Coastal Physician - April/May 2023

Inside this Issue

Spring Social Save the Date

pp. 6-7

Legislative Advocacy Day

Highlights

pp. 12-13

Member Spotlight

pp. 8-9

2023 Priority Bills

pp. 18

2023 BOARD OF DIRECTORS

Directors

Alejandro Francisco Centurion, MD Walter W Mills II, MD**

Eloy Romero, MD

Guadalupe Arreola, MD

*Elected CMA Delegates | **Elected CMA Alternates

The Cypress Foundation Board of Directors

Chairman Alfred Sadler, MD

Secretary/Treasurer Donna Odryna, Executive Director Directors: Valerie Berry, MD, Alexandra Klick MD, Melissa Nothnagle, MD

The Monterey County Medical Society and Santa Cruz County Medical Society are non-profit professional associations led by and for physicians. In partnership with the California Medical Association, (CMA), The Societies are dedicated to promoting excellence in the provision of quality, ethical health care; the health of our community; physicians’ personal, social, and professional integrity and well-being; and the common goals of similar organizations.

Opinions expressed by authors are their own and not necessarily those of Coastal Physician, MCMS. SCCMS or CMA or any of their related organizations.

President Steven Harrison, MD*

Treasurer James Hlavacek, MD Secretary Alfred Sadler, MD

Past President Maximiliano Cuevas, MD

2023 BOARD OF GOVERNORS

Governors

Clay Angel, MD*

Brian Brunelli, MD**

John B Christensen, MD*

Dawn Motyka, MD**

Inemesit U. Newsome, MD

Christopher O’Grady, MD

Joyce Orndorff, MD

John C. Pestaner, MD*

Jeannine M. Rodems, MD**

Kuntal Thacker, MD**

Jack Watson, MD*

*Elected CMA Delegates | **Elected CMA Alternates

Advisor to the Board

Donaldo Hernandez, MD

CMA President

Advisor to the Board

Gail Newel, MD, Public Health Officer

Physicians for a Healthy Central Coast Foundation Board of Directors

President Jack Watson, MD

Treasurer Grant Hartzog, PhD | Secretary Donna Odryna, Executive Director

Directors Violetta Barroso, MD, Amy McEntee MD, Jeanine Rodems, MD

The Cypress Foundation in Monterey and Physicians for a Healthy Central Coast in Santa Cruz are collaborative physician and community-led subsidiary 501(c)(3) public benefit corporations dedicated to improving community health, supporting physicians throughout their career, and serving as a leader in fostering careers in medicine. It is a of the Monterey County Medical Society and the Santa Cruz County Medical Society.

Coastal Physician reserves the right to edit all contributions for clarity and length, and to reject any material submitted in whole or part.

President Anthony Sturzu, MD*

Treasurer Amy McEntee, MD**

President-Elect Daniel Greene, MD

Immediate Past President Ciara Harraher, MD CMA Trustee & CA Association of Neurosurgeons President-Elect

MEMBER INTERVIEW

Dr. Harraher, right on the heels of completing your term as the SCCMS Board President, you ran for and was elected to serve as a Trustee on the CMA Board of Trustee’s. What compelled you to take this next step in leadership?

Like many things in life, the opportunity presented itself somewhat earlier than I had anticipated, and I needed to take it! This timing was affected by external factors that meant this trustee position would likely not come up again for some time. I have had several leadership roles in the CMA and felt I was a strong candidate. Furthermore, A neurosurgeon was stepping down and I wanted to keep representing my specialty at a state level.

What has your first 90 days in this role been like for you? Any a-ha moments?

I really enjoyed my first Board Of Trustees meeting in January as it felt invigorating to be surrounded by likeminded physician leaders throughout California in all manner of specialties and practice modes. I also appreciated for the first time all the “behind the scenes” work done by the CMA staff and leadership on a multitude of fronts Specifically, all the legal battles that CMA has taken on to protect physicians and patients in California that may not be widely known about.

Dr. Ciara Harraher, MD Immediate Past President of SCCMS and CMA Trustee

"As much as we try to protect our little girls and raise them to think that they can do whatever they want to do, there's a lot of societal pressures that are out of our control that change how they view women."

What do you hope to contribute as a new Trustee on the CMA Board?

I have experience as a leader in neurosurgery, yet understand the needs of my community physicians as past-president of SCCMS I hope this gives me a balanced and fresh perspective. Specifically, I feel that in order to recruit and retain physicians in the Central coast, we need to address issues in medical/medicare reimbursements

You are currently the president elect of the California association of neurological surgeons (CANS), your term as president begins January of 2024. What issues will you focus on effecting neurosurgeons in CA this coming year?

CANS focuses on socioeconomic issues facing neurosurgeons. This year we will continue to advocate for decreased administrative burdens, such as prior authorization and EHR hassles. Also, there are many areas in California where there is a paucity of neurosurgeons as many have left privatepractice due to these administrative burdens as

well as stagnant Medi-cal reimbursement rates for 25 years

What do you think are the top two most pressing issues facing all physicians in California this year?

I think many physicians in California are struggling on several fronts As we emerge from the Covid pandemic we see high levels of burnout and workforce shortages. Furthermore, the uncertainty in the economy has many worried how to keep their office doors open. We need to address fair reimbursement and decrease the external pressures on us that take us away from the job of taking care of patients.

McMaster University

Photo by GV Chana

Harvard University

Photo by Brett Wharton

Stanford Medical School

Photo by Ian Mackey

Dr. Ciara Harraher, MD

WELCOME OUR NEW MEMBERS

Herbert J. Harman, MD Vituity Psychiatry

Roshanak Ramezani, MD Vituity Psychiatry

Leonard Caputo, MD, MBA Academic Practice Surgery John D. Walther, MD Vituity Emergency Medicine

"Words mean more than what is set down on paper It takes the human voice to infuse them with deeper meaning

Executive Notes

Donna Odryna

Executive Director

In the seemingly never ending stream of priorities, responsibilities, and daily to dos, I find it easy to forget the power a single voice can have. But, as I sit here and reflect back on all the voices that filled the month of April, I can proudly say it's been an impactful time

First and foremost, I'd like to thank all the doctors who carved out time from their schedules to use their voices in Sacramento to advocate on behalf of all our members for the major issues facing our medical community. Attending CMA's annual Legislative Advocacy Day in order to speak directly with the people shaping the laws and policies affecting all of us, was a powerful way to apply the invaluable insight and knowledge only a physician can hold

Physician voices were heard in both our state capital and our boardrooms as we continued to cultivate a lasting partnership between Monterey and Santa Cruz counties April brought with it the drafting of the bylaws, along with the final agreement and the name under which our two counties' medical societies will move forward Additionally, our foundations continue their tireless work to support local community initiatives related to generating new pathways that will support and usher in our next generation of physician voices.

Protecting physicians so you all can continue to keep our communities healthy is of upmost importance. One of the ways we do that is through partnerships that bring our members resources at reduced costs To that end, I'm pleased to announce the new partnership between CMA and Lockton Affinity that will extend to all members in Santa Cruz and Monterey Counties Lockton is an insurance broker dedicated to providing the best coverage for physicians and over the next several months, physicians and groups currently insured through Mercer will be transitioned to Lockton Affinity. During this transition, if you receive communication from Mercer or Preferred that is confusing or causes you questions, please contact our offices for assistance Physicians taking advantage of this member benefit will receive a preferred discount because they are members - more information to come in the next issue

Thank you for sharing your time. Thank you for sharing your voices. And thank you for all you do to shape our communities for the better

"

Maya Angelou

CMA'S 49TH ANNUAL LEGISLATIVE ADVOCACY DAY

On April 19th, Sacramento became the platform for California healthcare champions to have their voices heard directly by state legislators. Leadership from both Santa Cruz and Monterey Counties joined over 400 other California physicians These trailblazers discussed bills impacting access to care, Medi-Cal rate increases, and health equity, including SB 598 (Skinner) - Prior Authorization, AB 765 (Wood) - Truth in Advertising, AB 1751 (Gipson) - Chiropractor Referral and Notifications, SB 524 (Caballero) - Pharmacist Scope Expansion, and AB 1570 (Low) - Optometrist Scope Expansion.

From left to right Donna Odryna, Dr Michael Klassen, Dr Ciara Harraher, Senator John Laird Dr Paul Yost, Dr John Christensen, Dr Donaldo Hernandez

Opening Remarks

Our leadership was proud to have one of its own, Dr Donaldo Hernandez, 2023 CMA President, give the opening remarks to physicians from across the state as they gathered to discuss the top priority bills impacting patient safety and the physician's role in patient care

Having taken time away from their local practices to bring their expertise to Sacramento, Santa Cruz and Monterey County leaders met with the offices of Assemblymember Robert Rivas, Assemblymember Dawn Addis, and Senator John Laird Together, they shared their invaluable insights into the impact various 2023 bills would have on the practice of medicine as well as the patients they serve

Our two counties were well represented by local leadership this year with Dr Michael Klassen - President of the California Orthopedic Association; Dr Ciara HarraherPresident-elect at the California Academy of Neurological Surgeons, and CMA Trustee; Dr Paul Yost - Immediate Past President of the Orange County Medical Association; Dr John Christensen - Governor/CMA Delegate with Santa Cruz Medical Society; and Dr Donaldo Hernandez - CMA president.

Monterey and Santa Cruz County Medical Societies are grateful for the invaluable time our physicians spent in the state capital cultivating and maintaining positive relationships with our local legislatives, representing the physicians who could not attend the event, and advocating for policies that will shape the practice of medicine for the better

CMA President, Dr. Donaldo Hernandez giving opening remakrks

Senator John Laird with Santa Cruz physician and CMA President Dr. Donaldo Hernandez

Stress, anxiety, depression, and grief are common, but they’re manageable. The Medical Societies of Santa Cruz County and Monterey County are working collaboratively to support Central Coast Physicians who are experiencing stress and burnout. Our resiliency sessions provide relief, an increased ability to cope, healing, and an opportunity for personal fulfillment.

Through the Resilience in Medicine Program (RIM), physicians can access up to two (2) annual resiliency sessions with approved and vetted RIM providers. We pay for RIM directly, discreetly, and anonymously to ensure the highest level of confidentiality. Your insurance will never be asked for, nor billed.

Through grants and private donations, we're able to offer the first two visits free of charge for physicians living and practicing in Monterey or Santa Cruz Counties. Physicians may extend their participation at their expense after the second visit.

Please ask for help. Sessions are not only confidential, they are also convenient, and FREE. Visit RIM to learn more about how to take advantage of these free and confidential resiliency sessions.

PHYSICIAN ADVOCACY

Keeping in step with the changing realities of the practice of medicine and the business of health care, the California Medical Association (CMA) understands the unique challenges facing health care providers. Change is inevitable – and CMA remains ready to meet the demands of the future and provide physicians and physician groups with the necessary support to surpass these challenges and succeed in the rapidly changing health care landscape. A snapshot of our member advocacy and service programs is provided below.

CONTACT CMA TODAY!

When you join CMA, you hire a powerful professional staff to protect the viability of your practice. By protecting your practice from legal, legislative, and regulatory intrusions, your CMA membership lets you focus on what’s really important: your patients.

Regards,

(800) 786-4262

cmadocs.org

Dustin Corcoran Chief Executive Officer

The Center for Strategic Engagement provides research and analysis on a broad range of health policy issues that impact physicians and patient care. The center performs a wide array of functions that are focused on CMA’s core mission of supporting physicians and ensuring that CMA’s advocacy positions are rooted in sound public policy and preserve the ability of physicians to care for their patients. Center functions include health policy research, regulatory advocacy, council and committee management, and physician education.

The Center for Government Relations is the voice of physicians at the state Capitol. Center staff work with legislators to educate them on how legislation could enhance or threaten patients’ health or a physician’s ability to practice medicine. Each year the center monitors over 500 bills and takes an active, public position on over 200 bills. The center’s activities include reading and tracking bills and amendments, shaping bill language, meeting with legislators, testifying in committee, conducting research, and preparing policy papers and position letters.

The Center for Legal Afairs provides legal advice and representation to the CMA Board of Trustees, officers, executive management and staff on legal and regulatory issues, including corporate governance, ethics, employment, health care, and nonprofit and political law. The center also defends the rights of physicians in the courts by filing lawsuits on behalf of California physician members and weighing in on cases before the courts as amicus curiae, or “friend of the court,” to influence health policy. The center maintains CMA’s comprehensive online health law library and provides information and resources to help CMA members comply with laws and regulations that impact the practice of medicine.

The Center for Strategic Communications crafts and delivers the organization’s mission to members, health care stakeholders, media and the general public. The center provides an internal and external resource through public affairs, media outreach, social media, video production and the development of marketing campaigns, newsletters, publications and webinars to effectively communicate the organization’s policy positions and strategic objectives.

The Center for Membership and Marketing’s two pillars are undoubtedly member retention and recruitment, but at its core are the myriad member services tailored to reach each of our unique membership segments, which include large integrated medical groups, physician practices of all sizes, and academic and hospital-based physicians. This center is also responsible for CMA’s corporate development and strategic partnerships.

Component Medical Society Services works in partnership with our 36 local medical societies to provide administrative support, executive services and affinity programs to meet physician needs at the local level.

The Center for Governance coordinates the association’s physician decision-making bodies, including, but not limited to, the Executive Committee, House of Delegates, Board of Trustees, and councils and subcommittees. The Center for Governance helps facilitate the smooth function of those bodies to conduct business, and ensures compliance with relevant association policies and bylaws.

The Center for Federal Government Relations is on the front lines, directly advocating the perspective of California’s practicing physicians before Congress and federal regulatory agencies. CMA is one of the largest state medical associations in the country, and our federal representatives are in key congressional leadership positions. This puts CMA in a unique position to effectively shape federal legislation that impacts physicians and their patients.

The Center for Economic Services is staffed by practice management experts with a combined experience of over 125 years in medical practice operations, providing one-on-one practice management assistance to physician members and their staff. Assistance ranges from coaching and education to direct intervention with payors or regulators. The center also empowers physicians by providing resources and guidance to improve the success of their practices. Over the past 14 years, CMA successfully recouped over $40 million from payors on behalf of physicians.

The Center for Political Operations is responsible for strategic utilization of CMA’s political resources to support candidates for office and initiatives that maintain a physician’s role in health care. This center also strives to connect individual physicians with legislators to support the activities of the Center for Government Relations through grassroots organization.

CMA is seeking physician and health care provider stories about the prior authorization process AND access issues in the Medi-Cal system.

You can help CMA explain to lawmakers why change is needed.

MEDI-CAL ACCESS TO CARE

Medi-Cal provides essential health coverage to one in three Californians and is foundational to the state’s health care delivery system and economy. However, much work remains to improve access to care.

How you can help: Share your unique experience as a Medi-Cal patient, physician or health care professional. Your story will help shed light on why the Medi-Cal system is vitally important to every Californian.

Go to cmadocs.org/your-story or scan the QR code.

PRIOR AUTHORIZATION

When insurance company prior authorization gets between patients and physicians, patients get sicker and health care becomes more expensive. It doesn’t have to work this way.

How you can help: Share your unique experience as a patient, physician or health care professional so we can fight back to ensure California policy puts patients first.

Go to cmadocs.org/priorauth or scan the QR code.

Questions? Contact CMA at news@cmadocs.org

CMA understands the unique challenges facing health care providers and provides services, resources and benefits to help you succeed. Members can offset the price of their annual dues when using CMA membership services and discounts.

PRACTICE RESOURCES

Reimbursement Assistance: Experts from CMA’s Center for Economic Services provide free one-on-one assistance to members and their staff on reimbursement, contracting and practice management-related issues. Services include educational resources, one-on-one assistance and direct intervention with payors. CMA’s reimbursement experts have recouped $33 million from payors on behalf of CMA physicians in the past 12 years. These monies represent actual physician reimbursements that would have likely gone unpaid without CMA intervention. Reach CMA’s reimbursement experts at (888) 401-5911 or economicservices@cmadocs.org.

Payor Contract Analysis: CMA members have free access to objective written analyses of major health plan contracts designed to help physicians understand their rights and options when contracting with a third-party payor, as well as which contract provisions are prohibited by California law. Learn more at cmadocs.org/ces

PatientPop offers the industry’s all-inone technology solution that’s proven to help physicians thrive in the digital age. With PatientPop, providers can promote their practice online, attract patients and retain them for life with integrated solutions including online reputation management, social media marketing and search engine optimization. Its

comprehensive suite of services enables physicians to thrive in today’s competitive market. In addition to deeply discounted service fees, CMA members save 50% off their implementation fee. Visit compare. patientpop.com/cma to learn more.

LEGAL RESOURCES

Legal Services: CMA’s legal department provides members with information and resources about laws and regulations that impact the practice of medicine. While CMA staff cannot provide physicians with individual legal advice, our health law information specialists, with the support of CMA legal counsel, will help you find legal information and resources on a multitude of health-law related issues.

Health Law Library: CMA’s health law library is the most comprehensive health law and medical practice resource for California physicians. Access to the library is free for CMA members (nonmembers can purchase documents at $2 per page). Access the library at cmadocs.org/healthlaw-library.

PROFESSIONAL DEVELOPMENT

Newsletters: CMA produces a number of publications to keep members up to date on the latest health care news and information affecting the practice of medicine in California. Subscribe to any of these newsletters online at cmadocs.org/ newsletters.

Webinars: CMA’s webinar series gives physicians the opportunity to watch online presentations on important topics of interest and interact with experts from the comfort of their homes or offices. The webinars are free to CMA members and their staff. CMA also has 100+ archived ondemand webinars available at cmadocs. org/webinars.

Seminars: Experts from CMA’s various centers travel to local county medical societies throughout the state, holding live seminars for members and their staff on a variety of issues. Contact your local county medical society for more information.

Career Center: The California Physician Career Center is the number one platform for employers to find the right talent for their health care organizations. Members enjoy free job postings and access to quality resumes. Whether you are a seasoned physician or just out of residency, the center offers the opportunities and resources you need to advance your career. This benefit includes tips on resume writing, interviews and networking, as well as hundreds of current job openings in California. Visit careers.cmadocs.org.

Student Loan Refinancing: CMA has partnered with SoFi, a leader in marketplace lending, to provide members with a variety of student loan refinancing options, including low-variable and fixed rates with terms ranging from five to 20 years. CMA members also qualify for an additional rate discount of 0.25% off the approved loan rate. Visit sofi.com/cma

INSURANCE

Association Member Benefits Advisors

(AMBA): As the primary insurance advisor for CMA and its affiliated county organizations, AMBA Health & Benefits Insurance Services LLC offers a wide variety of sponsored insurance plans and services for members. From solo practicing physicians to small, medium and large groups, AMBA provides savings, safety, service and stability no matter the size of your practice. Sponsored insurance plans include medical, workers’ comp, long term disability, long term care, level term life, business overhead expense insurance and more. For additional information on AMBA’s sponsored benefit program, call (800) 842-3761 or visit countycmamemberinsurance.com.

Auto and Homeowner’s Insurance: Mercury Insurance Group offers a discount of up to 23% on auto and homeowners’ insurance for CMA members. Call Mercury Insurance Group at (888) 637-2431 or visit mercuryinsurance.com/cma.

CONTACT CMA TODAY!

When you join CMA, you hire a powerful professional staff to protect the viability of your practice. By protecting your practice from legal, legislative and regulatory intrusions, your CMA membership lets you focus on what’s really important: your patients.

Contact CMA today at (800) 786-4262 or memberservice@cmadocs.org. Our Member Resource Center can also be reached via live chat at cmadocs.org.

CALPAC, the California Medical Association Political Action Committee, works to elect candidates who share our vision for the future of health care in California, as well as to maintain relationships with these legislators in offce.

Please donate today by scanning the code with your smartphone or visiting: calpac.org/donate.

CALPAC is a voluntary political organization that contributes to candidates for state and federal offce who share our philosophy and vision of the future of medicine. Contributions are not deductible for state or federal income tax purposes. More information available at CALPAC.org

CMA recommends solutions to increase the nation’s physician workforce (source: CMA)

“CMA is extremely concerned with the health care workforce challenges facing California and the nation and the impact it is having on patient access to high quality and affordable care.”

CMA applauds bipartisan bill to provide annual inflation for Medicare physicians(Source: CMA) ”By tying physician fees to the MEI, the bill will bring much-needed stability to physician practices and protect patients’ access to medical care in California, particularly in our underserved areas and low-income communities of color.”

DEA publishes guidance on new training requirements for prescribers of controlled substances

(source: CMA)

“Many California-licensed physicians may have already met the new DEA requirements because California requires similar education[…] CMA did not support the new DEA mandate, we worked to ensure that California physicians[…] can use all or some of our state-mandated CME to satisfy the DEA requirements. ”

California begins issuing $1 billion in health care workers retention payments (source: CMA)

On March 28, 2023, “The California Department of Health Care Services (DHCS) […] began issuing $1 billion in one-time retention payments to physicians and others who worked part- or full-time at qualifying hospitals and skilled nursing facilities during the COVID-19 public health emergency.”

CMA urges U.S. Surgeon General to issue report on gun violence epidemic (source: CMA)

“A recent study published in the American Journal of Medicine found that Americans are 25 times more likely to be victims of firearm violence than their counterparts in comparable high-income countries.”

CMA statement on Supreme Court’s order granting stay in medication abortion case (source: CMA)

Our very own Donaldo “Donald”

CMA applauds bipartisan bill to provide annual inflation for Medicare physicians(Source: CMA)

”By tying physician fees to the MEI, the bill will bring much-needed stability to physician practices and protect patients’ access to medical care in California, particularly in our underserved areas and low-income communities of color.”

TIRA IS UPDATING THIS PAGE

DEA publishes guidance on new training requirements for prescribers of controlled substances (source: CMA)

“Many California-licensed physicians may have already met the new DEA requirements because California requires similar education[…] CMA did not support the new DEA mandate, we worked to ensure that California physicians[…] can use all or some of our state-mandated CME to satisfy the DEA requirements. ”

California begins issuing $1 billion in health care workers retention payments (source: CMA)

On March 28, 2023, “The California Department of Health Care Services (DHCS) […] began issuing $1 billion in one-time retention payments to physicians and others who worked part- or full-time at qualifying hospitals and skilled nursing facilities during the COVID-19 public health emergency.”

CMA urges U.S. Surgeon General to issue report on gun violence epidemic (source: CMA)

“A recent study published in the American Journal of Medicine found that Americans are 25 times more likely to be victims of firearm violence than their counterparts in comparable high-income countries.”

Webinar: CMA Data Exchange Explainer Series #3Deep Dive into the Data Exchange Framework and Data Sharing Agreement

Hosted by CMA

When: June 15, 2023… 12:15pm - 1:15pm

Where: Online

Conference: Annual Rural Health Conference

Hosted by NRHA

When: May 16-19

Where: San Diego - Sheraton San Diego Hotel & Marina

Conference: Health IT: Powering Value-Based Care

Hosted by CMA

When: May 22, 2023… 9:00am - 4:00pm

Where: Sacramento - Kimpton Sawyer Hotel

Accreditation Workshop and CME Provider

June 22-23

Sacramento - Kimpton Sawyer Hotel

Retreat: The Mindful Healers Connect In Nature Retreat

Hosted by Pause & Presence with Jessie Mahoney, MD

When: July 14-16, 2023 (Friday-Sunday)

Where: Green Gulch Farm & Zen Center