Inside - American Association of Physicians of Indian Origin

Inside 

Global Healthcare Summit – 

New Delhi, India . . . . . . . . . . . . .22 

HIPAA – What’s New 

This Year? 

by Peter Parvis, 

Healthcare Attorney . . . . . . . . . . . . .36 

AAPI Launches Political 

Action Committee 

Vinod K. Shah, MD, AAPI President 

Dino Teppara, Esq. , AAPI Director 

of Legislative Affairs . . . . . . . . . . . . . 26 

AAPI President Attends 

State Dinner . . . . . . . . . . . . . . . . . 35 

The U.S. Ayurveda 

Delegation Trip to India, 

January 28 to February 4, 2010 

by Dr. Navin Shah, Medical 

Education Director, Metropolitan 

Urologic Institute . . . . . . . . . . . . . . . .43

2 www. aapiusa.org Winter 2010 AAPI Journal

AAPI Journal Winter 2010 www. aapiusa.org 

3

Contents 

aapi 

President 

Vinod K. Shah, M.D., F.A.C.C. 

600 Enterprise Drive, Suite #108 

Oakbrook, IL 60523 

Phone: (630) 990-2277 

Fax: (630) 990-2281 

www.aapiusa.org 

Editor 

Jayesh Kanuga, M.D. 

journal@aapiusa.net 

Co-Editor 

Prasad Srinivasan, M.D. 

prasads268@gmail.com 

Production & Design Coordinator 

Vipul Shah 

vipulshah.aapi@gmail.com 

Marketing Communications 

& Ad Sales 

Sam Fulambarker 

sam@aapiusa.net 

Accounts & Membership 

Vijaya Kodali 

vkodali@aapiusa.net 

Designed & Printed by 

GR Marketing & Graphic Design 

Phone: (813) 886-4500 

Fax: (813) 886-4501 

Copyright©2010 by 

American Association of Physicians 

of Indian Origin. 

All rights reserved. 

Winter 2010 AAPI Journal 

About The Cover 

Counterclockwise: Official banner of the Global Healthcare Summit in New Dehli, India; Audience 

members sit mezmerized at the depth of topics at the Global Healthcare Summit; AAPI President, Dr. 

Vinod K. Shah and wife, Ila, smile proudly at President Obama's first official State Dinner honoring 

Prime Minister Manmohan Singh; taken by Dr. VK Shah after a Lukemia & Lymphoma Society 

benefit, "Light the Night Walk", a beautiful picture of the U.S. Capitol Building on a cold, rainy night 

- despite the weather, thousands of people attended the LLS benefit; supporters of Team Ami-Ba are 

geared up and ready to walk the 2.5 mile "Light the Night Walk" to support the LLS - Team Ami-Ba 

raised over $32,000 (http://www.lightthenight.org/nca/localchapter/top_fundraisers) 

Executive Officers Reports 

President’s Report 

Vinod K. Shah, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 

President’s Elect’s Report 

Ajeet Singhvi, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Vice President’s Report 

Sunita Kanumury, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 

Treasurer’s Report 

Jayesh Shah, MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 

Secretary’s Report 

Narendra Kumar, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Board of Trustees Report 

Sanat Gandhi, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

In The News 

AAPI President Attends State Dinner 

Dr. Vinod K. Shah, the only national president of an Indian American 

community organization to attend the State dinner at the invitation 

of President Barack Obama, speaks about his experience. . . . . . . . . . . . . . . . . . . . . . . 35 

Dr. Sudhir M. Parikh Receives Padma Shri Award 

Dr. Sudhir M. Parikh, Publisher, India Advocate, 

Philanthropist, Physician 

Indian American physician, philanthropist and publisher, Dr. Sudhir M. 

Parikh, has been named a recipient of the 2010 Padma Shri award. . . . . . . . . . . . . . 27 

Dr. Onaly A. Kapasi Receives New England’s 2009 

Distinguished Humanitarian Service Award 

Onaly A. Kapasi, MD, a nominee for the American Academy of Orthopedic 

Surgery’s Humanitarian Service Award, recently received the Distinguished 

Humanitarian Service Award from the Indian Medical Association of 

New England (IMANE) on November 21, 2009. . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 

The AAPI Journal is published quarterly by the American Association of Physicians of Indian Origin (AAPI). This publication may not be reproduced 

in whole or in part without the express written permission of AAPI. All articles published including editorials, letters and book reviews represent the 

opinions of the authors and do not reflect the official policy of AAPI. 


Featured Articles 

AAPI Launches Political Action Committee 

Vinod K. Shah, MD, AAPI President 

Dino Teppara, Esq. , AAPI Director of Legislative Affairs 

Physicians are the key players in providing quality health care to the American people. 

However, they are not a large nationwide constituency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 

AAPI Clinic launches HIV, Hepatitis and Mother-Child 

programs and conducts health camp 

by Jagan Ailinani, MD, Past President, 

Board of Director AAPI-Charitable Foundation 

The AAPI Preventive Health Clinic, initiated several 

projects in rural Andhra Pradesh this year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

HIPAA – What’s New This Year? 

by Peter Parvis, Healthcare Attorney 

HIPAA (Health Insurance Portability and Accountability Act of 1996) 

affects everyone who uses, provides, or pays for health care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 

Special Articles 

MSRF: Year to Date 

by Chirag Parghi, MD 

The AAPI-MSRF (Medical Student, Resident, Fellow) section has 

had a busy year with a focus on increasing awareness nationwide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 

NRIs and Globalization 

The following is the summary of the invited talk given before 

the AP Medical and Dental College’s Management Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 

Process of Progress 

Onaly A. Kapasi, MD 

To analyze and comprehend progress we must understand 

and establish the process of measuring progress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

Global Healthcare Summit – New Delhi, India 

The American Associate of Physicians of Indian Origin (AAPI) was proud to host a 

Global Healthcare Summit at Modia Sheraton Hotel in New Delhi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 

Book Review: ‘CHEATING DEATH’ 

by M. P. Ravindra Nathan, MD, Brooksville, FL 

Anyone who is frustrated by the failure of standard approaches for treating critically ill 

patients will be amazed at what Dr. Sanjay Gupta has to say in his latest book, 

‘Cheating Death,’ a New York Times best seller. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 

The U.S. Ayurveda Delegation Trip to India, January 28 to February 4, 2010 

by Dr. Navin Shah, Medical Education Director, Metropolitan Urologic Institute 

Delegation: Seven delegates including six Complementary Alternative Medicine 

(CAM) directors of six major United States medical schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 


5

President’s Report 

Dear Friends, 

As your President, I have been regularly sending 

you a monthly e-newsletter to keep you abreast with 

the activities of our organization. This monthly 

communication has been very well received and I 

would like to express my gratitude for the many 

compliments you have sent to me and to the AAPI 

office. 

Fall Governing Body 

We had an exciting and very well attended Fall 

Governing Body meeting in San Antonio, TX. The 

Texas Indo American Physician Society SW 

Chapter (TIPS-SW) did a great job in organizing 

the event. The AAPI Charitable Foundation dinner 

generated $15,000. 

White House State Dinner 

I am honored that President Obama provided me 

with an opportunity to join 300 guests in welcoming 

Prime Minister Dr. Manmohan Singh. This was 

truly a memorable event recognizing the global 

presence of the world’s largest democracy. 

Reception in Honor of Prime Minister 

Dr. Manmohan Singh 

On November 25th, along with other AAPI 

members, I attended a reception in Washington, 

D.C. to honor Indian Prime Minister Dr. 

Manmohan Singh hosted by India’s Ambassador to 

the United States, Hon. Ambassador Meera 

Shankar. 

AAPI/AKMG Dubai Annual Convention 

and CME Program 

AAPI/AKMG Dubai CME meeting was well 

attended by over 600 physicians. The AKMG 

leaders were outstanding hosts and arranged 

excellent CME topics and speakers in addition to 

the gala dinner event cruise on New Year’s Eve. 

Vinod K. Shah, MD 

President 

AAPI Global Healthcare Summit - 

New Delhi, India 

AAPI Global Healthcare Summit was great a 

success and was well attended by physicians from 

around the world. The Summit shared the best 

practices and experience from leading experts around 

the world to develop actionable plans for launching 

demonstration projects with focus on prevention, 

treatment and management of priority disease states 

in India with define measurable metrics to ensure 

that action plans are economically viable. 

3C Conference in Ahmedabad 

Attended 3C Conference in Ahmedabad and gave 

a talk on “The Role of AAPI and US Physicians in 

Building the Bridge”. 

Spring Governing Body 

Meeting/Women’s Forum 

AAPI’s Spring Governing Body Meeting will be 

held in Washington, D.C. from April 17-18, 2010 

along with the Women’s Forum. AAPI delegates will 

have a private meeting with former President of 

India Dr. Abdul Kalam. 

AAPI Convention 2010 

The 28th Annual AAPI Convention will be held 

at the Gaylord National Hotel and Convention 

Center from Wednesday through Sunday, June 23- 

27, 2010. Registration opened on Sunday, February 

28th. As we received several requests from our 

Continued on page 7 


President’s Report...continued 

Continued from page 6 

members, we introduced kick off and advanced 

pricing for the initial 2 weeks. 

AAPI Bylaws 

AAPI Bylaws were extensively deliberated by the 

Bylaws Committee, Executive Committee, and 

approved unanimously at the Fall Governing Body 

meeting in San Antonio, TX. The changes of the 

Bylaws were mailed to the entire membership and 

the ballots were counted. I am pleased to inform you 

that 955 out of the 1,026 ballots that were returned 

showed unanimous approval of all changes 

presented. The new AAPI Bylaws will come into 

effect immediately. 

Opportunity for an existing Patron member 

to nominate a new Patron member 

The AAPI office has received 295 applications for 

the $100 Patron Nomination initiative. We are 

working on these applications and will present them 

to the Spring Governing Body for its final approval. 

I would like to express my gratitude for your 

friendship and trust and look forward to working 

with you in the coming years. 

Sincerely yours, 

Vinod K. Shah, MD, F.A.C.C. 

AAPI Executive Officers 


President 

Ajeet Singhvi, MD 

President Elect 

Sunita Kanumury, MD 

Vice President 

Narendra Kumar, MD 

Secretary 

Jayesh Shah, MD 

Treasurer 

Sanku Rao, MD 

Past President 

Sanat Gandhi, MD 

Chair, BOT 


7

President-Elect’s Report 

As the President-Elect of the American Association of 

Physicians of Indian Origin (AAPI), it is my privilege to 

present the President-Elect’s report. 

Ajeet Singhvi, MD 

President Elect 

I would like to thank the Constitution & Bylaws 

committee, for having deliberated and gone through the 

Bylaws extensively this year. The committee members are 

as follows: 

Advisors: Drs. S. Jay Jayasankar, MA & Krishan K. 

Aggarwal, WV 

Members: Drs. Madhu Aggarwal, WV Anuj Chandra, 

TN, Ashok Fulambarker, IL, Ashok Jain, MI, Narinder 

Kukar, NY, Arun Narang, IL, Nidhi Mehta, NV, 

Rajendra Mehta, NY, Jyotin Patel, CA, Velugubanti 

Prasadarao, VA, Manju Sachdev, TX, Lalit Savla, MA, 

Harnath Singh, AZ, Jawahar Tank, FL, Ram Upadhyay, 

MA, Priya Kundra, MD, Mamta Singhvi, CA 

We are working to update the Convention Manual 

which has been a guide for the convention committees for 

smooth execution of AAPI Conventions. In view of the 

fast evolving technology, a lot of information in the 

manual has become outdated. Lessons learned from past 

conventions also need to be incorporated. Senior leaders 

of AAPI have been devoting their valuable time in 

assisting us in this project. 

Since this year I did not need to spend time in 

campaigning for the AAPI elections which incidentally 

takes a lot of Officers’ time, I have had time at hand to 

help our President, Dr. Vinod Shah, Board of Trustee’s 

Chairman, Dr. Sanat Gandhi, Vice President, Dr. Sunita 

Kanumury, Secretary, Dr. Narendra Kumar,Treasurer, Dr. 

Jayesh Shah and various Committee Chairs in whatever 

capacity they have needed my help. 

Many members are willing to serve our organization in 

various committees. Please call me or the AAPI office at 

630-990-2277 and let us know if you would like to serve 

on any of next year’s Standing or Ad Hoc Committees. 

We are also planning a calendar of events for the year 

2010-2011. Please call us for any suggestions. We request 

you to join us in as many AAPI sponsored programs as 

possible.The 29th Annual AAPI Convention will be held 

in New York City from June 22-26, 2011 at The Hilton 

Hotel, at Avenue of Americas. The previous Convention 

held in New York City was in the year 2000. 

Vijaya and Sam have been very efficient and have been 

working tirelessly to catch-up with the extra work. 

Telephone calls are being personally answered and 

individual logs of outgoing and incoming calls are being 

kept. Any complaints or grief of AAPI members or 

vendors should be referred to an officer for swift 

resolution. 

I hope to see some you at the AAPI Governing Body 

meeting in April and many of you in Washington, D.C. 

for the 28th Annual AAPI Convention. The Convention 

committee under the leadership of Dr. Nayan Shah is 

planning a very good event and I you to join us for what 

will undoubtedly be a memorable event. 

I have been fortunate to have the full support and 

confidence of the Executive Committee, which has made 

my job easy and pleasurable. It has been my honor in 

serving the AAPI membership as your Treasurer, 

Secretary, Vice President and President-Elect. 

I will be happy to receive and respond to your 

comments. 

Respectfully Submitted, 

Ajeet R. Singhvi, M.D., F.A.C.G 

President-Elect, AAPI 

O: 951-929-0124 

H: 951-927-7177 

asinghvi@aol.com 



9

Vice-President’s Report 

Dear Colleagues, 

Thank you for supporting me and I am honored 

to serve as your Vice President in 2009-2010. In my 

90-day report, I had chalked out my agenda for my 

Year and I now present you my Semi Annual 

Report. 

Continuing on my Mantra about sound 

Membership, I am crediting my success to the 

concept of TEAM WORK. 

Having participated with the day to day workings 

of AAPI, I have attended The Governing Body 

Meeting, Indo-US Healthcare Summit and other 

AAPI related activities I have worked on towards 

membership issues. 

Membership Numbers as 

of February 28, 2010 

Chapter Patron Member – Three 

- American Association for Emergency 

Medicine in India (AAEMI) 

- Georgia Association of Physicians of Indian 

Origin (GAPI) 

- Knoxville Region of Indian Physicians 

Association (KRIPA) 

Sunita Kanumury, MD 

Vice President 

Reaching out to Membership 

I executed an initiative to vet Young Physicians to 

be Patron Members of AAPI by Launching “AAPI 

CONNECTS! Enhance Your Profession, Advance 

Your Career, and Enrich Your Community...........” 

My Membership Strategies, Database and 

Program Execution Teams have helped me perform 

with distinction in reaching out to Members. I 

brought awareness with a potential to grow the 

number of members by personally traveling to more 

than 18 events held by Local Chapters and Alumni 

Organizations across United States. 

We have designed an initiative to offer dual 

membership to members of Sister Organizations. 

This initiative was on the floor of the Governing 

Body in the Fall but was put for further discussion 


*Annual members from July 1, 2008 to June 15, 2009 

As of June 15, 2009 As of February 28, 2010 

From June 16 to 

February 28, 2010 

Patron – Life member 6583 6631 48 

MSRF – Our Future 7439 7888 449 

YPS – Our Youth 94 127 33 

Annual – Our Strength 157* 199 42 

Total 14273 14845 572 


Vice-President’s Report...continued 


in the Spring Governing Body of 2010. I have been 

working with the local chapter committees to come 

forward with proposals so that our committee can 

review the needs of our members before discussion 

and being formalized into a bylaw in future. 

My journey across America has helped me 

understand the concerns and challenges AAPI faces 

as an organization. As a result I have come across 

many physicians who excel in their work, 

community and charitable activities. 

I have requested many to participate in National 

AAPI events and have tried to showcase their 

activities on the AAPI website to inspire and help 

our members and younger physicians. 

Marketing and Promoting AAPI: 

To increase awareness about National AAPI 

issues, AAPI marketing materials and slides that are 

more informative and attractive have been 

distributed to chapter members in areas that I have 

traveled. 

The continuously monitored and updated AAPI 

website is a result of successful coordination 

between various committees in AAPI. 

Database Correction: 

My Vice Presidency had its Challenges which 

still remain when it come to the fact that significant 

portion of addresses and emails in our database are 

incorrect. I continue to strive to get this done and I 

am hopeful that my successor will do the same. I 

request all members to visit our new interactive 

website www.aapiusa.org to update their contact 

details. Our committee is working on a short term 

and long term plan on correcting the database. 

In the short term with the help of couple of my 

committee members and AAPI personnel we were 

able to correct about 500 addresses and some 

duplicates as of date and the process is ongoing. 

In the long term with the help of committee 

members and IT committee, working to come up 

with a plan to develop local chapter websites and 

integrate local chapter database with the National 

database, so that we can maintain accuracy. Working 

towards electronic database. 

I request all members to participate in AAPI. 

They can take pride in participating in an 

organization that can speak out on the issues 

affecting the field of medicine in communities 

nationwide. Join us and add your voice to ours on 

behalf of the future we will share. 

Please contact me at anytime, all the time. 

I am your Vice President and I am here to serve. 

Sincerely, 

Sunita Kanumury, M.D. 

Vice President, AAPI 

Chairperson, AAPI Membership Committee 

Office: 973-627-1000 

Email: sunitakanumury@yahoo.com 


11

Treasurer’s Report 

It is my privilege and honor to serve you as your 

Treasurer and I am happy to provide you with the 

updated financial status of our organization. I have 

done everything I could do to keep close tabs on 

expenses. The financial activities are monitored 

closely at the AAPI National Executive Office by 

a weekly teleconference with the AAPI office and 

Dr. Vinod Shah, and a monthly Treasurer’s Report 

is sent to the entire Executive Committee before 

scheduled teleconferences. 

• As Chair of the AAPI Resource Committee, I 

was able to secure funds to keep the AAPI 

Journal budget neutral. 


Treasurer 

• A detailed Treasurer’s report was presented at 

the Governing Body Meeting in San Antonio in 

October and I look forward to presenting an 

updated report at the Washington, D.C. 

Governing Body Meeting. 

• This year, in order to bring consistency and to 

consolidate our financial positions, the YPS, 

MSRF, and AAPI convention account holders 

were requested to bring their accounts to the 

AAPI central office. 

This year, besides keeping tabs on expenses and 

keeping books in order, I actively worked to: 

1. Increase involvement of young physicians and 

enhance their participation at all levels of 

Cash Balances as of February 28, 2010 

Expenses 

Operating Account $368,548.13 Bank Fees $2,156 

Healthcare Summit Account $9,169.64 Computer Related $17,450 

Women’s Forum Account $2,768.72 Condo Fee $4,739 

AAPI YPS Account $8,071.00 Office/Other Expenses $12,338 

AAPI MSRF Account $2,485.00 Storage $1,680 

AAPI ACCME Account $16,010.00 Legislative Director $23,000 

Washington DC Convention Account $993.04 Real Estate Taxes $1,727 

Orlando Convention Account $5,033.19 Postage $4,193 

Income Printing $52,486 

Orlando Convention Income $221,868 Salaries/Benefits $114,318 

Patron 5% $112,899 Travel $8,559 

Sponsorships $178,000 Audit $4,800 

Journal Ads $61,500 Insurance $3,133 

Membership Dues $6,850 Governing Body $2,607 

Election Nomination Fee $7,500 Legislative Expenses $2,584 

Royalties $4,027 YPS/MSRF Support $5,000 

AAPI CME $1,231 Texas A&M $35,000 

Website Ads $900 Media $7,500 

Miscellaneous $198 



Treasurer’s Report...continued 


AAPI. With the help of Dr. Vinod Shah, 

President, we were able to secure a grant to do a 

leadership and YPS conference for young 

physicians throughout the country. 

2. Develop and expand externship programs in 

the U.S. As the AAPI liaison officer for the 

Observership Committee, we have opened up an 

Observership Co-coordinator Position, which is 

an Internship position for a physician awaiting 

residency. At the main office, this physician will 

be responsible for coordinating matching 

observers with proctors. 

3. Strengthen the base of AAPI by empowering 

local chapters. As your representative, I 

attended a Chirag Fundraiser at Cleveland, an 

AKMG meeting in Chicago, an IMA meeting 

in Southern California, a MAPI meeting in 

Michigan, and a Queens and Long Island 

annual meeting. 

4. Further the goal to improve quality of healthcare 

in India. With the help of TIPS SW Chapter, a 

fund raiser event for the AAPI Charitable 

Foundation was organized and $20,000 was 

donated to the AAPI Charitable Foundation. 

Actively participated in the Global Healthcare 

Summit and worked on pocket cards for diabetes, 

which were distributed locally in India. 

5. Closely work with organized medicine at state, 

national and subspecialty levels. I will remain the 

AAPI liaison to AMA and will continue to 

advocate on behalf of IMG’s and other physicians. 

While concluding, I want to thank you for 

electing me as your next Secretary. I am humbled 

with your confidence in my abilities to bring this 

great organization to greater heights. 

With kind regards, 


Treasurer, AAPI 

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13

Secretary’s Report 

It has been a distinct pleasure working as your 

Secretary under the able leadership of our President 

Dr. Vinod K. Shah, President-Elect Dr. Ajeet 

Singhvi, BOT chair Dr. Sanat Gandhi and the entire 

Executive Committee. We all have been working 

together for the good of our organization, although at 

times we have to respectfully disagree on certain 

major decisions. It has been a humbling and learning 

experience for me to be your Treasurer and Secretary. 

As Secretary, I have tried to fulfill my duties to the 

best of my ability in keeping the AAPI office and our 

records in proper order. Our office staff Vijaya Kodali 

and Sam Fulambarker are doing a fantastic job and 

they are truly committed and devoted to our 

organization. We are in the process of filling a 

temporary office staff position during the busy 

Convention season. Hopefully one of these days we 

may be able to fulfill our goal of finding an Executive 

Director for our AAPI office. We are keeping proper 

records of all Executive Committee minutes, 

Governing Body minutes and General Body 

minutes. We also keep copies of all major contract 

negotiations. Our tax returns and Convention 

financial reports are up to date. We have been 

constantly trying to update our database and need 

Narendra Kumar, MD 

Secretary 

your continued help in this matter. With the 

changing times, we also have tried to upgrade and 

update our AAPI web site. In preparation for the 

2010 election, I have certified the voters list and the 

ballots. I am closely working with Dr. Vinod Shah 

and Dr. Nayan Shah (Convention Chair) on all 

matters relating to 2010 Spring Governing Body 

Meeting and Annual Convention. Hope to see you 

all in our Nation's Capitol. 

Thank you once again for your continued 

confidence and giving me another opportunity to 

serve as your next Vice President. 

Respectfully Submitted, 

Narendra R. Kumar, M.D. 

AAPI Secretary 

Board of Trustees Report 

Thanks to improving the stock market. Trust 

account has done well. 

Our Trust account is managed by Glad Kurian and 

Kamesh Nagarajan of Smith Barney. Our exposure to 

the stock market is about 48%, with about 10% in 

Gold and rest in the fixed income. Our total net 

stands at $2,406,241.46 as of February 28, 2010. 

Let us hope the stock market remains in a recovery 

phase. 


Chair, BOT 

Respectfully submitted, 


Chairman 

AAPI Board of Trustees 


MSRF: Year to Date 

by Chirag Parghi, MD 

The AAPI-MSRF (Medical Student, Resident, 

Fellow) section has had a busy year with a focus on 

increasing awareness nationwide. We have hosted 

charity networking socials in eight cities aimed at 

mobilizing Indian physicians in training. 

Contributions have been used towards earthquake 

relief in Haiti, building schools in India, and even 

funding charitable cataract surgeries in rural India. 

By linking our social and professional networking 

ability with these wonderful causes, we have been 

able to make a difference. This is an initiative that I 

am quite proud of and would like to see grow in the 

years to come as we have limitless ability to unite 

towards charitable endeavors. 

As this year’s match day approaches, another 

round of applicants will soon discover if and where 

they will be training. This application process is quite 

rigorous and often is controlled by random 

circumstances such as personal contacts or through a 

lucky meeting. Meeting a single advocate in your 

field can be the single-most important factor in 

securing a residency spot, or a desired residency 

position. In order to facilitate these encounters, 

MSRF has created a national database of our 

membership that can be sorted by specialty and 

location. Our members are already using it to get 

sage advice or find mentors in the different 

specialties. Career advancement in our stage of the 

game is a difficult process in medicine with its own 

rules; we offer our membership to help with this 

process. 

Lastly, I would like to encourage all of you to 

come to our annual convention in Washington, DC 

from June 23rd to 27th. My board and I have been 

enthusiastically planning what I am sure will be the 

most memorable MSRF convention to date. We 

have exciting daytime events including a research 

contest among our general membership, elegant 

evening galas utilizing the rich canvas of Washington 

DC, and a signature political twist that could only be 

done in our nations capital. Please check your 

calendars and register at www.aapiconvention.com. 


15

NRIs and Globalization 

A Non-Resident Indian’s Thoughts on Effects of Globalization and 

Market Economy on Medicine and Health Care 

The following is the summary of the invited talk 

given before the AP Medical and Dental College’s 

Management Association during the Platinum 

Jubilee Celebrations of the Medical Council of India 

at Hyderabad in December 2008. 

The benefits of globalization are potentially 

enormous and include increased sharing of: 

• Ideas and cultures 

• Lifesaving technologies 

• New infrastructures 

• Resources to breach disparities and lessen threat 

Yet, according to the United Nations Development 

Program, over the past 30 years, the gap in per capita 

income between wealthy and poor nations has tripled. 

More than 1.2 billion of the world’s people live on 

less than one dollar a day. Life expectancy in the 48 

least developed countries is just 51 years, and the 

infant mortality rate (IMR) averages 100/1000. 

WHEN ANYONE SNEEZES, EVERYONE 

CATCHES COLD – gist of globalization. 

One of the most predictable accompaniments to 

globalization is the emergence of new diseases and the 

re-emergence of old ones. In 1865, it took 365 days to 

circumnavigate the globe—now it takes 36 hours. 

Disease also migrates. The share of TB cases in the 

US’s foreign-born population increased from 30% of 

all US TB cases in 1992, to 46% in 2000. 

The share of multi-drug resistant cases occurring in 

the foreign-born US population increased from 31% 

to 72%. 

Four Globalization Gaps: 

1. Research 10/90 

2. Pharmaceutical research and development (R&D) 

for neglected diseases 

3. Internet 

4. Gender 

1. Research 10/90 gap 

Research 10/90 is a term that illustrates the fact 

that only 10% of the biomedical research funding is 

targeted to the diseases that account for 90% of the 

global burden of disease. 

According to the Commission on Macroeconomics 

and Health, at least $3 billion /year should be 

allocated to the R & D of the health priorities of the 

poor. Half of this $3 billion is proposed to go to a 

newly created international version of the National 

Institutes of Health (NIH), called the Global Health 

Research Fund. 

Yet the entire budget of tropical disease research at 

the World Health Organization (WHO) directed at 

the 8 major tropical diseases is only $30 Million. 

It is estimated that worldwide, countries annually 

spend more than $800 Billion on weapons and 

military resources. 

What India can do to reduce the 10/90 gap 

History has shown that excellent scientific research 

has not always translated into solutions. 

The stunning discoveries of the causes and 

treatment of tuberculosis and malaria have resulted in 

three Nobel Prizes but had not translated into general 

accessibility for the global populations. 



NRIs and Globalization...continued 


50 years later the incidence of tuberculosis is still at 

eight million cases per year—and it kills two million 

annually. 

The story of yellow fever is equally sad. 

Clinicians and researchers of India who can stand 

in the interface between the laboratory bench and 

global public health issues are vital to this process. 

2. Pharmaceutical R&D Gap 

The small part of the globe accounting for 15% of 

the earth’s population provides nearly all of the world’s 

technology innovation. North America, Europe, and 

Japan accounted for 80% of the world pharmaceutical 

markets in 2002 (total value $406 billion), while 

Africa, Asia, Latin America, and the Middle East 

accounted for 20% of the market, despite representing 

80% of the world population. 

Even when effective drugs are available, patent 

protection and WTO agreements on trade-related 

aspects of intellectual property rights (TRIPS) can 

hinder availability of drugs to those with the most 

need. 

3. Globalization and the Internet Gap 

The past two decades have seen dramatic advances 

in independent media and global communication 

with the dramatic expansion of the internet. It has 

been the internet that offers the most potential for 

scientific exchanges and unfettered management of 

scientific data. 

There is enormous internet gap between rich and 

poor countries. 

4. Gender Gap 

Recent studies of malaria have demonstrated that 

biological immunity is compromised in pregnancy 

and in the early post partum period. A recent study in 

Nigeria showed that the prevalence of Schistosomiasis 

in girls is highest at the age of 15, when they are most 

likely to be involved in domestic work that involves 

water. 

Access to hospitalization and drugs for tropical 

diseases often is limited to the male child in some 

developing countries. 

India and the Globalized World 

India can contribute greatly in the globalization of 

medicine. There should be some ground rules which 

nurture the positive aspects of globalization. 

1. Integrity of big corporations and government 

2. Effective and efficient legal system 

3. Regulation and supervision (quality control) 

India is in a unique position with it multitudes of 

educated people. It can excel in implementing and 

improving health delivery systems by telemedicine. 

As Nani Palkhivala said in his book “We the People” 

(in 1977) – if we “stop being foolish collectively in spite 

of being highly intelligent individually” the educated 

throngs can accomplish a world of good. 

"Money is not the measure of man, but it is often 

the means of finding out how small he is." 

~ Disraeli 

VK Raju, M.D., F.R.C.S., F.A.C.S. 

3140 Collins Ferry Road 

Morgantown, West Virginia 26505 

vkr@vkraju.com 

www.eyefoundationofamerica.org 

www.goutami.org 


17

To analyze and comprehend progress we must 

understand and establish the process of measuring 

progress. I believe that we often confuse change with 

progress simply because we fail to understand the 

difference between the two entities. 

In the past thirty–nine years I have attended a fair 

share of medical meetings and heard as many 

presidential addresses exalting progress made in their 

term in office. Initially such notations were what I 

wanted to hear, even though far from reality, as it gave 

me a sense of identity in a country where I was 

searching for my own identity. As I have matured my 

ability to differentiate reality from gloss, my sense of 

identity comes from within myself rather than from 

the collective that I associate with. Has that made me 

cynical? I believe not but a hair more, a realist. 

Webster’s dictionary defines “change” as “to 

become transformed or different.” Change therefore 

covers a wide spectrum of entities between good at 

one end and bad at the other end. “Progress” on the 

other hand is defined as, “the development of an 

individual or group in a direction considered more 

beneficial than and superior to the previous level”. To 

be able to establish that a group has benefited or 

established superiority we must have a measure for 

progress that is reproducible and verifiable even 

though progress has abstract dimensions. The famous 

wartime British Prime Minister was asked, “How is 

your wife?” And he responded, “Compared to whom?” 

Similarity, to measure progress we must have a 

measure of the present and an ability to extrapolate 

the future. 

To illustrate by example, a drop in membership of 

an organization even though denotes a change it 

cannot be slated as progress. Gandhijee with his “quit 

India” movement made a remarkable and lasting 

change in the status quo that was undeniably a 

progress as it was superior and beneficial to all 

Indians. 

Process of Progress 

Onaly A. Kapasi, MD 

New England AAPI Rep. 

Now that we have established the difference 

between change and progress we have to establish a 

verifiable and reproducible criteria to measure 

progress. I have observed progress measured either 

qualitatively or quantitatively or a combination of the 

two. 

A qualitative measure of progress has a built in 

personal bias and may not be reproducible. It may 

also be marred by personal state of the observer. Each 

year we hear anecdotal individual assertions of 

progress of a group or association. Conversely, when 

viewed objectively a decline in membership numbers, 

and a precarious financial structure may become 

apparent. Therefore I believe that a qualitative 

measure cannot truly depict progress. 

Quantitative measure on the other hand uses 

verifiable and reproducible criteria to measure 

progress. A quantitative analysis of a group or 

association removes personal bias to a great extent. 

Of course there is a remote possibility of people 

fudging and manipulating data to edify their term in 

office. I have suggested some basic parameters that 

may be utilized to measure progress of a group or an 

association. Other parameters may be added as the 

process matures. Let us look into each of the 

suggested parameters in detail. 


18 

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19

Process of Progress...continued 


Membership 

The number of active members and a crosssectional 

diversity is a good measure of the continued 

viability of any group or association. Member 

satisfaction is also very important and year after year 

loyalty greatly signifies satisfaction. An increase in 

membership of a group or an association is a fair 

measure of the continued participation, need and 

interest of the group or association. Member loyalty 

is multifactorial. Mostly it is related to the net returns 

that the member derives from the association, which 

may be camaraderie, need for continuing medical 

education, political clout, participation in charitable 

projects within the country or outside, and other 

tangible and non-tangible gains derived from 

collective bargaining power of the group and an 

additional draw of meeting like minded people with 

similar goals and aspirations. 

Financial Viability 

In the bygone days the medical industry assisted in 

financing medical conferences, continued medical 

education activities and some other nonmedical 

activities. However with the advent of stringent 

regulations both state and local and multiple lawsuits 

filed against the medical industry that venue has 

dwindled away. Therefore the financial viability of a 

group or association is now directly contingent on its 

collections from its membership dues. Obviously a 

financially sound association or group has the 

advantage and the potential of achieving its 

charitable goals and initiating programs to improve 

membership participation and satisfaction. In the 

present scenario where many associations are trying 

their best to get a share of the pie providing 

membership benefits is an added incentive. Ethnic 

organizations uniquely bring like-minded people 

together to share their values and exchange ideas. A 

home away from home concept. For the young 

physicians additionally it may be a venue to meet and 

interact with their ethnic counterparts. 

Charitable and Educational Goals 

Medical associations are known for their charitable 

and educational projects as physicians share a 

compelling need to foster charitable projects. It is 

part and parcel of our culture of global giving. The 

association’s progress may therefore be measured by 

its attainment of charitable goals. Most ethnic 

organizations contribute extensively to alleviate 

healthcare conditions within the country of their 

origin and also in the U.S. Most of our continued 

medical education requirements are easily fulfilled 

with our attendance of specialty conferences and 

hospital grand rounds however funding of research in 

diseases prevalent in the ethnic socioeconomic group 

and its medical education is a definite draw as seen 

with our continued interest in CADI and diabetes 

mellitus studies. 

I used some of the parameters mentioned above to 

reflect the performance of a small ethnic medical 

organization that was in the doldrums in the the 

years 2002-2003 and to help revitalize it. 

The bar graph of the year-end financial balances 

from 2000 to 2003 clearly illustrates a dismal future 

Ending balances from yrs. 2000-2003 



Process of Progress...continued 


for the organization. The analysis helped the 2004 

executive committee to tighten its shoestrings, and to 

explore alternative financing and to work relentlessly 

to replenish its coffers without compromising the 

quality of its meetings. Quantifying performance 

helped strategize future performance of the said 

organization, which managed to rebound in 2004 

leaving behind a financially secure association. 

members. Not discounting the fact that life 

membership was an expression of continued loyalty 

and a sense of belonging therefore looked with that 

perspective during data compilation. 

Increase in membership 

Seven-fold increase in CME 

During the year 2004 the organization managed to 

increase its CME activity seven folds as seen in the 

comparative pie chart. Each CME activity was 

planned and structured to be financially independent. 

Audience targeted CME programs brought in 

prospective new members and left surplus balance to 

finance other activities such as free clinics, free 

vaccination projects and also finance local health 

fairs. The apparent belief that less was more was 

dispelled by the reciprocal financial growth of the 

group. 

Realizing the fact that active yearly membership 

was a lifeline for the organization as active 

membership fee was recurring each year as opposed 

to life membership that was a one-time commitment 

the group made an effort to draw in active yearly 

In summary a comparative analysis that quantifies 

the performance of an organization may offer a means 

of measuring its performance in a verifiable and 

reproducible manner that is credible. It may give the 

Chief Executive Officer a means of substantiating 

his/her claim for success and offer direction and 

foresight to an incoming executive committee. 

I believe that photo opportunities are generally 

great as they give additional gloss and it also looks 

good in scrapbooks and periodicals and it may also 

help with establishing a public image but a 

meaningful true measure of performance can only be 

derived from substantiating performance utilizing 

verifiable and reproducible quantitative data. 

Onaly A. Kapasi, MD, FAAOS 

Boston, MA 

New England AAPI Rep. 

www. MassOrtho.com 

www.orthodoc.aaos.org/KapasiAssociates 

email: arthroscopy@live.com 


21

Global Healthcare Summit – New Delhi, India 

The American Associate of Physicians of Indian 

Origin (AAPI) was proud to host a Global Healthcare 

Summit at Modia Sheraton Hotel in New Delhi. The 

summit was a great success and was well attended by 

physicians from from Great Britain, Canada, Saudi 

Arabia, Australia, New Zealand, India, and all around 

the world. 

AAPI teamed up with British Association of 

Physicians of Indian Origin (BAPIO) and top-notch 

Indian Medical Professional Associations: Indian 

Medical Association (IMA), AmeriCares India, 

Federation of Obstetric & Gynecological Societies of 

India (FOGSI), Indian Academy of Pediatrics (IAP), 

Association of Surgeons of India (ASI), Indian Society 

of Medical and Pediatric Oncology (ISMPO) ICON 

and Urogynacology and Reconstructive Pelvic Surgery 

Society of India to make it truly a global summit. 

Healthcare companies like Johnson & Johnson and 

Pfizer are the global sponsors for the summit. 

It was our pleasure to have Union Minister of State 

for Health and Family Welfare, Honorable Dinesh 

Trivedi, to give the summit inaugural address. 

The Summit brought together some of the world's 

most renowned experts to focus on priority disease states 

such as Allergy & Immunology, Cardiovascular Disease, 

Diabetes, Infectious Diseases (HIV/AIDS), Emergency 

Medicine, Mental Health and Maternal & Child 

Health. For the first time in this 3rd Summit, we 

introduced four new tracks that are necessary elements 

of 21st century medicine; Applications of Health 

Information Technology, Innovative Surgical 

Techniques in Healthcare and The Growing 

Engagement of Consumers, Oncology, and Medical 

Tourism. This year's summit had a wider global 

perspective with the addition of Medical Tourism and 

Health Information Technology. 

The summit shared best practices and experiences 

from the leading experts from around the world to 

develop actionable plans for launching demonstration 

projects with focus on prevention, treatment, and 

management of priority 

disease states in India with 

defined measurable metrics to 

ensure that action plans are 

economically viable. 

The following pictures 

highlight some of the 

activities during this enjoyable 

and intriguing summit. 



23



25

AAPI Launches Political Action Committee 

Why we need a PAC on Capitol Hill 


AAPI President 

Dino Teppara, Esq. 

AAPI Director of 

Legislative Affairs 

Physicians are the key players in providing quality 

health care to the American people. However, they are 

not a large nationwide constituency. According to U.S. 

Department of Labor statistics, there were officially 

661,400 jobs held by physicians and surgeons in 2008. 

This works out to approximately 1,500 doctors for each 

congressional district. Out of nearly 700,000 

constituents, this means that less than 1% of any one 

Congressman’s constituents are physicians. 

On Capitol Hill, physicians are sometimes 

stereotyped as making many demands on politicians but 

doing very little politically to aid the reelection efforts of 

Members of Congress. Considering the small size and 

influence of physicians in the political process, the even 

smaller number of Indian Americans (only 3 million 

people out of a national population of more than 300 

million), and the even smaller number still of Indian 

American physicians, AAPI members must be 

cognizant of the enormous challenges facing the 

organization to increase its influence in the political 

arena. 

Frankly, politicians do not care that AAPI is the 

largest ethnic medical association in the United States. 

The fact is that Indian Americans will never be a large 

voting bloc equivalent to labor unions, African 

Americans or Hispanics in our nation. Therefore, 

AAPI must make up for its lack of size by gaining 

prominence through a political action committee, 

because politicians WILL care that AAPI has the 

largest PAC in the Indian American community. 

Mainstream corporations such as Pfizer that have 

PACs will be impressed by AAPI’s savviness in building 

up a PAC. AAPI will be successful in gaining 

sponsorships for its national conventions as 

corporations will see a benefit for them in joining forces 

with AAPI when they realize we have extensive 

political clout. This clout cannot be won any other way 

but through financial resources. 

First, AAPI as a nonprofit 501(c)(3) organization is 

permitted to have an unconnected political action 

committee. We will be establishing a separate legal 

entity entirely with a separate website and set aside 

approximately $200-$300 per month out of PAC funds 

to pay for a political consultant to file the necessary 

paperwork with the Federal Election Commission 

(FEC). The primary focus would be to raise funds in 

2010, as this is an election year. As the Asian American 

Hotel Owners Association (AAHOA) has $250,000 in 

its PAC, AAPI would have to raise at least $300,000 

this year to claim the mantle of having the largest PAC 

in the Indian American community. It is entirely an 

achievable goal and we must work together to do it. 

We are establishing a benefits package for Gold, 

Silver and Bronze donors. Gold donors are those who 

give the maximum allowable amount this year under 

federal law, which is $5,000. These donors will be 

invited to every exclusive event we do with senior 

politicians, will be publicly recognized in the media for 



IN THE NEWS 

Dr. Sudhir M. Parikh Receives Padma Shri Award 

Indian American physician, philanthropist and 

publisher, Dr. Sudhir M. Parikh, has been named a 

recipient of the 2010 Padma Shri award. The New 

Jersey-based doctor made the President of India’s 

honoree’s list released on Jan. 25th, the eve of the 

country’s 60th Republic Day. 

Dr. Sudhir M. Parikh 

Publisher, India Advocate, 

Philanthropist, Physician 

With this honor, Dr. Parikh now joins the ranks of 

most honored Indian Americans and the only one to 

receive all three much coveted awards: the Ellis Island 

Award, the highest honor conferred on U.S. immigrants 

for their lifetime of community service; the Pravasi 

Bharatiya Samman, a special award given by the 

Government of India to select non-resident Indians for 

their individual accomplishments and contributions to 

India, and ; the Padma Shri, which is awarded to 

distinguished Indians and people of Indian origin for 

their contribution in various speres of activity including 

the arts, education, industry, literature, science, sports, 

social service and public life.The award will be presented 

by President Pratibha Patil at a ceremony in New Delhi 

in March. 

“I’m deeply honored and humbled by the honor 

conferred on me by the President of India,” Dr. Parikh 

said in a statement, adding, “but I also recognize the 

responsibility of living up to this honor by redoubling my 

efforts to further U.S.–India relations, and making 

greater efforts at community service on both sides of the 

Atlantic.” 

Dr. Parikh, who is a noted allergist and an acclaimed 

authority n the field of allergy, asthma and immunology, 

is also the chairman and publisher of New York-based 

Parikh Worldwide Media, Inc., which publishes three 

periodicals – “News India Times, “Desi Talk” and “The 

Indian American.” (Please see the detailed resume 

attached.) 

Apart from medical practice and publishing, Dr. 

Parikh is actively involved in a number of charitable 

causes in the U.S. and in India. He was recently in New 

Delhi to attend the Pravasi Bharatiya Divas, where he 

was invited to speak about philanthropy as part of the 

PBD lecture series. 

Dr. Sudhir M. Parikh 

Publisher, India Advocate, Philanthropist, Physician 

Congratulations, Sudhir! 


27

Book Review: ‘CHEATING DEATH’ 

by M. P. Ravindra Nathan, MD, Brooksville, FL 

Anyone who is frustrated by the failure of standard 

approaches for treating critically ill patients will be 

amazed at what Dr. Sanjay Gupta has to say in his 

latest book, ‘Cheating Death,’ a New York Times best 

seller. The book is all about ‘medical miracles’ in 

which seemingly dead patients are revived back to 

real life. In other words, stopping death in its own 

tracks! Yes, a new breed of audacious and pioneering 

physicians and researchers using simple to complex 

innovations are doing just that, pushing the frontiers 

in medicine! 

Here are a few tantalizing stories you will read in this 

wonderful book: 

• A young medical resident in Sweden takes a 

tumble during skiing, gets trapped under the 

frozen fjords of Norway for 40 minutes and is 

practically dead but survives with proper 

treatment and is a practicing radiologist now. 

• A 59 year old sustains a sudden cardiac arrest 

while driving, crashes his car, but was resuscitated 

using a new version of CPR that involves 

nothing more than chest thumps and a few 

shocks, without giving a single breath. 

• A comatose brain surgery patient declared as 

‘vegetable’ by doctors is ‘chilled’ for several days 

and is slowly revived, recovers fully and goes 

home. 

• An unborn child with a serious heart disease who 

has no chance of being born alive undergoes 

intrauterine surgery to fix a heart defect and is 

born healthy and lives a normal life. 

• A 33 yr old man with the one of the deadliest 

cancers, ‘glioblastoma’ in the brain, beats the odds 

with a combination of treatments - a new drug, 

radiation and a newly developed vaccine CDX- 

110 by Duke. 

A few years ago, such feats would be simply the 

stuff of sci-fi novels or movies. But believe it or not, 

they are about to become 

common place in the 

medical field. Every story 

and every chapter in this 

book is yet another 

example of “man cheating 

death,” beating all odds 

through new scientific 

methods or innovations 

used deliberately and 

successfully. Some of these 

Published by 

Wellness Center 

Hatchette Book Group, 

282 pages 2009 

treatments are even low cost, low tech and can be 

achieved anywhere in the world. 

“Death is a complicated thing. It is not a single 

event, but the process could be reversed,” says the 

author. Dr. Gupta, CNN’s Chief Medical 

correspondent, a famous neurosurgeon and a best 

selling author, visits several countries and talks to 

many research scientists in his quest to understand 

the mechanisms leading to death and how it can be 

avoided or reversed. Human beings cannot survive 

even a few minutes without oxygen since ‘hypoxemia’ 

as occurs in cardiac arrests, severe trauma etc., can 

trigger a devastating cycle of inflammation and 

metabolic chaos in the body leading to death. 

Reducing the oxygen requirements during these 

critical times will be the key to survival. 

Lance Becker, Director of ER in U. Penn 

Hospitals says, “The chemical chaos in the death 

pathways seems to take place at the cellular level, 

mitochondria specifically, the part that produces 

energy.” Fred Roth at Fred Huntchinson Cancer 

Center studying molecular basis for immortality, 

agrees. “It is all about manipulating oxygen. Lack of 

oxygen or too much of it can injure the cells, 

especially if already damaged after a cardiac arrest.” 

By reducing concentration in the cells, you can put 



Book Review...continued 


them in ‘suspended animation’- a sort of hibernationwhich 

reduces the metabolic and energy demands. 

We learned about ‘suspended animation and 

hibernation’ as two approaches that can save human 

lives from animal models. Many animals go into 

hibernation in winter to conserve energy demands 

that aid in their long term survival. The painted 

turtles often burrow in the mud, without breathing 

for as long as four months, during a rough winter. An 

un-acclimatized first time climber of Mount Everest 

is likely to go into pulmonary edema which could be 

fatal, and yet a seasoned, well trained climber can 

scale high altitudes without much difficulty. The key 

word is ‘adaptation.’ In the case of patients, it means 

buying time to reduce body’s oxygen demands which 

in turn will reduce organ injury during the recovery 

process. Hypothermia using a variety of methods 

seems to be very beneficial. 

Dr. Gupta’s book teaches us, that the power of 

modern medicine continues to unfold revealing an 

amazing array of new treatment modalities and 

innovations which are helping us to cheat death and 

live longer. Thanks to these major breakthroughs, the 

mysterious line between life and death is being 

shifted in our favor. As Woody Allen says (quoted by 

Gupta) “I don’t want to achieve immortality through 

my work. I want to achieve it through not dying.” 

Don’t we all? Read this book and you will know how. 

CALL FOR 

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Africa for three couples which included 

my husband and me”. We are taking 

another trip with Safari Ventures to see the Tiger 

sanctuary in India. It promises to be as memorable 

as the tour we took seven years ago. 

Nalini Juthani, MD 

Life Member, AAPI 

ST-35254 

Ask about our 2010 special 

AAPI departures 

Call now TOLL FREE 1 888 341 7771 

Visit www.safariventures.com 

The Wild Of Africa – Within Your Reach… 


29

AAPI Clinic launches HIV, Hepatitis and Mother-Child 

programs and conducts health camp 

The AAPI Preventive Health Clinic, 

initiated several projects in rural Andhra 

Pradesh this year. Today, India has an 

infant mortality rate of 6.8%, almost fifty 

percent of children who survive are severely 

and chronically malnourished, and as they 

grow in to the rural population only 31% of 

them have access to potable water. As a 

result of poor nutrition and poor 

sanitation, infectious diseases are still a 

major cause of death in rural India. The 

current healthcare delivery system has not 

served the rural population well. 

AAPI preventive health clinic of Jagtial 

partnered with SHARE Health and has 

initiated many programs to rectify the 

health disparities in rural Telangana region of 

Andhra Pradesh by working with local and state 

by Jagan Ailinani, MD 

Past President, AAPI 

Board of Director, AAPI-Charitable Foundation 

(l-r) Dr. Jagan Ailinani, L. Ramana, Madhu Yaskhi, Jeevan Reddy, and Dr.Vijay Yel-dandi 

at the opening of the clinic. 

Dr. Vijay Yeldandi addressing the the gathering at the opening of the clinic. Dr. Jagan 

Ail-inani, L.Ramana, MLA, Madhu Yaskhi, Chief guest Member of Parliament, and 

Jeevan Reddy, Former minister, attended. 

governments to increase access to care. SHARE is 

providing technical support to the AAPI Preventive 

Health Clinic, which serves the Jagtial 

municipality as well as the 60 villages in 

three rural mandals of Jagtial, Raikal and 

Sarangpur located in Andhra Pradesh. 

This area has a high incidence of 

hepatitis and various water born diseases 

and is also has the highest number of 

HIV positive and full-blown AIDS cases 

in the state. In addition, Andhra Pradesh 

ranks third in Indian states in the 

incidence of AIDS and has the highest 

maternal and infant mortality rate in 

India. Funding for these will be raised 

through AAPI members from the Jagtial 

area and we will seek additional 

government funding. 



AAPI Clinic launches...continued 


The Hepatitis, HIV and motherchild 

program was inaugurated on 

August 9, 2009 by Dr. Vijay Yeldandi, 

Chair, AAPI HIV-AIDS Committee. 

Dr. Yeldandi is a infectious disease 

specialist, a professor of medicine at the 

University of Illinois, and program 

director at Resurrection Hospital, 

Chicago, Illinois. He secured a $5 

million grant from the Centers for 

Disease Control (CDC) for an 

HIV/AIDS awareness and education 

program in Andhra Pradesh. Chief 

guest Madhu Yaskhi, member of 

Parliament, commended the work of the 

clinic in promoting the health of the rural population 

of his district, and promised matching funds for this 

project and for conducting health camps. Other 

guests at the inauguration included Madhu Yakshi, 

MP L., Ramana Local MLA, and Jeevan Reddy, 

former minister. 

Administration of Hepatitis B vaccinations to school children. 

mandals. Group and one-on-one sessions clarify 

myths and misconceptions surrounding HIV while 

imparting knowledge about HIV and STIs, and the 

use of condoms, which are distributed free. Sexual 

matters are still considered a taboo, and therefore easy 

accessibility is very important. Nutrional support will 

be provided for children infected with HIV/AIDS. 

Mother-Child Program 

Dr. Dharmapuri Vidyasagar, past chair of the 

AAPI Board of Trustees and professor of pediatrics 

at the University of Illinois, Chicago will be 

overseeing the Mother-Child program to reduce 

maternal and infant mortality in these rural mandals 

of A.P. Dr. Vidyasagar has recently visited the area 

and is working on establishing educational and skill 

training programs in maternal and neonatal care. 

Distribution of nutritional food/supplements to HIV infected children. 

Hepatitis and HIV Program 

Periodic awareness education about HIV/AIDS 

will be conducted in all the villages of the three 

Both the Mother-Child and Hepatitis/HIV 

programs will be implemented in 60 villages in 3 

mandals of the Jagtial Constituency in the 

Karimnagar district of Andhra Pradesh. Our goal is 

to vaccinate all school children including for hepatitis 

B (HBV) and typhoid. 



31

AAPI Clinic launches...continued 


The prevalence rates for Typhoid and Hepatitis B 

is elevated in the covered mandals. To combat this, 

the clinic is conducting in-school immunizations as a 

preventive measure. In its first year, the project will 

cover 2,500 children and expand to all 120 schools in 

the coming years. Periodic eye camps will be 

conducted in these schools that each has about 300 

students and children with vision problems will be 

provided with eye glasses. 

Health Camp 

The Clinic conducted a health camp in Jagtiyal on 

August 9, 2009 with support from SHARE Health 

and Yashoda Hospital. Nearly 1,000 patients from 

Jagtiyal and the surrounding villages took advantage 

of the free camp, and about 20 doctors of various 

specialties participated. 

Yashoda Hospital of Hyderabad cosponsored the 

camp and provided specialists and a large mobile 

truck equipped to perform X-ray, ultrasound, EKG, 

and echo studies. Free labs were provided, including 

blood sugar and cholesterol testing. Education was an 

important part of the camp with Padmini Balagopal, 

a diabetic educator, participating, and staff 

distributed heart disease and diabetes education 

brochures developed by Dr. Purusotham Kotha, a 

cardiologist from San Diego, California. 

About the AAPI Preventive Health 

Clinic of Jagtial 

The AAPI Preventive Health Clinic was 

established in December 2005 with the mission to 

improve the health and wellness of villagers focusing 

on ABCD’S, AIDS, blindness prevention, Child- 

Mother health, deafness prevention, diabetes 

screening and education, safe drinking water, and 

sanitation. 

This Clinic conducts periodic 

health camps which include 

general medical, diabetic, eye, 

ENT, cancer, cleft lip palate and 

rehabilitation/artificial limb 

distribution camps. The Clinic 

also conducts annual physical 

exams for school children 

including vision, hearing and 

dental check ups and provides 

free eye glasses. The clinic also 

provides free ambulance to 

transport patients from villages 

to Karimnagar district 

headquarters or Hyderabad. Two 

safe drinking water plants were 

established in two villages in this 

region which were sponsored by 

two AAPI members. Villagers were educated about 

safe drinking water and sanitation. 


IN THE NEWS 

Dr. Onaly A. Kapasi Receives New England’s 2009 

Distinguished Humanitarian Service Award 

Onaly A. Kapasi, MD a nominee 

for the American Academy of 

Orthopedic Surgery’s Humanitarian 

Service Award recently received the 

Distinguished Humanitarian Service 

Award from the Indian Medical 

Association of New England 

(IMANE) on November 21, 2009. 

In recognition of his humanitarian 

services in Boston, India and Africa. 

He is also a recipient of the 2004 

Leadership Award from IMANE. 

Dr. Kapasi came to Boston as a 

pediatric orthopedic fellow at the 

Harvard affiliated Children’s Hospital Medical 

Center in 1975. 

Whilst in Kenya his puritan streak came to the 

forefront in August 1972 as he organized relief efforts 

for the 60,000 plus Indian refugees fleeing Idi Amin’s 

Uganda. 

This passion to assist the less fortunate resurfaced 

in 1980 when he and a fellow surgeon delivered very 

large bags containing a few hundred loaves of bread 

each Friday to a shelter for the homeless in Boston. 

He received a humanitarian service award from the 

Himalayan International Institute in 1998 for 

dedicated services to the indigent Himalayan 

community where he has continued to serve in 

person, kind and money for the past fifteen years. In 

Himachel he is fondly referred to as the Dhamad of 

Mandi. 

He received a dedicated service award in 2000 from 

his peers at the American Association of Physicians of 

Indian Origin (AAPI) for assisting Indian American 

Physicians practicing medicine in the U.S.A. 

Again in 2001 he received a 

special presidential award from the 

AAPI president, Dr. Naik, for 

assisting Indian physicians fighting 

peer review abuse. 

He has traveled to India where 

he has carried out free orthopedic 

surgeries in Bombay and Pune, 

conducted orthopedic camps, given 

continuing medical education 

courses in Patiala at the National 

Sports Academy, presented papers 

at orthopedic meetings in India 

and also traveled to East Africa on 

medical missions. He collects surplus medical 

equipment from the Boston hospitals that he 

repatriates to needy countries. 

He received the coveted Ethicon prize for 

meritorious academic performance in the Master of 

Medicine in Surgery program in Kenya, his research 

paper; “Psoriatic Hands” was acclaimed as the best 

paper of the year at the American Hand Society 

Meeting in September 1980. He was appointed to the 

Massachusetts Board of Registration in Medicine in 

1991 where he served as the chairman of the licensing 

committee and Joint Committee on Graduate 

Medical Education. He has also served as a physician 

member of the Massachusetts Acupuncture and 

Alternative Medicine Board. He has served as the 

chair of the AAPI Federation of Licensing Boards, 

Ethics and Grievances Committee, for two 

consecutive terms, and Awards Committee and 

member of many key committees. He is an appointed 

member of the American Academy of Orthopedic 

Surgeon’s Ethics Committee. 

His passion for humanitarian work resounds also in 

his personal poetries some of which are published. 



33

AAPI Launches Political...continued 


their contribution and will receive a prominent profile 

and picture on the PAC website. Silver donors are those 

who give $2,500 this year. They will receive invitations 

to two events this year and their name and picture will 

be placed on our website for their support. Bronze 

donors are those who give $1,000 this year. They will 

receive an invitation to one event and their name will be 

placed online as a supporter. Our PAC will be fully 

transparent with our FEC filings placed online. 

Dr. Vinod K. Shah is the President of Shah 

Associates, the largest medical practice in 

southern Maryland and is a Board Certified 

Internist and Board Certified Cardiologist. 

In order to make the maximum impact, we need as 

many donors to step forward and assist us in this 

endeavor. To show our commitment, a number of 

AAPI officers have already taken the initiative by 

contributing $5,000 each.The donors do not need to be 

Indian American, AAPI members or even doctors. As 

the PAC is a separate legal entity, it is unconnected to 

AAPI and can accept funds from anyone in any 

industry. 

We will establish a smart political process to allow 

local AAPI chapters the opportunity to present PAC 

checks to their own Congressman or Senator. This is a 

great way to build the AAPI brand name in the 

community, build our membership at the local and 

national level simultaneously and give our physicians 

more political clout. 

Dino Teppara is an attorney and the only Indian 

American to ever serve as Chief of Staff and 

Counsel to a Member of Congress. He will receive 

an Officer Commission later this year, making him 

the only Indian American Public Affairs Officer in 

the United States Navy. 

We would not give away all the money we raise this 

year. We will keep funds in the bank so we have a base 

to build upon when we begin fundraising in earnest for 

the 2012 national election. Lastly, our PAC will be 

completely bipartisan, with a plan of giving 50-50 to 

both Democrats and Republicans.This political balance 

will best serve the interests of Indian American 

physicians. 

We firmly believe that this new opportunity will 

greatly enable AAPI to take the organization to the 

next level in terms of membership, corporate sponsors 

and influence. But more importantly, it gives us the 

opportunity to have a seat at the table when politicians 

attempt to pass laws that affect us, our practices and 

families. 

Dr. Onaly A. Kapasi,...continued 


And he states that he is planning to publish a book of 

his personal poems some day. 

When asked about his passion he is quick to 

mention that he derives an inner strength from a 

family that is very supportive and also very giving. His 

brother a physician in the U. K. is a recipient of 

M.B.E. (Member of the British Empire) that was 

bestowed by the Queen of England for his services to 

the British Health Care. He believes that the need for 

giving was ingrained by his parents who also lived by 

an example of giving. 

Congratulations, Onaly! 


IN THE NEWS 

AAPI President Attends State Dinner 

Dr. Vinod K. Shah, the only national president of 

an Indian American community organization to 

attend the State dinner at the invitation of President 

Barack Obama, speaks about his experience. 

“I am honored that President Obama provided 

me with the opportunity to join 300 guests in 

welcoming Prime Minister Dr. Manmohan Singh 

and his wife Gursharan Kaur back to 

Washington, D.C. at the White House's first 

official state dinner. This was truly a memorable 

event recognizing the global presence of the 

world's largest democracy and I will never forget 

the evening my wife Ila and I had last night. 

President Obama's comments were very well 

received and he stated that the contributions of 

2.6 million Indian Americans were significant, 

and that he is looking forward to his visit to India 

with the First Lady and his two beautiful 

daughters in the near future. 

The Prime Minister spoke from his heart in a 

very passionate speech, moving the audience to 

applaud on many occasions when he 

acknowledged the wisdom and commitment of 

our President. During this difficult time, he noted 

that President Obama's leadership is important 

not only to the United States but globally and that 

India as the largest democracy has a role to play 

beyond our bilateral relationship to better the 

world. 

I am also pleased to announce that AAPI is 

tackling the challenges of public health 

mentioned in the joint statement issued by 

President Obama and Prime Minister Singh, and 

will be focusing on this very issue during our 

upcoming global health summit from January 2- 

3, 2010 in New Delhi. 

On behalf of AAPI's 15,000 members, we want to 

thank President Obama and Prime Minister Singh 

for their leadership in continuing the U.S.-India 

strategic relationship.” 


35

HIPAA – What’s New This Year? 

HIPAA (Health Insurance Portability and 

Accountability Act of 1996) affects everyone who 

uses, provides, or pays for health care. The HIPAA 

Privacy Rule, effective April 14, 2003, sets forth the 

standard for use and disclosure of protected health 

information. The HIPAA Electronic Transactions 

Rule, extended effective date October 16, 2003, 

establishes ten standardized electronic transaction 

formats that entities subject to HIPAA (called 

“Covered Entities”) must use in communicating with 

other Covered Entities. The HIPAA Security Rule 

established standards for securing protected health 

information. Physicians and other Covered Entities 

under the HIPAA rules spent a great deal of time 

and money to prepare for HIPAA. Many mistakes 

were made, but after five years most physicians had 

at least made peace with the rules and learned to live 

with them. They may have even made the mistake of 

thinking that was all they had to do. Wrong again. 

Welcome to the High Tech Act, part of the Recovery 

Act passed at the beginning of 2009 (ARRA) and its 

implementing regulations. This brief article will give 

you the high points of what you should do to comply 

with this latest round of HIPAA changes. We will 

start with a very brief description of the major points 

of HIPAA as we have known it and discuss the 

changes. 

1) Are you a Covered Entity? 

YES if you 1) are a health care provider that uses 

any of the ten specified electronic transmissions 

(“Provider”); 2) operate a health plan that pays or 

reimburses for health care (“Plan”); or 3) are a 

clearinghouse, such as a billing company. Some in 

house and occupational health clinics, many school 

health programs, and small providers may escape 

HIPAA if they only use paper in billing for the 

health care they provide. Medicare will require use of 

the electronic transmission standards. Almost every 

health plan will be a Covered Entity, including fully 

insured plans, governmental plans, and self-insured 

plans that either 1) use a third party administrator 

Peter Parvis 

Healthcare Attorney 

(“TPA”) or 2) have 50 or more participants. The 

employer (and its employment records) isn’t directly 

affected by HIPAA since it is not a Covered Entity, 

but HIPAA affects employers indirectly through the 

Plans they sponsor. Workers compensation and auto, 

disability and life policies are outside HIPAA. 

The High Tech Act does not change these 

definitions. 

2) What does HIPAA require? 

Privacy Rule 

The heart of HIPAA is the HIPAA Privacy Rule, 

effect which limits what you can do with health care 

information (called protected health information or 

“PHI”) that could identify the affected individual. 

PHI is protected in the hands of a Covered Entity or 

its “Business Associate”, defined as anyone with 

whom a Covered Entity contracts to perform any 

function involving PHI. In the list of things you 

already must have, we have identified with an 

asterisk points that are affected by the new rules. You 

already have to have: 

• Developed, posted and distributed the Notice of 

Privacy Practices (“Notice”) that describes what 

you will do with PHI and informs individuals 

about their rights under HIPAA. 

• Have a privacy officer. 

• Have policies and procedures regulating your use 



HIPAA – What’s new...continued 


and disclosure of PHI, and identifying by job 

description permitted internal and external uses 

and flow of PHI.* 

• Trained your workforce members, including unpaid 

volunteers, and each new employee, with access to 

PHI in your HIPAA policies.* 

• Have a complaint and sanction procedure. 

• Implemented reasonable technical and physical 

safeguards for your PHI. See the discussion of the 

Security Rule below.* 

• Established document retention procedures 

(everything needs to be kept for six years). 

• Honor the individual’s new federal right to inspect, 

request an amendment to, and obtain an 

accounting of unauthorized disclosures of, their 

own PHI.* 

• Have written contracts with, your Business 

Associates to make them protect PHI in their 

possession.* 

• If you sponsor a Plan for your employees, as 

opposed to purchasing coverage for them, and want 

more than very limited PHI from your Plan, you 

must amend your Plan to permit and protect such 

disclosures. 

Electronic Transactions 

If you are a Covered Entity, you must be able to 

use the 10 Electronic Transaction standards when 

communicating with other Covered.i The 

transactions all deal with payment for health care or 

insurance information, and were not directly affected 

by the ARRA provisions. 

Security Rule: 

The Security Rule governs the security of 

Electronic PHI (“ePHI”), defined as PHI 

transmitted by or maintained in an electronic media 

• Including hard drive, disk, CD and Internet 

• Excluding paper fax 

The security procedures adopted by a Covered 

Entity must ensure confidentiality of ePHI and 

protect against reasonably anticipated threats. A 

hospital is held to a higher standard than a small 

physician practice, but every Covered Entity must 

comply. The Security Rule contains: 

• 18 Standards (i.e., safeguards): administrative, 

physical, technical; and 36 Implementation 

specifications: some of these are mandatory, others 

are “addressable”, meaning the practice can come 

up with a solution designed for its size and unique 

problems. 

3) What can a Covered Entity do with PHI? 

You can use or disclose PHI for treatment of the 

individual, for payment (to bill or pay/get 

paid/coordinate benefits for the treatment), or for 

defined elements of your internal operations 

(“TPO”). You must describe your uses and 

disclosures in your Notice of Privacy Practices. For 

payment or operations, you can only use or disclose 

the minimally necessary information* for the task at 

hand. The minimum necessary requirement did not 

apply to disclosures for treatment, in response to 

provider’s legitimate concerns that treatment could 

be compromised if providers had to stop and 

question the necessity of using each piece of patient 

information when providing care. 

You can also disclose PHI pursuant to a specific, 

signed and time limited authorization from the 

patient. Limited other disclosures (such as those 

required by law, or in response to subpoena, or 

incidental disclosures) are also permitted. Any 

disclosure that is not listed is forbidden. This piece is 

too short to include all of the more specific 

disclosures permitted under HIPAA. 

The regulations are complex, but the intent is 

simple. Patient information is confidential and 



37



should be treated accordingly. Employees who don’t 

need PHI shouldn’t have access to it, and those who 

need it should only have access to the PHI they 

need. Only you know which of your employees, 

broken down by job title, actually require PHI to do 

their job. You must therefore adopt and periodically 

review policies that describe reasonable limitations 

on the flow of PHI within your workforce, train your 

workforce on your policies, and enforce compliance. 

4) What rights do patients have? 

Patients are afforded significant rights under 

HIPAA, and have many new rights under the High 

Tech rules. Again using an asterisk to identify areas 

of change, each patient has right to: 

• Review their health information* 

• Request changes or corrections in that information 

• Request an accounting of disclosures* 

• Designate persons to (or not to) receive 

information 

• Request restrictions in use of their health 

information* 

• Withdraw authorization at any time for any reason 

5) What about enforcement? 

The concern was that the penalties under HIPAA 

were too weak and enforcement too lax. The old 

penalty was $100/violation with a $25,000 annual 

cap. Civil monetary penalties for a HIPAA violation 

have greatly increased under the ARRA, both for a 

single violation and for the annual cap on violations 

of the same sort, up to a 60 fold increase in the 

annual cap: 

• Unknown violation: $100 - $50,000* 

• Violation due to reasonable cause: 

$1,000 - $50,000* 

• Violation due to willful neglect, corrected: 

$10,000 - $50,000* 

• Violation due to willful neglect, not corrected: 

$50,000* 

• New Annual Cap per calendar year - $1,500,000 

Criminal penalties were also added, and state’s 

attorney generals were given authority to enforce 

violations. HHS audit authority was also increased. 

Last, but most certainly not least, the penalties can 

now be imposed on business associates. Under the 

prior law, only a Covered Entity could be assessed a 

penalty under federal law for violations of HIPAA. 

Business associate agreements should be reviewed 

and amended to reflect this and other changes. 

6) What do you have to do when you 

discover a breach? 

The new rules place significant new duties on 

Covered Entities, and for the first time on Business 

Associates, when a breach occurs. The new breach 

rules cover “unsecured protected health 

information”. For now, “Unsecured” means any 

information not secured through encryption or 

destruction. Until further guidance is released, these 

are the only two safe harbors for PHI. “Protected 

health information” (PHI) retains same meaning as 

under HIPAA. If all your PHI is encrypted, the 

breach rules don’t apply. For almost everyone, that is 

not currently feasible. You need to inform your 

employees about the breach rules and develop 

policies for how to respond to any potential breach. 

What is a breach? 

Any unauthorized acquisition, access, use or 

disclosure of PHI that compromises security or 

privacy of PHI. “Unauthorized” means any use not 

permitted by HIPAA Privacy Rule. “Compromises 

security or privacy” means that unauthorized action 

poses significant risk of financial, reputational or 

other harm to the patient. This may not be 

immediately apparent, but you have a duty to 

determine whether there is significant risk whenever 

you discover that an unauthorized use or disclosure 

of PHI occurred. 



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39 

 

Morgan Stanley



Some mistakes do not constitute a breach. If deidentified 

information is disclosed, there is no breach 

since de-identified information is not PHI. If you 

believe, in good faith, that the unauthorized person 

who obtained the PHI could not reasonably have 

retained or further disclosed the information, it may 

not be a breach. Similarly, if workforce member 

accessed information without permission but in good 

faith, there is no breach as long as there is no further 

unauthorized action occurred. Or if workforce 

member reveals information to an unauthorized 

colleague, there is no breach as long as there is no 

further unauthorized action. This is not to say that 

action should not be taken if any but the first of these 

occurs. However, there is no breach so you don’t have 

to go on to the disclosure and notice requirements. 

What do you have to do if a breach 

occurred? 

If your investigation reveals that a breach 

occurred, many requirements apply. You have the 

duty to notify without unreasonable delay all affected 

individuals of the breach, and may have to notify the 

Secretary of Health and Human Services (HHS) or 

local media. You should of course investigate, but you 

only have a maximum of 60 days to notify, so the 

investigation should begin promptly. Mailed notice 

to the individuals will suffice if you have contact 

information. If you don’t, or can’t reach the 

individuals, telephone or personal notice works if 

there are fewer than 10, but if there are a significant 

number you have to either notify media outlets or 

post the information on your website for at least 90 

days. If the breach involves more than 499 

individuals, you also have to notify the Secretary of 

HHS, and media in any state if there are more than 

499 affected individuals in the state. You have to 

maintain a log of all breaches regardless of the 

number of individuals involved. There may be 

circumstances where you don’t know the exact 

number of individuals, but you are expected to have 

systems in place that will allow you to track and 

identify individuals when a breach occurs. There are 

requirements for the information that must be 

included in each notification. 

Your HIPAA policies must permit you to discover 

breaches and impose the duty on every employee and 

business associate the duty to notify you promptly of 

any potential breach. You should consider whether to 

impose the notice duty or cost of notice on your 

business associate if they are responsible for the 

breach. In any event, every possible breach must be 

investigated, logged and documented. This includes 

a detailed result of any investigation, even if the 

result was a determination that no breach occurred. 

You should get your attorney’s help in conducting 

the investigation and formulating a response if you 

discover any potential breach. 

What else changed? 

Patient’s Right to Request Restrictions on 

Disclosure 

Individuals can request that Covered Entities 

restrict disclosure of the individual’s PHI. 

- Pre-ARRA: Covered Entities were not required to 

comply with requested restrictions 

- Post-ARRA: Covered Entities are still not required 

to comply with requested restrictions, except where 

an individual requests a restriction on: 

• disclosure of PHI to a health plan for purposes 

of payment or operations (not treatment) 

• where the PHI relates to an item/service for 

which the provider has been paid in full out-ofpocket 

How much PHI can be used, disclosed or 

requested? 

- Pre-ARRA: Reasonable efforts to limit PHI to the 

minimum necessary to accomplish intended 

purpose 





- Post-ARRA: 

• By August 17, 2010, HHS must issue guidance 

on what constitutes “minimum necessary” 

• In the meantime, a Covered Entity is deemed 

compliant with the minimum necessary standard 

if PHI is limited to: 

• The limited data set; or 

• if needed, the minimum necessary PHI (the pre- 

ARRA standard) 

Patient’s Rights to an Accounting of 

disclosures have increased. 

Generally, an individual has a right to an 

Accounting of PHI disclosures by a Covered Entity 

going back six years, subject to various exceptions. 

- Pre-ARRA: Covered Entities were not required to 

provide an accounting of disclosures made to carry 

out treatment, payment or operations 

- Post-ARRA: 

• Treatment/payment/operations exception is not 

available with respect to disclosures made 

through an electronic health record by the 

covered entity that 

Date 

uses/maintains it 

• But, an individual can September 2009 

only request an accounting February 2010 

of such disclosures in the 

previous three (not six) 

years 

If disclosures were made to a January 2011 

business associate, the Covered 

February 2011 

Entity can elect to provide 

disclosure to the individual on 

behalf of business associates, or give the individual a 

list of Business Associates. If the latter, the business 

associate agreement should include the requirement to 

provide a response to individuals who request an 

accounting. This may be difficult. 

Access in Electronic Format 

An individual has the right to inspect and obtain 

a copy of the individual’s PHI. State laws also apply 

here, and the more stringent rule applies. 

Under ARRA, if a Covered Entity uses or 

maintains an Electronic Health Record: 

• An individual has a right to: 

• Obtain his/her PHI in an electronic format 

• Direct the Covered Entity to transmit a copy of the 

electronic PHI to a person or entity designated by 

the individual 

- Must be “clear, conspicuous and specific” 

• The Covered Entity may charge a fee, not to exceed 

actual labor cost 

The effective date of an individual’s the right to 

accounting and disclosure of electronic PHI varies 

with the date the Covered Entity acquired an EHR 

system: 

• January 1, 2014 – for Covered Entities that 

acquired an EHR on or before January 1, 2009 

• January 1, 2011 – for Covered Entities that acquire 

an EHR after January 1, 2009 

What applies? 

New notice of breach rule 

New business associate requirements 

New minimum necessary rule 

New individual access rules 

New restrictions on marketing 

Enforcement of breach rule sanctions 

New disclosure accounting rules begin 

New restrictions on unauthorized sale of EHR/PHI 

Penalties for noncompliance by willful neglect 

HHS may extend these effective dates, but not 

later than 2016 and 2013, respectively. We would 

simply add that at this time we don’t know how this 



41



will really work, what an electronic format for 

disclosure means, or how exactly you can charge for 

it in the face of state laws that limit what can be 

charged on a per page basis. 

When does all this become effective? 

What should you do? 

Greater enforcement, greater penalties, new 

requirements and new patient rights present a 

challenge which should be addressed by a review of 

your HIPAA Policies and Procedures, followed by 

amendments where necessary and training of all 

personnel in the changes. As a brief summary, we list 

the issues and policies to be reviewed below. 

1. Minimum necessary use and disclosure 

2. Security, as affected by the new notice of breach 

requirements 

3. Individual’s Right to request restrictions on use 

or disclosure 

4. Individual’s Right to access or inspect PHI 

5. Individual’s Right to request an accounting of 

disclosures 

6. Mitigation and security incidents 

7. Sanction, complaint, audit and enforcement 

8. Business Associate relationships and contracts 

9. Notice of breach responses 

10. Prohibiting sale of PHI 

A last word. This is important. Patient 

information should be protected, and the greater use 

of electronic communication poses additional risks. 

Get help if you need it and come up with an 

approach that your practice can make work. As with 

compliance, words alone are not sufficient. Get staff 

and physicians to buy in to the new approach and 

understand what they need to do to make it work. 

This article was taken from a webinar sponsored 

by Venable for its friends and clients. It is a brief 

summary, and should not be relied on as legal advice. 

I would like to thank my colleagues in the webinar 

for their kind assistance- Thora Johnson, Emilio 

Cividanes, Mike Pedone, Martha Jo Wagner and 

Davis Sherman, all of Venable LLP. 

Michigan Chapter Raises $10,000 for Haiti Disaster Relief 

Dr. Yash Shah 

In the wake of the recent tragedy in 

Haiti, MAPI President Dr. Yash Shah 

and the Foundation of MAPI 

(FOMAPI) Chairperson Dr. Dinesh 

Shah quickly mobilized their membership 

to raise over $10,000 for the international medical 

humanitarian organization, "Doctors Without Borders". A 

special thank you goes out to all the members who have 

contributed and donated to the effort. To learn more about 

how you can help please visit www.mapiusa.org and 

www.doctorswithoutborders.org 

Dr. Dinesh Shah 


The U.S. Ayurveda Delegation Trip to India 

January 28 to February 4, 2010 

Delegation: Seven delegates including six 

Complementary Alternative Medicine (CAM) 

directors of six major United States medical schools: 

1 – Dr. Navin Shah – Leader 

2 – Dr. Aviad Haramati – Coordinator, Georgetown 

University Medical School 

3 – Dr. David Eisenberg – Harvard University 

Medical School 

4 – Dr. Anastasia Rowland-Seymour – Johns 

Hopkins University Medical School 

5 – Dr. Victoria Maizes – University of Arizona 

Medical School 

6 – Dr. Anne Nedrow – Oregon Health & Science 

University 

7 – Dr. Benjamin Kligler – Albert Einstein College 

of Medicine 

This delegation visited New Delhi and Jaipur at the 

invitation of the Government of India, Ministry of 

Health – AYUSH (Ayurveda, Yoga, Unani, Siddha, 

and Homeopathy). The purpose of the U.S. delegation 

was to learn about evidence based Ayurveda, Yoga, 

meditation, and oil massage treatments, and also to 

discuss ten Indian proposals for joint Indo-U.S. 

research under NIH funding. This visit was also to 

explore possibilities of introducing evidence-based 

Ayurveda, Yoga, meditation, and oil massage 

treatments in the U.S. medical education, research, and 

patient care areas under CAM. 

The visit included: 

1 - AYUSH selected 10 evidence-based presentations 

on various diseases and drugs 

2 - AYUSH selected 10 proposals for joint Indo-U.S. 

Ayurveda research for consideration under the 

NIH funding 

3 - AYUSH selected site visits to: 

Navin Shah, MD 

Medical Education 

Director, Metropolitan 

Urologic Institute 

a. National Institution of Ayurveda at Jaipur, 

b. National Institute of Yoga at New Delhi, 

c. Maharishi Ayurveda Pharma Factory at New 

Delhi, 

d. Arya Vaidya Sala (Ayurveda hospital and 

outpatient clinic) at New Delhi 

These visits were arranged to educate the U.S. 

delegates on various facets of Ayurveda, Yoga, 

meditation, and oil massage treatments – teaching, 

training, practice, patient care (inpatient and 

outpatient), and complete process of drug 

manufacturing. 

4 – Meetings with ten AYUSH selected Ayurveda 

pharmaceutical companies officials, 

5 – Presentation by Dr. B. Kligler on “Research 

Methodology and publication in the U.S. 

Journals”, 

6 – Presentation by Dr. D. Eisenberg on “Evaluation 

of Medicinal Plants” (especially from China), 

7 – Presentations by Dr. A. Haramati on involvement 

of AYUSH in the Global CAM and Integrative 

Medicine arena. 

The delegates heard and interacted with over sixty 

different Indian experts on the above-mentioned 



43

The U.S. Ayurveda Delegation...continued 


subjects and visits. They met the following 

Government officials and conducted detailed 

discussions on various facets of the visits and future 

plans: Honorable Health Minister Mr. Ghulan Nabi 

Azad, Honorable Minister of State Health Mr. 

Gandhiselvan, Principal Secretary to the Prime 

Minister Mr. T.K.A. Nair, Health Secretary Mrs. 

Sujata Rao, AYUSH Secretary Mrs. S. 

Jalaja, AYUSH Joint Secretary Mr. B. 

Anand, and Foreign Secretary Mrs. 

Nirupama Rao. 

weeks course in Ayurveda in various Indian 

Ayurveda Institutes. 

5 – US institutions to invite the AYUSH selected 

Ayurveda faculty members for 2-4 weeks exchange 

visits to CAM departments of the US Medical 

Schools. 

6 – The delegates will study the nine joint proposals 

presented by the AYUSHA selected experts for 

joint research for further actions. 

On the last day, the delegates and 

participants discussed the future actions and 

road map to further the understanding and 

utilization of evidence-based Ayurveda and 

its research. The following few areas of 

mutual interest emerged. 

1 – Two Ayurveda Professors to visit Six US 

Medical Schools (as represented by six 

delegates) to teach evidence based 

Ayurveda to medical students, residents, 

faculty members & practicing 

physicians & also discuss joint Indo-US 

research projects. Each institution will 

host the visiting Ayurveda Professors for 

3 days. Hopefully, their interaction will 

promote Ayurveda teaching & its 

research in the U.S. 

2 – Consider a project to study Indian 

Medicinal Plants collection & research with Dr. 

David Eisenberg of Harvard University. (Harvard 

is conducting Chinese medicinal plant project for 

last ten years). 

3 – The US medical institution will consider positions 

for AYUSH selected candidates for two year 

masters program in clinical research. 

4 – Inviting the US (CAM) faculty members for 2 

7 – A separate funding for AYUSH by the Health 

ministry to conduct joint research by Indian 

Allopath and Ayurveda community. This will 

provide the foundation for the joint Indo-U.S. 

research proposals for consideration under NIH 

grants. This will also help the U.S. consortium of 

CAM and Integrative Medicine members to 




45

The U.S. Ayurveda Delegation...continued 


integrate evidence based Ayurveda in the U.S. 

mainstream medicine and research. 

8 – AYUSH to work with Dr. A. Haramati for 

participation and presentations in the Global 

CAM conference (in 2011, at Denver). 

All the mutually accepted proposals and activities 

will be coordinated by Dr. A. Haramati. The 

delegation will submit a final report on March 30, 

2010 to the Health Secretary, AYUSH, Mrs. S. Jalaja, 

Health Minister Mr. G.N. Azad, and the Principal 

Secretary to the Prime Minister, Mr. T.K.A. Nair. 

Respectfully, 

Navin Shah 

Medical Education Director, Metropolitan Urologic 

Institute 

Treasurer, Mid Atlantic Urology Associates 

Past president of Medical Staff, Doctors Community 

Hospital, Washington DC area 

Former Trustee, The Maryland State Medical 

Society 

Co-Founder and Past President, The American 

Association Physicians of Indian Origin (AAPI) 

Past President, The American College of 

International Physicians (ACIP) 

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