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State Senate OKs bill to curb ‘doctor shopping’

Voters soundly rejected Proposition 46 – which would’ve raised California’s 40-year-old cap on certain medical malpractice damage awards – in November, but a lesser-known part of that measure moved forward Thursday in the Legislature.

The state Senate voted 28-11 to approve SB 482 by Sen. Ricardo Lara, D-Bell Gardens, which would require California doctors to consult an already-existing state prescription database before prescribing addictive medicine to their patients. This was another part of Prop. 46, albeit less controversial than the medical malpractice segment. The bill now goes to the Assembly.

It’s a win for Bob Pack, the Prop. 46 proponent and Danville resident whose two children were killed by a drunk and drugged driver on Oct. 26, 2003. The motorist who hit Troy and Alana Pack, 10 and 7, had consumed alcohol, Vicodin and muscle relaxants before getting behind the wheel; Jimena Barreto in the weeks before the crash had received six Vicodin prescriptions from six different Kaiser Permanente doctors, who had failed to check into the injuries for which she claimed she needed the pills.

To prevent this kind of “doctor shopping” by abusers and addicts, SB 482 will require prescribers to check the Controlled Substance Utilization Review and Evaluation System (CURES) before prescribing Schedule II and III drugs like OxyContin and other opioids for the first time to a patient, and annually if the treatment continues.

“Prescription drug overdose kills thousands every year, but a simple check of a patient’s medical record can give doctors the information they need to intervene with those who are at risk or may be abusing medications,” Carmen Balber, executive director of Consumer Watchdog, said in a news release. “Requiring doctors to check California’s prescription database before prescribing the strongest, most addictive drugs will save lives and help stem the overdose epidemic.”

Results are promising in other states with similar laws, and Consumer Watchdog estimates that a 75 percent drop in doctor-shopping in California – as experienced in New York – would reduce state and local spending on prescription drugs for Medi-Cal patients by up to $300 million a year.

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Poll #s tanking, Props. 45 and 46 go on offense

As the Field Poll shows Proposition 46 all but done for and Proposition 45 struggling, backers of both those controversial, health-related measures went on the offensive Thursday by filing official complaints against their foes and challenging a big insurance company’s spending.

Prop. 46 author Bob Pack of Danville, whose two children were killed in 2003 by a drugged driver, filed a complaint with the state’s Fair Political Practices Commission claiming the No on 46 committee violated state laws that require disclosure of major funders.

Insurance companies have contributed $42.8 million of the $56.5 million given to the No on 46 campaign, Pack says, and state law requires campaign committees to describe in descending order their major donors. Yet the No on 46 campaign committee is officially known as “No on 46 – Patients, Providers and Healthcare Insurers to Contain Health Costs.”

“How dare the insurance industry claim the mantle of ‘patients’ after blocking life-saving patient safety reforms for decades,” Pack said in a news release. “No on 46’s misleading attack ads, funded by mostly insurance industry money, pretend that they are a public campaign for patients. California’s TV and radio stations have a duty to the public to take these ads down until voters are told the insurance industry is really behind No on 46.”

Proposition 46 would raise the $250,000 cap on “pain and suffering” damages in medical malpractice cases; require random drug tests for doctors; and force doctors to use an existing prescription database to weed out drug abusers.

The campaign for it is being run by Consumer Watchdog, a lawyer-funded nonprofit advocacy group that’s also behind Proposition 45, which would give the state insurance commissioner power to reject health-insurance rate hikes.

Consumer Watchdog President Jamie Court filed his own FPPC complaint Thursday arguing the No on 45 campaign’s name and radio ads don’t identify “health insurance companies” – the source of the $37.5 million to the campaign – as a major donor. But several insurers are listed by name, including Kaiser Foundation Health Plan Inc., Wellpoint Inc. and Blue Shield of California.

My read: This is a small-ball attempt to further publicize insurers’ role in the campaigns, a role that’s already been widely reported. Court said it himself in today’s story, describing why he believes Prop. 46 isn’t a lost cause despite cratering poll numbers among likely voters: “All we have to do is tell them that it’s the insurance companies on the opposing side lying to them.”

Court, California Nurses Association members and other Prop. 45 supporters will be rallying at 1:30 p.m. Thursday outside Blue Shield’s headquarters on San Francisco’s Beale Street to deliver 22,000 petition signatures decrying the insurer’s purchase of a costly luxury skybox at the new Levi’s Stadium in Santa Clara.

Blue Shield’s decision to spend money on the skybox underscores the need for Prop. 45, they argue, so the insurance commissioner can reject excessive rate hikes that then pay for such luxuries.

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Blue Shield criticized for Levi’s Stadium skybox

The campaign for a ballot measure to let the state insurance commissioner veto health insurance rate hikes is pointing to Blue Shield of California’s pricey luxury skybox at the new Levis’s Stadium as a sign that insurers’ spending is out of control.

Levi's Stadium luxury suiteConsumer Watchdog and the Yes on 45 campaign sent a letter Tuesday to California Attorney General Kamala Harris urging her to investigate “Blue Shield’s abuse of its non-profit status” and crack down on its spending.

The letter cites a San Francisco Chronicle article which said suites of the type that Blue Shield got at the San Francisco 49ers’ new home are “priced at between $250,000 and $400,000 a year and require a 10- or 20-year commitment. That puts the price at anywhere from $2.5 million to $8 million.”

“We urge you to investigate Blue Shield’s abuse of its non-profit status and use your authority to impose a ‘charitable trust’ on Blue Shield’s assets and block any additional wasteful spending that robs taxpayers and average California patients of their financial health,” Consumer Watchdog President Jamie Court wrote to Harris.

Proposition 45 “will ensure that companies like Blue Shield are not increasing premium charges to patients to fund excessive executive compensation, lavish entertainment and excessive reserves,” Court wrote. “Under current law, the California Department of Insurance does not yet have the authority to block excessive rate increases that funded Blue Shield’s skybox. Before November, only you have the power to protect California taxpayers.”

Neither the No on Prop 45 campaign, known as Californians Against Higher Health Care Costs, nor Blue Shield of California answered e-mails seeking comment Tuesday. Blue Shield spokesman Sean Barry told the Chronicle over the weekend that the luxury box’s primary purpose “is to interact social with some of our larger membership groups,” and it won’t be available to executives for “their personal use.”

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Medical-negligence measure hits the streets

A Danville man whose two children were killed by a drugged driver in 2003 has been cleared to start circulating petitions for his proposed ballot measure to raise California’s nearly 40-year old limit on medical-negligence awards and force doctors to check a statewide database before prescribing narcotic drugs.

Secretary of State Debra Bowen on Monday said proponent Bob Pack has until Feb. 10, 2014 to gather valid signatures from at least 504,760 registered voters in order to qualify the measure for next year’s ballot.

The Attorney General’s official title and summary for the measure is as follows:

DRUG AND ALCOHOL TESTING OF DOCTORS. MEDICAL NEGLIGENCE LAWSUITS. INITIATIVE STATUTE. Requires drug and alcohol testing of doctors and reporting of positive test to the California Medical Board. Requires Board to suspend doctor pending investigation of positive test and take disciplinary action if doctor was impaired while on duty. Requires health care practitioners to report any doctor suspected of drug or alcohol impairment or medical negligence. Requires health care practitioners to consult state prescription drug history database before prescribing certain controlled substances. Increases $250,000 cap on pain and suffering damages in medical negligence lawsuits to account for inflation. Summary of estimate by Legislative Analyst and Director of Finance of fiscal impact on state and local government: State and local government costs associated with higher medical malpractice costs, likely at least in the low tens of millions of dollars annually, potentially ranging to over one hundred million dollars annually. Potential state and local government costs associated with changes in the amount and types of health care services that, while highly uncertain, potentially range from relatively minor to hundreds of millions of dollars annually. (13-0011.)

Pack, supported by the Consumer Watchdog advocacy group, says his proposed ballot measure would prevent other families from suffering as his has. “It’s a simple and reasonable step forward that the Legislature should have taken decades ago,” Pack, 58, wrote in a July when announcing the measure.

But medical organizations staunchly oppose it.

“We see this initiative as a very stark, trial-lawyer-sponsored attempt to increase their ability for a payday,” Dr. Paul Phinney, the California Medical Association‘s president and CEO, said in July. “It will increase medical costs for everybody in the state without doing a thing to improve care. … We think policy now should be directed toward lowering health care costs, not increasing them to benefit trial lawyers.”

The California Medical Association, California Hospital Association, California Dental Association, Planned Parenthood Affiliates of California and Central Valley Health Network have created a “Patients and Providers to Protect Access and Contain Health Costs” committee to oppose the measure. Those and other groups have loaded that committee with $31.5 million so far.

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Medical orgs put up $7.5m against MICRA measure

As predicted, California’s medical establishment is starting to put up big money to oppose a proposed ballot measure that would lift the cap on non-economic damages that can be awarded in medical-negligence lawsuits.

The California Medical Association, California Hospital Association, California Dental Association, Planned Parenthood Affiliates of California and Central Valley Health Network recently created a “Patients and Providers to Protect Access and Contain Health Costs” committee to oppose the measure.

That committee got its first big cash injection last week: $5 million from the California Medical Association. The California Hospitals Committee on Issues anted up Wednesday with $2.5 million.

Leading the charge for the ballot measure is Bob Pack of Danville, whose two children were killed by a drugged driver in 2003. Supported by the Consumer Watchdog advocacy group, Pack says his proposed ballot measure – by raising California’s nearly 40-year old limit on medical-negligence awards and force doctors to check a statewide database before prescribing narcotic drugs – would prevent other families from suffering as his has.

The medical organizations see the proposed measure as “a very stark, trial-lawyer-sponsored attempt to increase their ability for a payday,” said Dr. Paul Phinney, the California Medical Association’s president and CEO. They say it will boost Californians’ medical costs without doing anything to improve care.

The proposed measure is awaiting an official title and summary from the state attorney general’s office before it can be cleared to start gathering petition signatures.

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Senators say state DTSC will cooperate with probe

The state Department of Toxic Substances Control’s director promised Monday that she’ll work with state Senate investigators to explore claims that the agency hasn’t properly enforced regulations, lawmakers said.

Senate Majority Leader Ellen Corbett, D-San Leandro, said she and state senators Kevin de Leon, D-Los Angeles, and Ricardo Lara, D-Long Beach, met today with DTSC Director Debbie Raphael regarding recent claims raised in a Consumer Watchdog report and subsequent media stories. The senators have asked the Senate Office of Oversight and Outcomes to launch a probe.

“We must get to the bottom of questions prompted by the Consumer Watchdog report,” Corbett said in a news release. “I appreciate that Ms. Raphael welcomes transparency and accountability. I look forward to the Senate investigation and making whatever changes may be necessary for DTSC to effectively do its job.”