CMA is a major player in Sacramento. The Association's staff lobbyists and an ever-growing cadre of physician advocates keep legislators aware of how proposed legislation could enhance or threaten patients' health or physicians' ability to practice medicine.

CMA's KEY LEGISLATIVE ISSUES FOR 2005

• Managed Care Reform
• Access to Health Care
• MICRA
• Fair and Equitable Physician Contracts
• Emergency Medical Services
• Scope of Practice
• State Budget
  

1. Managed Care Reform
   Managed care is a fact of life in California. But with increased emphasis on profits, physician-patient relationships are increasingly threatened. Physicians must be allowed to advocate for their patients without fear of retaliation from HMO administrators and must remain an integral part of the medical decision making process to preserve the quality of care that California consumers expect and deserve. CMA supports efforts to reform this system so that it allows physicians to practice medicine and treat patients in the manner in which they were trained and uses premium dollars for patient care, not administrative costs or excessive profits.
   
2. Access to Care
   Nearly seven million Californians do not have health insurance - the largest number of uninsured in the nation. The overwhelming majority of those individuals work full time in jobs that either do not provide health insurance or do not pay well enough to afford private insurance. CMA is working with a broad-based coalition of labor, business and other interest groups in an effort to craft a mechanism wherein employers would be required to either provide their employees with health insurance or pay into a state operated purchasing pool and allow employees to select coverage through that pool. CMA also supports efforts to expand the Healthy Families program to cover working parents of children enrolled in that state-federal program.
   
3. MICRA
   MICRA, the Medical Injury Compensation Reform Act of 1975, reformed the medical mapractice insurance system in California through implementation of a $250,000 cap on noneconomic damages, a limit on attorney fees, full disclosure of collateral sources of compensation and periodic payments for awards over $50,000. While a medical malpractice crisis is sweeping across America, MICRA, has kept the doors of medicine open and has protected the health care safety net in our state by keeping medical malpractice insurance available and affordable in California. CMA supports continuation of MICRA, including the quarter million dollar cap on noneconomic damages.
   
4. Fair and Equitable Physician Contracts
   Rampant consolidation has resulted in a few HMO's exerting a disproportionate influence on the California health care marketplace. Currently, six health plans control over 80 percent of the market in our state. With this substantial market dominance, health plans offer physicians onerous take-it-or-leave-it contracts that often include provisions that are bad for patients and undermine the physician-patient relationship. In order to address this problem, CMA supports legislation that would allow physicians to negotiate collectively with health plans, ensure that capitation rates are actuarilly sound, and prevent health plans from requiring physicians to bear the risk of pharmacy or hospital services.
   
5. Emergency Medical Services
   Emergency rooms and trauma centers are overcrowded, under-funded and in great distress. The overwhelming majority of California's emergency rooms lose money every year and emergency room physicians and other physicians who are on-call in emergency rooms provide more and more uncompensated care. CMA supports legislative efforts to stablize this troubled system and fully fund emergency medical services in California.
   
6. Scope of Practice
   While CMA does not oppose all expansions of scope of practice for non-physician providers, these proposals must be examined carefully to ensure that care of patients is not jeopardized. CMA believes that non-physician practitioners seeking to expand their scope must have the proper experience, training and education to treat patients safely and that the physician is the final decision-maker.
   
7. Regulatory Relief
   The state legislature frequently involves itself in the practice of medicine by requiring physicians to distribute written materials or verbally inform patients regarding certain clinical or disease related matters. This governmental involvement in the actual practice of medicine is often burdensome and unnecessary. CMA supports efforts to review such mandates already in existence and either sunsetting or at least consolidating some of them into a single physician friendly format.
   
8. Budget
   CMA strongly supports a state budget that will continue California's obligation to provide health care to the medically indigent and working poor. Program cuts in the area of health care can result in severe public health problems that cost the taxpayer a lot more in the long term. CMA believes that adequate state funding for Medi-Cal and other programs that provide health care to needy Californians must be preserved.
   

Contact: For more information contact the CMA Center for Government Relations at (916) 444-5532 or send e-mail to leginfo@cmanet.org.

Center for Government Relations
California Medical Association
1201 J Street, Suite 200
Sacramento, CA 95814
(916) 444-5532 - (916) 444-5689 fax

CMANET.org

The CMA Weekly Legislative Hot List provides a summary and current status of CMA-sponsored bills, as well as the progress of other significant legislation followed by CMA's Center for Government Relations. The Hot List represents only a small sampling of the 460 bills CMA is following this year. Members may login at http://www.cmanet.org to view the latest Legislative Hot List.

Private Sector Economic Advocacy 

CMA maintains a reimbursement and medical group solvency economic assistance program. CMA assists physicians, medical groups and IPAs with payment (fee-for-service and capitation), documentation and compliance issues involving government and private payers. CMA also helps physicians and groups who are affected by closures and bankruptcies. CMA was successful in securing more than $45 million in payments for physicians affected by the MedPartners bankruptcy. CMA Reimbursement Hotline 1-888-401-5911.