YA' WIN SOME, YA' LOSE SOME, BUT ALWAYS RELISH THE FIGHT!

For the private practice community, our biggest success was causing SB 923 (Deleon) to suffer a humbling defeat in the legislature. This bill would have replaced the Office Medical Fee Schedule (OMFS) with the Medicare RBRVS (specialty cuts proposed ranged from 29% for neurological procedures to 48% for internal medicine). The bill will return. Administrative fiats will be sought to help it along. Physicians' groups that sit on the sidelines may find that there's no field to which to return. Some physician-specialty groups will offer courses (for which they'll charge their members) and sub-specialty certifications (for which they'll also charge their members). Specialty organizations may find themselves more on the side of management than on the side of practicing physicians.

Governor Brown took the side of insurance interests in his veto of AB 584 (Fong). He indicated that Fong's bill was not consistent with Knox-Keene or private insurance plans that do utilization review. All medical organizations should see the handwriting on the wall and ask if it's time to revise or reject Knox-Keene.

The Governor signed AB 655 (Hayashi) which allows the unfettered transfer of peer review material from one hospital to another. Control of peer review is of minor interest to most practicing physicians although it's of major interest to hospital administrations and financial interests that seek to control hospital medical staffs. Physicians and their official organizations may not be a match for these interests but, so far, they haven't tried to be.

Meanwhile, in Washington, there's continued focus on the Affordable Care Act, Obamacare to some. This writer opposes the IPAB (Independent Payment Advisory Board) and feels that Section 10320 of the ACA should be repealed. Our further comments on this bill appear in POLITICO.