2006 CMA House of Delagates

By Tanya W. Spirtos, M.D.

The 138^th House of Delegates convened in Sacramento in October to debate and vote on the legislative, economic, legal, and public health advocacy of the medical association for the coming year.

This momentous occasion celebrated the 150^th anniversary of the founding of the CMA. On the heels of the cholera epidemic of 1850, the surviving physicians of Sacramento founded the association to "promote the science and art of medicine, protection of public health, and the betterment of the medical profession."

Dr. Michael Sexton, retiring CMA president, served the longest presidency in CMA’s history (19 months) with the House moving from a March to an October session to coincide with the state legislative agenda. Dr. Anmol Mahal, Oakland, was installed as the 139^th president and the current speaker, Dr. Richard Frankenstein, Santa Ana, will be president-elect. Dr. Luther Cobb, former surgeon at Santa Clara Valley Medical Center and Stanford and now working in Humboldt County, was elected as vice-speaker.

Executive vice president of the CMA for the past eleven years, Dr. Jack Lewin, is moving on to Washington, D.C., to head the American College of Cardiology. The Board of Trustees unanimously elected Senator Joe Dunn, trial lawyer and experienced legislator, to assume the reins at a time when practicing physicians face even more hurdles and challenges in the courts and in government. As Dr. Lewin testified, "CMA clearly has gained an experienced and talented Sacramento-savvy advocacy champion to continue to guide the association’s upward trajectory course in health policy leadership."

The District VII Delegation (Santa Clara, San Mateo, Monterey, Santa Cruz, and San Benito counties) is the largest district delegation in the House.

The entire list of resolutions accepted can be downloaded from the CMA Web sites www.cmanet.org or www.calphys.org. Just a few of the more than 200 resolutions are listed here:

The House directed the CMA—

Res. 406: to vigorously oppose the DMHC proposed regulations that would prohibit physicians from billing for services rendered and CMA to take all action necessary, including legal or legislative, to oppose any and all efforts to prevent physicians from billing for services rendered.

Res. 201: to seek congressional legislation that would alter the federal matching assistance formula for Medicaid to make it more equitable for states like California that have a higher percentage of population below the federal poverty level than the average state.

Res. 104: to continue to pursue repeal of the requirement for security prescription forms for schedule II-IV drugs and work to make the Controlled Substance Utilization Review and Evaluation System (CURES) database available to physicians in real time.

Res. 517: to reaffirm its opposition to legalization of physician-assisted suicide and recognized the need for appropriate end-of-life care, including the aggressive treatment of physical pain and compassionate care for physical and spiritual suffering.

Res. 610: to support further reduction in both license and application fees for residents and fellows in California training programs.

Res. 413: that medical necessity denials or modifications to a physician’s request for authorization should only be made by California-licensed physicians who are competent, by means of similar certification or training, as the treating physician.

Other resolutions sought to define "usual, customary, and reasonable" (res. 416), convened a committee to study and plan for collective bargaining (res. 507), reaffirmed commitment to assure better access and delivery of pain care (res. 613), supported adolescent immunization goals (res. 701), and urged easier availability of emergency contraception as initially proposed by the FDA committees (res. 722). The House continued to stress the need for Medicare SGR and geographic payment reform (res. 101) as well as advocating for additional funding for the entire Medicare system (res. 102).

There was also a great deal of attention focused on res. 609, which asks CMA to study means to assist solo/small group physicians to successfully compete with the 1206-L Foundations; larger nonprofit corporate entities, with tax benefits, may appear to have an advantage over solo practices in the current market.

Dr. Spirtos is District VII chair and is an obstetrics-gynecologist practicing in Mountain View.