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Top Story: CMA files petition to protect Medical Board funding
The California Medical Association has petitioned the California Supreme Court to review an appellate court decision concerning the boundaries of the state's authority to borrow from special funds. READ MORE
Also in this issue:
- CMA publishes Electronic Health Records Desk Reference
- CMA creates governance guidance for new physician organizations, including ACOs and IPAs
- CMA goes to Washington, tells CMS to stop the Medi-Cal physician payment cuts
- CMA announces sponsored bill package
- Leadership Academy to focus on successful practice strategies in the era of health reform
- Two CMA members receive medical board humanitarian awards
- Nominate an outstanding colleague for the 2011 Gary S. Nye, M.D., Award for Physician Health and Well-Being
- CMA provides independent physicians with strategies to succeed under health reform
- Webinar (5/25): EHR Overview
- Check out the new issue of CMA Practice Resources
- Aetna physicians: Are you still receiving paper EOBs?
Featured Member Benefit:
Staples
Members get up to 80 percent off office supplies and equipment from Staples. A members-only link is required to access this discount. READ MORE
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1. CMA files petition to protect Medical Board funding
The California Medical Association (CMA) has petitioned the California Supreme Court to review an appellate court decision concerning the boundaries of the state's authority to borrow from special funds. The petition argues that the state has unlawfully misappropriated physician fees from the Medical Board of California, earmarked for processing physician licensing applications and enforcement activities.
"CMA is a vigilant advocate on behalf of patients and physicians to ensure that these funds are spent to protect patients and properly regulate the profession and no organization in the state has spent more time or funds fighting to ensure the medical board has the resources it needs to achieve its critical mission," said James Hinsdale, M.D., president of CMA.
"Physicians and the public depend upon this important regulatory function and the state cannot continue to solve the budget deficit with fees that physicians pay to support licensing and disciplinary actions," Hinsdale stated. "There are already nearly $2.65 billion in outstanding special fund loans and the budget act of 2011-2012 includes about $2.5 billion in more loans. When will it stop?"
CMA's petition challenges a 2008 loan of $6 million in physician license fees taken from the medical board. Under the Medical Practice Act, physician fees may not be transferred to the state's general fund and can be used only by the medical board and only to regulate the practice of medicine. These statutory requirements are designed to ensure that the medical board can operate effectively in licensing physicians and protecting patients.
In 2009 CMA filed a lawsuit to end furloughs for medical board staff, stressing that the medical board must have the resources to alleviate the backlog of physician license applications and perform other important work affecting the quality and accessibility of medical care. The state intends to borrow another $9 million from the medical board for the next fiscal year and physicians are concerned about the impact of that loan.
"As long as these fees continue to be diverted by Sacramento elected officials for the purpose of plugging California's perennial budget hole, we will be repeatedly refilling a gas tank with a massive leak—then wondering why the car isn't running. Taking more funds from the Medical Board of California harms all Californians," Hinsdale added.
Download a copy of the petition.
Contact: Long Do, (916) 551-2556 or ldo@cmanet.org.
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2. CMA publishes Electronic Health Records Desk Reference
The California Medical Association (CMA) and the CMA Foundation recently published the "Electronic Health Records Desk Reference." The guide, which was funded by a grant from the Physicians Foundation, brings together tools and resources to help physicians make a successful transition to electronic health records (EHR) in their practices.
The guide is designed to help physicians at every stage of the EHR implementation process, from understanding the federal incentive programs to selecting and implementing the right EHR system and achieving meaningful use.
The Desk Reference is available free of charge to all physicians in the CMA resource library, thanks to the generous support of the Physicians Foundation.
CMA will be in many parts of the state over the next six weeks making presentations based on the Desk Reference. Watch your county medical society publications for more details on presentations in your area.
Contact: David Ford at (916) 551-2554 or dford@cmanet.org.
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3. CMA creates governance guidance for new physician organizations, including ACOs and IPAs
Are you being asked to join an accountable care organization (ACO), independent practice association (IPA) or other new organization? If so, governance will be a critical issue for you to consider as a fair and efficient governance structure is essential to the success of any organization.
CMA has produced a new medical-legal document that discusses the numerous, complex challenges that owners face in governing "physician organizations."
Such organizations come in many forms and include not only entities that provide medical care, such as medical groups or IPAs, but also health-related entities that provide nonmedical services in which nonphysicians may also hold ownership interests, such as management service organizations.
Regardless of the type of organization, physicians, in conjunction with their legal counsel, need to address how the organization will be controlled and whether appropriate safeguards are in place to ensure that the board of directors fairly represents the organization and its purpose.
To help physicians in this process, CMA has created medical-legal document #0239, "Governance Issues for Physician Organizations." This document includes sample provisions that are illustrative of the language that is typically used in governance documents, such as bylaws. It defines the three different types of governance roles, paying particular attention to the powers of the board of directors and the relationship between the board and the shareholders.
CMA medical-legal document #0239, as well as the rest of the medical-legal library (formerly known as CMA On-Call), is available free to members in CMA's online resource library. Nonmembers can purchase medical-legal documents for $2 per page.
Contact: Samantha Pellon, (916) 551-2872 or spellon@cmanet.org.
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4. CMA goes to Washington, tells CMS to stop the Medi-Cal physician payment cuts
Recently, a team of CMA leaders was in the nation's capital to push for action on CMA's federal health reform priorities. The main focus of the trip was to urge the Centers for Medicare & Medicaid Services (CMS) to stop California's 10 percent Medi-Cal physician reimbursement rate cuts.
In 2014, an estimated 3 million uninsured will be newly eligible for Medi-Cal under the new health care reform law. If these cuts are allowed to stand, California will not have the provider capacity to care for these new Medi-Cal patients.
CMA President James Hinsdale, M.D., Medi-Cal physician Margaret Juarez, M.D., CMA Chief Executive Officer Dustin Corcoran and CMA Vice President of Federal Relations Elizabeth McNeil met with high-level CMS officials and members of the California congressional delegation, urging them to reject the State of California's request to reduce Medi-Cal physician reimbursement rates.
CMA warned that the 10 percent rate cut 1) will harm patients and access to care; 2) will cost the state and federal government as much as three times more as patients' conditions worsen and they are forced to seek care in the ER; 3) is inconsistent with federal law, which requires the program to provide the same access to care for Medicaid patients as for the general population; and 4) will severely hinder the successful implementation of health care reform.
Dr. Hinsdale told CMS that "...these cuts would force physicians out of the program, cause irreparable harm to patients, and overwhelm the state's ER system which is already on the verge of collapse."
Last month, Governor Jerry Brown signed budget bills that cut Medi-Cal provider reimbursement rates by 10 percent. It is now up to CMS to approve or deny California's Medi-Cal rate cuts. This week U.S. Health and Human Services Secretary Kathleen Sebelius stated that the agency has not yet made a decision on whether it will allow California to move forward with its proposed cuts, but she did acknowledge that the connection between rates and access is a "critical issue."
CMA also urged CMS to significantly revise the unworkable accountable care organization regulations to make them less burdensome and more attractive for California's medical groups and solo/small group physicians. The CMA team also met with the CMS Innovation Center asking them to fund solo/small group physician projects in California. CMA will be developing several proposals to submit to the Innovation Center, which was recently allocated $12 billion to fund innovative physician payment and health care delivery reforms.
Before leaving Washington, CMA met with the Senate Finance Committee and the health care leaders in the California congressional delegation on other key issues, including Medicare payment reform and professional liability reform.
Contact: Elizabeth McNeil, (415) 882-3376 or emcneil@cmanet.org.
5. CMA announces sponsored bill package
The 2011-2012 legislative session is in full swing, and the California Medical Association (CMA) is busy participating in stakeholder meetings, committee hearings, and one-on-one policy briefings with members of the Legislature.
This year, CMA is sponsoring five important bills on a variety of topics affecting the house of medicine:
Medical school scholarships (AB 589): This bill seeks to address patient access to care in underserved areas by making available medical school monies to physicians who agree to serve in those locales for at least three years, through the Steve Thompson Scholarship Program. We believe that steps like these are critical to attracting and retaining physicians in those areas, while also addressing physician shortages in the state.
Peer review (AB 655): This bill will make positive changes in the physician peer review system by allowing certain information to be shared among hospitals or peer review bodies. It will provide a measure of transparency concerning physicians records.
Professional corporations—licensed physical and occupational therapists (AB 783): This bill clarifies existing law that allows for medical corporations to hire certain allied health practitioners, most notably physical therapists. The long-standing practice recently drew fire from the Physical Therapy Board of California, which threatened board action against physical therapists who are currently employed in such partnerships.
Postsecondary education—GME payments (SB 347): This bill aims to increase the amount of graduate medical education (GME) funding that California receives in another effort to help address physician shortages in the state.
Medicine (SB 742): This bill is being developed by CMA and other stakeholders to help provide a substance abuse and mental health disorder treatment program to physicians. A safe path for treatment is a critical element in addressing these issues and keeping physicians practicing safely in California.
For more information on these and other bills of interest to physicians, see CMA's new issues database.
Contact: Michelle Chapanian, (916) 551-2054 or mchapanian@cmanet.org.
6. Leadership Academy to focus on successful practice strategies in the era of health reform
The 14th Annual California Health Care Leadership Academy, "The Next Step: Successfully Negotiating Health Reform," will feature a slate of workshops designed to promote success in the brave new world of health system reform. The academy will be held June 3-5 at the Renaissance Esmeralda Resort and Spa in Indian Wells.
Featured Workshops
Strategies for Independent Physicians to Compete and Succeed: This workshop will provide practical information on business models available to help physicians with their practice in the new environment, how to improve quality and be positioned to participate in various payment models, and legal considerations concerning both physician and physician-hospital organizations.
Learning from Disney – Creating a Culture to Earn Patient Trust and Loyalty: This workshop will present principles from the Walt Disney Company that can used to inspire patient and employee loyalty and establish a reputation as "the best."
Other workshop topics include medical practice reengineering strategies, ICD-10 coding, how to effectively manage change, successful leadership in the new era, and how to assess physician-hospital alignment opportunities.
Academy workshops will complement general session presentations focusing on the policy and practical challenges of implementing federal health reform.
For more information or to register, visit the Leadership Academy website or call (800) 795-2262.
7. Two CMA members receive medical board humanitarian awards
On May 6, 2011, the Medical Board of California presented its annual Physician Humanitarian Award to California Medical Association (CMA) members Richard Kammerman, M.D., and Rodney Borger, M.D. The prominent award recognizes physicians who go above and beyond to ensure health care is delivered to underserved patients in their communities.
Dr. Kammerman, a Santa Ana family practitioner, is a member of CMA and the Orange County Medical Association (OCMA). His top achievements include launching the local Medi-Cal managed care program in 1993. He oversaw the program's research and design and was instrumental in forging the partnership between the county government, private physician, hospital and community clinics that is still in place today.
In 1991 Dr. Kammerman was elected OCMA's 102nd president and in 1997 he was honored by his colleagues as OCMA's "Physician of the Year." Now retired, Dr. Kammerman spends his time volunteering, working with professors at the UC Irvine School of Medicine to ensure residents at the UC Irvine Family Health Center master the skill of medicine.
Dr. Borger, an emergency physician in Colton, is a member of CMA and the San Bernardino County Medical Society. He is a member of the California Emergency Physicians Medical Group and also serves as chairman/medical director for the City of Colton's Department of Emergency.
Dr. Borger helped form the San Bernardino County Medical Reserve Corps (MRC) and has served as MRC commander since 2003. Dr. Borger has not only served his local community, but also served abroad. In 1990 he traveled to Africa to provide basic health care to the people of Botswana. In 2002 he provided medical care for missionaries and aid workers in remote Thailand.
Dr. Borger was recognized in 2010 as a "Top Doctor" by Inland Empire Magazine, and "Doctor of Distinction" by Southern California Physician Magazine.
8. Nominate an outstanding colleague for the 2011 Gary S. Nye, M.D., Award for Physician Health and Well-Being
The California Medical Association (CMA) is accepting nominations for the 2011 Gary S. Nye, M.D., Award for Physician Health and Well-Being, which honors a CMA member physician who has made significant contributions toward improving physician health and wellness. This award was established by the CMA House of Delegates in 2009 in recognition of Dr. Nye, who has been a leader in bringing attention to and developing solutions to the issue of physician impairment and rehabilitation.
The nomination deadline is Friday, June 17. Download the nomination form.
Contact: Yvonne Choong, (916) 551-2884 or ychoong@cmanet.org.
9. CMA provides independent physicians with strategies to succeed under health reform
Physicians face dramatically different market and economic forces created by passage of the Patient Protection and Affordable Care Act (ACA). The sweeping health reform law mandates a host of payment reforms and calls for creation of new physician networks organized to improve quality of care and reduce cost.
To assist independent physicians in navigating these uncharted reform waters, the California Medical Association (CMA) is working with county medical societies and associations to schedule a series of conferences called "Strategies for Independent Physicians to Collaborate and Succeed in the Era of Reform."
The conferences will provide information on the various business models that can help physicians pool their talents to effectively compete in the new health care marketplace. Topics will also include ways to provide improved quality of care through clinical integration and whether it is feasible to form physician-led networks, including new accountable care organizations (ACOs).
Upcoming presentations:
Redding (5/17): This two-hour evening workshop, hosted by the North Valley Medical Association, will be at 1670 Market St., Suite 118, in Redding, on Tuesday, May 17, from 6:30 to 8:30 p.m.
Indian Wells (6/5): California Health Care Leadership Academy attendees can attend a two-hour workshop during this year's conference at the Renaissance Esmeralda Resort and Spa in Indian Wells. (For more information, see the conference brochure at the Leadership Academy website.)
Additional dates will be scheduled soon. If you are interested in attending a conference in your area, contact your county medical society.
Contact: Astrid Meghrigian, (415) 350-3966 or ameghrigian@cmanet.org.
10. Webinar (5/25): EHR Overview
Join us on Wednesday, May 25, for an informative webinar, "EHR Overview." The presentation will cover the basics of electronic health records (EHRs), the federal incentive programs, and meaningful use. This webinar is intended for physicians and staff who are beginning to research EHRs and it will set the stage for later CMA EHR webinars.
The one-hour webinar will be presented twice on May 25, 2011, at 12:15 p.m. and again at 6:15 p.m. The webinar is free to members and their staff. Nonmembers can register for $99. For more information or to register, visit the CMA event calendar.
Contact: CMA member help center, (800) 786-4262 or memberservice@cmanet.org.
11. Check out the new issue of CMA Practice Resources
The May/June issue of CMA Practice Resources (CPR) is now available. In this issue, CMA provides a number of free resources and services to help members and their staff to simplify the payor contract review and negotiation process.
CPR, a free email bulletin from the reimbursement experts in CMA's Center for Economic Services, is full of tips and tools to help physicians and their staff improve practice efficiency and viability. Sign up now for your free subscription.
View the current issue at the CPR page.
Contact: CMA reimbursement help line, (888) 401-5911 or economicservices@cmanet.org.
12. Aetna physicians: Are you still receiving paper EOBs?
In 2008, Aetna launched an electronic EOB platform. Instead of paper EOBs, the insurer's online EOB tool allows you to view, print, and download your EOBs from Aetna's secure provider website.
Physicians are automatically enrolled in electronic EOB program unless they affirmatively opt out. If you want to continue receiving paper EOBs you must annually opt out of the electronic EOBs by completing and returning Aetna's Request for Exclusion from Paper Shut-Off form. Click here for a copy of the 2011 Opt-out form.
Contact: Aileen E. Wetzel, (916) 551-2037 or awetzel@cmanet.org.
13. Featured Member Benefits:
Staples
Members get up to 80 percent off office supplies and equipment from Staples. A members-only link is required to access this discount. Visit the member benefits page or call (800) 786-4CMA (4262) to get the link.
For more information on these and other member benefits, click here or contact CMA at memberservice@cmanet.org or (800) 786-4262 (4CMA).