The Los Angeles County Medical Association delegation to the California Medical Association House of Delegates had an amazingly successful and productive meeting this year. LACMA's advocacy on behalf of our members resulted in the passage of a number of policy statements by the CMA, including the two highlighted below:

Resolution 408-07, Balance Billing for All Physicians, was authored by Marcy Zwelling-Aamot, MD, former LACMA president and candidate for CMA president-elect. In part, it states:

Resolved, that the CMA ask the AMA to devote the necessary political and financial resources to introduce national legislation at the appropriate time to bring about implementation of Medicare balance billing and to end the budget neutral restrictions of the current Medicare physician payment structure that interferes with patient access to care; and be it further

Resolved, that this national legislation be designed to pre-empt state laws that prohibit balance billing and prohibit inappropriate inclusion of balance billing bans in insurance-physician contracts...

This resolution is particularly critical in view of the impending 10-percent cuts in Medicare reimbursement scheduled for Jan. 1, 2008, as well as the additional 3-percent cut in some urban areas due to the GPCI adjustment. It is galling that physician practices are subject to below-market price controls that no other industry experiences. Like most physicians, I am increasingly bitter about facing higher practice costs of rent, salaries, supplies and insurance, yet having no way to obtain increased reimbursement from the Medicare population.

Now, LACMA has achieved a policy statement that the CMA must bring before the AMA House of Delegates. We will be watching what action the AMA takes on this important issue.

Resolution 508-07, RICO Settlement Funds and Physician Foundations, was authored by Robert Bitonte, MD, JD, LACMA treasurer. It states:

Resolved, that CMA provide a full accounting of each foundation that received RICO settlement funds and their precise expenditures, and provide a copy of each foundation's work product to each county medical association and to specialty societies.

As you know, the CMA initiated a class-action lawsuit against a number of insurance companies that were systematically underpaying doctors via improper claims processing, downcoding and other unfair methods. Companies such as Blue Cross, HealthNet and Aetna settled, resulting in sizable refund checks to individual physicians and more than $300 million to fund foundations established to protect physicians from predatory insurance company practices.

LACMA leaders are concerned that we have not seen any results from the foundation money. I corresponded with the CMA CEO, as well as the heads of the foundations and received circuitous responses with no information. This policy requires that the CMA--which has seats on the foundations' boards--get information about where this money is and how it is being used, and report back to the membership.

Perhaps $30 million could fund additional lawsuits seeking to overturn current antitrust restrictions on physician negotiation with the insurance monopoly, which we all know is destroying medical practice and the patient-physician relationship.

LACMA's delegation introduced 22 resolutions--12 were adopted in either a substitute or amended form, six were referred for study or decision by the CMA board of trustees, and only four were not adopted. This accomplishment reflects the vigor of the delegates and the effectiveness of those who spoke at the house.

Sadly, we did not bring a full delegation to the meeting, as a number of delegates or alternates failed to attend. They will be removed so that many positions will be available at the next election cycle. I encourage participation-minded members to seek election in their districts. If you have questions about getting involved, e-mail me at president@lacmanet.org.