February 2023 Government Affairs Update by Ravi Goklaney, MD, DLFAPA

CSAP Government Affairs Committee has more than 30 members from five district branches, and everyone is getting along with each other.  During the last meeting, on January 19, 2023, we discussed a bill, which is being introduced by Senator Susan Talamantes Eggman, to reform and simplify the definition of “gravely disabled” to make it easy to establish the status of conservatorship.  This paper is still being reviewed and revised and the final draft will be reviewed by Government Affairs Committee for approval and returned to Senator Susan T Eggman.  Dr Roderick Shaner has received several complaints from private practitioners that BMQA is requesting records without any complaint by a patient and, if BMQA finds any deficiencies in the records, the practitioners are being penalized.  He introduced this problem to the SCPS Council and the Council approved to introduce it to the Government Affairs Committee.  I added a few more items related to BMQA harassment of private practitioners even if a patient files a simple complaint, not only is BMQA requesting medical records, but requests detailed course of treatment, progress of each visit, and take months to respond back to private practitioners and, at times, requesting more information, taking up to one to two years before they dismiss the complaint.  Dr Mina Hah also shared her experience of difficulty with BMQA.  Government Affairs Committee members discussed this issue and voted to establish a Sub Committee to deal with private practitioners issues.  Most likely, Dr Roderick Shaner will be Chairing it and I already have expressed strong interest in participating on this committee.

I had the privilege to attend AMA State Advocacy Summit in Arizona January 12, 2023 to January 14, 2023 as I am an AMA member and I had expressed my serious interest in advocacy.  There were approximately 400 physicians from all different specialties from all over the country.  I learned the following important information:

  1. AMA is pursuing, with the Federal Legislatures to limit the scope of practice for Family Nurse Practitioners and Physician to be the leader of the team.  There are two centers who have conducted the studies and found patients who were seen by FNP vs MD, FNP orders more CT scans and MRIs, their patients had higher rate of hospitalization and longer length of stay in the hospital.  One of these studies was conducted by Dr Chen of Stanford University over a period of two years.
  2. AMA is pursuing parity of reimbursement for all specialists as, at present, reimbursement varies with each specialty.
  3. AMA is pursuing to abolish preauthorization of visits and preauthorization of medication.
  4. AMA is pursuing for the rights of Gynecologists as, in some states, the new regulation prohibits abortions and Gynecologists can be charged with felony in case they perform an abortion.  AMA is very concerned with legislatures interfering with practice of Gynecologists.
  5. AMA is very concerned with physician burnout due to institutional bureaucracy, prejudice, and discrimination, and plan to come up with some solutions.
  6. AMA would like to remove the question of Mental Health, which physicians are asked by the Licensing Boards during the renewal of license and, in some states, even their Psychiatrists declare they are fit to work but Boards took extra steps to subpoena medical records, which AMA views as a violation of physicians privacy.
  7. AMA expressed grave concern of the fentanyl influx in the country, which is killing young Americans.  In 2021, the Department of Health and Human Services recorded 108,000 deaths due to fentanyl overdose and, in 2022, the numbers are expected to be much higher, which is extremely disturbing.  AMA Task Committee on Fentanyl is working with federal legislatures to take steps to prevent young Americans from losing their lives.

I learned a lot from the AMA Advocacy Summit and I highly recommend members of CCPS may consider becoming members of AMA so we could address issues to AMA which are concern to us.

I would also like to make a humble request to all CCPS members, if you know any peer who left APA membership, pursue them to consider rejoining APA as, in California, all psychiatrist working together in the best interest of the patients, their families, and to protect the integrity of our profession.

Ravi Goklaney, MD, DLFAPA
Chair, Government Affairs Committee