Monday Rx: Pre-Authorizations, LACMA Events, Legislative Advocacy Day and the State of Well-Being 2021-2022 Report April 4, 2022 AMA, Blue Cross of California, California, California Medical Association, CMA, COVID, COVID-19, Expanding Access to Healthcare in California, healthcare professionals, HR 3173, Legislative Advocacy Day, Medical Injury Compensation Reform Act, MICRA, physician, SB 250, State of Well-Being, Town Hall, U.S. Department of Health and Human Services, Vaccines, Variants, Virtual Grand Rounds, Young Physician Mixer 1202 Pre Auths and Some Levity As I mentioned previously, we are looking for solutions when it comes to the all too often egregious red tape physicians deal with. Insurance company prior authorization creates serious and dangerous delays in care for many California patients. According to a recent AMA survey, physicians and their staff spend an average of almost two business days (13 hours) each week completing an average of 41 prior authorization requests, resulting in a huge waste of health care dollars. Prior authorization also negatively impacts patients with 93% of physicians reporting that the process delays patient care, and more than four in five physicians (82%) said patients abandon treatment due to authorization struggles with health plans/insurers. CMA is sponsoring SB 250 (Pan) to require health plans to exempt physicians from prior authorization rules if they have practiced within the plan's criteria 80% of the time. All other physicians will have the right under the bill for a prior authorization appeal to be conducted by a physician in the same or similar specialty. CMA is also working to introduce federal legislation modeled after California’s SB 250. They are also supporting HR 3173, the “Seniors Timely Access to Care Act,” (Rep Bera), which would require Medicare Advantage plans to establish an electronic prior authorization process that provides “real-time decisions” for services that are routinely approved, publicly reported to the U.S. Department of Health and Human Services, the rate of prior authorization approval or denials and adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians. CMA is asking you to share your unique experience as a patient, physician, or health care professional so that we can best explain to lawmakers how prior authorization policies are harming patients. If you have waited days or months for an insurance company to approve a medicine prescribed by your doctor, we want to hear from you. If you are a physician frustrated with the administrative headaches and their impact on your patient, we want to know your story. Click here to share your prior authorization stories. Now some levity: Courtesy of Dr. Sam Fink, who shared some humor that, I’m sure, many members can relate to. View Here Town Hall Series Continues We are one week away from our third town hall on the topic of “Expanding Access to Healthcare in California,” featuring Dr. Stephen Shortell, Blue Cross of California Distinguished Professor of Health Policy and Management Emeritus and Professor of the Graduate School at the School of Public Health and Haas School of Business at UC-Berkeley, whose expertise is in policies and practices to reform healthcare delivery and improve the value of care (lower cost and higher quality) provided to patients. This discussion will be moderated by LACMA President-Elect, Dr. Omer Deen and LACMA Board member, Dr. Hector Flores. Objectives/Outline Understanding the challenge and the opportunity Listing the essential elements of integrated delivery models (including team-based care) Describing the role of value-based payment models in incenting continuous improvement in care Highlighting the evidence to date Defining and incorporating health equity under the capitation, integrated model Register Here Bowling, Great Conversation and Good Times! LACMA’s Young Physicians Committee is hosting its annual Young Physician Mixer on April 29th at the Lucky Strike at LA Live in Downtown LA! This is a great way to meet and connect with physicians, fellows, residents, and medical students from all over the county. You can bowl, play table games, or just come hang out! Hors d’oeuvres and beverages will be served. LACMA & CMA members are FREE! Please share with your peers and colleagues. Fellows, residents, and students have free membership. They can join here. Date: April 29, 2022 Time: 8:00 pm Register here. Register for Legislative Advocacy Day The California Medical Association (CMA) will host its 48th annual Legislative Advocacy Day in Sacramento. CMA's Legislative Advocacy Day consistently brings together more than 400 physician and medical student leaders from all specialties and modes of practice. Attendees will have the opportunity to meet with legislators on priority health care issues. Date: April 19, 2022 Register here. Download the State of Well-Being 2021-2022 Report Over the past year, hundreds of healthcare organizations and medical institutions from around the world used the Well-Being Index to measure and support the mental health of their workforce. The State of Well-Being 2021-2022 Report is a comprehensive analysis of data gathered from 165,000+ Well-Being Index assessments, designed to be your go-to resource for well-being statistics among healthcare professionals. In this free report, you'll find insights such as: 2019 vs 2020 vs 2021 distress levels Burnout levels by occupation Distress levels by years in practice Well-being statistics by age & gender identity What resource categories were accessed most And more Fill out the form to receive your free State of Well-Being 2021-2022 Report here. Virtual Grand Rounds: Pediatric COVID and Vaccines, and Variants Overseas As we enter the spring with our lowest COVID case rates in two years and roll back various recommendations and requirements on masking and gathering, many cautiously hope for a new phase of the pandemic at home. Simultaneously, we watch in trepidation as a new variant takes hold across the globe and causes cases to increase across Europe and Asia. How will this variant impact our management of the pandemic and exposure to COVID-19 at home? In this edition of Virtual Grand Rounds, we will hear from an infectious disease expert who will review COVID-19 in children, pediatric vaccines and offer advice on methods to communicate with families regarding vaccinating their children. CMA will also welcome back the state epidemiologist, Erica Pan, M.D., who will share the latest information about the state of COVID-19, the potential for new variants, and the availability of therapeutics in California. Date: April 5, 2022 Time: 12:00 pm - 1:00pm Register here. MICRA Media and Message Training The California Medical Association (CMA) is hosting a member-only training on the upcoming ballot initiative threatening to end California's long-standing liability reform law - the Medical Injury Compensation Reform Act (MICRA) on April 18, 2022. Participants will have the opportunity to receive a comprehensive overview and in-depth media training on the ballot initiative. Date: April 18, 2022 Time: 3:00 pm - 5:00pm Location: Sheraton Grand Hotel: 1230 J St, Sacramento, CA 95814 Register here. #MondayMotivation "The best preparation for tomorrow is doing your best today." Gustavo Friederichsen Chief Executive Officer Los Angeles County Medical Association “If it matters to our LACMA members, it matters to me.”