President’s Page: The Fight is On to Boost Medi-Cal Funding
By Albert L. Brooks, MD, ACCMA President
ACCMA, in partnership with the California Medical Association (CMA), other component medical societies, and a broad coalition of health care organizations, will be working hard this fall to ensure Proposition 35 is approved by voters in the November 5th election.
• When enacted, Prop 35 will generate between $6-9 billion annually to:
• Expand access to care by substantially increasing reimbursement rates for primary care and specialty care, bringing rates closer to Medicare levels
• Reduce wait times and alleviate overcrowding in emergency rooms and urgent care facilities
• Fund more GME residency programs to address the physician shortage
• Fund loan repayments for physicians and allied health professionals
• Help hire more first responders and paramedics to reduce emergency response times
Prop 35 is backed by both the California Democratic and Republican parties, and all major health care advocacy groups in the state, including CMA, Planned Parenthood, California Hospital Association, California Dental Association and the California Primary Care Association. Although there is no official registered opposition so far, Gov. Gavin Newsom has in recent weeks indicated he will oppose the measure so there are fewer restrictions on how legislators and the governor spend the money.
The basic premise of Prop 35 is simple: health care dollars should be spent on health care. Prop 35 will extend an existing tax on Managed Care Organizations (the “MCO tax”) that has been in place for nearly two decades to leverage billions in federal funds
for California. Prop 35 will prevent the state from redirecting these funds for non-health care purposes, capping administrative costs at 1% and ensuring the remaining 99% is spent directly on expanding access to health care. Prop 35 also restricts the legislature from increasing taxes on private health insurance plans, thereby protecting health care consumers from higher health care premiums.
Overcoming potential opposition from a popular governor will require hard work, and we need your help. Physicians are trusted messengers across regional and partisan lines and are important advocates to ensure California votes Yes on 35 to protect and expand access to health care. Here are some key actions you can take:
• Share Your Story: In your own words, tell why you support Prop 35.
• Post on Social Media: Share with your friends and family why you are voting #Yeson35.
• Order Campaign Swag: Request campaign materials for you to show your support.
• Email a Friend: Tell your friends and family why you support YES on 35!
• Download Materials: Get the latest campaign materials.
Scan the QR code below or visit voteyes35.com to take action and learn more about Prop 35.
NOV ELECTORAL CANDIDATES
Election day is on November 5th. ACCPAC and CalPAC are proud to support a number of candidates running for local and state office. These candidates have expressed support for ACCMA and CMA’s views regarding local health care issues. In addition to endorsing all incumbents, the endorsed candidates for open seats are below:
John Bauters, Alameda County Board of Supervisors District 5
Jesse Arreguín, Senate District 7
Jerry McNerney, Senate District 5
Tim Grayson, Senate District 9
Anamarie Avila Farias, Assembly District 15
ACCMA TO MEET WITH FEDERAL REPRESENTATIVES
During the month of August, ACCMA members will have the opportunity to meet with their Members of Congress. These important meetings are an opportunity to discuss the issues of highest priority to our physician members, including the need for Medicare payment reform to ensure an adequate number of physicians to provide timely care to seniors in our community, reducing Medicare administrative burdens that are negatively impacting patient care, ensuring that we are building a pipeline of young physicians by increasing the number of Graduate Medical Education residency training positions, and expanding access to care by permanently extending the expiring telehealth waivers. If you would like to attend one of these meetings, or are interested in learning more, please contact ACCMA Associate Director of Policy and Public Affairs, Brandon Azevedo, at bazevedo@accma.org.
CMA URGES CONGRESS TO PASS KEY MEDICARE PAYMENT REFORMS
CMA and AMA sent a letter urging Congress to reform aspects of the Medicare Access and CHIP Reauthorization Act and the Medicare Fee Schedule to provide fiscal stability for physician practices and improve access to care. The letter urges Congressional leadership to address Medicare Economic Index inflation, budget neutrality reform, Merit-Based Incentive Payment System reporting reform, and Alternative Payment Model reform by advancing five key bills including: H.R. 2474, the “Strengthening Medicare for Patients and Providers Act,” H.R. 6371, the “Provider Reimbursement Stability Act,” and S. 3503/H.R. 5013, the “Value in Health Care (VALUE) Act.”
ACCMA SIGNS ONTO TWO CLEAN AIR LETTERS
ACCMA has co-signed two letters related to clean air at the request of the American Lung Association. The first letter urges the U.S. Environmental Protection Agency (EPA) to authorize a
To find more information or to view full articles on any of these topics, scan the QR code, visit accma.org/Bulletin, or contact us at accma@accma.org or (510) 654-5383.
series of waivers that will enable California to implement clean air programs that are projected to deliver over $116 billion in health benefits and save over 11,600 lives over the course of the programs in California alone. The second letter calls on the EPA to authorize California’s proposed standards that will transition large truck fleets, which are a major source of harmful air pollutants along with toxic diesel particulate matter, to zero-emission vehicles.
INFORMATION-BLOCKING NOW IN EFFECT
HHS recently finalized a rule establishing financial disincentives for health care providers found to have committed “information blocking.” Effective July 31st, certain Medicare-enrolled providers may be subject to MIPS penalties if they violate federal information blocking regulations. Physicians have been subject to these regulations since 2021, however, there has been no enforcement mechanism until now. To prevent disincentives, physicians should reach out to their health IT developers and review and develop policies, procedures, and practices, regarding the use of EHI.
CMS EXTENDS IDR FILING DEADLINES DUE TO CHANGE CYBERATTACK
CMS will extend filing deadlines for out of network payment disputes under the federal No Surprises Act (NSA) as a response to the impact of the Change Healthcare Cyberattack. The first step in the NSA’s independent dispute resolution (IDR) process, will allow them to initiate the open negotiation at any point during the 120-day exception period, beginning June 14, 2024, and ending October 12, 2024. To invoke the exception, physicians will need to fill out an attestation form to indicate that their ability to initiate the dispute was impacted by the cyberattack and submit that form alongside the standard open negotiation initiation form.
ACCMA/CMA MEMBERSHIP RENEWALS
Membership renewal notices for 2025 will be mailed and emailed starting in September to your preferred addresses on file. Please pay by December 31st to capture the early bird discount. We appreciate and thank you for your continued membership and participation.
CMA BILL TO REDUCE MENTAL HEALTH STIGMA ADVANCES
CMA sponsored Assembly Bill 2164 has advanced out of the Senate Business, Professions, and Economic Development Committee and is headed to the Senate Appropriations Committee. The Medical Board of California recently adopted a support position on AB2164, which would help ensure physicians can access mental health care without fear of jeopardizing their careers. Currently the medical board licensure application for physicians and surgeons may inadvertently discourage physicians from seeking mental health services. AB2164, removes this barrier by eliminating the obligation for physicians to disclose personal medical information that does not impact their ability to practice medicine.
DHCS ISSUES GUIDANCE ON 2024 MEDI-CAL RATE INCREASES
In June, DHCS issued guidance to Med-Cal managed care plans on implementation of the 2024 Med-Cal Targeted Rate Increase (TRI) Fee Schedule and retroactive payments for claims with dates of service on or after January 1 that were paid but did not include the rate increase. Among the key provisions for physicians reimbursed on a capitated basis, plans must ensure the network provider is reimbursed a minimum of equal to or projected to be equal to the TRI fee schedule for applicable services. While the rate increases are focused on primary care, obstetric and non-specialty mental health services, any eligible provider billing eligible CPT codes will receive the TRI, without regard to the rendering provider’s specialty. This does not apply to services billed or rendered by assistant surgeons. Managed care plans and subcontractors must implement and make all retroactive payments to eligible network providers no later than December 31, except when payment would not otherwise be due by that date.
CMA BACKS PROPOSAL TO RE-CLASSIFY CANNABIS AS SCHEDULE III DRUG
CMA submitted comments to the DOJ and DEA in support of the DEA’s proposal to re-classify cannabis from a Schedule I to Schedule III drug under the Controlled Substances Act. This change would be a vital first step in increasing medical research, including through clinical trials, into the benefits and limitations of medical cannabis for the treatment of disease and illness.
ADVERTISING WITH ACCMA
Did you know that members can post classified ads online free of charge for two months? Take advantage of this benefit by contacting the ACCMA. Check out the current ads online now.
IN MEMORIAM:
We regret to inform you of the passing of the following ACCMA members: Drs. Robert L. Smith, Lionel W. Sorenson, Jr., and Fredric N. Herskowitz. We thank and honor them for their contributions to our community and the practice of medicine. You can find their obituaries on our website.
REGISTRATION OPEN: ACCMA AT CHABOT SPACE & SCIENCE
CENTER
This year’s ACCMA Annual Meeting will be unlike any other! Join us on Friday, November 15th for a “Galactic Gathering” at the Chabot Space and Science Center. The event will kick off with a welcome reception at 6 PM, followed by a short program in the Planetarium at 7 PM, after which guests will have access to the run of the museum: exhibits, planetarium showings, the famous Chabot telescopes, and more. Although the format and venue will be a big change from past annual meetings, the event will continue to serve as a fundraiser in support of the future of medicine. This year’s Annual Meeting is sure to be out of this world!
ACCMA UPCOMING EVENTS
PRESCRIPTION FOR SUCCESS –WHY PHYSICIANS NEED ATTORNEYS
Tuesday, August 27th | 12:15 PM
ACCMA PHYSICIAN MIXER
Wednesday, August 28th | 2:30 PM
COLOR ME MINE – THE ART OF HAVING FUN!
Sunday, September 1st | 11:00 AM
ACCMA MEMBERS’ APPRECIATION PICNIC AT QUARRY LAKES IN FREMONT
Saturday, September 7th | 11:00 AM
SSVMS JOY OF MEDICINE SUMMIT
Saturday, September 28th | 8:30 AM
SAVE THE DATE:
ACCMA PRIVATE HIKE & GOURMET PICNIC
Saturday, October 19th | 9:00 AM
REGISTRATION OPEN:
ACCMA 156TH ANNUAL MEETING
Friday, November 15th | 6:00 PM ALAMEDA-CONTRA
