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Reference Committee E: Resolution 501-03: Malpractice
Resolution 501-03: Malpractice ACTION: No action taken Resolution 502-03: Malpractice Premium Reduction For CMA Members RESOLVED: That CMA propose to those malpractice carriers offering coverage in California a reduction in their annual malpractice premiums for CMA members. ACTION: Reaffirmed Resolution 503-03: Limiting Compensation For Plaintiff’s Attorneys ACTION: Not adopted Resolution 504-03: Malpractice Coverage For Physician Volunteers RESOLVED: That CMA support the enactment of state legislation similar to the State of Wisconsin’s "Volunteer Health Care Provider Program," under which physicians providing free medical care to uninsured patients are deemed agents of the state and therefore receive state-provided legal defense and indemnification against any malpractice litigation related to the free medical care they provide. ACTION: Referred for study and report back Resolution 505-03: Medi-Cal as Charity Care ACTION: Not adopted Resolution 506-03: Good Samaritan Law For Physicians At Free Clinics ACTION: Not adopted Resolution 507-03: Waiver Of Licensure Fees For Physicians At Free Clinics RESOLVED: That CMA support legislation that would provide a waiver of fees for licensure renewals for retired physicians who volunteer to provide uncompensated care in a licensed clinic or other health facility. ACTION: Adopted as amended Resolution 508-03: Tax Relief Or Incentives For Physicians ACTION: No action taken Resolution 509a-03: Standards For Expert Witnesses RESOLVED: That CMA continue to urge specialty societies to develop expert witness testimony peer review programs, and that it encourage the Medical Board of California to review cases that are referred because of concerns about the validity of expert witness testimony. ACTION: Substitute adopted for combined resolutions
509-03 and 514-03 Resolution 510-03: Restoration Of Medical Privacy ACTION: Not adopted Resolution 511-03: Privacy Of Patients’ Information ACTION: Not adopted Resolution 512-03: Indiscriminate Release Of Billing Records ACTION: No action taken Resolution 513a-03: Physician-Specific Prescribing Practices RESOLVED: That CMA oppose the release of physician-specific prescribing practices to third parties by pharmacies, wholesalers or managed care companies; and be it further RESOLVED: That CMA support legislation prohibiting pharmacies, pharmacy wholesalers or health plans from selling or releasing physician-specific prescribing data to third parties. ACTION: Substitute adopted Resolution 514-03: Ethical Conduct Enforcement ACTION: See Resolution 509a-03 Resolution 515a-03: Peer Review Process RESOLVED: That CMA, in pursuing implementation, on a pilot basis, of a peer review alternative arbitration program consider incorporating in its criteria (a) eliminating economic conflicts of interest in the performance of peer review; (b) making a time-sensitive inexpensive and standardized tool; and (c) developing protocols for when and how the arbitration review process would be applied. ACTION: Substitute adopted Resolution 516-03: Establishing CMA Leadership In Quality Improvement RESOLVED: That CMA request the Institute for Medical Quality to study how to assess the quality of care delivered by physicians; and be it further RESOLVED: That CMA develop a plan to build public trust in CMA and the medical profession as champions of quality care, with report back to the House of Delegates at the 2004 Annual Meeting. ACTION: Referred for study and report back Resolution 517a-03: Medical Error Remediation RESOLVED: That CMA continue to support a non-disciplinary approach to medical errors and the establishment of a voluntary and confidential reporting system for medical errors, the focus of which would be to evaluate and provide recommendations to reduce systemic and human error in the delivery of health care. ACTION: Substitute adopted Resolution 518-03: Physician Prescribing Of Narcotic Medications For Pain RESOLVED: That CMA, in cooperation with law enforcement and the legislature, review the methods currently in use to assess the appropriateness of a physician's prescribing of narcotic medications, and seek adoption of a process to assure that physicians expert in pain management and addiction provide consultation to law enforcement on appropriate prescribing practices without disrupting the physician's practice; and be it further RESOLVED: That CMA work with law enforcement and the legislature to assure that, in cases where a doctor’s office is raided and records are seized, law enforcement immediately make copies of all seized patient records available to the local health department who will be responsible for assuring that all patients affected are assured continued medical care and continued on opiate medications upon which they are dependent. ACTION: Adopted as editorially amended Resolution 519-03: Selective Targeting Of Physicians By The Internal Revenue Service ACTION: Not adopted Resolution 520a-03: Advance Directive Documentation RESOLVED: That CMA continue to work with DHS and other organizations to promote the use of advance health care directives, specifically CMA’s Advance Health Care Directive Kit; and be it further RESOLVED: That CMA support recognition of and reliance upon advance directives by medical transport personnel and other health care professionals. ACTION: Substitute adopted Resolution 521a-03: End-Of-Life Care RESOLVED: That CMA promote end-of-life education to the physicians and people of California, with an emphasis on the simultaneous delivery of disease directed therapy and palliative care delivery, as clinically appropriate. ACTION: Substitute adopted Resolution 522-03: Appropriate Use Of CPR In Long-Term Care RESOLVED: That CMA policy shall be that it is good medical practice that patients in long-term care facilities will not be offered cardiopulmonary resuscitation unless it is specifically requested by the informed patient or responsible surrogate; and be it further RESOLVED: That CMA shall prepare and make available to patients and responsible parties patient educational material regarding advanced directive considerations and to help understand fully the consequences of CPR specifically for long-term care residents; and be it further RESOLVED: That this statement of policy is not intended to deny or limit CPR to those patients for whom CPR is appropriate; and be it further RESOLVED: That CMA shall encourage long-term care facilities to adopt a similar policy and clearly inform patients that the facility will not resuscitate patients whose heart or breathing stops unless specifically requested; and be it further RESOLVED: The CMA will refer this issue for national action. ACTION: Referred for study and report back Resolution 523-03: Improper Legislative Intrusion Into Physician-Patient Relationship RESOLVED: That CMA immediately send a letter to the California Congressional delegation expressing CMA's strong opposition to the improper legislative intrusion into the physician-patient relationship as expressed in the various Senate and House versions of the so-called "partial-birth" or late-term abortion bills; and be it further RESOLVED: That CMA, through its Center for Legal Affairs, join with other organizations to take legal action, such as the filing of an injunction or filing of a friend of the court brief, to prevent implementation should any of these bills become law. ACTION: Adopted as editorially amended Resolution 524-03: HIPAA Privacy Rule And California Law RESOLVED: That CMA seek to amend California law to minimize the burden, promote confidentiality and, where possible, conform California law to federal law; and be it further RESOLVED: That CMA seek changes in federal law to minimize the burden of compliance with the HIPAA Privacy Rules and to maintain the confidentiality of protected health information. ACTION: Adopted as amended Report E-1-03: No Fault Medical Injury Compensation ACTION: Filed for information Report E-2-03: Peer Review of Diagnostic Screening Tests RECOMMENDATION 1: That the House of Delegates adopt substitute Resolution 506-02 as follows: RESOLVED: That CMA only support diagnostic screening tests once they are linked to a specific evidenced-based review that determines the strength or quality of the evidence supporting the request and that evaluates the degree to which the test satisfies the minimal criteria for validating the appropriateness of the screening test, which are: (a) the test must be able to detect the target condition earlier than without screening and with sufficient accuracy to avoid producing large numbers of false-positives and false-negative results; (b) screening for and treating persons with early disease should improve the likelihood of favorable health outcomes compared with treating patients when they present with signs of symptoms of disease; and (c) the gender and age at which screening should begin and the frequency of screening. RESOLVED: That CMA encourage specialty societies, including the American College of Radiology, to develop appropriate indicators and peer review standards for elective imaging screening tests. ACTION: Recommendation adopted as amended and remainder
of report filed for information Report E-3-03: Peer Review Reform RECOMMENDATION 1: That the House of Delegates adopt a substitute Resolution 507-02 as follows: RESOLVED: That CMA pursue implementation, on a pilot basis, of a peer review alternative arbitration program that would utilize independent, non-biased peer review arbitrators that make judgments based upon clearly acceptable standards, taking into consideration reasonable differences of opinion; and be it further RESOLVED: That CMA seek further clarification in the law, as needed, to ensure that physicians are not automatically excluded by medical staffs or health plans based on a Medical Board probation. ACTION: Recommendation adopted and remainder of report
filed for information Report E-4-03: Institute For Medical Quality Review Of Therapies And Devices RECOMMENDATION 1: That Resolution 505-02 not be adopted. ACTION: Recommendation adopted and remainder of report
filed for information Report E-5-03: Policy Review RECOMMENDATION: THAT THE FOLLOWING POLICIES BE ALLOWED TO EXPIRE: Resolutions 210a-85, 801-85, 814-85, 805-86, 816-86, 818-86, 807-87, 819-87, 908-87 and 812a-88 ACTION: Recommendation adopted
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