California Medical Association House of Delegates
CMA 2013 REPORT OF REFERENCE
1
2 2. Resolution 102-13: TREATMENT OF TUBERCULOSIS AN ESSENTIAL HEALTH
3 BENEFIT
4 Author: Peter R. Kerndt, MD, MPH
5 RESOLVED: That CMA write the Board of Covered California to urge that Covered
6 California recognize that the diagnosis and treatment of TB disease and
7 infection is and should be recognized as an essential health benefit and a
8 prevention activity and therefore should be available without any
9 requirement for cost sharing and that insurance coverage must provide
10 medical care and anti-TB medications to patients with TB disease and
11 TB infection free of charge and that any attempt at cost sharing through
12 insurance co-pays or deductibles should be prohibited.
13
14 RESOLVED: That CMA write the Board of Covered California to urge that Covered
15 California recognize that the diagnosis and treatment of TB disease and
16 infection is and should be recognized as an essential health benefit and a
17 prevention activity and therefore should be available without any
18 requirement for cost sharing and that insurance coverage must provide
19 medical care and anti-TB medications to patients with TB disease and TB
20 infection free of charge and that any attempt at cost sharing through
21 insurance co-pays or deductibles should be prohibited.
22
23 RECOMMENDED ACTION: YOUR REFERENCE COMMITTEE RECOMMENDS
24 APPROVAL OF RESOLUTION #102-13 AS
25 AMENDED AND ASKS FOR A "YES" VOTE ON IT.
26 THE RESOLVED PORTION IS AMENDED TO
27 READ:
28
29 RESOLVED: That CMA advocate that medical care and anti-tuberculosis
30 medications for patients with both TB disease and TB infection be
31 provided by payors without cost-sharing; and be it further
32
33 RESOLVED: That CMA advocate to Covered California that the diagnosis and
34 treatment of TB disease and infection is and should be recognized as
35 an integral part of the preventive care provided to patients with TB
36 disease and TB infection, and that any attempt to impose cost-
37 sharing on such services and anti-TB medications must be
38 prohibited.
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CMA 2013 REPORT OF REFERENCE
1 Reason(s) for Recommendation:
2 A. The term “cost-sharing” is more comprehensive and covers cost-sharing mechanism
3 not explicitly mentioned by the author (e.g., coinsurance).
4 B. The term “advocate” grants CMA staff greater flexibility in the means of achieving the
5 author’s desired result.
6 C. The mention of essential health benefits has been removed because TB treatment and
7 anti-TB medications are already clearly included in that definition. Thus, advocating
8 for such inclusion would be unnecessary. The key point of advocacy here would be
9 getting TB treatment and anti-TB medications considered an integral part of
10 preventive care, which would prohibit cost-sharing for such services under recent
11 federal guidance.
12 D. The amended version would allow CMA to write a letter as requested in testimony,
13 but leaves flexibility to determine content and to whom a letter should be sent.
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16 3. Resolution 103-13: USE OF THE CALIFORNIA IMMUNIZATION REGISTRY TO
17 CONTROL AND PREVENT TUBERCULOSIS
18 Author: Peter R. Kerndt, MD, MPH
19 RESOLVED: That CMA support legislation and/or policy and/or regulatory change to
20 allow the California Department Public Health and local health
21 jurisdictions access to and the use of the California Immunization
22 Registry (CAIR) for the control and prevention of tuberculosis; and be it
23 further
24 RESOLVED: That CMA encourage medical providers to utilize CAIR to document TB
25 screening results and that this health information exchange be directly
26 linked when possible from the patient/provider electronic medical record.
27
28 RECOMMENDED ACTION: YOUR REFERENCE COMMITTEE RECOMMENDS
29 APPROVAL OF RESOLUTION #103-13 AS
30 AMENDED AND ASKS FOR A "YES" VOTE ON IT.
31 THE RESOLVED PORTION IS AMENDED TO
32 READ:
33
34 RESOLVED: That CMA encourage that the California Department Public
35 Health and local health jurisdictions be permitted to access and
36 use tuberculosis screening data reported to the California
37 Immunization Registry, when consent has not been withheld for
38 the screened person, for the control and prevention of
39 tuberculosis; and, be it further
40
41 RESOLVED: That CMA encourage medical providers to utilize the California
42 Immunization Registry to document tuberculosis screening results
CMA 2013 REPORT OF REFERENCE
1 and that this health information exchange be directly linked when
2 possible from the patient/provider electronic medical record.
3
4 Reason(s) for Recommendation:
5 A. TB continues to be a public health issue in California and CAIR could be an important
6 tool to help quickly initiate treatment to prevent the development of TB.
7 B. The changes to the first resolved allow for greater flexibility in finding solutions.
8 C. The issue of ensuring that access is consistent with the screened person’s consent was
9 raised in testimony.
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