Thursday, December 14, 2017

Advocacy Highlights

Medical students walking down stairwellWith the CMA, SSVMS has fought for issues crucial to the practice of medicine, including:

Protecting Medi-Cal Access

  • Working to stop the proposed 10% cut to Medi-Cal reimbursement through the courts and the Legislature.
  • Stopped $137 million in Medi-Cal physician payment cuts for services provided to children.

Medicare Payment Reform

  • Stopped the 27.4% cut to physician Medicare reimbursement scheduled to occur in 2012 and in 2013. CMA/SSVMS continue to work with the Congressional Leadership to permanently stabilize Medicare reimbursement by repealing the Sustainable Growth Rate (SGR).
  • Stopped the 20% SGR cuts in 2011, as well as the $150 million in Medicare geographic payment cuts to California physicians.
  • Successfully lobbied the Centers for Medicare and Medicaid Services (CMS) to make several adjustments to the proposed 2012 Medicare Fee Schedule, including updating it so an even larger percentage (3%) of payments is adjusted for geographical differences in practice costs.
  • Successfully lobbied CMS to drop a proposal that would have reduced payments to California physicians by $150 million.
  • Introduced legislation to allow seniors to privately contract with physicians and to repeal the Independent Payment Advisory Board that is mandated to make cuts to the Medicare program.
  • Secured reauthorization and funding of the Children’s Hospital Graduate Medical Education program.

 Budget Battles  

      • Protect the Healthy Families program.
      • Preserve $7.3 million to provide vaccines for low-income, uninsured Californians.
      • Secure $4.4 million in additional funds to the Every Woman Counts breast and cervical cancer screening program.
      • Prevent any diversion of the $55 million in Maddy Fund monies, which provide critical resources to reimburse physicians for uncompensated care provided in the ER.
      • Protect funding for the Emergency Medical Services Commission, which oversees planning for emergency services.
      • Organized a large patient, provider and health plan coalition, the Alliance for Patient Care, to ensure that key healthcare programs were not cut out of the state budget.

Health Care Reform

  • SSVMS/CMA continues to work closely with CMS and HHS to ensure that efforts to implement federal health care reform are physician-led and patient-centered.
  • Developed a reference piece for physicians on EHR implementation.
  • Developed a physician’s guide to Covered California, the state’s health benefit exchange.

Protecting Physicians

  • Successfully stood in defense of California’s Medical Injury Compensation Reform Act (MICRA) before the 5th Appellate District Court, which upheld MICRA’s constitutionality.
  • Filed a “friend of the court” brief in Howell v Hamilton Meats, in which the California Supreme Court agreed with CMA’s position on MICRA. 
  • Successfully stopped bills that attempted to erode California’s ban on the corporate practice of medicine. SSVMS/CMA worked with community clinics and other stakeholders to stop AB 1360, an attempt by hospitals to directly employ physicians.
  • Stopped several legislative attempts to expand the scope of practice of allied health professionals, including the following:
    • Blocked the implementation of new standards to certify optometrists to treat glaucoma by filing a lawsuit. 
    • Put on hold regulations limiting the ability of physicians to employ physical therapists.
    • CMA continues to litigate its lawsuit against the State of California to stop the expansion of the scope of practice of nurse anesthetists.
  • Fought aggressively to ensure that payors follow the laws to ensure fair and reasonable payment.
    • Filed a federal lawsuit challenging the use of Ingenix by Aetna, Cigna and Blue Cross to underpay physician for providing out-of-network services.
  • CMA’s Center for Economic Services (CES) successfully recouped over $2.7 million from payors on behalf of member physicians.
  • Filed a formal complaint with the Department of Managed Health Care regarding the Blue Cross Special Investigations Unit’s illegal recoupment policies.
  • SSVMS participates in the Managed Medi-Cal Advisory Committee to the Sacramento Department of Health & Human Services.

Public Health

  • Recent victories include Governor’s signing of bills that allow individuals to purchase sterile syringes at pharmacies without a prescription; require health insurance policies to provide coverage for maternity services; prohibit minors from using tanning beds without parental consent; allow minors to get the HPV vaccine without parental consent; and prohibit the sale, manufacture or distribution of products containing BPA, if the product is intended for a child 3 years or under.
  • SSVMS’ Public & Environmental Health Committee meets bi-monthly to address issues related to public health.
  • SSVMS continues to advocate on public health issues as a member of the Public Health Advisory Board to the Sacramento County Board of Supervisors.
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