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1. Members Needed to Testify at DMHC Hearing Next Week
on Doctors’ Right to Fair Payment from HMOs
The Department of Managed Health Care has scheduled a public hearing on a new set of proposed regulations that would prevent noncontracted physicians from billing patients for emergency services. The hearing is next Wednesday, October 24, in Burbank.
CMA encourages all members to submit written comments and to testify in opposition to these onerous regulations. CMA believes these regulations attack the future viability of physician practices. They do not address the key underlying problems of unfair contracts, which result in inadequate physician networks, and chronic and pervasive underfunding of emergency care by insurance companies.
It is critical that DMHC hear from physicians, county medical societies, and specialty societies so that regulators understand the severe economic impact that these regulations will have on physicians and the health system in general.
In addition to prohibiting noncontracted and contracted physicians from billing enrollees for emergency services (except for copayments, coinsurance, and deductibles), the new proposal creates a voluntary independent dispute resolution process to resolve payment disputes; requires HMOs in the event of a payment dispute to pay physicians an interim amount of 150 percent of 2007 Medicare rates; and modifies the Gould criteria (the nationally accepted standard for determining fair and reasonable payment for health care services) to include Medicare and contract rates.
Physicians interested in testifying at the hearing should contact Francisco Silva at 916/551-2565 or fsilva@cmanet.org. If you are not able to attend the hearing, you can submit written comments on the proposed regulations until November 15.
Click here for more information.
Contact: Francisco Silva, 916/551-2565 or fsilva@cmanet.org.
2. Poll Finds 70% of Public Disapproves of President’s Veto
of Children’s Health Insurance Program Expansion
The Henry J. Kaiser Foundation this week released results of a poll that found that 2 in 3 Americans disapprove of the President’s decision to veto a bill that would have provided health insurance to an additional 3.5 million children nationwide.
The poll was conducted jointly with
NPR and the Harvard School of Public Health.
Despite bipartisan support in both houses of Congress, President Bush recently 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 be 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 on September 30. 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 by a veto-proof 67 to 29 in the Senate, but the 265-to-159 House vote fell short of the two-thirds margin needed to prevent a presidential veto. The House could have overridden the veto with a two-thirds vote, but an attempt this morning to do so fell short, with a 273-to-156 vote.
CMA has over the past few weeks strongly urged House members to override the President’s veto and expand this valuable program that has provided health insurance to millions of California kids over the past decade.
Click here for more information.
Contact: Elizabeth McNeil, 415/883-3376 or emcneil@cmanet.org.
3. Governor Signs CMA-Sponsored Bills
In a series of last-minute bill signings, Governor Schwarzenegger this weekend signed all of CMA’s sponsored bills.
The CMA-sponsored bills signed by the governor were:
- AB 682, which will help make HIV testing a routine part of medical checkups.
- AB 632, which strengthens whistle-blower protections for physicians and prohibits hospitals from retaliating or discriminating against a physician on its medical staff for speaking out about the quality of care provided in the facility.
- AB 1226, which streamlines Medi-Cal physician enrollment.
- AB 1324, which confirms that it is illegal for insurers to rescind or modify authorization after services are rendered in good faith.
Two CMA-sponsored bills introduced this year will be taken up again in the next legislative session. These include the farmworker health coverage bill (AB 770), which would improve access to health care for farmworkers in California, and AB 1155, which would require mandatory penalties for HMOs that are found by the Department of Managed Health Care to have underpaid physicians, and would require those HMOs to automatically pay to physicians the full amount of underpayment plus interest.
Click here for more information.
Contact: Susan Bassett, 916/444-5532 or sbassett@cmanet.org.
4. It’s Antibiotic AWAREness Week!
The CMA Foundation’s Alliance Working for Antibiotic Resistance Education (AWARE) project is celebrating Antibiotic AWAREness Week by educating members of the public about what they can do to prevent the spread of germs and the reduce the incidence of antibiotic resistance.
AWARE has partnered with the California Pharmacists Association to identify 400 independent and chain pharmacies to participate in Antibiotic AWAREness Week activities. Participating pharmacies have been including patient education handouts in their prescription bags, placing tabletop displays on their counters, and having staffers wear AWARE buttons.
AWARE has also produced a new flu season tool kit for physicians and other clinicians. The tool kit contains an array of clinical resources and patient education materials to help reduce inappropriate antibiotic use.
Visit http://www.aware.md for more information.
Contact: Cristina Correa, 916/551-2551 or ccorrea@cmanet.org.
5. Participate in CMA’s Democratic Process
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.
6. Last Chance 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’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, cervical cancer prevention, and health disparities.
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: 30-50% off Epocrates
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. Group discounts are also available.
Epocrates provides physicians with point-of-care access (via PDA, desktop computer, or the Internet) to up-to-date information on drugs, diseases, and diagnostics. Epocrates allows physicians to make better clinical decisions, saving time and improving quality of care. To receive your discount, log in to the members-only website and follow the links to the Epocrates website.
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. 2114
