Weekly Roundup: In Case You Missed It

April 28, 2023

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Finding Solutions to Your Everyday Practice Problems – Summer Conference

Join physician colleagues from across the Bay Area on Friday, June 16 for a robust day of thought leadership and information sharing through interactive workshops and panel discussions focused on tackling the daily pain points of medical practice. This conference will equip you with practical tools and skills that you can apply immediately to your medical practice. You should leave feeling empowered with new ideas to minimize administrative burdens and restore joy to the practice of medicine. This event is free for members of all Bay Area Medical Societies. Breakfast and lunch are on us, plus stay after for a summer wine and beer reception. Register here.

Contact Your Legislators: Medicare Reimbursements

As you may know, physicians are the only providers whose Medicare payments do not automatically receive an annual inflationary update. As a result, Medicare physician payments have lagged 26% behind the rate of inflation growth since 2001. During this current period of record inflation and coming on the heels of a highly disruptive pandemic, this statutory flaw often amplifies the impact of other payment policy changes like "budget neutrality" adjustments, performance incentives, and so forth. Please take a moment and contact your legislators and urge them to help fix the flawed Medicare physician payment system by supporting H.R. 2474 today. Click here for charts addressing Medicare updates compared to inflation. 

Prior Authorization Bill Clears Senate Health Committee

A CMA sponsored bill to reform the prior authorization process passed out of Senate Health Committee on April 12. Senate Bill 598, authored by Senator Nancy Skinner, would require health plans to institute a one-year “gold card” prior authorization exemption for physicians who are practicing within the plan’s criteria 90% of the time. It would also grant treating physicians the right to have their appeal of a prior authorization denial conducted by a physician in the same or similar specialty.

Reproductive Health and Gender-Affirming Care Bills Progress Out of Legislative Committee

Two CMA priority bills protecting access to reproductive and gender-affirming health care services have cleared their first legislative committee hearings. Senate Bill 487 would protect California health care providers from being automatically suspended from the state’s Medi-Cal program if another state has sanctioned them for providing health care services that are legal in California. Assembly Bill 571 prohibits medical liability insurers from discriminating against physicians solely on the basis of providing reproductive health care services or gender-affirming care. 

APM Incentive Payment Extended Through 2023

In December 2022, Congress enacted provisions of the Advanced Alternative Payment Model (APM) Consolidated Appropriations Act, 2023 that extended the availability of an APM Incentive Payment, allowing eligible APM participants for the 2023 performance period to receive a 3.5% APM Incentive Payment in the 2025 payment year. For the 2023 performance period and the associated 2025 payment year, the APM incentive payment will decrease from 5.0% to 3.5% of the participant’s estimated aggregate payments for covered professional services in the performance year. If you meet the requirements to be a QP in the 2023 performance period, you will not need to do anything to receive your payment in 2025, unless CMS is unable to verify your Medicare billing information. 

HHS Awards $147 Million to Support Ending the HIV Epidemic

This week, HHS awarded more than $147 million to 49 recipients to advance the Ending the HIV Epidemic in the U.S. (EHE) initiative, which is part of the Biden-Harris Administration’s ongoing efforts to reduce the number of new HIV infections in the United States by at least 90 percent by 2030. This funding will help states and metropolitan areas with the highest levels of HIV transmission link people with HIV to essential care, support, and treatment, as well as support training and other resources for these jurisdictions. In the Bay Area, San Francisco EMA was awarded over $2.5 million and Oakland TGA was awarded $2 million. 

FDA Authorizes Changes to Simplify Use of COVID Vaccines

On April 18, the FDA amended the emergency use authorizations (EUAs) of the Moderna and Pfizer-BioNTech COVID-19 bivalent mRNA vaccines to simplify the vaccination schedule for most individuals. This action includes authorizing the current bivalent vaccines (original and omicron BA.4/BA.5 strains) to be used for all doses administered to individuals 6 months of age and older, including for an additional dose or doses for certain populations. The monovalent Moderna and Pfizer-BioNTech COVID-19 vaccines are no longer authorized for use in the United States.

Case of the Month: Patient’s Aggressive Choice Could Remove a Diagnostic Safety Net

When reporting their findings, it is common to see consulting physicians recommend further testing. Absent such an explicit recommendation, a patient’s decision to bypass conservative measures can spell trouble for all. Read more in the following Case of the Month, published by the Cooperative of American Physicians (CAP).

When a diagnostic mammogram on a 57-year-old woman with no family history of breast cancer identified a suspicious abnormality on the left breast, the patient’s primary care physician, Dr. PC, referred her for a core biopsy. Dr. P, a pathologist, diagnosed a left breast invasive ductal carcinoma. Dr. P assigned a provision grade of “II/III” and noted that “histologic grading is provisional owing to the limited sampling inherent in needle core biopsies. This may change when the entire lesion is evaluated.” Dr. P’s report made no other references regarding further tests to confirm cancer.” Continue Reading. 


A System-Level Approach to EHR Inbox Reduction 

Tuesday, May 9 | 9:00 am 

Hosted by the American Medical Assocation 


Join Christine Sinsky, MD and Jane Fogg, MD, MPH for this live discussion about the benefits of taming the EHR inbox and how to take the first step. 


Registration required. 

Protecting Patients from Inappropriate Scope of Practice Expansions 

Wednesday, May 17 | 9:00 to 10:00 am 

Hosted by the American Medical Association 


Patients deserve care led by physicians—the most highly educated, trained and skilled health care professionals. Through research, advocacy and education, the AMA vigorously defends the practice of medicine against scope of practice expansions that threaten patient safety.  

Join us for a webinar to hear more about the importance of these issues to organized medicine from the AMA, the Medical Association of Georgia and Washington State Medical Association. We’ll discuss the unique challenges states encounter when facing multiple scope bills, how to overcome these issues and ways physician advocates can get involved. 


Register here

Health IT: Powering Value-Based Care 

Monday, May 22 | 9:00 am to 4:00 pm 

Sacramento, CA | Free for CMA members 


Save the date for CMA’s first annual healt IT conference. The conference will bring together thought leaders from across California and the nation to explore the intersection of technology and payment reform. CMA expects a diverse set of attendees that will include physicians, medical groups and IPAs, health plans, health information organizations (HIOs) and others who will take the learnings from this conference to change how care is delivered in this state. 


Register here

ACCMA's On-Demand Library

To access all on-demand programs, go to https://www.pathlms.com/medical-society/courses 



Please contact ACCMA at 510-654-5383 or accma@accma.orgwith any questions or concerns you have.