Monday, December 18, 2017

OCMA Blog

COMING THIS NOVEMBER TO A BALLOT NEAR YOU: ANOTHER FLAWED GOVERNMENT-RUN DATABASE MANDATE WITH NEW THREATS TO PERSONAL PRIVACY

Experts Agree MICRA Measure Mandate “Won’t Work” While Opening Floodgates to Personal Prescription Drug Records of Millions of Californians with No Additional Security Safeguards 

SACRAMENTO – A coalition of business, medical, labor and civil liberties organizations have come together to fight a misguided, deceptive initiative that would increase health costs, reduce health access, and rely on a government-run computer system that isn’t close to fully functional – all while putting the prescription drug histories of millions of California patients at privacy risk with no additional security protections.

The initiative, which qualified for the November ballot on May 15, 2014, is written and funded by trial attorneys and their allies.  In addition to increasing the overall number of medical lawsuits and the cost of health care across the board, it contains a number of unrelated provisions designed to mislead and deceive voters – including a little-discussed mandate relying on a massive expansion of a government-run prescription drug database, which third-party analysts say cannot be implemented as written and will leave personal medical information vulnerable to privacy breach.   
 
“We always knew this flawed measure was bad for the pocketbooks of everyday Californians, but the more they read the fine print, the more they realize it’s equally bad for their personal privacy,” said Jim DeBoo, campaign manager for the broad-based coalition of Californians formed to oppose the initiative.  “If this measure passes, it will mandate a database that isn’t properly working and open the privacy floodgates to the sensitive personal medical data of millions of Californians with no increased security safeguards or funding.  It’s a hacker’s dream – and a privacy nightmare.”

The so-called MICRA (“Medical Injury Compensation Reform Act”) initiative requires health care practitioners and pharmacists to consult a government-run prescription drug database (known as CURES) prior to prescribing or dispensing Schedule II or III controlled substances to patients.

The mandate relies on the uploading of personal prescription drug records of millions of California patients onto the database – accessible by hundreds of thousands of users.  But the initiative fails to add new funding for its expedited expansion or require any additional security standards or safeguards to prevent hacking, theft or improper access by non-medical personnel.

What’s more, experts say the CURES mandate will not work as required by the measure, will not be operational by the law’s effective date and will put doctors in the impossible position of choosing between violating their oath as health providers or violating the law.

“The CURES mandate on physicians cannot be implemented as written.  CURES needs to be updated and modernized and nothing in the initiative does that.” said Tim Gage, former California Finance Director and Principal at Blue Sky Consulting.  “Therefore, the initiative will put health providers in the untenable position of either violating the new law or withholding necessary treatment from patients unless the law is suspended.”

“The consequences of mandating the use of a government-run website that experts say won’t work when required before physicians are allowed to prescribe needed medication is nothing less than a recipe for disaster,” said Dr. Richard Thorp, M.D., President of the California Medical Association.    
 
The CURES database mandate problem comes at a time of widespread reports of illegal hacking, much of it involving digital medical records. Studies show that public fears about personal privacy are at an all-time high.  Last month, it was reported the FBI had taken the extraordinary step of warning that the entire health sector was particularly vulnerable to “attacks by hackers searching for Americans’ personal medical records” (Reuters, April 23, 2014). 
 
Since 2009, the U.S. Department of Health and Human Services has reported 991 separate incidences of medical data breaches involving 500 people or more, affecting a total of 30 million patients.  While many states are moving to increase protections for online prescription drug data, this measure would have the opposite effect in California.

“The public and lawmakers are really starting to understand what kinds of threats to privacy come when you start centralizing great quantities of sensitive personal information in giant electronic databases,” said Nathan Wessler, an attorney with the American Civil Liberties Union, last week to the Wall Street Journal (May 7, 2014).

As proposed, the CURES database maintains an accessible online record of every dispensed prescription of a Schedule II or III controlled substance, including highly sensitive and potentially stigmatizing details about a person’s health.  This prescription information could include medicines used to treat anxiety, insomnia, obesity, narcolepsy, drug detoxification, pain, epilepsy, conditions related to cancer and AIDS, asthma, chronic infection, and other sensitive medical conditions.

The MICRA lawsuit measure which qualified today is formally opposed by (partial list):   

  • AFSCME California PEOPLE
  • International Brotherhood of Electrical Workers, Ninth District
  • International Brotherhood of Electrical Workers, Local 477
  • Service Employees International Union (SEIU) California
  • Union of American Physicians and Dentists (UAPD), AFSCME Local 206
  • California Medical Association
  • California Dental Association
  • California Hospital Association
  • California Pharmacists Association
  • American Congress of Obstetricians and Gynecologists
  • American College of Emergency Physicians, California Chapter
  • California Association of Physician Groups
  • California Association for Nurse Practitioners
  • Planned Parenthood Affiliates of California
  • Community Clinics Association of Los Angeles County
  • La Clínica de La Raza
  • California Association of Rural Health Clinics
  • Central Valley Health Network
  • California Chamber of Commerce
  • California Black Chamber of Commerce
  • California Hispanic Chamber of Commerce
  • City of Long Beach
  • American Civil Liberties Union of California 

To learn much more about the myriad hidden costs, consequences and flaws in the trial-lawyer-supported MICRA lawsuit initiative, visit the “Stop Higher Health Care Costs/Protect Access to Care” website at: www.StopHigherHealthCareCosts.com.

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The Doctors Company Alert: Windows XP Use May Trigger HIPAA Non-Compliance

Alert from The Doctors Company:

Now that Microsoft has stopped supporting the Windows XP operating system, physician practices using Windows XP face threats from viruses, Trojans, and other potential security breaches. All PC workstations and laptops using Windows XP that contain Protected Health Information (PHI) are no longer compliant with HIPAA and the HITECH Act. This includes devices used to access PHI via the Internet. HIPAA Security Rule section 164.308(a)(5)(ii)(B) states that practices must implement “procedures for guarding against, detecting, and reporting malicious software.” This is no longer possible with Windows XP.

If your practice system currently runs on Windows XP, follow these tips immediately to bring your practice into HIPAA compliance:

  • Identify all at-risk workstations and laptops.
  • Analyze the hardware in all at-risk computers to determine if they are capable of running a new operating system, such as Windows 7 or 8.
  • Upgrade all at-risk computers identified as capable of running a new operating system.
  • For computers that cannot be upgraded, either replace the hardware or purchase new computers.
  • Create a transition plan for upgrading or replacing computers.
Internet Explorer 8 is also no longer supported—if your practice is running Windows XP and using Internet Explorer 8, you may be exposed to additional threats.


Another Trial-Lawyer Backed Health Care Initiative

MICRA isn’t the only ballot issue facing California doctors this year – a health care rate regulation initiative threatening provider reimbursements is also on the November ballot. The same trial lawyer-backed group pushing to change MICRA is sponsoring a separate rate regulation ballot measure that would give the Insurance Commissioner new powers to approve or reject insurance rates, benefit levels, co-pays and deductibles, which would impact payments to providers and limit patient access to care. 

The Orange County Medical Association (OCMA) joins the California Medical Association (CMA) in opposition to this initiative. We are encouraging our members to join the official campaign opposed as individual physicians. 

The measure
  • Gives the elected State Insurance Commissioner new powers to set insurance rates at levels which don’t meet the cost of providing care, resulting in lower reimbursements to providers and ultimately reduced access to care for patients.  
  • Gives one politician the power to approve or reject benefits, interfering with care decisions that are better made between doctors, healthcare providers and patients. 
Not surprisingly, the proponents drafted the measure without any input from physicians, patients, hospitals, or other health care providers – even though it will create a massive new layer of health care regulation in California.

Of course, the real motive of the proponents is found buried in its language – a provision which opens up a new mechanism that allows the proponents and their trial lawyer backers to file lawsuits in rate proceedings, bleeding off invaluable health care dollars to line their own pockets.

We know defeating the MICRA initiative is a top priority. But we urge you to join us in also fighting this measure as it will have a significant impact on provider reimbursements and patient access to care.

Please join OCMA and a broad coalition of doctors, hospitals and health care providers in opposing this measure. 

If you would like to join the campaign’s media training webinar on May 8, please contact Kyle Griffith via email at kgriffith@bcfpublicaffairs.com

MICRA ALERT: Trial Lawyers Start Voter Mail Program

The trial lawyers and their front group "Consumer Watchdog" are taking the MICRA battle up another notch. With the start of their direct mail campaign to registered voters, it is clear they are looking to score a victory this year. Below is a photo of their mailer including a "38 Is Too Late" story card and an ever-so-subtle "morgue toe tag." Over the top tactics are to be expected.

Your help is critical to our continued success. Share the details of the trial lawyers efforts with your colleagues. Also, donating to CALPAC to your fullest ability and asking your colleagues to donateCMA/OCMA membership is crucial, so please consider becoming a member to help us with this fight. If you are already a member, we sincerely thank you for your membership.

CMA and our MICRA coalition members at Californians Allied for Patient Protection (CAPP) are fully engaged. With increased legislative visits and the preparation of our own mail and updated materials, we are telling the full story of MICRA and its important role in maintaining access for all. We completed our field poll testing and just received the results. This crucial data will help guide our campaign and ensure we deliver the strongest defense of MICRA at both the legislative level and to the voters of California.

Share this email with others and follow up to join and donate. We don't win unless the physicians of California are united and committed to beating back the trial lawyers. You have the strongest possible message to urge your fellow physicians to join the efforts to protect MICRA. And have no doubt, the fight will get more intense over the coming days and months.

We will win this fight once again because MICRA is a nationally-respected best-practice with overwhelming bipartisan support that has worked successfully in California for decades and, if changed, would result in higher health care costs for every Californian. Your commitment and efforts motivate our incredible staff at CMA. Thank you for all you do and will do. We will be back to you shortly with an update on our latest efforts.



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