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Legislative update: Year of challenges, victories



September 23, 2013

This year turned out to be a challenging year for the California Medical Association (CMA). We knew would be a historic year with the implementation of federal health care reform (ACA) and the wave of legislative freshman. We anticipated that many issues would arise as we helped to educate new legislators not only about the ACA, but about the many issues important to the physician community in California.


CMA faced an unprecedented number of scope of practice expansion bills introduced in the Legislature. These scope of practice bills were painted with a broad brush as necessary reforms to help implement the ACA. Those who wanted to expand scope had a key message: we need allied health professionals, including nurse practitioners, optometrists and pharmacists, to do more in order to prepare for the many Californians who would be new to the health care infrastructure in California. Our message was simple: we will not jeopardize patient safety and we need to promote integration of allied health professionals, not fragment them as these proposals suggested.


We faced a concerted effort by the nurse practitioners, optometrists and pharmacists who joined together to push their agenda collectively. They put in significant resources to mount a public relations campaign and were actively pursuing newspaper editorial boards across the state to promote their agenda. With the help from our specialty partners and our local medical societies, CMA won the argument in the Capitol. We successfully defeated the attempt by nurse practitioners to gain independent practice in California, as well as efforts by optometrists seeking to diagnose and treat diseases in patients. CMA significantly narrowed the pharmacists’ proposal to ensure that they could provide reasonable services in an integrated and safe manner that promoted collaboration with physicians.


CMA also tackled the incorrect perception that physicians are at the center of the opioids overdose crisis occurring in California. Physicians recognize the need to help ensure appropriate prescribing and the need to tackle abuse and diversion of prescription drugs. We helped craft a proposal that will ensure that our state’s prescription monitoring program, CURES, will be upgraded and funded. CMA also secured a streamlined application process for CURES, a requirement that a stakeholders group be consulted as the upgrade and maintenance occurs and a reduced fee impact on physicians. Most importantly, there will be no mandated participation required of physicians.


A proposal that would have given the medical board overly broad power to discipline physicians for inappropriate prescribing was soundly defeated by CMA in an overwhelming fashion on the Assembly floor. CMA was also able to make certain that any reports initiated by coroners involving overdose deaths would remain confidential. In addition, an effort to shift the investigative authority from the medical board to the Department of Justice was defeated.


The trial attorneys’ campaign to eviscerate MICRA was also in full gear this year. Trial attorneys invested heavily in three additional lobbyists and launched a public relations campaign titled “38 is Too Late,” and made several attempts to push a legislative bill in the Capitol. All these efforts resulted in no action in the Capitol, a major victory for CMA.


While CMA is proud of our legislative victories this year, we understand that these battles will continue next year. We know that that the trial attorneys are initiating a ballot fight and we know that some allied health professionals will continue to erroneously call for scope expansion. CMA will continue to be the voice of the physician community and is prepared to take on these challenges.


Contact: Juan Torres, (916) 444-5532 or jtorres@cmadocs.org.

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