CMA Sponsored Legislation By James R. Crotty, MD, MBA President, Santa Clara County Medical Association
JAMES R. CROTTY, MD, MBA
MESSAGE FROM THE
SCCMA PRESIDENT
President, Santa Clara County Medical Association
James R. Crotty, MD, MBA, is the 2014-2015 president of the Santa Clara County Medical Association. He is a urologist and is currently practicing with The Permanente Medical Group/Kaiser in San Jose.
It is Spring and time to turn our attention to baseball and the newly elected and current representatives to the California Legislature. They have been busy introducing bills that they hope will become laws of the land. CMA has also been busy supporting some bills and tracking many others. The Bulletin is another way to get the word out. Here are some of the bills that CMA is currently sponsoring: Assembly Bill 366, introduced by Rob Bonta, JD, currently representing the 18th district (East Bay/Oakland), and Senate Bill 243 introduced by Ed Hernandez (Optometrist), currently representing the 22nd district (San Gabriel Valley) would increase Medi-Cal reimbursements. Medi-Cal is one of the lowest paying Medicaid programs in the country, ranking the 47th state. Also, there was a temporary increase in primary care to match Medicare that expired last December. The bill would restore a 10% cut to Medi-Cal reimbursement rates, and also place reimbursement on par with Medicare, increasing payment rates for inpatient hospital services and most outpatient services. The proposals would also require the Department of Health Care Services to pay Medi-Cal managed care plans at the upper end of the rate range. In 2011, Medi-Cal payment rates to doctors, hospitals, dentists, and other providers were cut by 10% as a way to balance the state’s budget. California now has one of the lowest payment rates in the country. The Medi-Cal program now covers more than 12 million patients, one in three Californians, and one in two children as a result of expanded eligibility under the ACA. The Department of Health Care Services has evolved from a direct payer of care to a contractor with health plans to provide health care services and holding them accountable for performance, quality, and access measures. Senate Bill 277, introduced by Richard Pan, MD and Ben Allen, JD, currently representing the 26th district (Santa Monica), would remove the
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personal belief exemption that is currently allowed to the immunization requirements for enrollment in schools in California. It would also require that schools notify parents/guardians of students about the immunization rates of the school. Senate Bill 591, introduced by Richard Pan, MD would increase the tobacco tax by $2 per pack and would allocate those funds to tobacco education, and related services provided by the Department of Health Care Services. Assembly Bill 1396, introduced by Rob Bonta, JD would provide oversight for the allocation of funds related to SB 591. This bill would also require an annual independent assessment of whether Medi-Cal provider rates are adequate. Senate Bill 563, introduced by Richard Pan, MD would require employers and insurers to disclose payment methodologies for the process of reviewing, approving, modifying, delaying, or denying requests by physicians related to providing medical services to injured workers. Assembly Bill 637, introduced by Nora Campos, currently representing the 27th district (San Jose), would allow nurse practitioners and physician assistants under physician supervision to sign Physician Orders for Life Sustaining Treatment (POLST) forms. The aim is to increase utilization and availability of the POLST forms. Assembly Bill 1086, introduced by Matt Dababneh, currently representing the 45th district (San Fernando Valley), would require health plans to honor assignment of benefit agreements, thereby sending any payment directly to the out-of-network provider when such an agreement is present. Assembly Bill 1434, introduced by Kevin McCarty, currently representing the 7th district (Sacramento), would close the “loophole” which allows Blue Cross and Blue Shield to choose the regulator with which to file their PPO products. This current loophole has been blamed on a loss of potential funds to the General Fund. The bill would also allocate these funds for the purpose of increasing provider rates under Medi-Cal. Assembly Bill 319, introduced by Freddie Ro-