Hope Springs Eternal

The legislative season is in full effect. On April 19th, California Medical Association (CMA) and local medical societies stormed Sacramento with the intention of lending our voice to our state legislators. On the “hit-list” for our discussions were the commonsense reforms to the prior authorization process and the ridiculous cuts in Medi-Cal looming on the horizon. We are hoping for a successful 49th CMA Annual Legislative Advocacy Day. Hope springs eternal. I doubt Alexander Pope was referring to politicians listening to their constituents and stakeholders when he wrote An Essay on Man in 1730. Despite my cynicism I am confident that we succeeded in getting our point across to them.

ABOUT THE AUTHOR

Cyrus Fram Buhari, DO is the current president of the San Joaquin Medical Society and practices at the San Joaquin Cardiology Medical Group

California Senate Bill 598 seeks to overhaul the use of prior authorization given to plans in the Knox-Keene Health Care Service Plan Act of 1975. Yes, I said “1975.” In 2023 health plans seem to be using the prior authorization process in near punitive fashion to cut costs. The process is cumbersome and adds an extra layer of bureaucracy to the practice of medicine. I am not arguing that prior authorization has a role in identifying unnecessary tests and more cost-effective therapeutics. But these days the prior authorization process has been used to deny testing, more expensive but effective medications, and what is deemed appropriate care for patients by their physicians. It has morphed into a beast in and of itself whose purpose is to breathe a burden on physicians to cut cost. When last I checked, health plans in California tend to be profitable. Yet some of our stateof-the-art drugs in multiple subspecialties are routinely denied despite a very strong contemporary evidence base. SB598 is a big step in the right direction.

Additionally, we are fighting hard against cuts to the Medi-Cal program. As it is right now, practices that accept Medi-Cal are struggling. Both primary care and specialty practices alike accept very poor reimbursement as it is for taking care of these patients who often have multiple active comorbidities. We all treat and respect these patients as much as any in our respective practices. Yet while one side of the mouth says we need access for these patients to be expanded, the other says we are cutting your reimbursement. How then can anyone complain when practices stop taking patients? We will continue to fight for not only stopping cuts in reimbursement from these Federal and State agencies but for increases to get the reimbursement to an appropriate level in the year 2023. These patients need our care and these types of “not-so-brilliant” ideas of cost savings do not help the number one goal of the program, which is to expand care to the underserved of our state and our community.

The prior authorization process needs reform and your San Joaquin Medical Society (SJMS) and CMA are on the front lines lobbying on behalf of our members. I purposely kept this quarter’s article short so as not to bore everyone. Please support your local Medical Society and CMA and stand with us in protecting the sanctity of the doctorpatient relationship, reducing the burdens on physicians to deliver care, and to increase physician reimbursements to levels that will encourage expansion of access to and delivery of the highest quality healthcare we can offer.

Physicians gather in Sacramento as champions for patients and the practice of medicine!

Hundreds of physicians, residents and medical students gathered in Sacramento on Wednesday, April 19, 2023, for the 49th annual California Medical Association (CMA) Legislative Advocacy Day.

This year’s event was by all accounts a wildly successful endeavor. CMA welcomed nearly 400 attendees, representing 45+ specialties and 24 component medical societies. Attendees participated in a total of 120 legislator meetings as champions for patients and the practice of medicine.

“I think it is so important to advocate for our patients,” said Quinn Lippman, M.D., an ob-gyn who attended advocacy day with her peers from the San Diego County Medical Society. “There’s the one-on-one care we give in our offices every day, but [it's important that we] take a step back and look at the broader picture of who has access to health care, how that care is being delivered, what medications patients have access to.”

Attendees received updates from CMA President Donaldo Hernandez, M.D., and CMA’s chief lobbyist Stuart Thompson about key health care issues before the legislature this year. Attendees then lobbied their legislators in support of CMA's priority issues, including:

+ SB 598: Prior Authorization Reform, which would significantly reduce the administrative burden physicians must bear because of prior authorization.

+ AB 765: Truth in Advertising, which protects patients AND physicians against allied health professionals who use terminology to misrepresent themselves as physicians.

+ Medi-Cal: While we have made sure that all Californians have health care coverage, it is meaningless if they can’t see a provider or get regular, timely care outside of the emergency room. Access to care is the last leg of the stool that holds this safetynet program up and is the key to unlocking quality health care for all and reducing disparities.

Legislative Advocacy Day attendees also enjoyed an engaging panel discussion from our keynote luncheon speakers, physician Assemblymembers Joaquin Arambula, M.D.; Jasmeet Bains, M.D.; and Akilah Weber, M.D.

And the Golden Gavel Goes to….

The CMA Political Action Committee (CALPAC) concluded its three-week Golden Gavel contest in conjunction with Legislative Advocacy Day, with a fundraising total of just over $13,800. The $13,800 raised represents a historic record for fundraising at Legislative Advocacy Day.

CALPAC Chair Damodara Rajasekhar, M.D., is excited to congratulate the physicians of the San Bernardino County Medical Society as winners of the Golden Gavel – with the highest fundraising total of any medical society.

The Golden Gavel contest challenged physicians from each county medical society to make a new donation or upgrade their current level of giving to CALPAC. At the end of the three-week contest period, the medical society that had the highest level of giving won the Golden Gavel. The contest has now taken place three times, with a different CMA component medical society winning each year.

Donations to CALPAC are crucial for supporting the campaigns of political candidates who share CMA’s health care policy vision. The importance of CALPAC’s work, the core of which is electing legislators and maintaining positive relationships thereafter, was on full display at CMA’s Legislative Advocacy Day.

CALPAC is excited to build on this success and physicians are encouraged to give to CALPAC in support of CMA’s advocacy efforts by visiting calpac.org/donate

See You Next Year!

We are grateful for the time everyone took out of their busy schedules to speak with legislators on the issues impacting the delivery of health care in California. Next year will mark CMA's 50th Legislative Advocacy Day. We hope to see you in Sacramento on April 10, 2024!