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No.
2005
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1.
CMS Study Finds Physician-Owned Specialty Congress in 2003 placed a temporary moratorium on construction of new physician-owned specialty hospitals and on physician referral of Medicare and Medicaid patients to specialty hospitals in which they have a financial interest. The moratorium allowed CMS time to study and report back to Congress on the issues, including the effect for-profit specialty hospitals have on nonprofit community hospitals. Critics charge, without specific proof, that these physician-owned specialty hospitals “cherry-pick” healthier, well-insured patients, leaving community hospitals with sicker, uninsured and underinsured patients. The study found that while physician-owned specialty hospitals do provide less uncompensated care, the money they return to the community through sales tax, income tax, and real estate and property tax exceeds “the proportion of net revenues that community hospitals [devote] to uncompensated care.” CMS also announced last week that it would take administrative actions that would effectively extend the specialty hospital moratorium through the end of the year. Although the moratorium officially expires on June 8, CMS administrator Mark McClellan has said he will direct state and certification agencies to “refrain from processing further participation applications” from physician-owned specialty hospitals until CMS has had an opportunity “to correct system problems [identified in the study] that may unfairly advantage physician-owned specialty hospitals.” CMA opposes the extension of the present moratorium and any prohibition on physician ownership, control, or governance of specialty hospitals. CMA says it is illogical to call corporate-owned hospitals that specialize in orthopedic or cardiac care “centers of excellence” but then attack similar facilities if they are operated by physicians. To eliminate any unfair advantage for physician-owned specialty hospitals, CMS last week announced plans to adjust payments to better reflect the seriousness of illnesses. CMS also said it would more closely scrutinize these physician-operated hospitals to see if they meet the government’s definition of a hospital (a facility that provides primarily inpatient care). Facilities that do not qualify as a hospital would be classified as ambulatory surgical centers, which are paid lower reimbursement rates than hospitals. CMA supports CMS’s plan to adjust reimbursement rates to more accurately reflect the true cost of providing care. Click here for more information. Contact: Robin Flagg, 415/882-5110 or rflagg@cmanet.org.
2. California Earns ‘A’ for Efforts to Combat Childhood Obesity The report card comes from the University of Baltimore’s Obesity Initiative. Grades were based on legislation recently introduced and/or passed in eight areas: nutrition standards; vending machine usage; body mass index measured in schools; recess and physical education; obesity programs and education; obesity research; obesity treatment in health insurance; and obesity commissions. CMA urges physicians to get involved with local efforts to combat childhood obesity. For more information on what you can do to make a difference in the health of your community, contact the CMA Foundation. The foundation provides training and support for physicians so that they can educate and empower their communities to confront this health care challenge. “The odds seem stacked against our children, our families and our communities,” says Elissa Maas, vice president of the CMA Foundation. “We are more overweight as a nation than ever before and our children are poised to be the first generation to live fewer years than their parents, likely not the legacy any of us wants to leave behind. There is something we can do.” Click here for more information. Contact: Elissa Maas, 916/551-2550 or emaas@cmanet.org.
3. Highlights from CMA Board of Trustees Available Online Contact: Ginnie Yee, 415/882-5170 or gyee@cmanet.org.
4. No Significant Health Care Cuts in Revised Budget Despite CMA opposition, the budget proposal released on Friday by the governor continues to propose expanding the Medi-Cal managed care program and requiring monthly premiums from more than half a million beneficiaries at or above the federal poverty level. Click here for more details of the budget proposal as it relates to health care. Contact: Lisa Folberg, 916/444-5532 or lfolberg@cmanet.org.
5. Save the Date: Pain, Palliation, & Politics: Pain Management The program, tailored by CMA to meet the needs of physicians who do not specialize in pain medicine, has received rave reviews from past attendees. In the words of one physician, “I came here because I had to; it was legislated. So I had an attitude that it was a bit like traffic school. Instead, I was informed, challenged, and even inspired.” For those who can’t make the September meeting, the program will be repeated three times in 2006: January 6-7 and again December 1-2 at the Disneyland Hotel in Anaheim and September 8-9 in San Francisco. The program is presented by CMA and the CMA Foundation. Click here for more information. Contact: CMA’s Pain Management Seminar information line, 415/882-3330 or kdefabrique@cmanet.org.
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