With 11 trips to Washington under his belt, Dr. Ron Bangasser was pleased to announce the signing of the Omnibus Appropriations bill (H.J. 2), authorizing the Department of Health and Human Services to correct the 1998 and 1999 Medicare physician payment projection errors. This averted a 4.4% cut in Medicare physician payments that was scheduled to go into effect on March 1, 2003. As a result of this legislation, physicians will instead receive a 1.6% increase in 2003 spending, and baseline spending is now projected to increase $54 billion over the next 10 years. Dr. Bangasser also applauded the monumental efforts of CMA and AMA in passing the bill. The 1.6% increase will begin March 1, 2003.

A great deal of concern and consternation was expressed by some of the members regarding the anticipated Burton bill, a pay-or play bill for universal access of health coverage, that has yet to be introduced in the state legislature. CMA will be discussing this bill at the 2003 House of Delegates meeting, because the general feeling is that there should be some type of universal health coverage. Whether it be a single payer type or employer-based form has yet to be seen. However, there is division over the single payor strategy; some feel this is not an option and support an employer-mandated approach. Dr. Bangasser stated that everyone should have input regarding this matter.

Dr. Bangasser met with representatives from Senator Diane Feinstein's office in late January. They discussed Senator Feinstein's "pure" MICRA bill that would copy California's MICRA law, with a $250,000 cap on non-economic damages. Senators Feinstein and Frisk have been working together on this bill. CMA staff will assist the senators in writing the bill, which will hopefully be supported by the bipartisan Senate committee.

Dr. Bangasser will be installed President of the CMA on March 24, 2003 at the House of Delegates. The CMA President's Reception will be held that evening. The reception will be supported with funds donated by CMA, Beaver Medical Group, Redlands Community Hospital, Keenan and Associates, (NORCAL's broker), RCMA and SBCMS.

San Bernardino County Public Health Officer Thomas J. Prendergast, M.D. reported that the Health Department has received the smallpox vaccine. The Health Department tentatively plans to begin voluntary vaccination of public health staff starting the week of March 10, and hospital staff beginning the week of March 17. Dr. Prendergast also reported that they are now receiving over 100 cases a week of respiratory interstitial virus and four flu virus cases have been isolated in the county. The Public Health Department will host a live satellite broadcast of "Vaccines Against Biological Warfare Agents" in March for those military and civilian medical providers who would assist in recognizing/managing casualties from a biological agent attack. Dr. Frank Randolph circulated the minutes from the newly formed Health Department Bioterrorism Advisory Committee and said that he will attend their next scheduled meeting on March 5th.

The Board of Directors agreed to support the Public Health Department in their efforts to secure a community resource person for their Inland Empire initiative that would address the high incidence of coronary heart disease (CHD) in San Bernardino and Riverside counties. This initiative would establish a dialog with physicians to emphasize the importance of discharge protocols for CHD patients, and to increase referrals to community-based programs that support patient and family behavioral changes. It would also enable the Public Health Prevention Service to use science-based evidence to determine why San Bernardino County has the worst CHD rate in the state, and to develop an integrated prevention program including policy recommendations to combat the problem.

Dr. Ruchir Sehra reviewed the financial reports for the first two quarters of 2002/2003. Total revenue for the six-month period ending December 31, 2002 is $399,237.26 and total expenses are $254,359.81. Revenue is high because SBCMS receives the majority of their dues revenue between July and December. He reported that he anticipates SBCMS will end the fiscal year $12,000 to $15,000 in the black.

Dr. Frank Randolph informed the board that the $50 for MICRA Defense Pilot Program appears to be an overwhelming success. The purpose of this effort was to increase physician participation in organized medicine's political activities and increase CALPAC contributions. Each of the participating counties (Fresno, Orange, Riverside, San Bernardino, and San Diego) increased both contributions and physician participation dramatically.

Dr. Bangasser also reported that there would be no challenges to MICRA in the court this year. Board members agreed to send a letter to the CMA expressing their concerns about the high cost of premiums certain high-risk specialists, especially neurosurgeons, are paying for malpractice coverage. Dr. Bangasser said that CMA is already seeking opportunities to ease the distress of these specialists. California ranks the fifth highest in jury outcomes in the nation.

Dr. Randolph reviewed the 2003 Legislative Hot List that was provided by CMA. These CMA-sponsored bills will be discussed at this year's House of Delegates and can be viewed on CMA's website www.cmanet.org.

Dr. Randolph stated that the deadline to be in compliance with HIPAA standards is just around the corner (April 13th). The Medical Society and Inland Empire Health Plan (IEHP) will be putting on separate HIPAA seminars in March and will publicize both events in the fax newsletter. Dr. Randolph encouraged Board members to invite their colleagues to attend one of the seminars.

Dr. Randolph reported IEHP would drop costly, time-consuming, and redundant audits of medical groups or IPAs that agree to meet the high quality standards for accreditation by the National Committee for Quality Assurance (NCQA). IEHP feel the savings could be better spent on programs to benefit members and more patient care. It was noted that CMA's Institute for Medical Quality has accreditation and certification programs. Board members agreed to ask IEHP to encourage medical groups and IPAs to get either NCQA or IMQ accreditation.

Dr. Randolph congratulated Doctor Damodara Rajasekhar, a board certified Pediatrician in the High Desert, on his nomination for the position of Vice Chair of the California Medical Association OMSS (Organized Medical Staff Section). He also encouraged all board members to send in their nominations for the Annual Outstanding Awards by April 11th. He stated this was good way to honor colleagues and lay people from the community.

Dr. Randolph applauded the Historical Committee on another successfully "Open House" for the medical museum. There were about 200 people in attendance on Sunday, February 2nd for this year's "Lewis & Clark" lecture. He also congratulated Doctor Samuel Wilson on assuming the role of director for the African American Health Initiative (AAHI).

Ms. Stratton provided a list of dates and topics and encouraged board members to volunteers to appear on "Doctors On Call," a live half hour program on KVCR Channel 24. Board members approved the Executive Committee's recommendation to send a letter recognizing the program manager's accomplishments in bringing this television program to the public.

Dr. Randolph reported that active members of the Medical Society would be receiving their complimentary issue of the 2003 SBCMS Pictorial directory in March. Any member wishing to purchase additional directories can obtain copies at a discounted price from the Medical Society office.

Medical Society board members will again put on their white coats to march and rally at the State Capitol. This year's legislative leadership day is on April 30th.