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Supreme Court upholds ACA subsidies

In a major victory for the Obama administration, the U.S. Supreme Court upheld a key provision of the Affordable Care Act (ACA), reaffirming that 6.4 million people in 34 states can continue to receive subsidies to purchase health care insurance. The question in the case, King v. Burwell, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.” Chief Justice John Roberts and Justice Anthony Kennedy joined the court’s four Democratic ...

Registration now open for IMQ 2015 Medical Staff Conference

The California Medical Association's Institute for Medical Quality (IMQ) has opened registration for its annual Medical Staff Conference, to be held October 29 at Embassy Suites Hotel near LAX. At the conference, attendees will discover solutions and best practices that physicians need to successfully lead their medical staffs. The conference will answer questions about tackling difficult decisions that face medical staffs, such as granting privileges for aging physicians and those reentering practice after an absence. Through examples and discussion, the faculty will demonstrate how, by maintaining a focus on quality and ...

Governor calls for special Medi-Cal session after budget agreement struck with legislators

Governor Jerry Brown has called for a special session of the Legislature to address “Health Care Financing” after he struck a deal with Democratic lawmakers last week. California legislators passed a $115.4 billion budget, part of a deal with Governor Brown to hold back on spending despite the state’s improving financial picture. Left out of the budget agreement were higher rates for Medi-Cal providers. In a typical year, the conclusion of budget negotiations would mean the end of the California Medical Association’s (CMA) hopes of improving access for the over ...

Senate Bill 277 Clears Assembly

Sacramento — Senate Bill 277 jumped its final hurdle in the state Assembly today, clearing the house with overwhelming 46-30 approval. The bill now heads back to the Senate, where legislators will consider amendments made in the Assembly. “The California Medical Association (CMA) would like to thank the Assemblymembers who supported this important piece of legislation that will improve public health and keep our communities safe,” CMA President Luther F. Cobb, M.D., said. “Diseases that were once declared eradicated have resurfaced in recent years and SB 277 will help to ...

Court rules against constitutional attack on MICRA

On June 9, the California Court of Appeal based in San Francisco issued its precedential opinion in Chan v. Curran, fully upholding various provisions of California's landmark Medical Injury Compensation Reform Act (MICRA) against constitutional attacks by California’s trial attorneys. The California Medical Association (CMA), together with a broad coalition of health care providers, including the American Medical Association, the California Hospital Association and the California Dental Association, had filed an amicus brief last year supporting the constitutionality of the non-economic damages cap of MICRA. This appeal was the latest in ...

CMA works to address problems posed by CURES 2.0 launch on June 30

The Department of Justice (DOJ) recently announced that an update to the Controlled Substance Utilization Review and Evaluation System (CURES 2.0) database would go live June 30, but with browser requirements that could potentially cut off access for thousands of prescribers and dispensers. According to the DOJ, CURES 2.0 would require users to have Internet Explorer version 11, Firefox or Chrome Internet browsers installed on their systems in order to access the database. While it is possible for some users to simply update or switch to one of the supported ...

Physicians receiving notice from CHPI encouraged to verify data accuracy by July 31

On May 29, 2015, approximately 18,000 physicians in California were notified of a new quality rating program through the California Healthcare Performance Initiative System (CHPI). CHPI is managed by staff from the Pacific Business Group on Health (PBGH), but has its own board of directors. The letter states that 19 quality measures were constructed using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California and United Healthcare. This claims data includes both commercial and self-funded health plan data from HMO, PPO, POS and Medicare Advantage products. Along with ...

California State Auditor releases report outlining flaws with Medi-Cal program

The California State Auditor’s office released a report on Tuesday expressing a need for better monitoring of the health plans participating in California’s Medicaid program, Medi-Cal, in order to improve beneficiaries’ access to care. Among the key findings of the audit was that the California Department of Health Care Services (DHCS), which administers Medi-Cal, “has not consistently monitored health plans to ensure that they meet beneficiaries’ medical needs—it did not perform any annual medical audits before 2012 and performed medical audits on less than half of the health plans in ...

CMA Capitol Insight: June 23, 2015

CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Finding the fix: health care and transportation Democratic lawmakers and Governor Jerry Brown came to agreement on a $115.4 billion spending plan this week, which included billions more for schools, the California State University system and child care, while agreeing to expand Medi-Cal coverage to thousand of undocumented children. Despite some of the details of the landmark agreement, the budget may be more notable for what was not in the spending ...

Highlights from AMA's 2015 House of Delegates

The American Medical Association’s (AMA) House of Delegates tackled a diverse set of resolutions this year that are of interest to California physicians, including medical-only exemptions from school vaccination requirements, electronic health record (EHR) meaningful use, ICD-10 implementation, Medicaid rates and opioid abuse. Given the high level of interest in California’s Senate Bill 277 (Pan), which would eliminate the personal belief exemption for school vaccination requirements in California, AMA adopted a policy calling for immunization for all, and only allowing exemptions where medical reasons contraindicate vaccination. Several other vaccine-related resolutions were ...