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1. Governor’s New Reform Proposal
Does Not Contain 2% Tax on Doctors
Governor Schwarzenegger on Tuesday officially released his revised health care reform proposal. Thanks in large part to CMA's aggressive advocacy, the 2 percent tax on doctors is not included in this new proposal. The broad concepts of the governor's $14 billion plan, however, remain the same.
The proposal would: - require all Californians to obtain private insurance, either individually or through their employers;
- guarantee that everyone has access to affordable coverage by limiting on how much insurers can charge based on age or health status;
- subsidize coverage for individuals earning less than 250 percent of the federal poverty level;
- prohibit insurance companies from spending less than 85 percent of premiums on actual patient care;
- provide a tax credit for insurance expenses that exceed 5 percent of a family's income;
- require employers who do not offer health care coverage to contribute up to 4 percent of total payroll to cover the cost of providing health insurance to their employees.
Although CMA has not taken an official position on the proposal, we believe it is moving in the right direction and are supportive of the governor's efforts to provide health care coverage to more Californians.
Click here for more information.
Contact: Susan Bassett, 916/444-5532 or sbassett@cmanet.org.
2. Don’t Miss Your Chance to Claim a
Share of the Blue Shield Settlement
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. Although CMA is not a plaintiff in the suit, the suit affects all physicians because of its class-action status.
Click here for more information.
Contact: Desiree Rice, 916/551-2865 or drice@cmanet.org.
3. Tell Us What You Think; All Members Invited to Participate
in the House of Delegates Discussion Forum
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, 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 registration process, you will be able to read other members comments and post your own.
Click here for more information.
Contact: Roger Purdy, 916/444-5532 or rpurdy@cmanet.org.
4. PreCALS PLUS, IMQ’s Medical Staff Issues
and Answers Conference, Is November 1-2 in Irvine
The Institute for Medical Quality's PreCALS PLUS Medical Staff Issues and Answers Conference will be November 1 to 2 at the Hilton Orange County Airport in Irvine. Medical staff teams (chiefs of staff, committee chairs, quality-management personnel, and medical staff directors and coordinators) are encouraged to attend.
The conference will focus on changes to JCAHO's standards for 2008, with special attention to those related to the medical staff, credentialing standards, and quality improvement. Also discussed will be California's Title 22 regulations, new state laws governing inspection and licensure of hospitals and other health care facilities (SB 1301 and 1312), federal conditions of participation, and professionalism as it relates to medical staff reappointment. In addition, participants will learn about current legal issues involved with medical staff self governance.
Visit http://www.imq.org for registration information.
Contact: Leslie Anne Lacopi, 415/882-5167 or liacopi@imq.org.
5. Physicians Invited to Attend CMA’s Organized Medical
Staff Section Assembly and Educational Conference
CMA's Organized Medical Staff Section will hold its Annual Assembly and Education Conference Friday, October 26, 7:30 a.m. to 5 p.m. at the Disneyland Hotel in Anaheim. The conference immediately precedes the 2007 CMA House of Delegates, also at the Disneyland Hotel.
Scheduled speakers include Elizabeth A. Snelson, Esq., an attorney specializing in medical staff issues, who will discuss the Joint Commission's new medical staff standards (MS1.20). CMA legal counsel Greg Abrams, Esq., will discuss California's new hospital reporting and inspection law (SB 1301), and Howard Lang, M.D., and CMA lobbyist Brett Michelin will cover this year's CMA-sponsored physician whistle-blower protection bill (AB 632).
All physicians, medical staff professionals, and interested parties are invited to attend, but seating is limited. Cost is $100 for physicians and staff of CMA-OMSS members, $250 for CMA members who are not also OMSS members, and $300 for all others.
Click here for more details, including registration information and a tentative agenda.
Contact: John Boxberger, 916/551-2569 or jboxberger@cmanet.org.
6. There’s Still Time to Buy Tickets for CMA Foundation’s
2007 President’s Reception and Dinner Dance
The CMA Foundation's 2007 President's Reception and Dinner Dance is October 28 at the Disneyland Hotel in Anaheim, during CMA' 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, cervical cancer prevention, 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), and Kwabena Adubofour, M.D. (Adarsh S. Mahal, M.D., Access to Health Care and Disparities 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: Maria Moran, 916/551-2573 or mmoran@cmanet.org
7. Member Benefit of the Week: 6% Off athenahealth
CMA members receive 6 percent off athenahealth's unique web-based practice management service, which integrates web-based practice management, EMR software, and back office processing specialists into a single service.
athenahealth helps physicians get paid quickly, correctly, and with minimal hassle: On average, practices that use athenahealth get paid 30 percent faster and see a 5 to 10 percent increase in collections.
For more details, visit http://www.athenahealth.com/cma.
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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