Advocating for Healthy Physician Practices

By Edmon Soliman, MD, FACP, ACCMA President

TheAlameda-Contra Costa Medical Association (ACCMA) in partnership with the California Medical Association (CMA) empowers and organizes physicians to lead and improve the practice of medicine in order to better patients’ lives and the community’s health. One of the main ways we do this is by engaging in effective advocacy to support healthy physician practices.

At its core, advocacy means fighting for the issues that impact our profession and our patients, and there is no shortage of important issues that CMA will be fighting for this year. In fact, CMA’s Council on Legislation recently met in Sacramento and reviewed nearly 200 current bills that CMA will focus on.

Three of our highest priority bills this year will address some of the administrative burdens which are driving physicians to close practices, pursue nonclinical pathways, or retire early. Addressing these administrative burdens is a critical strategy to retain and sustain our physician workforce:

• SB 598: Prior Authorization, authored by local Senator Nancy Skinner from Berkeley, will require health plans to create exemption programs that allow physicians who are practicing within the plan's utilization criteria 90% of the time to receive a one-year exemption from the plan's prior authorization requirements. Additionally, the legislation will give a treating physician the right to have an appeal of a prior authorization denial conducted by a physician peer of the same or similar specialty.

• AB 815: Streamlining Physician Credentialing will streamline the credentialing process by requiring the creation of a panel to approve independent entities to credential physicians for health plan contracts. If a physician chooses to be credentialed by an approved entity, a health plan would be required to accept the physician’s credential. This would allow physicians to complete one credentialing application with a designated entity that would be uniformly accepted by all plans.

• SB 582: EHR Vendor Regulation will require the state body regulating physician compliance with data exchange regulations to also regulate EHR vendors, including incorporating into state law the federal standards for the reasonableness of vendor fees. These changes will allow regulators to crackdown on exorbitant pricing schemes and guarantee that physicians are not hampered by vendor practices.

A pair of bills are aimed at protecting physicians who provide reproductive health services and gender-affirming care. AB 571 will ensure that licensed medical providers have access to professional liability insurance coverage without discrimination for providing abortion care, contraception, and gender affirming care. SB 487 will protect California health care providers from automatic suspension from the Medi-Cal program if they are suspended from a Medicaid program in another state as a result of providing health care services that are legal in California. It will also prohibit health insurers from discriminating against or refusing to contract with a health care provider who may have been sanctioned in another state for providing health care services that are prohibited or restricted in that state but are legal in California. Furthermore, SB 487 strengthens civil protections and provides additional safeguards for California abortion providers and other entities and individuals that serve and support abortion patients that reside in states with hostile abortion laws.

AB 765 is another important bill which will ensure health care consumers receive more accurate and clearer information about the education and training of their providers by preventing non-physician health care providers from using terms like “-ologist", "surgeon", “medical doctor”, or other similar combination of “physician-equivalent” titles. Cited as the California Patient Protection, Safety, Disclosure, and Transparency Act, it would restrict the adoption of the above terms and titles, reserving them only for those authorized and licensed to practice medicine as a physician or surgeon.

My physician colleagues, your membership supports our ability to fight for you and your patients on these important issues. Members can also get more directly involved in our advocacy efforts by occasionally calling or emailing your legislators, attending local ACCMA meetings with legislators, or by attending CMA Legislative Day on April 19th. During this annual event, dozens of ACCMA members caravan to Sacramento to meet with our East Bay representatives in the California Legislature. This is a great continued on page 9