SBCMS News/Media

Highlights from AMA's 2013 House of Delegates

The California delegation to the American Medical Association’s (AMA) House of Delegates presented a number of important resolutions at the AMA annual meeting in Chicago. The following are summaries of some of the California resolutions that the AMA House of Delegates adopted as policy.

1. Health Risks of Sitting (Res. 413): The delegates adopted a resolution that asks AMA to recognize that there are potential risks of prolonged sitting and encourage efforts by employers, employees and others to make available alternatives such as standing work stations and isometric balls, and to encourage educational efforts on ways to minimize this risk.

2. Monitoring for Radiation in Seafood (Res. 414):The delegates adopted an amended California resolution that asks AMA to call for the federal government to continue to monitor and fully report the radioactivity levels of edible Pacific Ocean species sold in the United States that could reasonably have been exposed to radiation from the ongoing Fukushima disaster and to include the potential health implications of consuming such foods.

3. Prevention of Falls Through Windows (Res. 415): The delegates adopted an amended California resolution that asks AMA to support the use of window guards and devices that prevent windows from opening enough to allow a child to fall through, and to support public education regarding the risks of children falling through windows.

4. Public Education on Distracted Driving (Res. 416): The delegates adopted a resolution that asks the AMA to support public education efforts on the dangers of distracted driving, particularly activities that take drivers’ eyes off the road.

5. Revised Blood Donor Deferral Criteria (Res. 514): The delegates adopted a substitute resolution that asks AMA to oppose the current lifetime ban on blood donations from men who have sex with men, and to express support for the use of rational, scientifically based deferral periods that are fairly and consistently applied to donors according to their level of risk rather than being solely based on sexual orientation.

6. Targeted Tuberculosis Testing of School Children (Res. 515): The delegates adopted as amended a California resolution that asks AMA to support efforts to replace universal tuberculosis (TB) testing of school aged children with a TB risk assessment questionnaire, and support TB testing of school aged children based on the results of that risk assessment.

7. Early Treatment and Partner Services for HIV (Res. 516): The delegates adopted an amended California resolution that asks AMA to support programs raising physician awareness of the benefits of early treatment and of “treatment as prevention,” and the need for linkage of newly positive persons to clinical care and partner services.

For an expanded summary of California resolutions from the AMA House of Delegates, click here.

Contact: Nick Birtcil, (916) 551-2570 or nbirtcil@cmanet.org.

Scope of practice bills to be heard on July 2, urge your legislator to OPPOSE these bills

The California Medical Association (CMA) is urging physicians to contact legislators and ask for NO votes on SB 491, SB 492 and SB 493. These three bills will expand scope of practice of nonphysician practitioners and remove necessary physician supervision, ultimate harming patients and decreasing quality of care. These bills may be heard in the Assembly Business, Professions and Consumer Protection Committee as early as July 2.

Senate Bill 491 (Hernandez) would allow nurse practitioners to open practices without any oversight from a trained medical doctor and prescribe dangerous, addictive drugs without supervision. While an important part of the health care delivery system, nurse practitioners simply do not have adequate training or years of education that physicians do in order to be qualified to practice medicine without physician involvement.

Senate Bill 492 (Hernandez) would allow optometrists to provide primary care service including diagnosing diabetes, high cholesterol and hypertension. Under this bill, optometrists would be able to examine, prevent, diagnose and treat any disease, condition or disorder of the visual system, the human eye and adjacent related structures.

Senate Bill 493 (Hernandez) would allow advanced practice pharmacists to evaluate and manage diseases and health conditions without physician consultation. Additionally, any pharmacist would be able to furnish prescription smoking cessation drugs and devices with known harmful side effects including depression and in some cases, suicide.

Legislators need to know the true impact these bills would have in their districts.

Your calls are imperative to help us stop these bills and protect patients. We ask that you and your colleagues call, fax or email your legislators TODAY and urge them to vote NO on SB 491, SB 492 and SB 493!

For more information, including talking points and a sample letter, see CMA's grassroots action center.

CMS conducts meaningful use audits in California

The Centers for Medicare & Medicaid Services (CMS) has begun auditing California physicians who received payments through the federal electronic health record (EHR) incentive programs. Physicians selected for the audit have received letters from CMS contractor Figliozzi and Co., with requests for documentation to support their stage 1 meaningful use attestation. Figliozzi is an accounting firm that specializes in auditing health care facilities for Medicare cost compliance.

Under the 2009 federal economic stimulus package, health care providers can qualify for Medicaid and Medicare incentive payments by demonstrating meaningful use of certified EHR systems. The law also requires CMS to audit health care providers attesting to meaningful use. According to CMS, the audits will impact 5 to 10 percent of physicians who have received incentive payments.

The letters generally request that physicians provide the following information:

• Evidence that they are using certified EHR technology
• Their method of reporting emergency department admissions
• Documentation that the physician completed the attestation module for the core set and menu set objectives and measures.

Physician practices who receive such a letter should consider contacting a Regional Extension Center such as CalHIPSO (www.calhipso.org), their EHR vendor or a consultant for assistance.

For more information on the federal EHR incentive programs and meaningful use, see CMA On-Call documents #4301, "EHR: Federal Incentive Program," #4302 "Meaningful Use of Electronic Health Records (EHRs)." These documents, as well as the rest of CMA's health law library, are available free to members on CMA's website at www.cmanet.org/cma-on-call. Nonmembers can purchase documents for $2 per page.

Contact: Center for Legal Affairs at (800) 786-4262 or legalinfo@cmanet.org

CMA amicus brief argues exorbitant 'nominal' damage puts patient care at risk

In June, the California Medical Association (CMA) filed an amicus curiae letter with the Court of Appeals in the case Regents of the University of California v. The Superior Court of Los Angeles County (Platter).

This case arises from the theft of a computer hard drive containing private, confidential information on approximately 16,000 patients. The plaintiffs filed a class action lawsuit alleging that the UC Regents failed to have proper safeguards in place to prevent the theft in violation of the Confidentiality of Medical Information Act (CMIA).

The plaintiffs seek $1,000 for each of the 16,000 patients for a total of $16 million in “nominal” statutory damages. Despite the lack of any allegations of affirmative acts by the defendants to release or disclose confidential information or any actual harm suffered by the plaintiffs, the trial court held that plaintiffs could maintain a cause of action and seek nominal damages under the CMIA.

CMA’s letter brief in support of UC Regents argued that the trial court’s ruling puts California physicians at risk for devastating lawsuits that can increase the cost of health care and ultimately create barriers to patient access to care. Such exorbitant damages can be disproportionate to the underlying violation by the defendants or the actual harm suffered by the plaintiffs and have a dire financial impact on health care providers, directly undermining the viability of their practice and their ability to provide medical care. The brief argued that CMIA’s provisions should be applied in a way that balances the protection of privacy of patient medical information without placing excessive burdens on health care providers.

For a copy of the brief click here.

Contact: Center for Legal Affairs at (800) 786-4262 or legalinfo@cmanet.org

Medical board decides it does have authority to discipline utilization review physicians

The Medical Board of California recently considered the issue of whether workers' compensation utilization review can be considered the "practice of medicine" and, if so, does the medical board have the authority to discipline physicians who do not practice within the standard of care when performing utilization review on behalf of payors and other entities?

After testimony by the California Medical Association (CMA) and the California Society of Physical Medicine and Rehabilitation (CSPMR), the board agreed that physicians conducting worker's compensation utilization review were indeed engaged in the practice of medicine and subject to review by the board. Although the board has long stated publicly that physicians performing utilization review are engaging in the practice of medicine, it had recently been denying jurisdiction to investigate complaints about utilization review physicians' decisions and their impact on injured workers.

Utilization review is a process required by law and is used to determine if medical treatment requested for an injured worker is medically necessary. Recently, several entities have asked that the medical board investigate complaints filed against physicians who participate in utilization review activities. CMA and CSPMR had joined together to push the board to accept jurisdiction and follow up on these complaints.

Medical board staff has been directed to bring forward any legislative or regulatory changes that would be required to allow these complaints against California licensed physicians performing utilization review to be investigated.

The board does not, however, have jurisdiction over out-of-state physicians performing utilization review in California. State law does not currently require utilization review physicians to be licensed by the California Medical Board.

In 2011, Gov. Jerry Brown vetoed AB 584, which would have required worker's compensation utilization review physicians to be licensed in California. CMA supported that bill, as well as numerous others, to require that all utilization review be done by California-licensed physicians in order to ensure that there is a disciplinary pathway for the medical board in case an injured worker is unduly hurt by a utilization review-based modification or denial of care.

Contact: Carolyn Ginno, cginno@cmanet.org or (916) 551-2547.

SBCMS Alliance Disbanding After 83 Years of Service

For 83 years the Alliance of the San Bernardino Medical Society has sponsored, developed, and participated in many worthwhile community
programs and coordinated social activities for physicians and their spouses. As times change, so has our Alliance. We have seen a decline in membership and active participation in our organization. The SBCMS Alliance Board of Directors has come to the decision to recommend that we close the Alliance on June 30, 2013. On June 4, a vote of the membership was taken to dissolve the membership.

We invite any Alliance member interested in participating in one of our worthwile community programs, to contact SBCMS Staff, Debbie Long, at 951-787-7700 or dlong@sbcms.org.

Memorial Service for Wendell Moseley M.D.

Dr. Wendell Moseley, 85, beloved husband, father and physician, went home to be with the Lord on June 17, 2013 in San Bernardino, CA.  A General Practitioner in the San Bernardino area for over 45 years, he was a graduate of Redlands University and Loma Linda University School of Medicine.   He proudly served our nation during WWII in the United States Army. 

Some of his many accomplishments are: past President of the San Bernardino County Medical Society, President of Medical Staff at St. Bernardine Medical Center and San Bernardino Community Hospital, a delegate to the California Medical Association, and a Member of the Governing Board of Southern California Physicians Insurance Exchange.  Honors include the Nicholas P. Krikes Award for Outstanding Contribution to the Medical Society 1993 and Loma Linda University School of Medicine Department of Family Medicine 1995-96.

He was preceded in death by his siblings, Marilyn, Claude Jr. and Roland.  He is survived by Bobbie, his loving wife of 67 years.  Also surviving him are his children Dennis (Carole), Bruce (Nora) and Debra (Stephen), his brother Orville (Anna), his six grandchildren, and his great granddaughter. 

A Memorial Service will be held on Saturday, June 22, 2013 at 11:30 am at Immanuel Baptist Church, 28355 Base Line, Highland, CA.  In lieu of flowers please make donations in Wendell’s memory to the Building Fund at Immanuel Baptist Church.

Interment will be private at Montecito Memorial Park.  To sign Wendell’s Memorial Page, please visit www.bobbittchapel.com

California Medical Association releases White Paper on Opioids

Sacramento – Today, the California Medical Association (CMA) released Opioid Analgesics in California: Relieving Pain, Preventing Misuse, Finding Balance, a report on the use of opioid medications.

California, along with the nation, is faced with a serious health care dilemma: how to use opioid medications to relieve pain safely and effectively, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose.

“Physician, patients, law enforcement and the general public need accurate information about appropriate opioid use,” said Paul R. Phinney, M.D., CMA president. “CMA has developed the white paper as a tool to help stakeholders understand the multi-faceted and very complex issues around opioid prescribing and use.”

The paper outlines a set of key recommendations, including: education for prescribers, policymakers and the public; increased use and funding of tools to improve patient safety; and obtaining additional California specific data on opioid use and misuse.

“Everyone involved in this complex issue can and must work together in order to advance pain care while minimizing risks to patients and to the general public,” said Dr. Phinney. “CMA’s belief, based on data and science presented in this paper, is that opioids have a legitimate role in helping people in pain and can be safe and effective when prescribed responsibly. Pain is the most common reason people seek health care. It is vital that we take a comprehensive look at this complex issue and find the best solutions for patient safety.”

A copy of the executive summary can be found here and a full copy of the white paper can be found here.

2013 SBCMS Installation of Officers

The San Bernardino County Medical Society’s (SBCMS) Installation of Officers dinner was held on June 11th at the Sierra Lakes Golf Club in Fontana.  Nearly 200 people were in attendance to pay tribute to a number of physicians being recognized and honored at the annual event.

SBCMS President Leroy Ounanian, MD, served as Master of Ceremony for the evening at which the new board officers were introduced including Raman Poola, MD, who will serve as the Society’s 121st president during 2013-14.  Dr. Poola is a Gastroenterologist who practices in Apple Valley, CA.

Joining Dr. Poola on his leadership team will be Montri Wongworawat, MD, President-Elect; Marti Baum, MD, Vice President; Michael Sequeira, MD, Secretary; and Eric Hansen, DO, Treasurer.  Dr. Ounanian will serve as Immediate Past President.  Paul Phinney, MD, President of the California Medical Association, facilitated the installation.

Dr. Ounanian, on behalf of the Bangasser family, awarded Shahrzad Lalezari from Western University of Health Sciences the 2013 Bangasser Medical Student Scholarship of $5,000.  The scholarship is in memory of the late Ron Bangasser MD, former President of SBCMS and CMA. 

Other award recipients included Thomas Gibson, MD for the Nicholas P. Krikes, MD Award for Outstanding Contribution to the Medical Society; Thomas Minahan, DO for the William L. Cover, MD Award for Outstanding Contribution to Medicine; Paul Whiteside, MD for the Merlin A. Hendrickson, MD Award for Outstanding Contribution to the Community; and Nancy Young for the Outstanding Citizen Award.

Brad Gilbert, MD, received the 2013 SBCMS Presidential Award.  The award is granted to an individual exhibiting exemplary character and commitment to organized medicine and the medical profession.  Dr. Gilbert is the CEO of Inland Empire Health Plan (IEHP).

The San Bernardino County Medical Society is comprised of nearly 1,700 physicians, residents and medical students within the county.  It is a chartered County Medical Society of the California Medical Association.

Click here to view pics from the event.

Noridian Transition Date Set

Transition of the Medicare Administrative Contract from Palmetto GBA to Noridian is scheduled for September 16, 2013 (Part B). To help physicians understand what is changing, Noridian is offering a series of Implementation 101 and EDI Support Services web-based workshops. Noridian is also holding in person “Meet and Greet” workshops at the following locations:

June 11-13
Doubletree by Hilton Sacramento
2001 Point West Way
Sacramento, CA 95815

June 18-20 
Embassy Suites San Francisco Airport South
250 Gateway Boulevard
South San Francisco, CA 94080

July 9-11 
Embassy Suites Anaheim South
11767 Harbor Boulevard
Garden Grove, CA 92840

July 23-25 
Embassy Suites San Diego La Jolla
4550 La Jolla Village Drive
San Diego, CA 92122

Specific times and registration information are available on the Noridian website.  Other programs will be added as they progress through the transition. SBCMS/CMA encourages physicians to join the Noridian mailing list to stay apprised of changes.