The SFMS developed policy to curtail overuse of antibiotics in agriculture in 2002, and had that policy adopted by the AMA. We have worked with Senator Feinstein on this topic in more recent years, and she has now taken on a leadership role. Washington—California Sen. Dianne Feinstein renewed a decade-long push Friday to phase out the routine use of antibiotics in livestock, hogs and poultry. Her bill follows the emergence in Germany of a lethal antibiotic-resistant strain of E. coli linked to 35 food-poisoning deaths and the discovery this month in Britain of an antibiotic-resistant bacteria in cow’s milk.
Government officials have warned that increasing antibiotic resistance in humans poses a serious public health threat. In the United States, the Food and Drug Administration has confirmed that 80 percent of all antibiotics are given to farm animals in low doses intended to stave off disease in large livestock operations.
This morning Governor Brown held a press conference announcing he would veto the budget sent to him by the Legislature just hours before. Both the Senate and Assembly met yesterday and passed the main budget bill as well as various “trailer” bills that implement policy changes pursuant to appropriations and spending reductions contained in the main budget. The main bill was passed on a party-line vote, and did not contain either a “bridge tax” to continue the current tax rates (raised in the 2009-10 budget) nor the requirement for a public vote to determine whether or not to extend those tax rates for another 2 to 5 years. As a result, new cuts and spending shifts were included to close the remaining gap of approximately $9.6 billion.
Fortunately the budget bills that were passed did not eliminate the Healthy Families program, which was a huge victory for the California Medical Association (CMA) and all county medical societies and our partners in this effort including the California Chapter of the American Academy of Pediatrics and the California Academy of Family Physicians. However, the battle is far from over, as the main budget bill contained language to begin transferring the administrative function and expenditure authority for Healthy Families over to the Department of Healthcare Services (currently the Managed Risk Medical Insurance Board operates the program). The main budget bill also required that a transition plan for Healthy Families be developed and put into law through separate legislation. As the process gets underway again following the Governor’s veto this morning, CMA will continue to be fully engaged in the process to protect against further devastating cuts to the safety net and ensure adequate coverage and access to care for California’s needy children.
The budget package did include some good items, including $7.3 million for vaccines for low-income, uninsured Californians, $4.4 million in additional funds resulting from interest earnings to the Every Woman Counts breast and cervical cancer screening program, and the creation of the Keeping Adults Free from Institutions program to provide adult day health services to eligible individuals. Another substantial policy change contained in the budget is to authorize the Department of Health Care Services to develop a new methodology for reimbursing pharmacy products utilizing Average Acquisition Price.
It is important to note that while Gov. Jerry Brown has vetoed the main two budget bills (SB 69 and AB 98), he has not yet acted on the various trailer bills that also passed yesterday that contain policy changes to implement the budget’s spending directives.
CMA/SFMS will continue to provide you with updates as the budget process moves toward a final resolution, and will continue to be actively involved in the process in order to ensure that all Californians have access to quality care when they need it.
Should you have any questions please feel free to contact Carolyn Ginno at (916) 444-5532 or cginno@cmanet.org.
Under the Centers for Medicare & Medicaid Services (CMS) e-prescribing rule, physicians must issue at least 10 electronic scripts (e-scripts) by June 30, 2011, to avoid an e-prescribing penalty that amounts to a 1 percent reduction from their total Medicare Part B allowable charges in 2012.
On May 26, CMS released a proposed rule that would allow physicians, if they qualify, to apply for one of several new e-prescribing penalty exemptions through a Web-based portal that is still under construction. Physicians would have to apply for an exemption by October 1 to avoid the penalty.
Physicians are still required to e-prescribe using a qualifying system and report the G8553 code on at least 10 Medicare Part B claims from January 1 to June 30, 2011, to avoid the 2012 penalty. However, physicians who find it difficult to meet the 10 e-script requirement can apply for one of the following exemption categories by October 1 of this year:
Their practice is located in a rural area without high-speed internet access.
Their practice is located in an area without sufficient available pharmacies for ePrescribing.
They are registered to participate in the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program and have adopted certified EHR technology.
They are unable to electronically prescribe due to local, state or federal law or regulation (such as prescribing controlled substances).
They prescribe infrequently (for example, they prescribed fewer than 10 prescriptions between Jan. 1 and June 30).
There are insufficient opportunities to report the e-prescribing measure due to program limitations (for example, a surgeon e-prescribes but not on the date of the patient encounter in accordance with the program requirements).
Communication can go a long way toward reducing health disparities, and improving care for all patients. Communication Climate Assessment Toolkit (C-CAT), a new set of assessments developed by the AMA, can help keep physician practices measure how well they communicate with patients. The free C-CAT contains surveys that can help you or the organization you work in measure whether effective communication is taking place. Questions focus on common communication problems facing diverse patient populations, such as culture, language, and health literacy gaps. The C-CAT also features various data tools to demonstrate whether a practice’s policies, practices, and culture promote effective, patient-centered communication.
The C-CAT’s surveys are in the public domain and are available here for viewing. For more information about this tool and other resources available, please go to http://www.ethicalforce.org.
The CMA Foundation invites San Francisco Medical Society members to the 2011 Ethnic Physician Leadership Conference, scheduled for September 17-18 in San Jose. With a theme of “The Challenge of Health Care Reform,” the conference features a keynote address from Richard Figueroa, Program Director at The California Endowment.
September 17-18, 2011
Hilton San Jose Hotel
300 Almaden Boulevard, San Jose, CA
Registration Fees:
$50 for physicians and members of a community-based organization
$25 for medical students (Limited scholarships are available for medical students for travel & hotel. Please contact Anna Gutierrez for details at (916) 779-6627 or agutierrez@thecmafoundation.org)
livestock, hogs and poultry. Her bill follows the emergence in Germany of a lethal antibiotic-resistant strain of E. coli linked to 35 food-poisoning deaths and the discovery this month in Britain of an antibiotic-resistant bacteria in cow’s milk.
