Posted on 08.23.10 by Executive Vice President Susan Hogeland, CAE

Last Hurrah for AB 1542?

In the absence of a hail Mary-type pass, CAFP faces the very real possibility that AB1542, legislation to define the Patient Centered Medical Home (PCMH), will not pass.  CAFP legislative advocate Tom Riley and his staff have spent hundreds of hours on this legislation, with the assistance of physicians such as past presidents Carla Kakutani and Eric Ramos, both of whom have testified on behalf of the bill. 

Why has CAFP put so much effort into a definition bill?  It's a starting point - California is light years behind many other states in its progress on PCMH implementation.  A bill to define PCMH is a good starting point for our efforts to transform practices in our state.  Whatever the outcome of AB 1542, it won't be CAFP's last effort on PCMH.

CAFP-Supported Osteopathic Physician Bill Signed

Late Tuesday night, and with less than two hours remaining before his midnight deadline to take action, Governor Schwarzenegger signed into law CAFP-supported (sponsored by the Osteopathic Physicians and Surgeons of California) SB 1050 (Yee - D-San Francisco).  This important legislation will "re-separate" the functions of two very different oversight boards within the Department of Consumer Affairs; the Naturopathic Medicine Committee (NMC) and the Osteopathic Medical Board of California (OMBC). The bill will also remove the two naturopathic doctor positions from the Osteopathic OMBC. Naturopathic doctors, whose own board was slated for sunset, were added to the OMBC in the final minutes of last year's budget compromise, to the surprise of many. For more information, see AB X4 20 (2009-10 Budget trailer language) and SB 1050 (Yee).

 CAFP Immunization Bill Still Awaits Floor Hearing

The end of the two-year legislative session is Friday, August 27 and while CAFP's co-sponsored AB 2093 (M. Perez, D - Cathedral City is scheduled for a vote by the full State Senate, it's in a long queue of bills waiting to be heard. Our legislative staff needs your help - if you haven't yet contacted your senator to ask for support of the bill, please do so as soon as possible.   To identify your state senator, please go here:  http://www.leginfo.ca.gov/yourleg.html

CAFP Comments on 1099 Requirement

In an understandable effort to crack down on individuals and companies that fail to pay federal income taxes on some or all of their revenues and to help offset the expense of expanded health care coverage, provisions were contained in the Patient Protection and Affordable Care Act (PPACA)(HR 3590/PL 111-148) that amended current tax laws by expanding the reporting requirement to include the purchase of goods, as well as services, and to include purchases from corporations as well as from individuals.  The threshold for the requirement remained at $600; the effective date is January 1, 2012.  According to AAFP, the Congressional Budget Office has estimated that this provision of the Affordable Care Act will produce between $16 billion and $19 billion in additional revenue for the federal government over ten years.

The unforeseen consequence of the provision, however, is the additional burden it will create for small organizations and businesses - including medical practices - that must now file 1099 forms for all vendors with whom they do more than $600 worth of business.  At CAFP, that additional work is estimated to cost about $2,000 in accounting fees. 

There are competing bills in the U.S. Senate to amend PPACA - one that would repeal the provision and lower the threshold for the cost of insurance premiums to five percent from eight, creating an estimated two million more uninsured (Johanns R-NE), and another that would exempt businesses with 25 or fewer employees from the reporting requirement and raise the reporting threshold from $600 to $5,000 for businesses with more than 25 employees (Nelson D-FL).  The IRS also would be given authority to exempt payment for items with minimal compliance risk (e.g., office supplies, airline tickets and restaurant meals).

Senator Nelson's amendment would pay for the difference by repealing tax cuts for the five largest oil companies with more than $1 billion of before-tax income that currently allow them to deduct six percent of their income from oil and gas production from their tax liability.   

CAFP has provided input to AAFP on the amendments that urges no weakening of the provisions of PPACA, but seeks relief from the burden of the 1099 reporting requirement for members.

PCMH Discussions for Fresno Continue

CAFP remains closely engaged with representatives of the Joint Health Management Board for the Fresno Unified School District on the possibility of a PCMH pilot project in Fresno.  We are in weekly conference calls and recently communicated with the twenty-five family physicians who responded positively to a CAFP survey on interest in participating in a PCMH pilot project there.  Stay tuned!

Physicians' Foundation for Health Systems Excellence Awards Two Grants to CAFP

CAFP received word that The Physicians' Foundation for Health Systems Excellence has awarded two new grants to us:  one to help with a health information technology toolkit on meaningful use requirements for electronic health records and another to do leadership training for continuing professional development faculty.  Congratulations to CAFP staffers Leah Newkirk and Shelly Rodrigues for their hard work on these successful grants!  (Oh, right, NOW the real hard work begins.)

Congratulations to New Employees       

Three new CAFP employees completed their introductory periods recently:  receptionist Cecile Awayan, Director of Health Policy Leah Newkirk and Associate Director of Health Care Workforce Policy Callie Langton.  Marian Yee will begin working with the Academy on September 1 as the Director of Continuing Professional Development.