In a last minute reprieve for physicians with Medicare patients, the Senate approved the House-passed bill to reverse the 21 percent Medicare physician payment cut under the Sustained Growth Rate (SGR) that was to have gone into effect on March 1. Payments at the restored level are guaranteed until March 31.  An elimination of the 21 percent cut had been held up by Senator Jim Bunning (R-KY) under Senate rules that allow a single Senator to delay action.  In Senator Bunning's case, he sought to offset the bill's cost through cuts in other programs in an attempt not to contribute to the federal budget deficit.

According to AAFP, the Senate is working on a bill to extend these same benefits for several more months.  In the case of the SGR, payments would be extended to October 1, 2010.  This bill will likely pass the Senate by early next week and should be approved quickly in the House. 

AAFP cited physician calls protesting the payment cut as central to the urgency with which the SGR cuts were reversed. CAFP and AAFP encourage members to keep up the pressure on their Senators and Representatives by emailing, calling, and writing to emphasize the importance of dealing with the SGR planned cuts now.

The final touches are being added to CAFP's 2010 Congress of Delegates, including the recent addition of President of the Patient Centered Primary Care Collaborative Paul Grundy, MD, Global Director of Healthcare Transformation for IBM, who will be part of the Town Hall discussion on the Patient Centered Medical Home (PCMH) on Saturday, March 6. 

Also addressing the Congress, as well as swearing in CAFP's new officers, is AAFP President Lori Heim, MD. 

State Senate President Pro Tem Darrell Steinberg (D-Sacramento) will be the luncheon speaker on Sunday, March 7 after the conclusion of the Congress.

For information about attending the Congress, the training sessions on media and legislative participation, and the Legislative Day in Sacramento on Monday, March 8, please contact CAFP at 415-345-8667.

CAFP is surveying members about the Patient Centered Medical (PCMH). Our goal is to have comprehensive data on where CAFP members see themselves on the PCMH adoption continuum. In addition, we'd like to know what tools and resources we can provide that would be of greatest valuable to our members.  We know members have a range of views on the concept of the medical home, as well as many PCMH activities and functions (i.e., improving patient access and communication). Understanding these views will help shape the development of programs and resources. If you have not already taken this survey, we would appreciate if you would access it here: http://www.surveymonkey.com/s/PQZKBZH. The survey should take less than 15 minutes.

Please contact CAFP Director of Health Policy Sandra Newman, MPH with questions.

On May 11-12, AAFP will host its annual Family Medicine Congressional Conference in Washington, DC. Join your family physician colleagues in our nation's capital to learn the basics of federal advocacy. Then, put your training into practice by meeting with elected officials from your district!   CAFP puts together a delegation each year - we hope you can join us this time.  

Whether it's support for improved Medicare payment, encouraging progress on reform efforts or improving funding for family medicine education and training, it's important to make your voice heard!

Conference information is available on AAFP's Web site. You may also contact CAFP's Director of Health Policy, Sandra Newman, MPH, for more information.

CAFP continues to meet the clinical and practice needs of California family physicians. Both clinical and practice excellence will be highlighted at this year's Annual Scientific Assembly (May 15-16 in San Francisco's Grand Hyatt) in main stage lectures and workshops. Our sessions are on topics you have requested, by faculty members you like best. Register online TODAY!

• Keynote speaker on Saturday: Terry McGeeney, MD (pictured), CEO of TransforMED and leader in the practice redesign field, will be interviewed by Len Fromer, MD about how you and your practice team can evolve into the Patient Centered Medical Home. They'll talk about practical solutions based on what the 36 TransforMED pilot practices have learned.
• Controversies in Cancer Screening: At last year's meeting, attendees participated in a needs assessment session. They noted that screening and selecting the proper screening guidelines were important. With the recent changes in screening recommendations and the controversies they have raised, we've asked Carol Havens to shed light on the issues you'll face in your practice.
• Adult Pneumococcal Vaccines: Suggested guidelines say your diabetes patients need an annual pneumococcal vaccination. Do they always get one? Might be a systems problem. Are there other patient populations that should be receiving a vaccination? When? How often? With what interactions? Geoff Leung, MD and Jeff Luther, MD will provide practical practice recommendations.
• Listening to the Voices: Two patients with OAB will talk with faculty member Kate Galluzzi, DO about their symptoms, concerns, questions, and treatment options. These patients will offer practical solutions on how best to open these conversations in your own practice.
• Practical Strategies for the Clinical Management of GERD: This session will assist you in devising appropriate treatment plans that take into consideration action, efficacy and safety of acid suppression medications.
• The Physician as Patient: Lessons from the Other Side of the Stethoscope: Jeff Cain, MD, Colorado family physician and member of the AAFP Board, invites you to share his journey through a horrendous accident, life-saving ride in a flight-for-life helicopter, multiple surgeries in his own ICU, and, finally to recovery with a new-and-thriving life.
• Pediatrics: Three Cases of Common and Not-so-Common Issues in Kids: When was the last time you saw typhus? Katherine Schaerth, MD, a family physician at Loma Linda, has seen four cases of typhus in the last couple of months. Using the cases she sees in her practice, she'll discuss fevers of an unknown origin, plus MRSA and the newest evidence on UTIs in kids.
• Two Minutes/Two Slides/Two Questions: We've borrowed (not stolen) this interactive event from our colleagues in San Diego - and San Diego family physician David Bazzo, MD will referee. Six presenters will have two minutes to present two case slides; the audience will have two minutes to ask questions. Using our Audience Response System, the winning case and presenter will be crowned. Great fun, great learning.

The CAFP Foundation is planning its Fifth Annual Silent Auction for the 2010 Annual Scientific Assembly!  Proceeds will be used to support Family Medicine Interest Groups and medical students on our California campuses.  We are requesting donations from members, chapters, corporate partners - anyone willing to make a contribution! All types of auction items - from art pieces to travel packages, from wine to gift certificates - are greatly appreciated. We especially need small gifts and luxury items. The CAFP Foundation is a 501(c)(3) charitable organization and all donations are fully tax deductible.

To donate today, please download and fill out a contribution form and mail/fax it to us. Questions? Contact Mariah Brooks at 415-345-8667.

3/6-8: Congress of Delegates in Sacramento

3/17: Sonoma Excellence in Primary Care Lecture Series

5/15-16: CAFP's 62^nd Annual Scientific Assembly in San Francisco

6/25: San Diego Chapter's 2010 Postgraduate Symposium

For more information on upcoming events, click here

As President Obama continues to fight for health care reform, the number of uninsured continues to increase.

Initially designed to call media and elected officials' attention to the challenges the uninsured and their physicians face daily, CAFP's "A Day in the Life of the Uninsured" project launched the day Mr. Obama was sworn in as president.

The Web site, www.adayinthelifeoftheuninsured.org, displayed personal stories and photos (identified by first name only) of real patients in real family medicine practices. More than a year later, the Web site continues to receive a substantial number of hits per day. Please help us continue to show the faces of the uninsured. Go here to download the participation document, which includes a description of the project, instructions for participation, sample stories and a HIPAA release form.

Following last Friday's deadline for introduction of new bills, CAFP is reviewing more than 1,300 pieces of legislation. The Legislative Affairs Committee will examine bills affecting family physicians and their patients and will recommend positions and priorities to the CAFP Board. Two bills are already of high priority to the Academy, as they were carried over from last year:
 
AB 1542 (Assembly Health Committee): This CAFP-sponsored bill would add a functional definition of "patient-centered medical home" to California law.
AB 2093 (V. Manuel Perez): This bill is similar to a bill CAFP co-sponsored last year (AB 1201) that:

• Requires health insurers and plans that provide coverage for childhood and adolescent immunizations to pay a physician or physician group the actual cost of acquiring vaccines plus the cost of administration of the vaccines. This requirement would not apply to services provided in the Medi-Cal or Healthy Families Program due to budget constraints, except with respect to vaccines that are not part of the current contract between a plan and a physician or physician group.
• Prohibits an insurance policy providing coverage for childhood or adolescent immunizations from imposing a deductible, copayment, coinsurance, or other cost-sharing mechanism for the administration of a childhood or adolescent immunization.

Other Bills of Interest

SB 1050 (Yee): This bill would exclude naturopathic doctors from the membership of the Osteopathic Medical Board (OMB), thereby reducing the membership of the board to five osteopathic physicians and surgeons. This problem arose because of budget actions from last year that combined the OMB with the Naturopathic Board.
AB 1825 (De La Torre): Requires health insurance policies to provide coverage for maternity services.
AB 2470 (De La Torre): The goal of this bill is to further protect patients from unfair insurance company practices such as rescinding coverage for spurious reasons when a patient requires care. To do this, the bill requires the state to establish standard information and health history questions to be used by health care service plans and insurers for their individual health care coverage application forms. This bill would also require all plans and insurers to complete medical underwriting prior to issuing a health care service plan contract or insurance policy.
SB 1069 (Pavley): This bill would allow a Physician Assistant to:

• Sign and attest to any document evidencing any physical examination or similar task that might ordinarily be signed by his or her supervising physician.
• Order durable medical equipment, certify disability, and make arrangements with regard to home health services or personal care services.

Samantha Malm, MD testified last week at a Department of Managed Health Care (DMHC) hearing regarding "discount health plans." These plans often promise consumers discounts on physician visits and procedures that cannot be delivered. Patients arrive in physicians' offices hoping to receive treatment or believing that they are insured when they are not.

In 2001, the Attorney General reviewed the discount health plan business model and concluded that a corporation may not charge an annual subscription fee, including a reasonable profit, for furnishing a list of physicians willing to provide medical services at discounted rates to uninsured indigent persons. Dr. Malm explained to the DMHC that the very act of developing these regulations will legitimize such illegal activity. Further, while these regulations may inhibit unfair (and dangerous) business activity, their complexity may make full enforcement difficult or impossible. Partial adherence of the regulations by unscrupulous discount plans may create the appearance of legitimacy. In short, to regulate something that has already been determined to be illegal is inappropriate and dangerous.

CAFP is pleased to announce Karen Hopp, MD as our March Member of the Month. Dr. Hopp is board certified in both family medicine and psychiatry and practices both specialties in Woodland.  After graduating magna cum laude from the University of Minnesota with a BS in economics, Dr. Hopp developed a diverse business career that led her to health care and medicine.  Working in the business of health care inspired her to return to college after 15 years.  Dr. Hopp completed a five-year combined residency program in family medicine and psychiatry at UC Davis School of Medicine and earned academic honors and election to Alpha Omega Alpha.  For the last two years, she has attended the Congress of Delegates for the Yolo County Chapter and the CMA House of Delegates as an alternate delegate from the 11th District.

Click here to learn more about Dr. Hopp

The Ventura Chapter and the Alameda-Contra Costa Chapter hosted well-attended inaugural meetings in February.  Ventura family physicians, residents and colleagues enjoyed an intriguing Patient Centered Medical Home (PCMH) presentation by Len Fromer, MD of TransformMED, while Alameda Contra-Costa members heard all about advocacy efforts to encourage progress on health care reform and policy by CAFP Director of Government Relations Tom Riley and chapter leadership.

Click here for more details and see pictures from the events

CAFP is surveying members about the Patient Centered Medical (PCMH). Our goal is to have comprehensive data on where CAFP members see themselves on the PCMH adoption continuum. In addition, we'd like to know what tools and resources we can provide that would be of greatest valuable to our members.  We know members have a range of views on the concept of the medical home, as well as many PCMH activities and functions (i.e., improving patient access and communication). Understanding these views will help shape the development of programs and resources. The survey should take less than 15 minutes; access it here: http://www.surveymonkey.com/s/PQZKBZH

Please contact CAFP Director of Health Policy Sandra Newman, MPH with questions.