2022 YEAR IN REVIEW

By Paul Hegyi, MBA

IN

A Moment When So Much Feels Like It

is changing, there is one constant: Physicians want to help people. In 2022, you and our other members have found every possible way you can do so. For that, I thank you.

First, I’d like to acknowledge the role San Diego’s physicians played locally. In the recent impact report, Champions for Health found that donations and volunteers enabled them to provide more than 30,000 COVID vaccine doses, many in the most under-resourced areas in San Diego. More than 80% of vaccine sites were in health-equity-priority zones — double the state recommendation. Your membership and donation helped get vaccines into the hands of those who need it most.

Your membership also played a big role in public health education, disseminating much needed information throughout San Diego. Due to the membership of people like you, there were more than 150 Speaker’s Bureau presentations educating more than 3,000 San Diegans, with public health events continuing in 2023.

I think 2022 will be remembered as the year of transition to a new normal, following the heights of the COVID pandemic. Events and meetings returned as in-person affairs, in some but not all cases, as the convenience of virtual gathering continues to be preferred by many. We shared that hybrid practice, with some committees meeting in person when there was value for that and others continuing virtually. Throughout, all of our standing committees met regularly.

Our largest in-person activity was the decision to hold our gala for the first time since 2019. A massive success, this was the highest turnout gala we’ve had in over a decade. Participants highlighted how much they valued interacting in person again after such a long time away. Supervisor Nathan Fletcher and Assemblywoman Dr. Akilah Weber, MD, each gave keynote addresses. Thankfully, we avoided becoming a super-spreader event as many others around that time sadly were.

Advocacy continued to be at the forefront of society activity, highlighted by efforts to protect the Medical Injury Compensation Reform Act (MICRA). At the end of April, CMA and Californians Allied for Patient Protection seized an opportunity to end one of the longest running political battles in California. The legislative deal (AB 35), which modernizes MICRA while preserving its underlying principles, has ushered in a new and sustained era of stability around malpractice liability. Your engagement and feedback created a long-term solution that gives you the protection you need to best care for patients.

Throughout the MICRA efforts and after, SDCMS continued to work with state and national organizations to ensure the relationship between physician and patient remains sacred and that all of our patients have equitable access to the right care at the right time. Our delegation to CMA’s Annual Legislative Day was the largest in my seven years with the society (including numerous students and residents). We actively engaged with candidates in three open legislative contests, endorsing Steve Padilla, David Alvarez, and Catherine Blakespear, all who went on to win in November.

CMA member Dr. Jasmeet Bains, MD, joined the Cali- fornia Assembly as its third physician legislator, while incumbent assemblymembers Dr. Joaquin Arambula, MD, and our own Dr. Weber were reelected. At the federal level, representatives Dr. Ami Bera, MD, and Dr. Raul Ruiz, MD, were reelected to Congress. CMA also saw its ballot measure positions reflected in election results, including the rejection of Prop. 29 (dialysis clinic requirements) and passage of Prop. 31 (ban on flavored tobacco).

We achieved significant victories on health information technology issues by extending the COVID telehealth waivers into 2023; permanently extending key Medi-Cal telehealth payment parity; eliminating e-prescribing burdens (AB 852); and helping physicians comply with the new federal information blocking rule while protecting patients’ sensitive medical information (SB 1419).

After literally thousands of physicians spoke up, Governor Newsom vetoed the dangerous AB 2236, which would have allowed optometrists to perform eye surgeries that require use of a scalpel or an injection and “anterior segment lasers” if they met minimal specified education and training conditions that are far inferior to the requirements that ophthalmologists must meet. Members highlighted that all Californians deserve to have well-trained physicians to provide high-quality care, and they expect the State of California to ensure strict safety standards to protect patients.

All this is to say that in more than 150 years as a medical society, I don’t know that we have ever been as needed as we are now. Among all the challenges, we’ll keep doing what we do best — helping people. We’re continuing to host public health education events for both the public and physicians. And with the return of our Physician Socials and the creation of our Physician Wellness Committee, we’re doing everything we can to give physicians the space, opportunity, and resources they need to heal, learn, and grow.

SDCMS physicians continued to earn and serve in leadership positions throughout medicine. Our current president, Dr. Toluwalase Ajayi, was elected to the AMA board of trustees — the first San Diegan to serve in that role. Dr. Robert Wailes completed his term as president of CMA this October, where our Dr. Sergio Flores currently serves as vice chair of the board of trustees. Dr. Holly Yang was appointed to chair CMA’s Governance Reform Technical Advisory Committee, charged with identifying and developing proposals to improve various attributes of CMA’s governance structure. She also serves as the president-elect of the American Academy of Hospice and Palliative Medicine. Dr. Karl Steinberg is the immediate past president of AMDA: The Society for PostAcute and Long-Term Care Medicine.

After 22 years, Thomas Henderson retired as executive director of the Imperial County Medical Society (ICMS) effective Aug. 31. SDCMS and ICMS have long had a close relationship, including being paired as a delegation to CMA, which we have now expanded into a management services agreement. The SDCMS team has 40 years of collective experience working in organized medicine. Together with the ICMS board of directors we are committed to providing the highest quality services to our physician members for their professional needs as we work as an advocate for improving the doctor-patient relationships in the healthcare community. There are many unique challenges physicians and their patients face in a rural setting and we’re committed to ensuring that every patient receives the highest quality of care.

Looking to 2023, CMA will be leading an effort to infuse an additional $6 billion annually into the Medi-Cal system. Proposition 56 from 2016 successfully added more than $1 billion to the Medi-Cal system, providing increased payments for a total of 23 CPT codes, through both the feefor-service and managed care delivery systems. Yet overall Medi-Cal rates remain woefully behind Medicare and the actual cost of providing care, resulting in access challenges for patients who are in the most need. This new source of funding will stabilize the Medi-Cal system, opening access and ensuring that your practice is able to see these patients. Look for more on this initiative during the first part of 2023.

I believe passionately in organized medicine and am proud of the success we’ve had in recent years. That success has only been made possible because of you and the many other members that have joined together to protect both physicians and patients in California. Thank you for your membership and I look forward to seeing you at one of our member events over the next year.

In a year where the world was starting to return to “normal,” the California Medical Association (CMA) seized the opportunity to make big gains for physician practices in several areas, from modernizing crucial malpractice legislation, preserving reproductive rights and encouraging grassroots engagement. This year’s achievements include:

MICRA Modernization

Facing another statewide ballot proposition that would have effectively eliminated MICRA’s cap on non-economic damages, CMA and Californians Allied for Patient Protection seized an opportunity to end one of the longest running political battles in California. The legislative deal (AB 35), which modernizes MICRA while preserving its underlying principles, has ushered in a new and sustained era of stability around malpractice liability.

Reproductive Rights

After the Supreme Court’s Dobbs decision, CMA worked with the Future of Abortion Council to protect and expand access to reproductive health care in California, leading to 15 bills signed into law, $200 million in the state budget and the passage of Prop. 1 to enshrine abortion rights into California’s constitution.

Election Victories

CMA member Jasmeet Bains, M.D., joined the California Assembly as its third physician legislator, while incumbent assemblymembers Joaquin Arambula, M.D., and Akilah Weber, M.D., were re-elected. At the federal level, representatives Ami Bera, M.D., and Raul Ruiz, M.D., were re-elected to Congress. CMA also saw its ballot measure positions reflected in election results, including the rejection of Prop. 29 (dialysis clinic requirements) and passage of Prop. 31 (ban on flavored tobacco).

Federal Loan Forgiveness

The U.S. Department of Education overhauled the Public Service Loan Forgiveness Program, including the specific fix that CMA advocated for that will allow all eligible California physicians to receive loan forgiveness.

Billing and Burdens

CMA recouped more than $1 million this year (nearly $40 million over 14 years) on behalf of physician members through direct payor interventions. CMA also stopped Cigna’s burdensome modifier 25 policy.

Health IT

CMA achieved significant victories on health information technology issues by extending the COVID telehealth waivers into 2023; permanently extending key Medi-Cal telehealth payment parity; eliminating e-prescribing burdens (AB 852); and helping physicians comply with the new federal information blocking rule while protecting patients’ sensitive medical information (SB 1419).