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1. Physicians Must Complete Pain CME by End of Year
California law (AB 487) requires physicians to complete 12 hours of continuing medical education (CME) in pain management and the care of terminally ill and dying patients. Physicians have until December 31 to satisfy this requirement. Doctors licensed in California after 2002 (when the law was enacted) have four years from the date of licensure to complete the CME requirement.
Physicians can choose from a variety of courses to fulfill this requirement, including:
Pain, Palliation, & Politics: Pain Management and End-of-Life Care in California’s Regulatory Environment: This practical, two-day CME program will be held September 8-9 at the San Francisco Marriott Hotel and again December 1-2 at the Disneyland Hotel in Anaheim. CMA tailored this program to meet the needs of physicians who do not specialize in pain medicine. Offering 14 hours of Category I CME, this program completely fulfills California’s AB 487 mandate.
CMA members pay $335 (nonmembers $600). Register early and get $40 off the registration fee.
CMA/UCSD Pain Management CME Program on DVD: CMA and the UCSD School of Medicine have created a unique case-based CME program on DVD that physicians can use to receive their state-mandated 12 hours of Category I CME in pain medicine and end-of-life care. The program, “Pain Management: A Case-Based CME Program for Physicians,” provides specific information on the most common pain syndromes. It features several expert presenters who have also been participating in “Pain, Palliation, & Politics,” CMA’s ongoing series of pain and end-of-life care conferences.
CMA members pay $150 for 12 hours of CME (nonmembers $200) or $100 for 6 hours (nonmembers $150).
Essentials of Pain Medicine: What You Need to Know on the Front Line of Medicine: This program, presented by the American Academy of Pain Medicine and endorsed by CMA, is June 24-25 in Newport Beach. The program, designed for physicians who do not specialize in pain management, offers clinically focused lectures and case presentations on the assessment, diagnosis, referral, and treatment of patients with complex pain. End-of-life care and regulatory issues that impact pain management will also be covered.
CMA members pay $295 (nonmembers $345). Participants can receive 12 hours of Category I CME.
Click here for more information.
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2. State's New HIV Reporting Requirements Are Effective Immediately
Physicians and other health care providers must now report cases of HIV infection to health officials using patients’ names. Previously, such cases were reported using alphanumeric codes created from birth dates, gender, and elements of patients’ last names.
This change is the result of a law signed Monday by Governor Schwarzenegger. The CMA-supported “urgency” bill (SB 699) passed unanimously in both the Senate and the Assembly. Because of the bill’s urgency clause, name-based reporting of HIV cases in California will begin immediately.
The code-based reporting system was created in 2002 to ensure patient confidentiality, but it proved to be a bureaucratic nightmare for health officials and the resulting data was unreliable. California was one of just 7 states that hadn’t already switched to a confidential name-based reporting system. The Centers for Disease Control and Prevention does not consider code-based HIV reporting to be accurate, and federal officials have said they will withhold funds from states that use code-based reporting rather than names-based reporting.
Click here for more information.
Contact: Robin Flagg, 415/882-5110 or rflagg@cmanet.org.
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3. Plans Cannot Dictate Changes in a Patient’s
Prescription With Changes in Formulary
When a health plan changes its formulary of covered prescription drugs, it cannot limit or exclude previously covered drugs that were prescribed for its enrollees before the formulary was changed. That’s the law, thanks to a CMA-sponsored measure passed almost 10 years ago.
HMOs are constantly negotiating for better prices on prescription medications. Often when a plan negotiates a cheaper price on a comparable drug, it changes its formulary. Thanks to the CMA-sponsored law passed in 1997 (AB 974), physicians cannot be forced to change their patients’ prescriptions every time a plan changes its formulary.
The law also requires health plans that provide prescription drug benefits to cover all medically necessary outpatient drugs. If a physician believes that a nonformulary drug is medically indicated, health plans are required by law to maintain an expeditious process for obtaining authorization for medically necessary, nonformulary prescription drugs.
Physicians should not, however, automatically reject a plan’s formulary or its recommendation to prescribe an alternate medication. Drug prices are soaring and there is no reason to prescribe an expensive drug if a lower-cost medication is just as effective. Physicians are encouraged to work with plans to prescribe the least expensive medication that is medically appropriate.
For more details, see CMA ON-CALL document #0507, “Drug Formularies and Pharmacy Benefit Managers.” ON-CALL documents are free to members at CMA's members-only website. Nonmembers can purchase ON-CALL documents for $2 per page in CMA's online bookstore.
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Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.
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4. Medicare Part D Assistance Available for Non-English Speakers
To help non-English-speaking Medicare beneficiaries understand how Part D coverage works, the Centers for Medicare & Medicaid Services (CMS) has made available on its website information in Chinese, Korean, Russian, Spanish, Tagalog, and Vietnamese.
CMS has also established toll-free information hotlines for Spanish, Chinese, Korean, and Vietnamese speakers.
- Spanish: 800/MEDICARE (633-4227)
- Chinese (Cantonese and Mandarin): 800/582-4218
- Korean: 800/582-4259
- Vietnamese: 800/582-4336.
Physicians are encouraged to share this information with their non-English speaking patients. The May 15 Medicare Part D enrollment deadline is fast approaching. Under the law, eligible patients who do not sign up by the deadline will face a 1 percent per month premium penalty for the duration of the program.
Click here for more information.
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5. U.S. Health Quality and IT Leaders to Address Leadership Academy
Two of the federal government’s top health care officials—Carolyn Clancy, M.D., and David Brailer, M.D., Ph.D.—have joined the faculty of the 9th Annual California Health Care Leadership Academy. This year’s academy is May 5-7 in Indian Wells.
Dr. Clancy is director of the U.S. Department of Health Services Agency for Healthcare Research and Quality (AHRQ), which is dedicated to improving the quality, safety, efficiency, and effectiveness of health care. Dr. Clancy will discuss the forces driving outcomes-based reimbursement and quality incentives, including “pay for performance.”
Appointed by the president as the nation’s first health information technology coordinator, Dr. Brailer has been charged with improving safety and efficiency by leading the paper-burdened health-care system into the technology age. Dr. Brailer will discuss the future of the health communication infrastructure, including electronic health records and the digital exchange of medical information.
The California Health Care Leadership Academy has been lauded for its unique dual focus on leading-edge health policy trends and practical leadership skills development. To view the conference agenda or to register, visit http://www.cmanet.org/leadership or call 800/795-2262.
Click here for more information.
Contact: 800/795-2262
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6. Space is Still Available for CMA Foundation's Golf Tournament
There's still time to sign up for the CMA Foundation's fourth annual golf tournament, which will be held in conjunction with the CMA Health Care Leadership Academy. This year, the Leadership Academy will be May 5-7 at the Renaissance Esmerelda in Indian Wells. The golf classic will be May 6 at the Golf Resort at Indian Wells, selected last year by Golf Digest as one of its “Best Places to Play.” The style of play is a scramble, with a best ball format. Play begins with a shotgun start at 1 p.m.
After a great day of golf, there will be a ceremony including cocktails, snacks, and awards from the day’s play.
Your participation in the golf tournament will help support the foundation’s many valuable public health programs, including appropriate antibiotic use, childhood obesity, diabetes, smoking cessation, and health disparities.
Click here for more information.
Contact: Donna Astrinidis, 916/551-2054 or dastrinidis@cmanet.org.
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7. Holding Blue Cross and Other Health Plans Accountable:
What the RICO Settlements Mean to You and Your Practice
CMA and AMA are presenting two one-day seminars to educate physicians about the RICO settlements and what the settlements mean to their practices. The seminars will be Thursday, May 18, at the Los Angeles County Medical Association offices in downtown Los Angeles, and Friday, May 19, at the Alameda Contra Costa Medical Association offices in Oakland.
To date, six major health plans (Blue Cross/Anthem/Wellpoint, Aetna, Cigna, Health Net, Prudential, and Humana) have settled CMA’s RICO lawsuit, which alleges that the health plan defendants engaged in fraud and extortion by wrongfully denying payment to physicians, in violation of federal racketeering law.
Although the settlements have provided nominal cash payments to physicians, their true value lies in the prospective relief that is estimated to be worth more than $1 billion in increased revenue to physicians over the next few years.
Seminar participants will learn how to maximize their relief under the settlements by identifying inappropriate health plan business practices—including improper health plan claim denials—and holding the health plans accountable for failures to comply with the settlement terms. Under the settlements, the compliance process is overseen by a court-appointed mediator.
Registration for the LACMA seminar is $49 for members, $149 for nonmembers; ACCMA seminar is $49 for members, $199 for nonmembers.
Click here for more information.
Contact: Jewel Thompson, 916/444-5532 or jthompson@cmanet.org.
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8. Did You Know?
Did you know that long-time CMA member H. Corwin Hinshaw, Sr., M.D., was nominated in 1952 for the Nobel Prize in Medicine for his pioneering tuberculosis (TB) studies? Dr. Hinshaw was the first physician to successfully treat patients with the anti-tuberculosis medicine streptomycin.
Shortly after streptomycin was discovered in 1944, Dr. Corwin—a thoracic surgeon at the Mayo Clinic in Rochester, Minnesota—and a veterinarian friend attempted its use on guinea pigs with TB. In just five days, the guinea pigs were cured of the then-incurable TB, and within five years its use in humans proved just as successful.
The coveted Nobel Prize went instead to Selman A. Waksman, M.D., of Rutgers University, who discovered streptomycin.
In 1949, Dr. Hinshaw moved to California and joined the Stanford Medical School faculty and CMA. Dr. Hinshaw, a CMA member for 50 years, died in 2000 at age 98. Two of his four children became California physicians.
CMA is celebrating its 150th birthday! Visit http://www.cmanet.org/150 for other interesting information about CMA history.
Contact: Karen Nikos, 916/444-5532 or knikos@cmanet.org.
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9. CMA Member Benefit of the Week: HIPAA Compliance Assistance
CMA lawyers have spent hundreds of hours poring over the details of the Health Insurance Portability and Accountability Act (HIPAA) so physicians don’t have to. Through ON-CALL documents, CMA Alert articles, interactive compliance tools, and compliance workshops, CMA is there to help physicians make their practices HIPAA compliant.
Click here for more information about the benefits and discounts available to CMA members.
Contact: CMA's membership help line, 888/233-2937 or lgodward@cmanet.org.
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No. 2048 
