State Chapters
CAL/AAEM Update

Chapter Holds Second Annual Business Forum

by Paul Windham, MD, FAAEM

Our second annual Business Forum was held Thursday, June 13, during the Cal/ACEP Scientific Assembly in Long Beach. John Calomeni, MD JD FAAEM was our presenter. The Cal/AAEM board meeting was held immediately following the Forum. Another highlight of the Scientific Assembly was the Ultrasound course offered June 11-12. Because of deadline constraints, I was not able to publish a full report on the events in this issue. Look for more details in the September/October issue of Common Sense.

As many of you already know, Dr. Robert Derlet will be leaving his position as editor of the California Journal of Emergency Medicine (CAJEM). We are all indebted to Dr. Derlet for his indefatigable work in developing CAJEM. It is a journal for those of us in the clinical trenches, written by and for practicing emergency physicians. Dr. Kazzi, who has been a one-man recruitment committee, announced Dr. Derlet’s successor at the CAL/AAEM board meeting. Robert Rodriguez, MD FAAEM, will serve as the new editor in chief of CAJEM. We are very happy to have Dr. Rodriguez on board and look forward to continued success with the journal.

Educational Opportunities

The AAEM Written Board Review Course will be held September 27-29, 2002 at the Embassy Suites Hotel in Atlanta, Georgia. Registration for the Oral Board Review Course to be held September 14-15 began on June 3. Space is limited for this popular course, so call 1-800-884-2236 soon to ensure your place.

19th Annual Emergency Medicine Symposium will be held November 7-10, 2002 at the San Diego Marriott Mission Valley. AAEM and the San Diego Naval Medical Center sponsor the Symposium.

In closing, I would like to say I find this an exciting time to be an emergency physician. We have the challenge of embracing ever-new technologies that enhance our care at the bedside. We have the challenge of being the canary in the coal mine, the harbinger of the collapse coming in the EMS safety net, and we are challenged to help find a way to deal with the chronic underfunding of medical care in California. I know we can meet these challenges. As Robert Kennedy said, “If not us, who? If not now, when?”

Legislative Update

The Department of Managed Health Care convinced Senator Scott to introduce SB 1881 in this session. This disastrous bill would have prevented emergency and on-call physicians from billing patients if their HMO failed to pay for services rendered, even if the physician had no contract with the HMO. It was introduced in response to consumer complaints sent to them by physicians fed up with denied, delayed, and downcoded claims. Thanks to a lot of heavy lifting by CMA, Cal/ACEP, and other specialty societies, this bill has been withdrawn. Special consideration should be given to Dr. Loren Johnson, President of Cal/ACEP, and Jim Randlett, Cal/ACEP’s legislative analyst. They have become a bridge between the CMA and the hospitals, and have forged ties with CHA as well as CMA. California’s hospitals face the continued challenge posed by SB 1394, which limits their charges to uninsured patients to 150% of MediCal rates. The financial impact of price controls on our hospitals is scary.

May Revise – The Governor released the May Revise, his proposed budget for the coming fiscal year. He has used a combination of funding cuts for MediCal, tax increases on vehicle registrations, and securitizing the tobacco settlement money to balance the budget after facing a $23.6 billion shortfall. The 40% increase in MediCal reimbursement we were recently given has been canceled. Coming on the heels of the 8% reduction in Medicare reimbursements by the federal government this January, cuts in MediCal may spell catastrophe in medical communities throughout the state. According to the CMA, the cuts will result in at least 400,000 Californians losing access to care. 15,000 more will not be able to find doctors who will take MediCal. The average physician office visit would now be paid $16 vs. the current $20. Extension of Healthy Families to parents is deferred. The state will save about $180 million. The CMA points out that the state will lose $269 million in matching federal dollars by making these cuts.

EMPAC arranged a meeting with Gov. Davis on May 22. I’ll let you know how the meeting went in the next legislative report.

The situation next year is foreboding. Securitizing the tobacco settlement money results in a one-time payment instead of receiving the money in installments over 20 years. The revenue stream is sold to Wall Street traders, who pay a smaller, up-front, one-time price. This money is being used to balance this year’s budget and will be used up in an attempt to avoid tax increases in an election year; raising taxes will almost certainly be required next year in addition to further cuts in health care expenditures. We, the members of Cal/AAEM, need to lend our voice in support of CMA, Cal/ACEP, and even to our some-times adversary CHA in order to help find a solution to our mutual crisis.

CAL/AAEM is the California State Chapter of the American Academy of Emergency Medicine. Paul Windham, MD FAAEM, is the President of CAL/AAEM and can be reached at pcwindham@patients1.com.