California Medical Association votes to protect patients.

SAN FRANCISCO--(BW HealthWire)--March 26, 1997--California Medical Association, with 35,000 members the nation's largest state medical association, yesterday concluded its Annual Session.

The session is attended each year by 472 physician members of the CMA House of Delegates, which sets association policy for the coming year. On the final day of this annual five-day meeting, CMA passed a resolution calling for a halt to the community placement of the mentally disabled until the state's policy of doing so is reviewed by a competent authority.

The move is a response to reports of increased mortality among certain populations of the mentally disabled when released from institutional settings to community care. The House also passed a resolution calling on the CMA to immediately begin efforts at the federal level to make inhaled marijuana available for use in clinical research to determine the efficacy of medical marijuana.

CMA's House of Delegates later voted to work with the California Legislature to make universal health care insurance coverage a priority issue on both the state and the national level. The decision reflects CMA's commitment to work with health providers and local, state and federal agencies to find a way to extend affordable health care insurance to the nearly 7 million Californians currently without coverage.

The House also voted to continue its support of current domestic violence reporting laws, but to address concerns raised by advocates of battered women. Legislation passed in 1993 requires mandatory reporting of domestic violence, but advocacy groups claim that such reporting can potentially expose women to further abuse. The House of Delegates has directed CMA to support legislation to allow victims to refuse, in writing, to have their case of domestic violence reported.

In light of recent new HIV treatments to prevent the progression to full-blown AIDS, CMA House of Delegates narrowly voted to support confidential reporting of cases of newly identified HIV infection to local health officials. At the same time, the House affirmed its support for anonymous testing sites, home testing, and strict confidentiality.

After passage of a related resolution, CMA adopted a policy which would require insurance companies to notify individuals immediately if any serious conditions are revealed during physical examinations taken in the course of applying for insurance. Testimony was offered during CMA House discussion of one individual who only found out two years later that he had tested positive for HIV during such an exam. Immediate notification would have enabled the individual to begin treatment earlier and increased his chances of surviving the disease.

And in light of the current popularity of cigar smoking, the House directed CMA to educate the public -- particularly women and ethnic groups -- about the dangers of all kinds of smoking.

The House also addressed a range of issues dealing with managed care: CMA delegates then voted to work with the state Department of Corporations to prevent managed care companies from interfering with physicians' decisions about what kinds of drugs to prescribe their patients, and later that decisions by managed care companies to change medications available to patients be based on "objective, compelling data supported by peer-reviewed literature."

The House also asked CMA to help patients by sponsoring legislation that would require medical insurance companies and health plans to promptly notify patients whether requested surgical and medical procedures would be covered. The House recommends that health plans and insurance companies give their patients such notification within 24 hours for urgent cases and within five working days for non-urgent cases.

The House also called upon health plans to endorse a "prudent layperson" standard for reimbursement of emergency care. The standard would prevent plans from denying payment for symptoms severe enough that a prudent layperson could "reasonably expect that the absence of immediate medical care would place the patient in serious jeopardy." A second resolution would put CMA on record as opposing any denials of coverage that occur because a health plan has unilaterally or retroactively changed the benefits it covers in mid-term.

And the House directed CMA to develop and publicize a "Patient Bill of Rights" which would take into consideration the changing health care system and inform patients of their rights to, among other things, access to needed medical services and experimental treatment, and what patients can do when care is denied.

In order to protect the patient/physician relationship, the House voted to support litigation brought against a health plan by a Sacramento doctor, after that health plan "deselected" him and nearly 300 other physicians. The doctor charges that the plan admitted him and the other doctors into the plan, enrolled these physicians' patients, then let the physicians go without reason -- depriving the patients of access to their doctors.

Competition from managed care companies has decreased the number of patients who go to academic medical teaching centers for care. Lack of patients has reduced revenues, which in turn has reduced the amount of money available to the centers for medical education and research. In response, CMA delegates voted to consider ways to encourage HMOs and other private health plans to pay their share to support medical research and education.

House members -- faced with more than 5,500 firearm deaths per year in California -- also voted to support legislation prohibiting the sale and manufacture of Saturday Night Special handguns. And the House recommended that CMA redouble its efforts to protect the public from food-born illness, possibly through the development of state-wide food handler education programs.

The House also decided that the CMA should urge the appropriate state and federal agencies to facilitate universal access to 911 services via cellular phones, and to ensure that such calls should be traceable so that emergency personnel can locate and assist the caller.

The California Medical Association represents California physicians from all regions, modes of practice and medical specialties, and is committed to the health of all Californians.

CONTACT: California Medical Association

Hobart Swan, 415/882-5131