VALUE OF ADVOCACY

Passion and Purpose Make CMA the Most Effective Advocacy Organization

The California Medical Association (CMA) proudly advocates on behalf of its nearly 50,000 members for pragmatic and forward-looking policies that keep patients healthy and communities thriving. The 2021 legislative session has once again demonstrated CMA’s ability to develop and enact health policy that reflects the needs of physician practices, while the COVID-19 pandemic has reinforced why CMA must continue to champion sound, science-based policies, legislation and regulations. For 165 years, CMA has been honored to represent physicians to ensure the medical community is well-equipped to address any challenge that stands in the way of their ability to deliver timely, accessible and affordable health care to all Californians.

Reducing Costly Administrative Burdens

In this legislative session, CMA blocked attempts to add costly administrative burdens in physician practices, so physicians can dedicate more time to patient care. This included:

Defeating attempts to add over $2 billion in unfunded staffing

costs at a time when physician practices were already struggling financially due to the public health emergency

+ Saving physicians approximately $40 million over two years by defeating attempts to increase Medical Board of California licensing fees by nearly 50% + Ensuring physicians retain valuable patient care time by: ٙ Defeating legislation that would have required physicians to provide written and oral disclosure to every patient of all payments received by all drug and/or device manufacturers, as well as notifying patients of the existence of the Open Payments database where that information is housed ٙ Preventing new burdensome and duplicative reporting requirements that would have required physicians to submit weekly reports to the California Department of Public Health (CDPH) on any patient with a respiratory disease even though this information is already being submitted through the Confidential Morbidity Report + Saving physicians from costly new annual disclosure requirements by defeating legislation that would have required updated recordkeeping software and additional staff to ensure compliance + Defeating legislation that would have wasted time and money on unnecessary testing by creating new obligations for physicians in emergency departments

Helping Physicians Navigate the Pandemic

Throughout the public health emergency, CMA has advocated for programs and policies to support physician practices as they navigate the hardships of the COVID-19 pandemic. This included:

Distributing $100+ million worth of PPE at no cost to more than 8,000 physician practices across the state to ensure they can safely serve the patients of California

+ Successfully advocating for reduced administrative burdens related to licensure renewal and continuing medical education (CME) requirements during the pandemic + Advocating for policies to ensure practices could both implement and be reimbursed for telehealth so physicians could continue providing care safely to their patients

+ Advocating for and administering the CalVaxGrant program, which provided $40 million to health care providers to encourage participation in the COVID-19 vaccination program. Applicants enrolled to become vaccine providers, including physician practices with 200 or fewer physicians, were eligible for grants of up to $55,000.

Protecting the Financial Health of Physician Practices

Over the past year, CMA has made it a top priority to ensure the financial health of physician practices. We accomplished this by:

Making permanent $1.2 billion in tobacco tax funding

to increase Medi-Cal reimbursements for eligible services

+ Extending telehealth payment parity to require health insurers to cover services provided via telehealth—including audio-only services—in the same way they would an in-person encounter for all plan-provider contracts. This requirement applies to Medi-Cal managed care to ensure that Medi-Cal providers have the same economic benefit as commercial providers. + Defeating attempts to change the timeframe during which patients may consent to be charged for medical services, while allowing for consent to be given electronically + Securing physician reimbursement for adverse childhood experiences (ACEs) screenings from commercial plans, in addition to Medi-Cal + Providing more than $150 million in state tax relief for physician practices by bringing full conformity between California state tax code and federal law with regard to Paycheck

Protection Program (PPP) loans, making forgiven PPP loans state tax-deductible and delivering tax relief to businesses hit hardest by the pandemic + Restoring the full deductibility of state and local taxes for federal tax purposes for entities organized as LLCs, Partnerships and S-Corporations. The 2017 Federal Tax Cut and

Jobs Act had placed a cap of $10,000 on the amount of state and local taxes that an individual could deduct on their federal taxes. This policy negatively affected physician practices as their state and local taxes paid were often higher than this cap.

Increasing Health Care Coverage

Increasing access to quality health care for all Californians has remained a top priority for CMA.

This year we continued the fight by:

Preventing health plans from steering patients away from their own community doctors for telehealth visits, helping physicians maintain a stable patient load and provide better integrated care

+ Securing additional eligibility for Medi-Cal in several ways in the 2021-2022 state budget: ٙ Extending coverage to all children under 5, eliminating the risk of these patients sliding into and out of coverage while a physician is managing their care ٙ Expanding eligibility for full-scope coverage to individuals 50 and older, regardless of documentation status ٙ Restructuring the eligibility determination to focus on income rather than assets, thus widening the pool of Californians with access to health care coverage

+ Protecting patients from delays or treatment interruptions by creating a more transparent and standardized process in step therapy protocols ٙ Requiring prior authorization or step therapy exception requests to be deemed approved if a health plan or insurer fails to act within a specified timeframe Physician Workforce

CMA is committed to ensuring California is training and recruiting enough physicians to meet current and future demand. This year, we:

Increased state investment in physician recruitment incentives and programs, including $30 million for

physician loan repayment

+ Simplified the process of obtaining a California medical license for out-of-state physicians, while still maintaining current licensing and professional standards + Expanded the definition of CME-qualifying activities to include practice management content, as these topics assist physicians in carrying out their professional responsibilities more effectively and efficiently, and results in better services to patients