A Local Advocacy Win
By Clifford Wong, MD, ACCMA President
This past month, ACCMA helped secure an important victory for patients and physicians across Alameda County.
For more than three decades, Alameda County has maintained what is known as an “Exclusive Operating Area (EOA)” for emergency ambulance services. By having one contracted ambulance company, the County has been able to ensure equitable access to emergency medical services, consistent response standards across communities, and the ability to implement advanced clinical innovations. The current system is not without its opportunities for improvement, but the model has ensured that the County has oversight and leverage with the sole ambulance company that is contracted to take our patients to our local emergency rooms for care. Every 5 to 10 years, the County goes out to bid for a new contract. In 2025, however, the Board of Supervisors declined to approve a new contract and raised the possibility of a rapid shift to an open EMS system, whereby upwards of a dozen different ambulance providers could operate in the County without the same consistency, oversight and accountability as a sole provider under the EOA. This raised significant concerns about equity, patient safety, and accountability – particularly for Medi-Cal and uninsured patients and for residents of underserved neighborhoods.
After careful deliberation – and strong advocacy from our Association and physician leaders – the Alameda County Board of Supervisors voted to extend the current ambulance services contract for at least 2.5 years, while undertaking a more deliberate, data-driven planning process to evaluate any potential transition to a nonexclusive EMS system.
The Board’s decision to slow the process, maintain stability, and require thoughtful planning reflects that message – and reflects the power of physician advocacy. This outcome did not happen by accident. It happened because ACCMA has the credibility, relationships, and resources to engage effectively with local decisionmakers. That capacity exists because you support us through membership.
At every level – local, state, and federal – ACCMA serves as your voice. We translate your frontline clinical experience into policy advocacy that decision-makers can understand and act on. When it matters most, we show up.
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Working closely with emergency physicians and County EMS experts, ACCMA helped elevate the clinical and equity implications of this issue. Our message was simple: decisions about emergency medical services must prioritize patient care. A rapid move away from the current model to an untested open system was a risky bet that could harm patients.
Each month, ACCMA proudly honors a remarkable member making a difference. Do you know a physician who goes above and beyond, creating a lasting positive impact in their community? Share their story with us! Check out our previously featured members.
ENSURING SAFE ACCESS TO MEDICAL CARE FOR ALL PATIENTS
The ACCMA is deeply concerned by reports of immigration enforcement actions that interfere with the delivery of medical care and create fear, trauma, and avoidance of health services. Consistent with ACCMA and CMA policy, we affirm that access to affordable, quality health care should be available to all regardless of immigration status and oppose the use of clinical settings or patient information for immigration enforcement. We urge that enforcement actions respect due process, protect patient confidentiality, and preserve health care spaces as safe environments.
ACCMA OPPOSES FEDERAL PROPOSALS RESTRICTING GENDER-AFFIRMING CARE FOR MINORS
The ACCMA has submitted formal comments opposing two proposed federal regulations that would restrict access to certain gender-affirming medications and surgical services for patients under age 19 by tying prohibitions to Medicare, Medicaid, and CHIP participation and funding. ACCMA argues that these proposals inappropriately interfere with physician-led clinical decision-making, misuse regulatory and funding mechanisms, and do not reflect current evidence showing improved mental health outcomes associated with gender-affirming care. The Association also raises concerns about the broader precedent such restrictions could set for political interference in medical practice and the physician–patient relationship. .
AMA WORKSHOP HELPS PHYSICIANS PREPARE TO RUN FOR OFFICE
Physicians interested in pursuing elected office can gain practical, hands-on guidance April 17–19 in Washington, D.C., through the 2026 AMPAC Candidate Workshop. Hosted by the AMA, this bipartisan instruction helps participants transition from the exam room to the campaign trail by building the skills and strategic foundation needed to run for public office. The program is open to AMA physician members, residents,
fellows, medical students, member spouses, and state medical society staff. The deadline to register is March 20, or sooner if capacity is reached.
CMA SPONSORS BILL TO MODERNIZE E-BIKE SAFETY LAWS & PROTECT KIDS
The CMA and Assemblymember Lori Wilson announced the introduction of Assembly Bill 2346 to modernize CA’s electric bicycle (e-bike) safety standards in response to a sharp rise in serious injuries among children and teenagers. The legislation is informed by a state legislature-commissioned report from the Mineta Transportation Institute at San Jose State University, which highlighted how rapid technological advancements have outpaced current laws, leading to a proliferation of "out-of-class" vehicles that lack safety measures.
CMA SPONSORS LEGISLATION TO PROHIBIT AUTOMATIC DOWNCODING BY INSURANCE COMPANIES
Assemblymember Darshana Patel has introduced Assembly Bill 2431, sponsored by the CMA, to protect physician practices and patient access to care by prohibiting automatic downcoding by health insurance companies. Increasingly, insurers rely on automated "claim-editing" algorithms to downcode claims without clinical review, forcing physicians to spend significant time and resources appealing unjust payment reductions. AB 2431 aims to codify fair payment practices and ensure clinical accuracy.
UNDERSTANDING CALIFORNIA’S NEW HEALTH LAWS: 2026 GUIDE FOR PHYSICIANS
Many new CA health care laws took effect Jan. 1, including CMA-sponsored measures to curb misleading use of AI, protect independent physician judgment from corporate interference, and reduce unnecessary prior authorization. To support physicians as these changes roll out, CMA has published “Significant New California Laws of Interest to Physicians for 2026,” a comprehensive guide to the most important new laws affecting medical practice. The report is available at no cost.
CMA PRESIDENT CALLS ON PHYSICIANS TO STEP BOLDLY INTO PUBLIC LEADERSHIP
During his first official report to the CMA Board of Trustees in late January, CMA President René Bravo urged CA physicians to step boldly into public leadership. Dr. Bravo noted that public service is embedded in the profession’s DNA and remains essential as physicians face modern challenges,
including misinformation, workforce strain, growing mental health needs, and persistent health inequities. He encouraged physicians at all career stages to view leadership beyond clinical practice as part of medicine’s core mission.
CMA SEEKING NOMINATIONS TO THE AMA HOUSE OF DELEGATES
The CMA is seeking nominations for physicians to serve as delegates and alternates to the American Medical Association (AMA) House of Delegates. Delegates or alternates serve twice a year during the annual (June) and interim (November) meetings of the AMA House of Delegates for a two-year term. Nominations must be submitted no later than 11:59 p.m. on March 13.
PROTECTING PATIENT ACCESS TO CARE AMID IMMIGRATION ENFORCEMENT ACTIVITY
California physicians are increasingly concerned that immigration enforcement actions are creating fear that deters patients from seeking medically necessary care. State law provides protections to help ensure health care settings remain safe spaces, and physicians are encouraged to review legal guidance and update office protocols accordingly. Physicians practicing in facility settings should also familiarize themselves with the facility’s policies and procedures on immigration law enforcement actions.
CMA ENDORSES AAP’S EVIDENCE-BASED IMMUNIZATION SCHEDULE AMID FEDERAL ROLLBACKS
CMA has endorsed the 2026 immunization schedule released by the American Academy of Pediatrics (AAP). The AAP schedule continues to recommend 18 science-backed vaccines in contrast to the Centers for Disease Control and Prevention’s significantly reduced schedule.
HOUSE NARROWLY PASSES REVISED SPENDING PACKAGE, DELAYS LONG-TERM DHS FUNDING
The U.S. House of Representatives approved a revised version of H.R. 7148, the Consolidated Appropriations Act, 2026, by a 217-214 vote, and the bill was signed into law on Feb. 3, ending a partial federal government shutdown. The final law funds multiple agencies for fiscal year 2026, including Labor, HHS, and Education, and advances key health care policies supported by organized medicine. However, it does not include measures to improve coverage affordability such as restoring enhanced Affordable Care Act premium tax credits.
CMA ENDORSES CONGRESSMAN ERIC SWALWELL FOR GOVERNOR
The CMA announced its endorsement of Congressman Eric Swalwell for California Governor. Swalwell has a record of supporting policies that strengthen the physician workforce, protect access to care, and advance public health, and is committed to mental health, reproductive freedom, and addressing the social drivers of health such as economic stability, access to a quality education, and environmental safety.
CMA PUBLISHES 2025 YEAR IN REVIEW
CMA's 2025 Year in Review highlights CMA's work to ensure California physicians have the support they need to deliver the highest quality of care. At the federal level, CMA engaged throughout the year, pushing back against a series of efforts that threatened to undermine core public health protections.
For more information or to view full articles of any of these topics, scan the QR code or visit accma.org/bulletin.
At the state level, Gov. Newsom’s May budget diverted critical Prop 35 funds to address budget shortfalls, but after significant pressure from CMA, the first bucket of funding was released in late summer.
CMA LAUNCHES CMA AUDIO NEWS
CMA has launched CMA Audio News, a new members-only feature in the CMADocs app that delivers short, timely audio updates on policy, regulatory and practice issues affecting CA physicians. Designed to be concise and accessible, these updates make it easier to stay informed during a commute, between patients, or whenever you have a few spare minutes. Download the "CMADocs" app today from the Apple or Google Play app stores.
DHCS IMPLEMENTS PRIOR AUTHORIZATION POLICY UPDATES
As a reminder, DHCS implemented a series of Medi-Cal Rx policy updates on January 1 under which more than 30 drugs are not eligible for extended duration prior authorizations (PAs). Claims submitted for these drugs without an approved PA will deny with Reject Code 75 – Prior Authorization Required. Prescribers must submit a PA request for coverage consideration.
MAKE THE MOST OF YOUR APPEALS
CA law requires that provider appeals are reviewed promptly by payors, including payor acknowledgement of receipt of a written appeal within two working days for electronically submitted appeals or within 15 working days for paper appeals. Physicians can improve their chances of success by clearly labeling appeals, using the correct submission channels, stating the specific action requested and closely tracking required response deadlines. CMA members and their staff can access step-by-step appeals guidance through the CMA Know Your Rights series.
MEDI-CAL REFERENCE GUIDE FOR VACCINES FOR CHILDREN PROGRAM
Medi-Cal has released an updated reference guide for the Vaccines For Children (VFC) program. As noted in the guide, Medi-Cal will reimburse VFC-enrolled providers for VFC-funded vaccines when administered to eligible MediCal members 18 years of age and younger for the following services: vaccine administration fee, professional dispensing fee, and pharmacist services (consultation and assessment [vaccine initiation] fee).
Taking care of your mental wellness
sustains and extends your ability to care for patients. The ACCMA provides support for members by offering up to four virtual sessions with a therapist at no charge. Scan the QR code to learn more.
