Dr. Bangasser reported that he flew to Washington D.C. on January 8-9 with a delegation from CMA to continue their efforts to urge Congress to enact legislation to avert additional Medicare payment cuts. On January 23, 2003, the Senate passed House Joint Resolution 2, which fixed the impending 4.4% RBRVS cuts by concurring with the House-originated Concurrent Resolution to continue to fund the federal government in the ongoing absence of a budget agreement. HJR 2 now goes directly to the President's desk for what is presumed to be an easy signature. HJR 2 does not correct the 5.5% Medicare cut of last year, nor does it prevent future cuts, but it puts over $3,800 additional dollars per average physician per year back in the pockets of physicians by preventing the cuts scheduled to go into effect March 1, 2003. The Board agreed that the efforts of the AMA, CMA, and county medical societies deserve major recognition. SBCMS will send a letter to nonmember physicians describing these efforts to fix the Medicare error and how they saved $1 billion for physicians by preventing the March 1 cuts to proceed.

U.S. Senator Diane Feinstein announced publicly that she would introduce a MICRA bill in the Senate. President Bush has stated that he will support a national plan modeled after MICRA. Feinstein's measure would provide prompt payment to patients for their injuries and adequate funds to cover all future medical expenses, rehabilitation and lost wages, as well as limited damages for pain and suffering. While President Bush proposed that the national version also caps punitive damages, Sen. Feinstein's bill will not include a punitive damages cap. Dr. Bangasser said the bill has had great response from both Democrats and Republicans. Board members were provided a memo from CMA urging state and national specialty societies to support the efforts of Senator Feinstein to obtain national medical malpractice reform.

Dr. Bangasser also stated that the Governor's proposed Medi-Cal cuts would not be imposed during the first six months of the budget. This gives CMA time to work on a solution for the remainder of the year.

San Bernardino County Public Health Officer Thomas J. Prendergast, M.D. referenced a memo from Jack Lewin, CEO, CMA stating that Dr. Diana Bonta, California Director of Health has asked CMA to organize physician support and assistance for the upcoming smallpox Phase I vaccination process in California. She will not order a supply of smallpox vaccine for the State until mid-to-late February. There has been growing resistance by many hospitals and physicians, related to the risk of some serious vaccine-related morbidity, work-loss costs, and potential liability. CMA is calling for primary care, dermatology and infectious disease physician volunteers who would support the local county health department in assessing potential vaccine reactions. Patients might be seen at the doctor's office during off-hours, or at the public health department. Doctors Randolph and Bangasser will volunteer to coordinate with the Public Health Department. Board members were provided a memo from the San Bernardino County Public Health Department providing information to the smallpox coordinators and also information for physicians on what they should know about smallpox vaccinations.

IEHP Medical Director Bradley Gilbert, M.D. reported that total IEHP membership is 250,550. Medi-Cal enrollment is 223,989 with 26,561 enrolled in the Healthy Families program. Healthy Kids Enrollment is 1,743. The auto assignment percentage in September was approximately 30 percent.

Dr. Gilbert reported that San Bernardino County's Healthy Kids program will be in place in three to six months. It will differ somewhat from Riverside County's program in that it will include children who don't have access to any insurance, and the income level of acceptance into the program may be different. IEHP is having difficulty with the state budget cuts, and it is unclear how they will be able to arrange for reimbursement for physicians whose Medi-Cal patients won't have access to certain benefits they need that have been eliminated from the budget. With the reinstatement of quarterly eligibility for adults and revision of their eligibility program, IEHP estimates that 40,000 Californians will not be eligible for Medi-Cal - the Governor wants them to pay a big share of cost before they are covered. Dr. Bangasser stated that CMA will set up a blue ribbon health care committee consisting of physicians and health plans to work with the Governor's office because the blanket cuts will not work.

Dr. Randolph stated that most IPAs find it difficult to attract new primary care physicians under the current reimbursement. He questioned Dr. Gilbert's report that shows IEHP's IPA members are increasing rather than decreasing and said that local IPAs are not pleased with IEHP's policy of direct contracting. Dr. Gilbert said that IEHP only direct contracts with federally qualified health centers, patients involved in the Tower bankruptcy, and in areas where there is only one IPA.

Board members reviewed and approved the Nominating Committee's report for 2003/2004.

The Board expressed their appreciation to Sue Bradshaw, SBCMS Director of Communications, who will retire on March 31. She will continue to work with SBCMS as an independent contractor. One of her duties has been the Public Service Committee, which reviews complaints from patients of SBCMS members. The Executive Committee evaluated the need for this service, and Board members agreed to place the committee on inactive status and appoint the Chair as a consultant. Staff will refer patient complaints to other sources, such as the medical group/IPA, Better Business Bureau, insurance carrier, and the Medical Board of California.

The Board of Directors voted to nominate Dr. Ron Bangasser for the 2003 James C. MacLaggan Political Action Award. The CMA and CALPAC honors a physician or Alliance member who has demonstrated exemplary commitment and service in support of medicine's political agenda. In other action, Board members also approved the nominations of Drs. Peggy Fritzsche (Senate District 31) and Thelma Korpman (Senate District 32) for reappointment to the 2003-2004 CALPAC Board of Directors.

Dr. Randolph encouraged Board members to fill out and return to Ms. Stratton CMA's 2003 Professional Liability Insurance Survey and to nominate their colleagues for the 2003 Outstanding Physicians and Citizen Awards.

Dr. Randolph summarized the January 14 Town Hall Meeting at San Antonio Community Hospital. 55 physicians met with CMA Legal Counsel Ms. Catherine Hansen and Elizabeth McNeil and Joy Higa from the Department of Managed Health Care in regard to the Inland Global Medical Group closure. The CMA and SBCMS worked feverishly to find ways to make available to physicians the $800,000 in reserve monies that the health plans were holding which should be distributed to physicians for their unreimbursed claims. The physicians were very appreciative. Dr. Bangasser reported that CMA is working with Sen. Jackie Speir's office on legislation that would ensure that health plans take back the responsibility of reimbursing physician claims.

Board members were provided information concerning SBCMS' participation in CMRI's Partnership for Quality. Dr. Randolph reported he, Drs. Irving Spratt, Kenneth Lane, and Ron Bangasser, have volunteered to participate as team leaders or "Clinical Champions." Champions will work in close partnership with CMRI to promote quality improvement and encourage the adoption and use of performance improvement tools and practices. He encouraged additional volunteers.

Dr. Edward Hess will appear on KVCR-TV's "Ask Your Doctor." He encouraged Board members to volunteer for the program. Ms. Stratton will prepare a list of topics for the next Board meeting February 24.

Dr. Randolph announced that Dr. Peggy Fritzsche was installed as the 88th President of the Radiological Society of North America on December 5, 2002. An article will be included in the SBCMS section of the March Southern California Physician.