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With 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.
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.
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.
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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