Los Angeles County Medical Association Districts 6 and 17 hosted an Economic Advocacy Seminar on Nov. 29 at Maggiano's Little Italy Restaurant in Woodland Hills. More than 30 doctors and office managers attended for a lively discussion on how to handle unfair insurance company payment practices and how to obtain better PPO contracts.

Speakers included Bill Ross, executive director of Bay Area Preferred Physicians, a messenger-model organization in Oakland, and Catalina Jovane, former director of economic advocacy services at LACMA.

Ross offered an informative lecture on BAPP, which assists solo and small-group practice physicians with PPO contracting. In his presentation "Conspicuous Success in the Face of Adversity," Ross explained that BAPP negotiates contracts with insurance companies based on what a group of physicians says they will accept.

"When PPOs make an offer to the group, the offer is run against a database that reports on the outcome for each individual member," Ross says. "If a majority of the members have individually accepted the contract, it is signed with the PPO as a group agreement." He invited the physicians in attendance to join BAPP.

Then, Jovane provided an overview of AB 1455, which requires health plans to adhere to prompt payment regulations and dispute resolution processes. Also known as the Prompt Payment Act, the law authorizes the Department of Managed Health Care to impose penalties on health plans that engage in unfair payment practices.

"The Prompt Payment Act says that health plans must fully and regularly disclose fee schedules to contracting physicians," Jovane says. "Health plans must also provide changes to fee schedules and payment rules 45 days in advance. If health plans do not comply, you have the right to report them."

To wrap up the meeting, Jovane reminded physicians to look closely at their contracts, to learn each health plan's dispute resolution mechanism and to hold health plans accountable.