- MOASC & ANCO, with their lobbyist, attended the CMA Specialty Coalition and Council on Legislation meetings last week.  The cancer care and coverage bills highlighted below on which the California Oncology PAC took positions on this year are:  

* RecommendSUPPORT:  AB 1860 (Limon, Cervantes):  Health Care Coverage:  Cancer Treatment:  This is the CalOncPAC co-sponsored bill related to extending the law that caps out of pocket costs to $200 for oral chemotherapy. CMA has a recommended SUPPORT position on the bill, and the CalOncPAC will be available to talk with anyone should this bill raise any concerns.

* Recommend SUPPORT:  AB 2342 (Burke):  BRCA mutations:  screening, counseling and testing:  This bill would require all health insurers, including the Medi-Cal program, to cover the cost of screening, genetic counseling, and testing for BRCA gene mutations in women who have not been diagnosed with BRCA-related cancer, but who may have an increased risk based on one or more of specified family history risk factors.

The CalOncPAC supported a bill last year on this subject, AB 1386 (Waldron), which was signed by the Governor.  That bill, however, during the course of the year, was forced to take amendments to water down its ultimate value.  That bill required the Medi-Cal program to include information of the BRCA in its materials for beneficiaries.  AB 2342 this year would go a great deal further to make sure patients received the services, as needed. 

*Recommend SUPPORT:  SB 945 (Atkins):  Breast and Cervical Cancer Treatment Program - This bill would remove the arbitrary month caps on cancer care for breast and cervical cancers in the Medi-Cal program. Currently, Medi-Cal patients can only receive care for cervical cancer for 24 months and 18 months for breast cancer. 

This bill is sponsored by the CalOncPAC AB 1860 Co-sponsors, Susan G. Komen, and is authored by the incoming Senate Pro tem- Elect Toni Atkins.

This issue was discussed several years ago; the CalOncPAC supported a similar bill that got watered down as it made its way through the process.  According to the sponsors, there are no other caps on cancer care like these included in the program for breast and cervical cancer. 

*Recommend Neutral:  SB 1034 (Mitchell):  Health Care Mammograms - This bill would remove the sunset date on the legislation that requires health plans to notify women if they have dense breast tissue.  This is a very controversial bill from several years ago, in which the CalOncPAC went neutral on once the language of the notice to women was included in the statute and deemed appropriate.  No problems have been reported now that the bill has been implemented for several years, though no benefit has been reported either.  It will be watched carefully at this point in the session.

 

- A sweeping package of legislation was introduced in the California Legislature last week that sets a clear and realistic path forward to achieve universal access and improve affordability to health care in California. Key components of the legislative package will help increase access to care and expand access to undocumented patients, including the expansion of Medi-Cal to income-eligible undocumented adults. While the proposed legislation represents a significant step forward, a truly successful universal access plan cannot be achieved without addressing the health care workforce shortage facing a majority of counties. As the recent University of California, San Francisco report commissioned by the California State Assembly recommended, any successful legislative proposal to achieve universal health care must ensure that California has a strong physician workforce.

 

- Despite existing California law that prohibits unfair health plan payment practices, many of them continue to flout the law.  The Department of Managed Health Care (DMHC) has been slow to address provider complaints and has taken few enforcement actions against health plans that unlawfully underpay providers. When DMHC has acted, the penalty amounts have been small in relation to the economic injury to consumers and providers. Because of this, some health care service plans make economic decisions to violate the law, knowing that any penalty amount that may be imposed will be outweighed by the extra revenue the health plans will generate by, for example, underpaying medical care.  The CMA is sponsoring AB 2674 (Aguiar-Curry) to increase penalties on DMHC regulated health plans that engage in unfair payment patterns. The bill would require DMHC to investigate provider complaints that a health plan has underpaid or failed to pay the provider as required by state law (under the Knox-Keene Act of 2000). If DMHC finds that a health plan has unlawfully underpaid a provider, AB 2674 would require a penalty amount at least equal the amount of the underpayment plus interest.

 

- The California Medical Association (CMA) is seeking applications and nominations for physicians interested in serving as delegates or alternates for their mode of practice forum delegations to the CMA House of Delegates.

CMA's mode of practice forums include the Solo and Small-Group Practice Forum, the Medium Group Practice Forum, the Large Group Practice Forum, the Very Large Group Practice Forum, the Academic Practice Forum, the Administrative Medicine Forum, the Government-Employed Physicians Forum and the Hospital-Based Physicians Forum. Membership in these forums is determined by each member's self-selected mode of practice.

Delegates and alternates will be responsible for representing their modes of practice and overall constituency, not just their own personal views on issues, by attending and actively participating in delegation caucus meetings and in annual House of Delegates.

Please submit nominations to nominations@cmanet.org. See theNominations Solicitation Memo for nomination forms and other requirements.

Nominations must be submitted via email no later than 11:59 p.m. PDT, on Monday, April 9, 2018. The CMA Committee of Nominations will meet in early May to review applications and create a slate of nominees. A ballot will be distributed no later than May 7, 2018, to all eligible members of a given mode of practice forum. Election results will be announced no later than June 15, 2018. Contact: Navdeep Dhaliwal, (916) 551-2073 or ndhaliwal@cmanet.org, for more information.