D., FACP
David B. Bernard, M.D., FACP, FRCP (UK), a board-certified nephrologist, is currently a Senior Vice President and the Chief Medical Officer at Beth Israel Medical Center, New York. He is also a Professor of Clinical Medicine at the Albert Einstein College of Medicine and an Adjunct Senior Fellow at the Leonard Davis Institute of Health Economics at the Wharton School, University of Pennsylvania. During his long healthcare career, Dr Bernard has held numerous clinical, executive and academic positions. His clinical and research interests, in which he has written and lectured extensively, are in the areas of nephrology and healthcare quality and safety.
Andrew T. Cheng, M.D., FACS
Dr. Andrew Cheng is a board certified Otolaryngologist-Head & Neck Surgeon. Dr. Cheng graduated from Cornell University and State University of New York--Downstate Medical College. He conducts a solo practice in New York City since 1986. Dr. Cheng is active in clinical teaching as Clinical Assistant Professor of New York Eye & Ear Infirmary/New York Medical College. He has broad interest in various health issues with focus in health disparity, tort reform and healthcare manpower needs in minority communities. Dr. Cheng has served as past president of New York County Medical Society (2003-4) and previously served on the New York City Mayor's Office Special Task Force on Liability Crisis.
Verna Gibbs, M.D.
A native of New Jersey and a third generation physician, Dr. Gibbs moved to San Francisco in 1979 after completion of her BA degree from Harvard University and her MD degree from Duke University Medical School. She completed her residency in General Surgery at the University of California, San Francisco (UCSF) in 1984 and continued her clinical training in renal transplantation with a fellowship at the California-Pacific Medical Center in San Francisco. Following a molecular biology fellowship at Genentech Inc., in 1989, Dr. Gibbs joined the faculty in the Department of Surgery at UCSF where she is currently a Professor in Clinical Surgery. From 2002-2004 she was Chief of General, Vascular and Thoracic Surgery at the San Mateo Medical Center.
In 2000, Dr. Gibbs shifted her 10-year research interest from the molecular interactions of the interferon receptor system to areas in health services, quality improvement and patient safety. She is currently engaged in studies examining issues in surgical patient safety, quality improvement and error analysis. In October 2004 she started a surgical patient safety project entitled “NoThing Left Behind”: Prevention of Retained Foreign Bodies with the intent to make this a national surgical patient safety initiative. The goal is to develop and implement evidence-based, ALL stakeholder policies and procedures in all hospital operating rooms to ensure that surgical sponges, needles and instruments remain in the OR and not in the patient.
Margaret Juarez, M.D.
Margaret Juarez, M.D., Board Certified OB/GYN, has been in private practice for 20 years in the San Gabriel valley in California, just east of Los Angeles. She has been president of California Latino Medical Association and is present president of the Los Angeles Chapter. She has been active in CMA Foundation and at present is Vice Chair of the Network of Ethnic Physician Organization. She is also a delegate of the CMA in the EMOS Section. She has been active on several boards and is a board member of Foothill Family Services, serving at risk children in the San Gabriel valley. She is a member of the credentialing committee of Anthem Blue Cross for several years and a member of the California PRC for Anthem Blue Cross.
Jeffrey Linzer, M.D.
Jeffrey Linzer Sr., MD, FAAP, FACEP is the Associate Medical Director for Compliance and Business Affairs for the Emergency Pediatric Group at Children's Healthcare of Atlanta at Egleston and Hughes Spalding and an Assistant Professor of Pediatrics and Emergency Medicine at Emory University. He sits on several national committees that deal with documentation and coding issues.
Alan London, M.D.
Dr. London is a Board Certified Family Physician that has spent the past 20 years in various physician management positions. He has been with The Cleveland Clinic Health System for 11 years as the Executive Director of Managed Care and led the physician/hospital organizations that contracted with insurers, government agencies and international payors. In 2003, Dr. London became Chairman of the Risk Management Steering Committee which oversees all of the medical/legal efforts to manage medical liability costs and captive insurance companies. In 2005, he became Executive Director of International Business Development and works on numerous international healthcare initiatives.
Theodore M. Mazer M.D.
Ted Mazer, MD, is a Board Certified Otolaryngologist-Head and Neck Surgeon, with a solo private practice in San Diego, California, covering general Otolaryngology for all ages, with focuses on sinus surgery, ear surgery, balance, and laryngology. He completed his residency training at Baylor College of Medicine in Houston, TX in 1988. In addition to his practice, Dr. Mazer is active in patient and physician advocacy, and currently serves as President of the San Diego County Medical Society (2006-2007), Trustee of the California Medical Association, and President of the Pacific Foundation for Medical Care. He has served as Medical Director for a multispecialty 300-physician IPA, and helped found a specialty IPA. Dr. Mazer also performs medical legal evaluations for the Department of Labor, and is involved in medical-legal and workers compensation evaluation services as well as external third party review.
Mitchell B. Miller, M.D., FAAFP
Dr. Miller is a solo family physician, currently practicing in his 25th year, in Virginia Beach, Va. He has served as President of the Medical Society of Virginia and the Virginia Academy of Family Physicians. He currently serves as a Virginia Delegate to the American Medical Association and the American Academy of Family Physicians. Dr. Miller also serves as Chairman of the Credentials Committee at Virginia Beach General Hospital, where he is a Past President of the Medical Staff. Dr. Miller also serves as Chairman of Continuing Medical Education for the Virginia Academy of Family Physicians.
Simeon Schwartz M.D.
Dr. Schwartz is a board certified hematologist and medical oncologist in clinical practice since 1983.
He is the founder and president of The Westchester Medical Group, which today is a 100-physician multi specialty medical practice in White Plains New York. The Group’s mission is “Happy patients, happy doctors”. To achieve this goal, they have leveraged IT technology to create a paperless practice that has improved business and clinical efficiency and is a platform for their evidence-based quality programs.
Richard H. Tuck M.D.
Dr. Richard Tuck is a general pediatrician in a private group practice in Zanesville, Ohio. He is also medical director of Quality Care Partners, a southeastern Ohio PHO. Dr. Tuck has extensive knowledge of CPT and ICD coding, as well as payer and reimbursement issues, gained through his personal practice and state/national committee involvement. He serves as the American Academy of Pediatrics’ representative to the AMA RBRVS Review Update Committee (RUC). Dr. Tuck is committed to teaching physicians accurate appropriate coding for their services. This will assist physicians in obtaining adequate payment for the work they do and maintain access to care for their patients.
David Welsh M.D., F.A.C.S.
Dr. Welsh is a board certified general surgeon in his 18th year of practice in a small town in southern Indiana. He has special interests in trauma and endoscopy. He is chairman of the Board of Trustees of the Indiana State Medical Association. A major concern of Dr. Welsh and the ISMA is patient access to quality care. Dr. Welsh is also his county’s Health Officer and a fellow of the American College of Surgeons.
The following e-mail address is only for questions related to the WellPoint Physician Advisory Council (PAC): email@example.com
Please direct inquiries related to benefit coverage, new ID cards, billing practices, prior authorization, pre-determination or reimbursement, and medical policy or clinical guidelines to the local plan provider representative, billing/reimbursement department or Customer Service, as applicable, by calling the number listed on the member ID card. Queries of this type sent to the PAC e-mail address will receive no response.