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Tell Senators Boxer and Feinstein: Patients Will Be Left Without Physicians in Senate Health Reform Bill!

Though both Senator Barbara Boxer and Senator Diane Feinstein support CMA's position and are actively working to improve Senate health reform legislation, it is still important that they hear a uniform message from thousands of California physicians about how bad a final Senate bill could be for physicians and their patients.

ADVOCACY CAMPAIGN INSTRUCTIONS:

  1. Read the talking points and background information below.
  2. Call as many of the senators' offices as you would like and communicate our talking points.
  3. If you are an SDCMS member physician, click on "log in" below "Actions You Can Take" at the bottom of this page and enter your username and password (if you aren't already logged in). If you do not know your username and/or password, contact Kyle Lewis at (858) 300-2784 or at KLewis@SDCMS.org.
  4. Now, under "Actions You Can Take" at bottom, you will find hyperlinks to email and fax the senators. When you click on any of the "email" or "fax" links, a sample letter will pop up. IMPORTANT: MAKE SURE YOU CUSTOMIZE BOTH THE EMAIL AND FAX WHERE NECESSARY! When you are finished, click "submit" and the email or fax will be sent automatically.

Senator Dianne Feinstein's Telephone Numbers and Email Address:

Senator Barbara Boxer's Telephone Numbers and Email Address:

  • Washington, DC: (202) 224-3553
  • Sacramento: (916) 448-2787
  • San Francisco: (415) 403-0100
  • Los Angeles: (213) 894-5000
  • San Diego: (619) 239-3884
  • Fresno: (559) 497-5109
  • Inland Empire: (909) 888-8525
  • Email: https://boxer.senate.gov/contact/email/policy.cfm

TALKING POINTS:

I. Thank you for your support of physicians!
CMA physicians support health reform and expanding access to care, BUT Senate Health Reform is an empty promise of coverage without a doctor.

II. Issues

  1. Please repeal the Medicare SGR.
  2. Stop the IMAC (Independent Medicare Commission). Return it to Congress.
  3. Oppose the Value Index and the Feedback Program. They impose arbitrary payment reductions and should be tested under pilot programs.
  4. Increase Medicaid rates to ensure access to physicians.

Physicians: Please give your name, location, and specialty. If you are sending an email, please include a short personal story about the impact this will have on your practice.

BACKGROUND:

  1. SGR: The Senate Finance Committee bill does not reform the Medicare Sustainable Growth Rate (SGR) formula. It stops the SGR cut in 2010 but imposes a 25% cut in 2011 with additional cuts in later years. Physician rates lag at least 20% behind their practice costs. It is time to repeal the SGR once and for all; otherwise, Medicare seniors will have an increasingly hard time finding a doctor.
  2. IMAC: The Senate Finance Committee bill establishes an Independent Medicare Commission (IMAC) to adopt policies to rein in Medicare spending. They are mandated to find $22 billion in savings over 10 years if spending exceeds the CPI. CMA believes that Congress is the accountable body that should be making important decisions impacting patient access to care. Physicians face two sets of cuts from both the SGR and the IMAC. It's double jeopardy.
  3. Physician Outlier Feedback Program AND the Value Index: The bill establishes two similar programs that could impose Medicare payment cuts on California physicians. The Feedback Program would reduce payment by 5% for physicians who are "outliers" — utilization is above the 90th percentile of national utilization rates. This could penalize physicians who treat the sickest patients because current risk adjustment methods are not adequate. The Value Index program would reduce payment to physicians in high-spending regions. California has high-spending regions in part because we have high practice costs (rents and staff wages) and higher numbers of uninsured, poor, minority patients who have not had good access to medical care and, therefore, their conditions are more costly once they reach Medicare age. Both the Physician Outlier Feedback and Value Index programs would depend on claims data that is extremely limited. CMA physicians have documented serious problems with the current individual physician reporting program being run by the California Physician Performance Initiative (CPPI). Both programs are based on unproven systems. They should be tested and improved before Congress reduces resources to communities with the greatest healthcare needs.
  4. Medicaid Reform: The Senate bills include major expansions of the Medicaid program to cover low-income families. Yet families on Medi-Cal in California are already experiencing serious problems finding a doctor because the payment rates are 60% below Medicare rates. New families signing up for Medicaid will not find a doctor. Thirty-one percent California emergency room visits are from Medi-Cal patients vs. 18% for the uninsured. Congress will exacerbate the access problems if they don't finance increased Medicaid rates.

For more information, visit CMA's website.

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