FDA restricts use of cough and cold medicines with codeine or hydrocodone for kids The U.S. Food and Drug Administration (FDA) said today that cough and cold medicines containing codeine and hydrocodone should not be prescribed to children and adolescents because of serious safety risks posed by the opioid ingredients. The FDA also announced that such products will now be required to carry "boxed warnings" – the FDA’s strongest warning – that highlight the risks misuse, abuse, addiction, overdose, death, and slowed or difficult breathing. According to the FDA, it is taking this action after an extensive review that determined the risks associated with these medicines outweigh their benefits in patients younger than 18. Click here for more information. January 30, 2018 General Food and Drug Administration, Opioids, Pediatrics 0 0 Comment Read More »
CMA Doc: Richard Pan, M.D. Senator Pan presenting Senate Bill 277 in Senate Health Committee "Vaccines are so effective that parents, and even many younger physicians, have never seen many vaccine preventable diseases. This lack of personal experience with these diseases has created opportunities for anti-vax charlatans to spread misinformation and create anxiety and doubt about vaccines for their own personal gain." --Sen. Richard Pan, M.D. As a physician, I have witnessed first-hand how vaccines protect our children and communities from dangerous diseases. I attended medical school at the University of Pittsburgh, where I learned microbiology from Julius Younger, Sc.D., who worked with Jonas Salk, M.D., to develop the first successful polio vaccine. I never expected to see measles, but in 1991, in a Philadelphia clinic, I witnessed an outbreak that infected over 900 people and killed nine children. In the meantime, widespread use of the Hib (Haemophilus influenzae type b) vaccine began while I attended medical school, and during my residency, I only saw one case of invasive Hib, a disease that previously filled pediatric ICUs. Vaccines are so effective that parents, and even many younger physicians, have never seen many vaccine preventable diseases. This lack of personal experience with these diseases has created opportunities for anti-vax charlatans to spread misinformation and create anxiety and doubt about vaccines for their own personal gain. Years of vaccine hesitancy, fueled by a fraudulent study linking vaccines with autism, have taken a toll on the community immunity needed to keep diseases at bay. In 2000, only 0.77 percent of California kindergartners had personal belief exemptions on file. By 2013, that percentage more than quadrupled to 3.15 percent statewide. In some places in the state, vaccination rates dipped below 70 or 80 percent. As community immunity eroded, preventable diseases returned—with dangerous consequences. In 2010, there were 9,120 cases of pertussis reported in California—more than any year since 1947, and 10 babies died in that outbreak. Measles infections nationally rose from 37 infections in 2004 to 644 in 2014. Then, in 2015, a measles outbreak began at Disneyland, infecting 147 people and hospitalizing at least 20 people. Parents demanded action to keep their children safe, and thanks to the advocacy of Vaccinate California, Senator Ben Allen and I authored and passed SB 277, which eliminated non-medical exemptions to school vaccination requirements. In the first year of implementation, vaccination rates among kindergarteners rose to levels not seen in a decade and a half. Kindergarten students receiving required vaccines rose from 93 percent in the 2015-16 school year to 96 percent in 2016-17. However, many older children who previously received exemptions remain unvaccinated, and an entire generation of young people—referred to as the “Wakefield generation,” after the discredited anti-vax researcher—remain vulnerable and can accelerate the spread of future outbreaks. While laws like SB 277 have a tremendous impact on vaccination rates, continued success requires physicians to educate our patients about the benefits of vaccines and the dangers of the diseases they prevent. Vaccine misinformation continues to be spread by social media, videos and books. Even the President has given credibility to vaccine myths and welcomed anti-vax quacks. Fake news sites such as Natural News, InfoWars and Mercola.com spread anti-science conspiracy theories and attack science advocates like Paul Offit, M.D. But this misinformation can be overcome by physicians who build trust with their patients and families, listen carefully to their concerns, and speak with confidence about the efficacy and safety of vaccination. As a pediatrician, I learned the science of vaccines; but while passing vaccine legislation, I also learned the myths of anti-vaxxers. Anti-vax charlatans promote parental anxiety about vaccines so parents are more susceptible to the marketing of alternative products they’re selling. These frauds sow distrust of physicians and science and downplay the dangers of disease. Some misinformed parents even say they’d prefer their children get infected with polio, measles, pertussis and chicken pox than to be vaccinated. Fortunately, a large majority of parents listen to our advice and support vaccination. However, even if only a few percent of parents don't vaccinate their children, community immunity is compromised for the entire community. Thus, physicians and our public health and education partners must reach out to parents and counsel them about the truth of vaccine-preventable diseases. Physicians should not wait until a baby’s first visit to discuss vaccines, but should begin the discussion while parents are planning a pregnancy or during pregnancy. Too often, parents begin searching the internet for information on vaccines—where anti-vax misinformation is rampant and paid to be at the top of search engines. We need to reach parents early to answer their questions and allay their anxieties. Thanks to a strong partnership between parents and physicians, SB 277 passed in California and our children are safer for it. Many of our most vulnerable children, including very young infants and children who have cancer, transplants, or immune conditions, cannot be vaccinated, and they depend on community immunity from vaccinated people. As physicians, we need to maintain the political will to sustain California’s vaccination laws through our vigorous efforts to teach all parents about the efficacy and safety of vaccines and the dangers of the diseases they prevent. Richard Pan, M.D., MPH, FAAP, is a pediatrician and State Senator representing Senate District 6 (D-Sacramento). He has been a member of the California Medical Association and the Sierra Sacramento Valley Medical Society since 1999. California's doctors aren't just health care and medical experts. They're also community leaders, philanthropists, entrepreneurs and policymakers dedicated to ensuring that patients receive quality health care at an affordable cost. #CMAdocs showcases California physicians leading the charge to help their communities thrive. August 9, 2017 CMA, General California Senate, CMAdocs, Pediatrics, Vaccination 0 0 Comment Read More »
Amador physician featured in Big Tobacco's latest misleading ad, CMA responds The latest misleading ad from the tobacco industry-funded No on Prop. 56 campaign prominently features a retired ob-gyn from Amador county, Arnold Zeiderman, M.D. In the ad he claims, “I do everything in my power to stop people from smoking, but that's not what Prop. 56 is really about." The Executive Committee of the California Medical Association and physician leaders across the state today issued an open letter to Dr. Zeiderman, urging him to reconsider his role as spokesperson for the tobacco industry and join with the rest of the California health care provider community in protecting kids, saving lives, keeping people from smoking and supporting Prop. 56. Because keeping kids from starting and getting smokers to quit is absolutely what Prop. 56 is about. “This is one retired doctor, reciting talking points that have been widely discredited, in an ad paid for by Phillip Morris and RJ Reynolds,” said Jeanne Conry, M.D., an ob-gyn from Roseville. “It comes down to a very simple question. Who do voters trust: Tobacco companies who spend billions marketing deadly products to kids and millions lying to Californians, or caregivers, medical professionals, business groups, cancer groups and teachers?” Prop. 56 taxes deadly tobacco products that take the lives of 40,000 Californians each year, costing taxpayers $3.5 billion annually. Around the world, the public health community unanimously agrees that tobacco taxes work to reduce smoking. Big Tobacco has invested $56 million towards deceptive ads and false claims to defeat Prop. 56, and has spent more than $200 million to defeat tobacco taxes in California over the last 10 years. “Tobacco companies aren’t giving us enough credit if they think we believe that they are spending millions on attacking Proposition 56 because it doesn’t do enough to curb smoking,” said Dr. Conry. “The reality is that Proposition 56 will reduce smoking and prevent children from ever starting. Proposition 56 will make a meaningful impact on California’s health care system, and, most importantly, a meaningful impact on the health of Californians.” Prop. 56 will increase California’s cigarette tax by $2 per pack, with an equivalent increase on products containing nicotine derived from tobacco, including e-cigarettes. The majority of the funds generated by Prop. 56 will go to Medi-Cal, which provides health care services to low income Californians. Prop. 56 will also triple the current funding levels for the state's tobacco control program. To help spread the word about the life-saving tobacco tax, the Save Lives California campaign has developed a variety of materials to display in your office, share with colleagues and patients, and post on social media. To view the materials, visit www.yeson56.org/spread-the-word. Additional materials in the campaign store include yard signs, t-shirts, hats and campaign kits containing a variety of materials, perfect for a physician’s office. October 13, 2016 CMA, General Obstetrics and Gynecology, Tobacco Tax, Ballot Measures, Pediatrics, Prop. 56 (tobacco tax), Tobacco 0 0 Comment Read More »
AAP urges states to take firmer stand on nonmedical vaccine exemptions The American Academy of Pediatrics (AAP) this week called nonmedical vaccine exemption laws a failure and urged state governments to follow California's lead by eliminating nonmedical exemptions and enacting policies to improve immunization rates. “It’s clear that states with more lenient exemptions policies have lower immunization rates, and it’s these states where we have seen disease outbreaks occur as the rates slip below the threshold needed to maintain community immunity,” said Geoffrey R. Simon, M.D., lead author of AAP's new policy statement, “Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance." Recent disease outbreaks, such as California's 2015 measles outbreak, show how critical vaccines remain for children’s health. High community immunization rates protect vulnerable individuals, including children who cannot be vaccinated because of medical problems or because they are too young. AAP also this week published advice for pediatricians in counseling families who are hesitant to vaccinate their children. In a new clinical report, “Countering Vaccine Hesitancy,” AAP advises pediatricians to have compassionate dialogues with parents to clear up misconceptions around vaccines, provide accurate information about the safety and importance of vaccines, and strive over time to help parents make the decision to vaccinate their child. “Pediatricians know some parents have concerns about vaccines, and the best way to answer these questions is by discussing them with the doctor,” said Jesse Hackell, M.D., an author of the vaccine hesitancy report. “Both parents and pediatricians are in agreement in wanting the best for a child’s health and well-being.” AAP urges pediatricians to address the specific concerns individual parents may have about vaccines, noting that one-on-one contact with an informed, caring and concerned pediatrician is the “single most important influence” on parents’ acceptance of vaccines. In one study, 80 percent of parents said their decision to vaccinate was positively influenced by their primary care provider. AAP is also offering a free online training course for pediatricians on counseling vaccine-hesitant parents. The course, "Challenging Cases: Vaccine Hesitancy," is available at http://bit.ly/cc-vaccinehesitancy. California's new vaccine law (SB 277), which took effect this year, eliminates the personal belief exemption and requires all children to be up to date on their vaccinations prior to enrolling in a public or private elementary school or child care center, unless the child has a medical exemption. For more information on California's vaccination law, visit www.cmanet.org/vaccinations. September 12, 2016 General Pediatrics, Personal Belief Exemption, Public Health, Vaccination, American Academy of Pediatrics, Immunization 0 0 Comment Read More »
DHCS reopens window for NICU/PICU claims submission under ACA PCP rate increase On May 18, the California Department of Health Care Services (DHCS) released additional information about Medi-Cal payment increases for primary care physicians under the Affordable Care Act (ACA) who file claims for patients treated in neonatal intensive care units (NICU) or pediatric intensive care units (PICU). In the past, NICU/PICU claims were billed to Medi-Cal using a local code. In order to be eligible for the ACA enhanced payments, physicians were required to submit claims with ACA modifiers beginning April 11, 2014, that linked the local code to an eligible CPT code level. However, DHCS provided no pathway for physicians to ensure that claims submitted prior to April 11, 2014, were paid at the enhanced rate. At the request of the California Medical Association and other stakeholders, DHCS agreed to allow claims data to be submitted for this category via a one-time upload of the “claim to ACA modifier” spreadsheet without the need for individual claim inquiry forms to be submitted. The original deadline to submit the “claim to ACA modifier spreadsheet was October 1, 2014. However, DHCS is reopening the window to allow physicians a second opportunity to submit their spreadsheet. Spreadsheets must be received no later than June 15, 2015, to be considered for payment. For instructions on completing and submitting the spreadsheet, click here. DHCS also announced that the ACA Primary Care Physician Self Attestation webpage will be removed from its website and will no longer be accessible after June 15. DHCS has advised that eligible claims from providers who attested for the ACA increase primary care rate increase between September 1 and December 31, 2014, along with any NICU/PICU claims associated with the spreadsheet submittals, will be automatically reprocessed for payment consideration at the enhanced rate in summer 2015. May 26, 2015 Medi-Cal Affordable Care Act, Medi-Cal, Pediatrics, ACA 0 0 Comment Read More »
DHCS identifies glitch in UCR web app for CHDP primary care rate increase payments The California Department of Health Care Services (DHCS) has identified an error in its web application that was designed to allow physicians the ability to enter their usual and customary rates (UCR) for Child Health and Disability Prevention Program Services (CHDP) claims. Physicians who already entered their UCR data prior to November 26, 2014, will need to return to the portal and reenter their information. The web app was developed to address a problem with the Affordable Care Act primary care rate increase unique to CHDP providers. Before the rate increases were implemented, some practices had been instructed by DHCS to bill CHDP claims at their Medi-Cal rates. This caused concern – based on DHCS’s pricing logic of paying the lesser of Medicare’s rate or the billed charges – that some practices would not qualify for the retroactive increases once the systems were updated to process claims at the higher rates. The error resulted in previously submitted data being overwritten when subsequent data was entered by other physicians. DHCS corrected the problem as of November 26, so physicians who entered their UCR prior to that date will need to visit the portal and reenter their information. Because of the glitch, DHCS has extended deadline to submit physician UCR charges to January 16, 2015. Click here for instructions on how to access the CHDP web app. December 9, 2014 Managed Care, Medi-Cal Medi-Cal, Pediatrics, Affordable Care Act, Department of Health Care Services 0 0 Comment Read More »
Soda warning label bill clears committee A California Medical Association-sponsored bill that would place safety warning labels on sodas and other sugary beverages sold in California has cleared California’s Senate Health Committee on a 5-2 vote. The first-in-the-nation legislation (SB 1000) was introduced by State Senator Bill Monning (D-Carmel) and would ensure that all Californians are aware of the critical scientific information linking sugary drink consumption to exploding rates of diabetes and obesity. The bill would place a simple warning on the front of all beverage containers with added sweeteners that have 75 or more calories per 12 ounces. The label, developed by a national panel of nutrition and public health experts, would read: STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. Supported by overwhelming research linking soda and sugary drink consumption to skyrocketing rates of diabetes, obesity and tooth decay, the bill now moves forward to the Senate Committee on Appropriations, before being referred for a full Senate floor vote. According to a recent field poll, 74 percent of California voters support warning labels on sugary drinks. Sugary drinks are also the single largest contributor of added calories in the American diet, responsible for 43 percent of the additional calories consumed over the last 30 years. Drinking just one soda a day increases an adult’s likelihood of being overweight by 27 percent and a child’s by 55 percent. Research has also shown that a soda or two a day increases the risk of diabetes by 26 percent. “I see more and more patients losing limbs or going blind every year, and many of them drink a soda a day, unaware of just how hazardous the habit is to their health,” said Ashby Wolfe, M.D., of the California Medical Association. “Diabetes rates have skyrocketed by over 600 percent over the past generation, and liquid sugar is uniquely responsible for this epidemic. Warning labels are a vital step toward preventing a lot of trouble down the road.” These health implications are felt most acutely by California’s communities of color, which are the largest consumers of sugary drinks. In addition to CMA, the legislation is co-sponsored by the California Black Health Network, California Center for Public Health Advocacy and the Latino Coalition for a Healthy California. Complete information on SB 1000, including fact sheets on the science linking sugary beverages to diabetes, obesity and cavities, is available at www.sodawarninglabel.org. April 16, 2014 General Pediatrics, Public Health, State Legislation, Obesity 0 0 Comment Read More »
