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1. Congress Delays Medicaid Security Prescription Law;
New Implementation Date Is April 1
President Bush on Saturday signed a bill delaying implementation of the law requiring physicians to use tamper-resistant prescription pads for Medicaid patients. The new implementation date is April 1, 2008. This six-month extension will allow physicians and pharmacists time to make sense of the new and somewhat confusing rules and ensure that patient care and access to prescription drugs is not negatively impacted.
As you have read in previous issues of CMA Alert, CMA aggressively lobbied Congress for just such a delay. The association remains concerned, however, that the additional hassle and cost involved will force physicians to leave the Medi-Cal program, where access to care is already a problem. CMA continues to seek to reverse the law or at least make it consistent with current state law, which requires security prescriptions only for controlled substances.
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Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
2. Preview CMA’s 2007 House of Delegates Agenda Online
At this year’s House of Delegates, physicians from across the state will debate and set policy on important health care issues including health system reform, universal health care, and health care information technology. The House of Delegates convenes October 27 to 29 in Anaheim.
During the three-day meeting, the 500 delegates will address more than 100 resolutions on these and other key issues that affect the practice of medicine. The resolutions and reports presented to delegates are available online for viewing and downloading at the members-only website.
Contact: Roger Purdy, 916/444-5532 or rpurdy@cmanet.org.
3. Online Forum for House of Delegates Now Live
CMA is debuting an online forum for discussion of resolutions and reports that will be considered by the 2007 House of Delegates (HOD). The delegates, your elected representatives, meet annually to establish CMA policies on key issues that affect the practice of medicine, from medical ethics to critical matters of public health.
The HOD functions very much like our state and federal legislative bodies. Prior to debate of resolutions on the floor of the HOD, the proposals are discussed and debated in one of seven “reference committees.”
The discussion forum is being piloted with one reference committee (committee C, which covers issues related to membership, finance, and governance), but will be expanded to include all resolutions and reports in 2008. All CMA members are invited to visit the online forum to comment on committee C resolutions and reports. Members of the reference committee will consider these comments along with the oral testimony presented at the House of Delegates meeting, October 27 to 29 in Anaheim.
To participate in the online discussion, log in to the members-only website and click on “House of Delegates Forum” under “CMA Spotlight.” After a simple self-registration process, you will be able to read other members’ comments and post your own.
Resolutions and reports for all other committees have also been posted to the members-only site. Complete agenda materials for the meeting were mailed to delegates and alternates this week.
Contact: Roger Purdy, 916/444-5532 or rpurdy@cmanet.org.
4. President Vetoes Health Insurance for Children of Working Poor
Despite bipartisan support in both houses of Congress, President Bush this week vetoed a bill that would have expanded the State Children’s Health Insurance Program (SCHIP) to cover 10 million poor children.
The expansion would cost an additional $35 billion over five years (for a total of $60 billion), which would have been financed by a 61-cent increase in the federal tobacco tax.
The program, which currently provides insurance for 1.1 million children in California and 6.6 million nationwide, expired last week. If the program isn’t extended, millions of children could at least temporarily lose their health insurance as early as next month.
The bill passed 67 to 29 in the Senate, with enough support to override a veto. But the 265-to-159 House vote fell short of the two-thirds margin needed.
“Failure to fund SCHIP is a slap in the face to America’s children, who we need to make a health-care funding priority,” says CMA President Anmol S. Mahal, M.D.
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Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
5. Deadline to Claim Your Share of the
Blue Shield Settlement Is October 19
As previously reported in CMA Alert, Blue Shield of California refused to settle a class-action lawsuit filed in 2003 that would have meant tens of millions of dollars for California physicians. This lawsuit alleged that Blue Shield’s payment practices defrauded physicians out of monies due for patient care. Blue Shield of California is one of the few Blue Shield companies of nearly 40 licensees in the nation that has refused to settle this case and pay doctors the money they are owed.
Even though Blue Shield of California chose not to participate in this settlement, all class members, including most California physicians, are eligible for one or more shares of the $130 million settlement. The class includes all physicians who billed any of the Blue Shield companies or their contracted intermediaries (capitated medical groups, IPAs, etc.) for services provided between May 22, 1999, and May 31, 2007.
The deadline to submit a claim is October 19. Physicians do not have to provide documentation for individual Blue Shield claims. To receive your share of the settlement, you need only calculate the aggregate payments received from the settling Blue Shield companies from 2004 to 2006. Claims submitted to Blue Shield of California should not be included in the calculations.
Because Blue Shield of California was unwilling to settle, most California physicians will only be entitled to one settlement share. Physicians who have treated a large number of out-of-state Blue Shield patients may be entitled to more.
Physicians with $5,000 or less in claims billed to the settling defendants are eligible for one pro rata share; those with $5,001 to $49,999 are entitled to five shares; and those with more than $50,000 will receive 10 shares. The share value will be determined once all claims have been received.
If Blue Shield of California had participated in the settlement, most California physicians would have received 10 pro rata shares.
The case, Rick Love, M.D., v. Blue Cross Blue Shield Association, was filed in May 2003 in federal district court in Miami. The suit accused the insurers of a pattern and practice of denying and delaying care, including intentionally programming computer billing databases to automatically downcode physician claims. The suit was filed under the federal civil racketeering (RICO) statutes. Although CMA is not a plaintiff in the suit, the suit affects all physicians because of its class-action status.
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Contact: Desiree Rice, 916/551-2865 or drice@cmanet.org.
6. Medical Board Seeking Nominations
for Physician Humanitarian Award
The Medical Board of California is seeking nominations for its Physician Humanitarian award, which recognizes physicians who have demonstrated excellence in their efforts to improve access and fill gaps in the health care delivery system. The nomination deadline is November 16. Visit http://www.mbc.ca.gov for details.
Contact: Candis Cohen, 916/263-2394 or cchohen@mbc.ca.gov.
7. Buy Your Tickets Now for CMA Foundation’s Annual Dinner
The CMA Foundation’s 2007 President’s Reception and Dinner Dance is October 28 at the Disneyland Hotel in Anaheim, during CMA’s annual meeting. The deadline to purchase tickets is October 19.
Proceeds will support the CMA Foundation, a charitable organization that links physicians and their communities to raise awareness about important public health issues, including appropriate antibiotic use, childhood obesity, diabetes, smoking cessation, and health disparities.
Honored at the dinner will be incoming CMA President Richard Frankenstein, M.D., and the foundation’s leadership award recipients, Condessa Curley, M.D. (Robert D. Sparks, M.D., Leadership Award), Kwabena Adubofour, M.D. (Adarsh S. Mahal, M.D., Access to Health Care and Disparities Award), and Edward Chow, M.D. (Ethnic Physician Leadership Award).
Tickets are on sale now. Individual tickets are $125; 10-person tables are $850. Raffle tickets are also available for $5 a ticket ($20 for five). Grand prize is a seven-day Caribbean cruise for two, including air travel. You need not be present to win.
Visit http://www.calmedfoundation.org for more information.
Contact: Liz Burdick, 916/551-2886 or lburdick@cmanet.org.
8. Member Benefit of the Week: Health Savings Accounts
2007 Final Deadline! CMA has partnered with Marsh and UMB Bank to create the CMA Health Savings Account (HSA) Program.
An HSA is a federally tax-exempt account used to pay for current and future health care expenses.
Maximum annual contributions in 2007 are $2,850 for an individual and $5,650 for a family. (Individuals ages 55 to 64 can contribute an additional $800.)
Members who wish to open a health savings account and make their full 2007 contribution must make sure their qualified high deductible health plan is in effect no later than December 1.
Visit http://www.cmanet.org/hsa or call Marsh at 800/842-3761 for details.
Click here for more information on your membership benefits.
Contact: CMA's membership hotline, 800/786-4CMA (4262) or lgodward@cmanet.org.
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No. 2112
