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1. New Law Prohibits Administering Mercury-Containing
Vaccines to Young Children and Pregnant Women
Effective July 1, it will be against California law to administer mercury-containing vaccines—including inactivated influenza vaccine from multi-dose vials—to pregnant women and children younger than 3 years old. Multidose vials of flu vaccine are made with thimerosal, a mercury-containing preservative.
Next flu season, only doses of influenza vaccine from single-dose syringes or vials with trace levels (less than 0.5 micrograms of mercury per 0.5 milliliter dose for pregnant women, less than .25 micrograms per .5 milliliter dose for small children) or no mercury may be given to pregnant women and children under 3.
Physicians need to consider this new law when ordering influenza vaccine for the 2006-07 influenza season. Prebooking has already begun for some influenza vaccine manufacturers.
Click here for more information.
Contact: Robin Flagg, 415/882-5110 or rflagg@cmanet.org.
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2. CMA and CHCF Team Up to Offer Physicians Deep
Discounts
on Handheld Medicare Drug Formulary Information
CMA and the California HealthCare Foundation (CHCF) have collaborated to put easy-to-use technology and valuable information about drug formularies—including Medicare Part D—literally in the palm of physicians’ hands.
For a bundled price of $99, physicians can purchase a Palm Z22 handheld computer and the Epocrates Rx Pro premium software. That’s nearly 40 percent off the regular price. This offer, available to physicians and other clinicians, is only good through the end of May.
With the launch of Medicare Part D in January, Medicare recipients in California now can choose from 48 health plans. The multiple formularies complicate the prescribing challenges facing physicians. These tools will help physicians manage the volume of information needed to pick the correct medicines and provide high-quality care for their patients, especially those with chronic conditions who require multiple medications. Epocrates-enabled handheld computers allow a physician in an exam room to identify which medicines are in which formularies, check for drug interactions, and find drug alternatives.
“We are leveraging easy-to-use technology to simplify the delivery of medicine to patients,” says CMA CEO Jack Lewin, M.D. “This is an important step to make the Part D program safer and more efficient.”
Already have a handheld computer? Access the Part D formularies free through Epocrates’ online and handheld drug reference guides. And don’t forget that CMA members receive 30 percent off one-year subscriptions and 35 percent off two-year subscriptions to any Epocrates product. Students and residents receive 50 percent off all Epocrates products.
Click here for more information.
Contact: CMA’s member help line, 888/233-2937 or lgodward@cmanet.org.
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3. Physician-Assisted Suicide Bill Is Back
CMA last year helped defeat a bill that would have legalized physician-assisted suicide in California. Nevertheless, proponents have introduced a similar bill this year.. Their efforts were given added impetus from a 2006 U.S. Supreme Court ruling that barred the U.S. Attorney General from using federal prescribing regulations to penalize physicians who participated in Oregon’s physician-assisted suicide program. Though CMA opposes physician-assisted suicide, CMA did file a brief opposing federal interference in the physician-patient relationship.
This year’s physician-assisted suicide bill (AB 651), renamed the California Compassionate Choice Act to make it more appealing, would permit an adult with a qualified terminal medical condition to request prescription medicine for the purpose of ending his or her life. CMA policy reaffirmed by the CMA House of Delegates in 2005 opposes the legalization of physician-assisted suicide as a violation of the fundamental ethic of the medical profession to “do no harm.”
Physicians are trained to provide compassionate care. A patient with a terminal illness may suffer from fear of pain, depression, isolation or a loss of dignity. The physician’s role is to reduce such suffering and provide compassionate palliative care. Research shows that many individuals who request physician-assisted suicide withdraw such requests when their fears are addressed and their pain and depression are treated.
The bill is currently before the state Senate Judiciary Committee. CMA urges physicians to call their senators and ask them to oppose the legalization of physician-assisted suicide.
Click here for more details, including legislators’ contact information and talking points.
Contact: Susan Bassett, 916/444-5532 or sbassett@cmanet.org.
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4. President Signs 2006 Budget Rolling Back
Medicare Payments to Higher 2005 Rates
President Bush Wednesday signed the federal budget package, reversing the 4.4 percent cut to Medicare physician payments that took effect January 1. The Centers for Medicare & Medicaid Services (CMS) has instructed carriers to retroactively adjust claims to compensate physicians for the 4.4 percent cut. Physicians will not have to resubmit claims. Medicare carriers will automatically make retroactive payments for eligible claims.
NHIC, California’s Medicare carrier has informed CMA that it will be posting the revised 2006 fee schedules on its website no later than Friday, February 10. The new fee schedule is effective immediately. Physicians should download the new fee schedule as soon as possible, as many of the RVUs have changed.
The budget bill does not fix the flawed geographic payment (GPCI) formula or provide a permanent solution to the sustainable growth rate (SGR) problem. Under the current SGR formula, physicians are due to face another reduction on January 1, 2007. Although MedPAC, the independent body that advises Congress on Medicare issues, has recommended a 2.8 percent payment increase for physicians in 2007.
The Bush Administration this week released its proposed 2007 budget, which calls for $36 billion in Medicare program cuts. Although the budget proposal does not include the recommended 2.8 percent physician rate increase, the administration recognized that physicians are facing multiple years of steep cuts and expressed interest in pursuing physician payment reform this year. However, the President said payment reform must be budget neutral and linked to quality reporting.
CMA and AMA will continue to aggressively advocate for a fair physician payment formula that is based on actual practice costs.
Click here for more information, including a summary of the health care provisions of the proposed 2007 budget.
Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
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5. Medical Staffs Are Invited to Attend Physicians Advocacy Forum in Irvine
The Orange County Medical Association (OCMA) is hosting a Physicians Advocacy Forum Saturday, February 25, at the Hyatt Regency Hotel in Irvine. A dynamic group of speakers will talk about issues facing physicians and medical staffs in California, including pay for performance, Medicare and Medi-Cal reimbursement, EMTALA reform and protection, and SLAPP (Strategic Lawsuits Against Public Participation) lawsuits. They will also discuss strategies for safeguarding medical staff self-governance from increasingly aggressive hospital administrations.
Speakers will include State Senator Joseph Dunn (D-Garden Grove), CMA CEO Jack Lewin, M.D., governance bylaws consultant and CMA Past President Howard Lang, medical staff attorney Tom Curtis, and AMA OMSS chair William Monnig, M.D.
There is no charge to attend this event, but advance registration is required as space is limited. Breakfast and lunch will be provided. Please RSVP by February 21.
Click here for more information.
Contact: Linda Johansen, 714/978-1160 or ljohansen@ocma.org.
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6. Order the 2006 California Physician’s Legal Handbook
Physicians can now order the 2006 California Physician’s Legal Handbook (CPLH). This indispensable manual is published annually by CMA’s Center for Legal Affairs and answers the legal questions most frequently asked by physicians. It can be purchased as a six-volume, 4,000-page print edition or an interactive CD-ROM.
The handbook has been completely updated for 2006 to reflect new laws, court decisions, and other developments in the health care system. It includes practical summaries of state and federal laws, the text of laws where necessary, and useful forms.
New for 2006 are chapters on new medical error reporting requirements, the Medicare Part D prescription drug benefit, the expansion of Medicare managed care plans (also known as “Medicare Advantage” plans), and national provider identification (NPI) numbers. (NPIs will become the standard unique identifier for health care providers on May 23, 2007.)
The CD-ROM offers all of the content of the print version, plus many enhancements, including fully searchable content, interactive forms and sample letters you can customize easily with your computer’s word-processing program, and hyperlinks that let you navigate within the CD-ROM and onto the Internet for more information about cited court cases.
The CD-ROM is priced at $399, the six-volume print version costs $799, and the CD-ROM/print version combination costs $899. Click here to place an order for the 2006 CPLH in the CMA Bookstore.
Members can access most of the CPLH content free through ON-CALL, CMA’s online medical-legal information library.
Click here for more information.
Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.
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7. Don't Miss the Humana Settlement Claim Deadline, February 17
Physicians have until Friday, February 17, to file a claim for their share of the $40 million Humana settlement.
Even physicians who did not treat Humana patients are still likely eligible for a pro rata share of the $40 million. To be eligible, you need only have provided covered services between August 4, 1990, and October 19, 2005, to any patients covered by any of the defendants in this case—CIGNA, Aetna, Anthem, Coventry, Health Net, Humana, PacifiCare, Prudential, United Healthcare, and Wellpoint.
Humana is the 7th HMO to settle with CMA and more than a dozen other state medical associations in CMA's RICO lawsuit.
Claim forms and filing instructions, including the list of all Humana affiliates whose claims can be used to calculate how many settlement shares you are owed, are available in CMA’s RICO Resource Center.
Click here for more information.
Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.
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8. QUALITY MATTERS : AMA’s Author in the Room Teleconference Series
To help physicians translate the results of published studies into clinical action, AMA and the Institute for Healthcare Improvement (IHI) last year launched the Author in the Room Teleconference series.
| Quality Matters is a new monthly column from CMA that focuses on practical ways physicians can improve the quality of the care they provide to their patients. Quality Matters will be published in CMA Alert and at the California Physician website the second Thursday of every month. |
This monthly program is designed to help physicians explore specific, peer-reviewed articles directly with the articles’ authors so that the reported clinical science can be more effectively and quickly incorporated into clinical practice.
Each month, one JAMA article is selected that contains evidence-based ideas ready for action in real-world clinical practice settings. Physicians are invited to participate in a conference call with the author of that article to clarify the findings and to explore the issues and challenges of incorporating the changes into clinical practice. Joining the author on each call will be a moderator and a clinician skilled in quality improvement processes. Each call is followed by an online discussion group.
The next teleconference is February 15, from 11 a.m. to noon pacific time, and will feature Olga Jonasson, M.D., author of “Watchful Waiting vs. Repair of Inguinal Hernia in Minimally Symptomatic Men.”
Click here for more information.
Contact: Sandra Bressler, 415/882-5171 or sbressler@cmanet.org.
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No. 2038 
