Executive Director's Note: This board meeting was held just days before significant news was released about physician reimbursement. In early February, California Medical Association and San Bernardino County Medical Society efforts resulted in reversing physician Medicare cuts in Washington, D.C., and Medi-Cal cuts in Sacramento.

Gov. Arnold Schwarzenegger signed a CMA-sponsored bill (SB 912) that eliminated the 5 percent Medi-Cal rate cut that took effect Jan. 1. This emergency legislation stopped the cut and protects access to care for 3 million poor, elderly and disabled Medi-Cal beneficiaries.

President George Bush signed the federal budget package, reversing the 4.4 percent cut to Medicare physician payments that took effect Jan. 1. Physicians will be compensated retroactively for the 4.4 percent cut and will not have to resubmit claims.

At the board meeting, CMA Trustee Dev GnanaDev, MD, discussed the 5 percent Medi-Cal provider payment cut that took effect Jan. 1, as part of Gov. Schwarzenegger's budget. On the positive side, he said, the budget includes $34.2 million to promote and maximize enrollment in the Medi-Cal and Healthy Families programs. The budget expands Medi-Cal managed care, and integrates adult day health, long-term care and Medi-Cal services. It also alters Medi-Cal Treatment Authorization Request (TAR) processing by including modest funding intended to optimize and expand the electronic TAR and auto-adjudication processes.

In addition, Dr. GnanaDev discussed the balance billing issue. The CMA Dispute Resolution Technical Advisory Committee will take about 40 recommendations to the CMA House of Delegates in October 2006. The recommendations are general principles that can guide CMA negotiations with the Legislature or the Department of Managed Health Care rather than definitive policy suggesting a possible dispute resolution system.

Finally, Dr. GnanaDev announced that the California Hospital Association, along with other heart, lung and cancer associations, has crafted a new Tobacco Tax Initiative. Given the proposal's positive elements, the CMA is now giving cautious support, reversing its absolute opposition to the previous CHA proposal. There is still concern regarding the "stipend caps" language and the aggressive $2.60 per pack tax increase, which may be difficult for voters to accept.

American Medical Association Delegate Ron Bangasser, MD, reported Medicare physician payment cuts began Jan. 1 due to Congress finishing its session for 2005 without passing the federal budget package. The House was to return Feb. 1 to take up the budget bill. It plans to approve the provision freezing Medicare rates at 2005 levels. Until Congress acts, physicians will be paid at lower 2006 rates.

Dr. Bangasser also stated that the AMA is exploring how to best educate patients about the new Medicare Part D program. In the meantime, California legislators approved AB 132, which provides $150 million in emergency drug coverage for seniors and disabled people who were unable to get medications because of problems with the program.

In addition, Dr. Bangasser discussed his attendance at the Flu Vaccine Summit in Atlanta with about 200 people, including six from California. The focus was vaccine supply and distribution. Vaccine manufacturers licensed for the 2005-06 influenza vaccination season, the Food and Drug Administration, and the Health Industry Distributors Association offered various perspectives.

In other business, the board approved the six-month financial report for the period July 1, 2005, through Dec. 31, 2005, as submitted by SBCMS Treasurer Rodney Borger, MD. Total revenue was $257,695. Total expenses were $235,402. Excess revenue over expenses was $19,303 after depreciation.

The board approved the Nominating Committee's slate of nominations for SBCMS officers, board members and representatives, and its appointments and reappointments for CMA delegates, alternate delegates and representatives.

The board was educated about various recruitment efforts conducted during the past six months, which have resulted in 42 new members. Nominations were solicited for the 2006 Outstanding Physician Awards and the Outstanding Citizen Award that will be presented at the June 21, 2006, Installation of Officers program at the Sierra Lakes Golf Club.

SBCMS leaders were encouraged to attend the meeting on Feb. 21 regarding the status of the Inland Empire Regional Health Information Organization (RHIO). Gary Levin, MD, is the coordinator for the Inland Empire RHIO Task Force. SBCMS has not endorsed a RHIO plan, but has agreed to host the meeting venue, along with the Riverside County Medical Association, with both groups attending as interested parties. Funding and bringing stakeholders and providers to the table are the RHIO's two main challenges. SBCMS will continue to monitor the status of the RHIO before making a commitment to the project.

In other action, Executive Director Linda Stratton encouraged the board to make reservations for the April 4, 2006, CMA Annual Legislative Leadership Day and to consider sponsoring a medical student. Dr. GnanaDev also invited SBCMS leaders to attend the legislative candidate interviews being held on Feb. 7 and 15.

Inland Empire Health Plan Medical Director William Henning, MD, reported total membership is 294,375. Medi-Cal enrollment is 245,761, with 36,606 enrolled in the Healthy Families program. Healthy Kids enrollment for San Bernardino County is 3,325. In-Home Supportive Services enrollment is 1,350. He also said that IEHP continues to work toward implementing a Medicare Part D benefit for dual eligibles by January 2007.