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october 18, 2017



CAFP Opposes President's Call to Eliminate Birth Control Coverage Mandate

President Trump recently announced two new policies, which take effect immediately, to allow employers to claim a religious or moral objection to the Affordable Care Act's (ACA) birth control coverage mandate. The first policy lays out how an employer can claim an exemption for religious beliefs. The second provides an exemption for sincerely held moral convictions. CAFP strongly supported the ACA policy which required health plans to provide FDA-approved contraception at no cost. The AAFP joined its Group of 6 partners in sending a letter to President Trump expressing disapproval of these actions and the Administration's approach to women's health in general. AAFP also expressed concern with the Administration's introduction of a new standard, which they refer to as a "moral exemption." The American Civil Liberties Union and California Attorney General Xavier Becerra each filed lawsuits to block the new rules. CAFP and AAFP are evaluating opportunities for advocacy on this issue and will keep you apprised of our actions as we proceed.



CAFP's Quality Payment Program Physician Profiles

As physicians prepare for the required measurement and reporting for Medicare, CAFP wants to ensure small, solo or rural practice physicians have the necessary support to successfully transition and avoid negative payment adjustments. To this effort, CAFP introduced our Quality Payment Program Physician Profile series to give physicians a glimpse into their peers' experiences and a first-person perspective of challenges faced. Our first profile featured a small practice physician's concerns about the new requirements and helpful tools he employed to mitigate any negative consequences.


CAFP is excited to introduce our second profile of a family physician from Eureka who, amidst rapid changes in the health care landscape, made the decision to give up his small practice and work for his local hospital. His story highlights some of his major concerns and what ultimately led him to make this decision. If you would like to contribute your own story, please contact Sonia Kantak at or (415) 345-8667 to set up an interview.



CAFP Condemns Trump’s Move to End ACA Subsidies

In its latest attempt to undermine the Affordable Care Act (ACA), the Trump Administration announced its plan to cut off subsidy payments to insurers selling ACA coverage. The subsidies, which are worth an estimated $7 billion per year, are paid out in monthly installments to help insurers provide coverage to low-income individuals and families. The President for months has threatened to cut off the payments. Covered California added a 12.4 percent surcharge on Silver plans as a hedge against the possibility that subsidies would be eliminated. New York Attorney General Eric Schneiderman, who led a group of Democratic attorneys general to defend the subsidies in court this spring, said the group would sue to stop the Administration from acting. Some insurers are also likely to sue. AAFP and other national physician groups released a strong joint statement condemning the Administration’s action. CAFP agrees with AAFP’s condemnation and will keep you updated on this situation.



Complete the CAFP Demographic Survey

Have you completed our survey yet? It takes less than three minutes of your time and your input will be invaluable to us in planning future activities and programs. You will need your AAFP Member ID number to complete the survey. If you don’t remember it, contact staff for assistance. The survey will remain open until Friday, December 29, 2017.




Why Will YOU Renew Your Membership?

Your CAFP membership helps you grow your professional network and develop leadership skills that position you to be an advocate for your patients, your profession and yourself. Member Alex McDonald, MD says, “Through CAFP I have fostered personal and professional relationships that will last throughout my career. CAFP has given me the tools and resources to be the family doctor I wrote about in my medical school application.”


Have you renewed your membership for 2018? Renew now on the AAFP website. Thank you for your support.




Governor Signs Five CAFP High-Priority Bills

Last week, Governor Jerry Brown signed five CAFP-supported bills that address high-priority issues, including pharmaceutical pricing transparency, reducing physician administrative burden, improving Controlled Substance Utilization Review and Evaluation System (CURES) functionality and alleviating the strain of student loans.



  • SB 17 (Hernandez) will require pharmaceutical companies to notify the state and health insurers if they plan to increase the price of a drug (with wholesale cost of $40 or higher) more than 16 percent over two years and explain the reasons for the price increase. The new law will also require companies to report the introduction of high-priced drugs to market, explain their marketing plans and indicate if the drug is an improvement on the already available. Finally, it requires health plans to report on the drugs with the highest annual cost increases and document how much drug spending factors into premium rates.
  • AB 40 (Santiago) will allow Electronic Health Records to interact with the CURES database, creating easier access to patient prescription information for physicians.
  • AB 340 (Arambula) – This bill would require that screening services under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program include screening for trauma. The goal of this bill is to identify those children who suffered trauma early in life and start providing them with preventative services. Evidence suggests that trauma early on in a child's life directly correlates to the development of a number of illnesses later in life including depression, anxiety, heart disease and high risk of alcohol and substance abuse.
  • AB 1048 (Arambula) will allow a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescribing physician. It would also remove the requirement that pain be assessed at the same time as vital signs.
  • AB 461 (Muratsuchi) ensures that gross income does not include any loan amount canceled or repaid by the United States Secretary of Education. Several student loan forgiveness programs are offered by the US Department of Education, which cancel outstanding loan debt once a maximum repayment period has been reached. Students frequently have a partial financial hardship, meaning that the standard loan payment would exceed a certain portion of their discretionary income. These individuals usually do not possess the financial means to make full or regular payments on their loans and enroll in these programs to immediately get a lowered payment to help them stay afloat. AB 461 would ensure that individuals will not incur a state tax liability once their loans are forgiven under these federal programs.


Unfortunately, the Governor also signed the one CAFP-opposed bill that made it to his desk, AB 443 (Salas). This bill seeks to expand the scope of practice of optometrists. While CAFP succeeded in removing many of the primary care services optometrists inappropriately sought, the bill allows optometrists to administer immunizations for herpes zoster virus, pneumococcus and influenza.



CO*RE Partner Medscape Releases Updated REMS-Compliant Opioid Enduring Education

Opioid Prescribing: Safe Practice, Changing Lives summarizes the key steps to safe opioids use, meets the FDA’s Risk Evaluation and Mitigation Strategy (REMS) and addresses current CDC guidelines, immediate-release opioids and other pain relief tactics.


This activity provides 2.00 AMA PRA Category 1 Credit(s)™ and includes three sections:

  • Assessing Patients and Initiating Opioid Therapy
  • Managing and Monitoring Therapy
  • Take-Home Points and General Drug Information



The ASAM Fundamentals of Addiction Medicine – A Live Workshop

The ASAM Fundamentals of Addiction Medicine is a practical, case-based workshop designed for providers new to the field of addiction medicine, such as primary care physicians, clinicians and general psychiatrists, who see patients at risk for or with substance use disorders (SUDs). This workshop will also support providers in emergency care settings who often see patients with addiction. Attend this workshop on Wednesday, November 15, 2017 from 8 am to 5:30 pm at the Westin Bonadventure Hotel, Los Angeles. This live activity is acceptable for up to 8.00 Prescribed credit(s) by the AAFP and 8 AMA PRA Category 1 Credits™. Use promo code CAFPNOV15 and receive $100 off registration if you sign up by November 3.