Thursday, January 17, 2019

Opioid Advocacy Update

From the beginning of the opioid epidemic, the California Medical Association (CMA) has been one of the most engaged and determined stakeholders working to strike a balance between patient access to necessary medicine and preventing and addressing abuse.

 

CMA has been a leader in advocating for increased funding, access and availability of preventive services, opioid-use disorder treatment programs and non-opioid therapies, including mental health services and medication-assisted treatment (MAT). We have successfully worked to stop legislation that interferes with the practice of medicine and creates barriers to care, such as government-mandated dosage and duration limits.

 

Over the last few years, the changing landscape surrounding prescribing opioids has been dizzying as payors, legislators, pharmacies and medical boards seek ways to be proactive in addressing the opioid epidemic – sometimes ignoring the actual realities of medical practice and creating barriers to good care. And as you’re aware, California physicians have been engaged in the debate since the beginning, on behalf of our patients and profession.

 

CMA released a white paper, “Opioid Analgesics in California: Relieving Pain, Preventing Misuse, Finding Balance” in 2013. Developed through CMA’s Council on Science and Public Health, it has been the cornerstone of our work to educate physician colleagues, guide the medical board and policymakers, and help health care stakeholders navigate the evolving science related to opioids. At its core is the premise that care must be evidence-based and reflect the individual needs of the patient – ultimately, allowing physicians to make proper care decisions.

 

CMA’s emphasis on these principles has remained constant, including advocacy on opioid-related activities in 2018, which include:

 

Controlled Substance Utilization Review and Evaluation System (CURES): CMA has been working with the state for years to ensure adequate educational and technical support for physicians who will have to check CURES as part of their prescribing workflow, starting on October 2, 2018. CMA has advocated for sustained user outreach and educational efforts by the state that provide clarity of this new law, as well as prioritize the clinician perspective on an ongoing basis following implementation. We will continue to engage as the new requirement to consult CURES is implemented and work with stakeholders to ensure CURES has adequate support.

 

Ensuring Fair Enforcement: The Medical Board of California is examining deaths associated with the use of prescription opioids and is reviewing whether the care and treatment provided by physicians to those individuals met the standard of care. As part of a “routine” review, the board sent letters to physicians who were identified as prescribing opioids in a manner that, after physician review, merited further investigation, and requested that those physicians submit additional information including a summary of the care provided, the patient’s medical records, and any additional materials that would be pertinent to the board’s investigation.

 

CMA has raised concerns about the board’s process and will continue to work with the board to address physician concerns, monitor the board's process to determine whether disciplinary actions are based on the appropriate standard of care, and if the process used to identify physicians subject to these inquiries needs additional transparency or modification. Physicians who are under review may contact CMA (800-786-4262, CMAdocs.org) for information about the disciplinary process and their legal rights.

 

Access to Medication-Assisted Treatment and Overdose Reversal Medications: To help reduce the rates of overdose and stigma associated with opioid-use disorder, CMA sponsored AB 2384 (Arambula), which would have removed barriers to coverage of MAT services and naloxone to ensure that people who face addiction have better access to treatment. Governor Jerry Brown vetoed AB 2384, claiming a need for utilization controls and barriers to patient access of life-saving treatments. In response, CMA issued a statement expressing disappointment and concern, while reiterating our intention to work with the next governor to make this issue a priority in 2019.

 

The federal opioid bill continues to push treatment in the right direction by providing grants to improve access to MAT and codifying the ability for physicians to prescribe MAT for up to 275 patients, which is critical since the current caps are far too limiting and leave many patients on waiting lists for years.

 

Individual Patient Care: At the federal level, CMA successfully fought back against legislation that would have required one-size-fits-all medicine by mandating prescription drug dosage and duration limits.

 

California legislators also sought to statutorily limit dosages and durations of opioid pain relievers through AB 2741 (Burke) and AB 1998 (Rodriguez), using arbitrary and minimal amounts. Both bills were defeated earlier this year.

 

Federal Funding and the Congressional Opioid Crisis Response: Earlier this year, Congress approved $10 billion in new funding for states to address opioid-related education, prevention, treatment and law enforcement issues. The House and Senate reached an agreement on the “Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act,” and they will send it to President Donald Trump soon. It is a comprehensive package of more than 300 bills that, among other things, provides grants to states to address prevention and treatment, as well as stop the flow of illicit drugs, such as fentanyl. It also expands the number of Institute for Mental Diseases inpatient Medi-Cal beds available for opioid substance abuse disorder treatment and enhances Medi-Cal patient access to non-opioid options. Medicare coverage for treatment has been expanded, with new Medicare payment and delivery demonstration projects approved for comprehensive management of opioid-use disorder.

 

Unfortunately, the bill package also includes a mandate for physicians to e-prescribe controlled substances for Medicare patients after January 1, 2021. However, it includes many exceptions, and it directs the Centers for Medicare and Medicaid Services to implement additional exceptions. In a major win, the Drug Enforcement Administration (DEA) has been mandated to update its antiquated and burdensome process for e-prescribing. While more than 90 percent of physicians e-prescribe, only 21 percent e-prescribe controlled substances, largely due to the DEA’s burdensome requirements. The state mandate takes effect in 2022.

 

Physician Education on Safe Prescribing and Treatment: Governor Brown recently signed AB 2487 (McCarty), which originally mandated all California physicians to take an eight-hour course required to qualify for a federal waiver to the Drug and Addiction Treatment Act of 2000 in order to allow physicians to prescribe MAT drugs, like buprenorphine, outside of an opioid treatment center.

 

After CMA-led negotiations with the author, the bill was amended to allow physicians who seek to prescribe MAT to fulfill their annual continuing education requirement by completing the DATA-Waivered Physician course along with four additional credit hours on treating substance use disorders. Successful advocacy prevented additional and mandatory continuing education.

 

The road has been long and hard-fought, and California’s comprehensive approach has focused on safe prescribing, naloxone distribution, public education campaigns, local opioid safety coalitions and increasing access to treatment, including MAT.

 

This approach has produced promising results. From 2013-2017, California experienced over a 24 percent decrease in opioid prescriptions, and is only one of five states with a multi-year decrease in prescription opioid overdoses. California is now tied for the lowest per capita opioid prescription rate in the country, while opioid prescribing has decreased for the fifth year in a row.

 

More work remains, as the drugs responsible for these overdose deaths are changing and have been spurred by illicit fentanyl. CMA will continue to work with policymakers, elected officials and health care stakeholders to ensure your voice – and your patients’ voices – are heard.

 

ADDITIONAL RESOURCES:

 

White Papers:

 

Webinars:

 


AB 3087 Defeated

Assembly Bill 3087 (Kalra) has been defeated.  This dangerous legislation would have created a commission of unelected political appointees empowered to arbitrarily cap rates for all health care services in all clinics, hospitals and physician practices in California. 

Thousands of physician members contacted their legislators because AB 3087 would have:

  • Decimated California’s health care delivery system.
  • Disrupted care and limited choice for millions of California patients.
  • Caused 175,000 health care workers to lose their jobs.
  • Forced hospitals to close and pushed health care providers into early retirement.
  • Caused a “brain drain” of talented medical students and residents fleeing California for more ideal working conditions.

 


RCMA's Free Saving Private Practice Consortium 8/18/2018 Murrieta

All physicians and their practice administrators are invited to get the help they need to survive and thrive in the ever-changing world of healthcare. Free 15 minute personal one-on-one consultations will be scheduled with RCMA/CMA subject matter experts and industry experts serving the local physician community. This is a great opportunity for physicians to get their questions answered, problems solved, and explore resources that can help doctors continue caring for their patients irregardless of their mode of practice.

SPECIAL GUEST SPEAKER: Janus Norman, Senior Vice President, CMA Centers for Government Relations & Political Operations

Download Flyer                              RSVP Online

AREAS OF CONSULTATION INCLUDE:

  • All Practice & Personal Insurance
  • Billing & Collections
  • EHR & HIE Implementation
  • Estate Planning & Asset Protection
  • Information Technology
  • Legal Support
  • Malpractice Risk Management
  • Medi-Cal & Medicare
  • Office Staffing
  •  
  • Professional Liability Insurance
  • Payor Contracting
  • Payor Advocacy
  • Payor Reimbursement Support
  • Physician Employment Contracting
  • Physician Recruitment
  • Practice Management
  • Practice Cost Reduction
  • Strategic Planning
  •  

    MEET THE EXPERTS

    California Medical Association Center for Economic Services
    Areas of Consultation: Practice Management, Medicare, Medi-Cal, Payor Contracting, Denied Claims
    CMA’s Center for Economic Services (CES) is staffed with practice management experts with over 125 years in medical practice operations experience. With the combined strength of all the departments of the CMA, CES is able to empower physician practices by providing resources and guidance to improve the success of the practice. Assistance ranges from coaching and education to direct intervention with payors or regulators.
    CMA CES experts onsite at Saving Private Practice include:
      Cheryl Bradley, Associate Director - Medicare
      Kris Mark, Associate Director - Medi-Cal & Contracting
      Mitzi Young, Physician Advocate - Practice Management & Denied Claims

    Inland Empire Health Information Organization (IEHIO)
    Areas of Consultation: HIE Connections, EHR Implementation, EHR Workflow & Documentation
    IEHIO is a non-profit grass-roots organization providing linkage between healthcare stakeholders in the Inland Empire and Manifest MedEX, California’s HIE. IEHIO goals are to coordinate data sharing services not only for treatment at the point of care, but also for care management and population health analytics specific to participant needs and programs; while promoting a community-wide data-sharing model that improves healthcare for all residents of the Inland Empire.
    IEHIO experts onsite at Saving Private Practice include: Stacy Proctor, IEHIO, Program Director & Cardelia Reid, RN, MSN, MBA, IEHIO Clinical Informatics Director.

    Intalare
    Areas of Consultation: Reducing Practice Costs, Purchasing
    Intalare is a Group Purchasing Organization (GPO) with more 35,000 physicians offices and clinics as clients nationwide who trust Intalare to provide the products and services they need most at the best possible price! By aggregating purchasing volume as a group practices can leverage superior pricing and save money on everything a physician practice buys.
    Intalare experts onsite at Saving Private Practice include: Jennifer Brons, Intalare, Account Manager

    MediQuest Staffing
    Areas of Consultation: Office Staffing (Hiring, Interviewing, Salary Surveys, Retention Strategies, Difficult Employees, etc.)
    MediQuest Staffing matches high-quality healthcare professionals with fully screened, talented medical support staff such as front and back office MAs, billers, coders, medical collections, and practice managers to name just a few.
    MediQuest experts onsite at Saving Private Practice include: Rachael McGarvey, MediQuest, Regional Service & Delivery Manager

    Mercer Health & Benefits Insurance Services, LLC
    Areas of Consultation: Practice Insurance & Personal Insurances
    RCMA’s endorsed Business Partner Mercer provides information to make informed decisions with your needs in mind. Available programs include: Workers’ Compensation, Individual and Small-Group Health insurance, Cyber Liability, Life, Disability, Business Owners Policies, Long-Term Care and more.
    Mercer experts onsite at Saving Private Practice include: Liz Fogle, Mercer, Relationship Manager

    NetServe Systems, Inc.
    Areas of Consultation: IT, Cloud Services, HIPAA, Network/Security Risk Assessments, Technical Consultations
    NetServe Systems is a comprehensive one-stop IT solution for medical offices handling ALL your IT needs.
    NetServe Systems experts onsite at Saving Private Practice include: Abdi Ahmed, NetServe Systems, CEO

    NORCAL Group
    Areas of Consultation:
    Medical Professional Liability Insurance, Risk Management
    As RCMA’s endorsed partner, NORCAL Group has over 32,000 insureds including physicians, medical groups, clinics, hospitals and healthcare facilities. NORCAL continually strives to remain true to their history and values, and to maintain their singular focus on protecting their policyholders’ careers and professional reputations while supporting the delivery of safe, quality patient care.
    NORCAL Group experts onsite at Saving Private Practice include:
    Bradford S. Dunkin, MHA, NORCAL Group, Sr. Risk Management Specialist & Belinda Ramon, NORCAL Group, Regional Business Development Representative

    RCMA Physician Workforce Development
    Areas of Consultation:
    Physician & Mid-Level Provider Recruitment and Resources

    RCMA is committed to addressing the physician shortage in Inland Southern California and RCMA’s Physician Recruitment Development Director is available to meet with you and provide additional help and resources to help you hire an associate.
    RCMA experts onsite at Saving Private Practice include:
    Sonya Jackson, RCMA, Physician Workforce Development Director

    Thakur Law Firm, APC
    Areas of Consultation:
    Healthcare Law, Employment Law, Business &Corporate Law, Real Estate Law, Estate Planning & Asset Protection
    Thakur Law Firm is a full service law firm with expertise in Health Care Law, Business & Employment Law, Estate Planning, Real Estate, Tax Law and Litigation. Thakur Law Firm, APC is a full service law firm with expertise in Health Care Law, Business & Employment Law, Estate Planning, Real Estate, Tax Law and Litigation.
    Thakur Law Firm experts onsite at Saving Private Practice include: Pamela Thakur, Esq., Jas Sondh, Esq. & Ash Dudheker, Esq.

    Universal Financial Systems
    Areas of Consultation:
    Medical Billing & Collections
    Universal Financial Systems (UFS) is a Southern California based financial services company specializing in medical billing & collections, consumer & commercial collections, litigation & judgment collections, accounting services and general business consulting.
    UFS experts onsite at Saving Private Practice include: George Christidis, UFS, COO

    Zymeda Provider Solutions
    Areas of Consultation:
    Practice Management, Strategic Planning, Payor Contracting, Billing Zymeda Provider Solutions is a full service practice management partner offering services in strategic planning, operational process improvement, billing, medical practice staffing and training, benefit administration and managed care operations.
    Zymeda experts onsite at Saving Private Practice include: Helene Beilman-Werner, Zymeda, CEO & Pam Geukens, Zymeda, Director of Operations

    Nominations Solicitation

    The CMA Committee on Nominations is now seeking nominations for elections of Mode of Practice delegates and alternate delegates for the 2016-2018 terms, which begins July 1, 2016 and runs through June 30, 2018. 

    The following seats are now open for nominations:

    • Academic Mode of Practice Forum Delegation represents the special concerns of physicians practicing as part of a medical school faculty.
    • Administrative Forum Delegation represents the special concerns of physicians practicing in administrative settings such as medical directors and administrators of medical organizations.
    • Government Employed Physicians Forum Delegation represents the special concerns of physicians employed by the federal, state or county government.
    • Hospital Based Practice Forum Delegation represents the special concerns of physicians whose practice is based in a hospital.
    • Medium-Size Group Forum Delegation represents the special concerns of physicians who practice in professional medical corporations or partnerships with between five (5) and one-hundred and fifty (150) shareholders, partners, and/or physician employees.
    • Large Group Forum Delegation represents the special concerns of physicians who practice in professional medical corporations or partnerships with between one-hundred and fifty (150) and one thousand (1,000) shareholders, partners and/or physician employees.
    • Very Large Group Forum Delegation represents the special concerns of physicians who practice in professional medical corporations or partnerships with over one thousand (1,000) shareholders, partners and/or physician employees.


    RCMA members can apply directly. Nominations must be submitted using the forms below and must be e-mailed no later than Thursday, April 14, 2016 to Nominations@cmanet.org 

    Instructions: Please submit nominations to nominations@cmanet.org including:

    • Indication in your email subject line which office/ seat you are interested in
    • Statement of Interest/qualifications. If you are selected as a nominee, this statement will appear alongside your name on the ballot (not to exceed 250 words).

    For more information, please contact: Michelle Chapanian mchapanian@cmanet.org or (916) 551-2054

     


    It's Finally Over! The Medicare SGR is Dead!

    LAST NIGHT THE SENATE APPROVED H.R. 2: THE MEDICARE SGR REFORM AND THE CHILDREN’S HEALTH INSURANCE REAUTHORIZATION ACT WHICH REPEALS MEDICARE’S SUSTAINABLE GROWTH RATE FORMULA, HOURS BEFORE DOUBLE-DIGIT PAYMENT CUTS TO PHYSICIANS WERE SET TO TAKE EFFECT. THE BILL HAS BEEN SENT TO THE WHITE HOUSE WHERE PRESIDENT OBAMA IS EXPECTED TO SIGN IT INTO LAW.

    After a decade of battling, the U.S. Senate, in a whopping vote of 92-8, passed H.R. 2, the monumental, bipartisan Medicare SGR Payment Reform and Children’s Health Insurance Program (CHIP) Reauthorization Act. Both California Senators Feinstein and Boxer voted in the affirmative. Two weeks earlier, the U.S. House of Representatives adopted the legislation in a landslide vote of 392-37. This was a rare, bipartisan achievement in a deeply divided Congress. RCMA, CMA, AMA and more than 780 state and national physician organizations supported the bill. In 2013, the policy was jointly developed on a bipartisan basis by the three House and Senate health committees. This year, U.S. House of Representatives Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) are credited with negotiating the final budget offsets to fund the SGR bill.

    RCMA/CMA extends a sincere thank you to all physicians for the extraordinary campaign this last decade to end the SGR. We have kept up the fight these last two years to hold Congress’ feet to the fire to develop a comprehensive bill to reform Medicare physician payments. The unity within organized medicine finally put this over the finish line. Moreover, 52 out of 54 Members of the California Congressional delegation voted to support physicians. This is an incredible achievement in one of the most dysfunctional Congresses in history.

    PLEASE BE SURE TO CONTACT YOUR REPRESENTATIVE AND
    THE CALIFORNIA SENATORS TO THANK THEM FOR THEIR SUPPORT!

    While H.R. 2 is far from perfect, it represents a significant improvement over the current Medicare program which mandates penalties up to 13% in the coming years with no opportunities for payment updates or bonuses. This bill consolidates the burdensome reporting programs and reinstates significant bonus payments. By repealing the SGR and providing annual updates, it provides stability to physician practices that allows for longer term planning. Significantly, it allows physicians to design new payment systems that work for physicians and patients instead of government bureaucrats. And it mandates physician involvement in defining and developing quality measures. Moreover, once the costly SGR is repealed, it will be much easier for physicians to work with Congress to make improvements to the payment system (such as increasing the annual update) at a lesser cost. The enormous cost of the SGR has been a barrier to making any improvements.

    Note that Medicare should begin processing claims today for services provided in April at the rates that were effective before the 21 percent cut was scheduled to take effect. Under the provisions of H.R. 2, the fee schedule conversion factor will be increased by 0.5 percent on July 1, 2015, and by another 0.5 percent on January 1, 2016.

    A Letter from CMA President, Luther F. Cobb, M.D.

    Dear Colleagues:


    Although 2014 will long be remembered as the year that all modes of practice and specialties of the House of Medicine came together in a group effort to defeat Proposition 46, it is imperative that we maintain the momentum we have gained as we confront the issues of the coming year and beyond.

     

    Following such a historic year, I would like to take a moment to reflect on what we have accomplished and what we can look forward to over the next 12 months.


    I have, for over three decades, been a firm believer in the institution of organized medicine and the good that we can accomplish with unified action. As the President of the Humboldt-Del Norte Medical Society and Chair of the Council on Legislation, and in my time as Vice Speaker and Speaker of the House of Delegates, I have seen you all accomplish remarkable feats together. Whether it has been determining our stance on the sweeping changes of health system reform; combating unwarranted extensions of allied health professionals’ scope of practice; fighting for access to care; working to ensure the practice of medicine is dedicated to patient welfare rather than the insurance bottom line; redefining Medicare geographic payments, and on and on; we have been able to get all this done because we work together for the benefit of all.

     

    Our political power was evidenced this November when we handed the trial attorneysProposition 46 an unprecedented two for one electoral defeat, in conjunction with an unparalleled coalition across all party and advocacy lines. We distributed over three million lab coat cards, hundreds of thousands of patient brochures, posters and yard signs all over the state, mostly because of the ground game we mobilized.

     

    Such a victory would never have been possible if not for the dedication we all had to one another and to the future of the practice of medicine.

     

    It is indeed a great honor to follow in the footsteps of Richard Thorp, M.D., who as last years president led an incomparable team effort to victory, not only with Proposition 46, but also the other battles and challenges we faced.

     

    So what does that mean for the year ahead?

     

    Already, the California Medical Association (CMA) has been involved in a public launch to increase the tobacco tax in California. We currently stand 47th in the nation in that regard. A broad coalition of public health advocates will be working all across the state. This action may end up being a legislative effort, or perhaps a ballot initiative, but we will be pressing forward this year.

    We know that as millions of citizens are signing up for health insurance coverage, it is more important than ever to ensure that they have real access to quality medical care, not just a card promising care without the infrastructure to deliver. To that end, CMA has been working with partners to educate physicians and patients about their choices.

     

    Many other issues are sure to arrive in the coming year; they always do. As a group, united, we can accomplish great things, as we have already proven.

     

    I look forward to working with you all in the exciting new year.

    Luther F. Cobb, M.D. CMA President



    CMA 2013 Annual Report

    Serving more than 39,000 members, CMA and its staff remain committed to our time-honored mission statement: to promote the science and art of medicine, protection of public health, and the betterment of the medical profession.

    Download the 2013 Annual Report to see how CMA supported its mission, including advocacy efforts, member benefits, ways to get involved and more.

    Click here to download the 2013 Annual Report.

    Governance Reform: CMA envisions a new future for organized medicine

    By Steven E. Larson, M.D., MPH, Chair of the CMA Governance Technical Advisory Committee

     

    Change is never easy. But oftentimes is it necessary, and even invigorating. The California Medical Association (CMA) is about to embark on a journey of change that will position our association as a nimble, proactive organization ready to lead the practice of medicine into a brave new world. In 2013, the CMA House of Delegates (HOD) approved a plan to reform the way our association is governed. Will it be easy? No. Will it be worth it? There is not a doubt in my mind.

     

    In a nutshell, the reforms will make CMA more relevant and effective by focusing the association on, and bolstering its resources to address, the critical issues of universal importance to physicians. By doing so, CMA will be better able to protect the interests of its physician members and, even more importantly, guide the future of our profession, not only in California but nationwide.

     

    150 Years of Tradition

    For 150 plus years, CMA has been guided by the HOD, which meets once a year to set policies and direct resource allocation. This has led to a sometimes unwieldy 581-member HOD, a Board of Trustees numbering more than 50, a seven-member Executive Committee and hundreds of other members serving as alternate delegates and in various capacities on dozens of councils, committees, sections and mode of practice forums.

     

    Over the years, there have been several task forces assigned to this subject. It wasn't until this year, however, that the abstract discussions about "governance reform" began to produce concrete results.

     

    These discussions resulted in big questions. Does the HOD foster a reactive culture rather than a proactive one? Does it inhibit CMA’s ability to take quick action in a rapidly evolving health care environment?

     

    While these questions were being asked, the HOD was spending most of its time on a growing number of resolutions that struggled to be assigned or implemented because of resource limitations.

     

    The CMA Board of Trustees, realizing that a floundering governing style prevented the organization from quickly acting on issues of universal import to the membership and their patients, created a committee—the Governance Technical Advisory Committee (GTAC)—to look at this issue.

     

    The GTAC confirmed what the executive committee had feared —the association was unable to quickly address universal issues that arose faster than the once-a-year HOD meetings could handle. And, there were other inefficiencies in CMA’s governing bodies and processes.

     

    And there was the cost. An independent study commissioned by CMA (an activity-based costing, or “ABC” study) found that CMA governance is far more resource-intensive than previously thought, accounting for almost one-third of CMA’s operating budget—an allocation that commensurately reduces resources available for advocacy and other member services.

     

    The GTAC began its discussion of how to bring relevance, democracy and cost-effectiveness to governing the association. It became clear to us that the rank and file members want more advocacy, while the delegates and trustees are heavily invested in leadership.

     

    Tackling the Big Issues

    A proposal to reform CMA's governing structure, put before the 2013 CMA HOD by the GTAC this past October, proposed that instead of a diffuse focus on many issues, the HOD take on a limited number of big issues—the most important, most pressing matters facing physicians and the practice of medicine.

     

    CMA’s long-standing traditions of democratic participation and representative governance would continue; the difference, as envisioned by the GTAC, is that specific issues that are of concern to a narrow spectrum of the membership would no longer command HOD’s limited time. Rather, the democratically elected Board of Trustees would act on those issues, as it already does on the increasing number of matters referred to the board for action by a House that is aware of its policy-making constraints.

     

    The HOD would continue to set policy on major issues, and its decisions would be informed through a year-round process not constrained by 15-minute limits on debate of recommendations developed in a rushed overnight exercise, as is currently the case. More focused expertise would be brought to bear in a more careful development of recommendations for action. Policy on other issues would realize the same benefits of a more careful and expert deliberative process throughout the year.

     

    We would like to improve the discussion at the House of Delegates to deal with the big issues of the day and to utilize the valuable resources of our delegates for the collective development and direction of important policy matters. We believe this proposal has real potential for a robust discussion around issues that will impact all physicians.

     

    The reforms would also open the discussion to individual members who could continue to bring forth their ideas and proposals through a year-round resolution process provided for in the CMA bylaws. Such proposals would be studied, with recommendations acted on by the board.

     

    A year-round dialog about timely issues should result in well-thought out policy pieces that could be brought to the floor during HOD.

     

    Charting a Course for the Next 150 Years

    This year’s discussion and debate at HOD on governance reform has set the stage for the GTAC to make proposals to modify the bylaws to begin the changes needed to set CMA’s course for the next 150 years.

     

    I am optimistic that this will result in an improvement for our entire organization. It will make CMA more effective in reaching the average member and give them a direct voice in policy, bringing broader input into our more difficult decisions.

     

     

    The full report of the CMA Governance Technical Advisory Committee, as amended by the House of Delegates at its October 2013 meeting in Anaheim, is available for download on the California Medical Association website. To access the report, available to members only, visit www.cmanet.org/hod and click on the "documents" tab. The report begins on page 12 of the "Actions of the 2013 House of Delegates" document.


    CMA Launches Exchange Resource Center

    In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the individual and small group health insurance markets and, beginning in 2014, will provide health insurance to much of the nation's uninsured. Under the ACA, two-thirds of California's uninsured may be may be eligible to purchase coverage through the health benefit exchange. The exchange's goal is to begin open enrollment on October 1, 2013 – with coverage beginning on January 1, 2014.

    To help educate physicians about the exchange and ensure that they are aware of important issues related to exchange plan contracting, the California Medical Association (CMA) has developed a resource page where physicians can find all of CMA's exchange-related news and resources.

    The new exchange resource center can be found at www.cmanet.org/exchange.

    For more information about California's Health Exchange, contact RCMA’s physician advocate Mitzi Young at (888) 236-0267 or myoung@cmanet.org.

     


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