When we ask Los Angeles County Medical Association members and non-
members what they consider to be the most important activities that LACMA should engage in, we are consistently told that economic and legislative advocacy are the two highest priorities. In both areas, LACMA continues to excel. We need to get this message out to all of the physicians in Los Angeles County.

In my message last month, I discussed the continuing problem we face with insurers who are looking for reasons to decline payment to physicians for services rendered. These activities have also been extended to patients, with insurers rescinding healthcare policies when a patient's medical expenses attract their attention. As a result, patients are losing their health insurance when they most need it, often based on a minor error on their health insurance application.

Also, insurers tell physicians who have rendered services in good faith to pay any monies received from the patient back to the insurance company or that amount will be deducted from future payments due to the physician. These unconscionable acts leave patients feeling lost in a time of need, while exasperating physicians who find themselves in the middle of a dispute not of their making.

These actions by insurance companies recently came to the media's attention with the $9 million judgment against Health Net in the arbitration of a case where a woman with breast cancer was denied coverage. She had reported her weight incorrectly when a Health Net sales agent came to her shop and convinced her to change her coverage. He took the application right then and there--and the mistake helped end her coverage. A second item that recently brought this ongoing problem to light was the doctors' outcry when Blue Cross sent letters to physicians asking them for information on patients who appeared to be hiding pre-existing conditions, or who had requests to see specific specialists outside of a large medical group's usual panel.

Thankfully, the media outcry caused Blue Cross to withdraw the letter, and I appeared on local television news and on National Public Radio to express LACMA's--and all physicians'--position regarding patient privacy. This kind of economic advocacy benefits all doctors and is one more reason why you, as members, need to reach out to your fellow physicians one at a time and convince them to join our organization.

In response to the insurance companies' ongoing outrageous behavior, Los Angeles City Attorney Rocky Delgadillo launched a first-of-its-kind health insurance fraud website (www.protectingtheinsured.org) where patients and physicians can go to post complaints or concerns about health insurance activities that hinder patients from receiving needed care, or doctors from receiving appropriate payment. Activities that Attorney Delgadillo wants to hear about include denial or delays of authorization and payment of claims, and cancellations of recently issued policy coverage.

LACMA is meeting with Attorney Delgadillo to determine how we can best partner, and how we can aid both our members and our patients during the information-gathering and investigation. Remember, Attorney Delgadillo needs to hear from physicians who have had payment withheld, delayed or retroactively denied for services rendered under a health plan or insurance policy. Now is the time for physicians to contact him via his website so that we can stop the practices of the for-profit insurance companies from inhibiting our ability to practice medicine and properly care for our patients.

The imperative for physicians to join their medical association increases daily. The association is the only voice with any clout that speaks on behalf of physicians, and we operate in multiple arenas constantly. You can be sure that with the election of a new president of the United States in November, a strong medical association voice will be needed to help mold healthcare reform efforts into something that we can work with and live with, whether you are a doctor or a doctor who is also a patient.