CMA_AnnualReport_Web_2015

1California Medical Association • 2014 Annual Report
CMA
STRONG
Physicians dedicated
to the health of California
California Medical Association
2014 Annual Report

2 California Medical Association • 2014 Annual Report
For more photos, visit flickr.com/californiamedicalassociation.
2014 Legislative Leadership Day

The Coming Year, and Beyond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
A message from CMA President Luther F. Cobb, M.D., FACS
One United Voice for Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
A message from CMA Chief Executive Officer Dustin Corcoran
Fighting for Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Achieving Victory: No on 46. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
CMA’s Got You Covered. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Board of Trustees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Member-Only Discounts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Get Involved. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Financial Statements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
How Can We Be of Service?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
County Medical Societies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Table of
Contents

Although 2014 will long be
remembered as the year
that all modes of practice
and specialties of the
House of Medicine came
together in a group effort to
defeat Proposition 46, it is
imperative that we maintain
the momentum we have
gained as we confront the
issues of the coming year and beyond.
Following such a historic year, I would like to take a
moment to reflect on what we have accomplished and
what we can look forward to over the next 12 months.
I have, for over three decades, been a firm believer in
the institution of organized medicine and the good that
we can accomplish with unified action. As the President
of the Humboldt-Del Norte Medical Society and Chair of
the Council on Legislation, and in my time as Vice Speaker
and Speaker of the House of Delegates, I have seen you
all accomplish remarkable feats together. Whether it has
been determining our stance on the sweeping changes of
health system reform; combating unwarranted extensions
of allied health professionals’ scope of practice; fighting for
access to care; working to ensure the practice of medicine
is dedicated to patient welfare rather than the insurance
bottom line; redefining Medicare geographic payments,
and on and on; we have been able to get all this done
because we work together for the benefit of all.
Our political power was evidenced last November
when we handed the trial attorneys’ Proposition 46
an unprecedented two-for-one electoral defeat, in
conjunction with an unparalleled coalition across all party
and advocacy lines. We distributed over 3 million lab coat
cards, hundreds of thousands of patient brochures, posters
and yard signs all over the state, mostly because of the
ground game we mobilized.
Such a victory would never have been possible if not for
the dedication we all had to one another and to the future
of the practice of medicine.
It is indeed a great honor to follow in the footsteps of
Richard Thorp, M.D., who as last year’s president led
an incomparable team effort to victory, not only with
Proposition 46, but also the other battles and challenges
we faced.
So what does that mean for the year ahead?
Already, the California Medical Association (CMA) has been
involved in a public launch to increase the tobacco tax in
California. We currently stand 47th in the nation in that
regard. A broad coalition of public health advocates will be
working all across the state. This action may end up being
a legislative effort, or perhaps a ballot initiative, but we will
be pressing forward this year.
We know that as millions of citizens are signing up for
health insurance coverage, it is more important than ever
to ensure that they have real access to quality medical care,
not just a card promising care without the infrastructure to
deliver. To that end, CMA has been working with partners
to educate physicians and patients about their choices.
Many other issues are sure to arrive in the coming year;
they always do. As a group, united, we can accomplish
great things, as we have already proven.
I look forward to working with you all in the exciting new
year.
The Coming Year,
and Beyond
Luther F. Cobb, M.D., FACS
President

2014 House of Delegates

Dustin Corcoran
CEO
Dustin Corcoran is Chief Executive Officer for the California Medical Association
(CMA), a non-profit professional organization of over 40,000 physicians
dedicated to protecting public health and promoting the science and art of
medicine. As CEO, Mr. Corcoran has the responsibility for the overall
supervision, direction and control of the business and staff of CMA. Mr.
Corcoran also serves as the chairman of Patients and Providers to Protect
Access and Contain Health Costs, the campaign committee opposing the anti-
MICRA ballot initiative, as well as Californians Allied for Patient Protection
(CAPP), a broad-based coalition of health care providers, hospitals, community clinics and labor interests dedicated to
the defense of MICRA.
Mr. Corcoran has advocated tirelessly for California physicians and the patients that they serve since 1998. He
started at CMA as the membership coordinator for the association's political action committee. Within a year, Mr.
Corcoran moved to CMA's Center for Government Relations where he worked under the guidance of the legendary
Steve Thompson as a staff lobbyist. When Mr. Thompson passed away in 2004, Dustin succeeded him as Vice
President of Government Relations where he managed CMA’s overall legislative program, representing physicians’
interests before the State Legislature and the Governor. In 2009, Mr. Corcoran was promoted to Senior Vice-President,
where he oversaw the day-to-day operations of CMA, as well as the Center for Government Relations and ultimately
became CEO in February of 2010.
Dustin’s career has been marked by years of leadership and service
 In 2005, Mr. Corcoran was named “Most Effective Lobbyist Under 40” by AroundtheCapitol.com.
 Since 2009, Mr. Corcoran has been listed annually on Capitol Weekly’s top 100 power brokers in California –
most recently, in 2014, listed at number 14.
 In 2012, Mr. Corcoran’s work as CMA’s chief executive officer was recognized when he was named to the
Sacramento Business Journal’s “40 Under 40” list of top business and civic leaders.
Mr. Corcoran serves on the Board of Directors for the Neuropathy Action Foundation, Physicians Advocacy Institute,
the Institute for Medical Quality, and the California Medical Association Foundation.
Dustin lives in Sacramento with his wife Glenda who serves on the Board of Governors of the State Bar of California
and their children, daughter Dylan and son Fletcher.
Dustin Corcoran
CEO
Dustin Corcoran is Chief Executive Officer for the California Medical Association
(CMA), a non-profit professional organization of over 40,000 physicians
dedicated to protecting public health and promoting the science and art of
medicine. As CEO, Mr. Corcoran has the responsibility for the overall
supervision, direction and control of the business and staff of CMA. Mr.
Corcoran also serves as the chairman of Patients and Providers to Protect
Access and Contain Health Costs, the campaign committee opposing the anti-
MICRA ballot initiative, as well as Californians Allied for Patient Protection
(CAPP), a broad-based coalition of health care providers, hospitals, community clinics and labor interests dedicated to
the defense of MICRA.
Mr. Corcoran has advocated tirelessly for California physicians and the patients that they serve since 1998. He
started at CMA as the membership coordinator for the association's political action committee. Within a year, Mr.
Corcoran moved to CMA's Center for Government Relations where he worked under the guidance of the legendary
Steve Thompson as a staff lobbyist. When Mr. Thompson passed away in 2004, Dustin succeeded him as Vice
President of Government Relations where he managed CMA’s overall legislative program, representing physicians’
interests before the State Legislature and the Governor. In 2009, Mr. Corcoran was promoted to Senior Vice-President,
where he oversaw the day-to-day operations of CMA, as well as the Center for Government Relations and ultimately
became CEO in February of 2010.
Dustin’s career has been marked by years of leadership and service
 In 2005, Mr. Corcoran was named “Most Effective Lobbyist Under 40” by AroundtheCapitol.com.
 Since 2009, Mr. Corcoran has been listed annually on Capitol Weekly’s top 100 power brokers in California –
most recently, in 2014, listed at number 14.
 In 2012, Mr. Corcoran’s work as CMA’s chief executive officer was recognized when he was named to the
Sacramento Business Journal’s “40 Under 40” list of top business and civic leaders.
Mr. Corcoran serves on the Board of Directors for the Neuropathy Action Foundation, Physicians Advocacy Institute,
the Institute for Medical Quality, and the California Medical Association Foundation.
Dustin lives in Sacramento with his wife Glenda who serves on the Board of Governors of the State Bar of California
and their children, daughter Dylan and son Fletcher.
One United Voice
for Medicine
As 2015 is well underway,
it’s clear that this is going
to be another pivotal
year in health care. At
the California Medical
Association (CMA), our
advocates are already in
the limelight, fighting on
behalf of over 40,000
members on issues facing
California physicians. Our efforts this year come on the
heels of what was one of the greatest demonstrations of
unity our organization has ever experienced.
In 2014, CMA led an unprecedented effort to defeat
Proposition 46. When the trial lawyers pursued this
ill-conceived measure that would have obliterated the
strongest tort reform law in the nation, the Medical Injury
Compensation Reform Act (MICRA), CMA rose to the
challenge. The dedicated staff at CMA came together in
an incredible feat and distributed over 3 million pieces of
literature, posters, placards and sign-up forms for your
offices, your patients and your neighbors. Physicians not
only spoke to their friends and families, but spoke out
at community events and political gatherings across the
state. Together, we amassed one of the largest and most
diverse coalitions to defeat a ballot measure in California
history. On Election Day, when the trial lawyers lost 33
percent to 67 percent, it was clear that CMA physicians
were a force to be reckoned with. In fact, we did not lose
a single county in California.
Our political success did not stop there, however. For the
first time, a CMA member was elected to the California
State Senate. Then Assemblymember Richard Pan, M.D.,
beat his trial lawyer opponent to bring a strong physician
voice to the Senate chambers. CMA also worked tirelessly
to support candidates who share our vision for the future
of medicine both here in California and in Washington,
D.C., including Congressmen Ami Bera and Raul Ruiz,
both physicians.
The work we did in 2014 stretched far beyond the ballot.
Working with coalition partners and other advocacy
organizations, CMA continued to be a leader in the
regulatory, legal and legislative arenas.
Your membership and support of organized medicine
is how we continue to do this important work. CMA is
only able to be at the forefront of important public health
discussions around vaccination policy and tobacco use
because you choose to belong to CMA.
It was because of you that we were able to defeat
Prop. 46. It was because of you that we were able to
stop numerous legislative attempts to expand scope of
practice for allied professionals in their tracks last year. It
was because of you that we stand together as one united
voice, looking ahead.
I cannot thank you enough for the dedication and
fortitude you demonstrated in 2014. As we look ahead to
2015 and years beyond, I’m certain that the same levels
of commitment will enable physicians to succeed in
these turbulent times.
Dustin Corcoran
CEO

In order to serve our more than 40,000 members, the California
Medical Association (CMA) spends every day fighting for California
physicians and their patients in a variety of advocacy areas. In
2014, we experienced one of our biggest fights – and victories –
the battle to save the Medical Injury Compensation Reform Act
(MICRA) and defeat Proposition 46 (see “Achieving Victory”).
CMA also fought long and hard on the federal level, ultimately
achieving a victory worth billions to California physicians.
During one of the most dysfunctional Congressional sessions
in history, CMA successfully advocated for passage of a fix to
the Medicare California geographic practice cost index (GPCI),
providing substantial payment increases to California physicians
and improving access to care for all Californians.
Starting in 2017, the GPCI fix will update Medicare payments
in 14 California counties by up to 14 percent per year. It also
establishes a payment floor for California’s rural physicians to
ensure payments in those areas will not go down, even during
another recession. No other state, specialty or national medical
organization has been able to achieve such substantial Medicare
payment increases and protections for their physician members
in recent years.
In addition, for the first time in a decade, Congress and organized
medicine developed and moved a bipartisan, bicameral bill that
would have eliminated the Medicare sustainable growth rate
(SGR) and instituted an alternative payment system. Although
Congress ultimately could not agree on a funding source before
the deadline, instead adopting the 17th short-term patch in
a decade, we have never been so close to achieving reform.
Hopefully, in 2015 we will finally be able to completely eliminate
the SGR. CMA will continue advocating for Medicare payment
reform to ensure physician practices have the appropriate
resources to ensure access to quality care.
Fighting for
Physicians

CMA also worked with the American Medical Association
(AMA) to reduce Medicare payment penalties for the new
value modifier payment program, which starts tracking
in 2015. CMA (with the invaluable help of the California
Congressional delegation) also successfully convinced
the Centers for Medicare and Medicaid Services (CMS)
to reverse their mandate on California to retroactively
recoup a 10 percent Medi-Cal reimbursement rate cut
from 2011, retaining $218 million in payments.
CMA in the
State Capitol
On the state level, Medi-Cal reimbursement rates
continued to be a hot topic in 2014. Over the last several
years, CMA has led the effort to stop the implementation
of Governor Jerry Brown’s 10 percent cut to Medi-Cal
reimbursement rates, arguing that this reduction would
threaten the ability of physicians to continue to treat
Medi-Cal beneficiaries and create significant gaps in
access to care for patients that rely on the program. CMA
worked throughout the year to collect providers’ stories
that demonstrate Medi-Cal network inadequacy and
hindered access to continuous, quality care for Medi-Cal
patients.
While participating in a number of DHCS workgroups,
CMA made it clear that increasing Medi-Cal payment
rates is a prerequisite to implementing incentive
payment reforms. Additionally, CMA called for the state
to conduct an independent, third-party assessment on
reimbursement rates, stating that such an assessment is
a critical component in determining both the baseline
rates and the level of incentive payments required.
Grassroots efforts
During CMA’s Legislative Leadership Conference and the
Ethnic Medical Organization Section/ Network of Ethnic
Physician Organizations Ethnic Physicians Leadership
Day, more than 400 physicians, medical students and
CMA Alliance members descended on Sacramento
to lobby a package of CMA-sponsored bills aimed at
increasing access to health care throughout the state.
Attendees discussed many of CMA’s major legislative
issues, including:
Support for budget talks to restore the 10 percent
Medi-Cal reimbursement rate cut.
Support for AB 2400, which would have required
greater transparency in physician contracts by allowing
physicians to opt-in to each network or product, instead
of being forced to participate in “all products,” a complaint
stemming from Covered California provider contracting
(see “CMA’s Got You Covered”).
Opposition to a dangerous scope-of-practice bill, SB
492, which would have allowed optometrists to diagnose
and treat any disease with an ocular manifestation.
Opposition to AB 2533, which would have imposed unfair
contracting conditions on physicians and exacerbated
the state’s current network adequacy concerns.
Support for SB 1000, which would have placed a health
warning label on sugary drinks.
SB 1000, which came out of the 2013 “My CMA Idea”
contest, was a priority bill for CMA last year. The bill
would have placed a simple warning on the front of all
beverage containers with added sweeteners that have
75 or more calories per 12 ounces. Backed by a large
coalition and carried by state Senator Bill Monning, SB
1000 was approved by the state Senate, but stalled in the
Assembly Health Committee.
FIGHTING FOR PHYSICIANS

Workforce issues
CMA continues to prioritize improving our state’s physician workforce by increasing the number of residency slots for
medical school graduates and by pushing the state to make an initial investment in its future medical workforce.
Following unprecedented grassroots advocacy by the physician and medical student community, the Legislature
approved a 2014 - 2015 state budget that includes $7 million for primary care residency slots. With $3 million applied
to expand the Song-Brown program to all primary care specialties (family medicine, internal medicine, obstetrics-gyne-
cology and pediatrics), the additional $4 million will fund the expansion of some residency programs. The budget also
requires priority be given to programs that have graduates of California-based medical schools.
In the courts
CMA’s Center for Legal Affairs advocated on behalf of
California physicians in the courts throughout 2014,
including several cases that will have long-lasting impacts
on the practice of medicine in California.
Fitzgibbons v. IHHI - CMA filed an amicus brief that argued
hospitals must be held liable for the actions of their CEOs
in order to establish a system of accountability. The case
involved a physician who was awarded emotional distress
and punitive damages for a campaign of egregious
intimidation and harassment against him by the hospital’s
CEO.
Armstrong v. Exceptional Child - CMA, along with AMA
and other physician organizations, filed an amicus brief
before the U.S. Supreme Court in this case to determine
whether Medicaid providers have a cause of action to
challenge a state’s compliance with Medicaid laws in
setting reimbursement rates. CMA’s involvement is critical
to uphold and protect precedential Ninth Circuit decisions
and to extend the law recognized in those cases to the
entire country.
Prescription Drug Monitoring Program Privacy
CMA and AMA filed amicus briefs in two cases that raise the
important issue of the privacy of patient data in prescription
drug monitoring programs (PDMP). CMA’s briefs in Lewis
v. Medical Board of California (California Supreme Court)
and Oregon Prescription Drug Monitoring Program v.
DEA (U.S. Court of Appeals, Ninth Circuit) underscore
the importance of confidentiality of medical information
as an indispensable component of quality medical care
and argue that there must be clear guidelines on the use
and disclosure of such data by government agencies to
assure patients of confidentiality of their protected health
information.
Association of California Life Health Insurance
Companies v. California Department of Insurance (CDI)
- CMA filed an amicus brief supporting CDI in a case over
the implementation of AB 2470, a 2010 CMA-sponsored
bill. The law addresses the widespread problems caused
by retroactive rescissions and post-claims underwriting
that were prevalent in the health insurance industry. CMA’s
brief provided the court with background on the harmful
rescission practices that led to AB 2470, and argued that
CDI’s regulatory rules were necessary and reasonable to
fully realize the patient protections established by the law.
Children’s Hospital v. Blue Cross of California – CMA,
along with other physician organizations, urged the
California Supreme Court to review a Court of Appeal
decision dealing with the calculation of the reasonable
market value of medical services. Although the Court
denied review, CMA continues working to identify ways
to minimize the negative impact of the decision in the
courts, the Legislature and before the Department of
Managed Health Care (DMHC).
The Center for Legal Affairs also provided legal
information on a variety of issues in 2014, receiving 654
total calls from physician members in 33 counties. CMA
attorneys continue to update and publish legal resources,
including the California Physician’s Legal Handbook and
CMA’s online health law library, and give presentations
throughout the state on relevant topics facing California
physicians.

2014 No on Prop 46 Campaign

On November 4, the voters of California
spoke loudly and definitively, sending
the trial lawyers’ Proposition 46 to defeat
by a vote of 67 percent to 33 percent. It
was the only ballot measure defeated in
every county, as well. The message was
clear – Californians simply don’t want to
increase health care costs and reduce
health access so trial attorneys can file
more lawsuits.
An increase in MICRA’s cap on
non-economic damages has been
rejected in California again and again: 10
times in court, five times in the Legislature
and now overwhelmingly by voters. But
this time, CMA membership as a whole
was energized to fight the fight together,
as one unified voice of medicine,
representing the patients we so deeply
care about and the care that we have
committed to provide them.
Despite the trial attorney proponents’
attempt to sweeten the deal by adding
provisions that polled well – physician
drug testing and mandatory checking
of California’s PDMP – voters said NO
on Election Day. As people throughout
the state heard from physicians and No
on 46 coalition members about the real
intentions of the measure’s proponents,
there was resounding opposition.
Achieving Victory
No on 46
No on Prop 46No on Prop 46
Yes on Prop 46
RESULTS BY
COUNTY

The campaign
The entire CMA team dove into the MICRA campaign
whole-heartedly. As soon as ballot language was filed, CMA
created a brochure to inform California voters about how
the measure would affect their access to care by causing
community health centers and physician offices across the
state to close.
CMA also sent a large contingent of physicians and over
100 medical students to the California Democratic Party
Convention to educate party delegates about the real
intentions of the trial lawyer sponsors of the measure.
Roaming the halls, lining the backs of caucus rooms
and speaking to delegates in their white lab coats, CMA’s
representatives spoke with delegates about the effects any
changes to MICRA would have on California’s health care
system.
Physician and medical student volunteers engaged
hundreds of people in conversation about the importance
of MICRA – leaving a truly lasting impression. And, during the
huge general session, medical students greeted hundreds
of delegates with information regarding the trial lawyers’
ballot measure “sweetener” ploy. In the end, these efforts
resulted in the California Democratic Party rejecting lawyers’
attempts to gain an endorsement, instead voting to remain
neutral. And, due to efforts by CMA and the entire coalition,
the anti-MICRA measure gained the opposition of many
county Democratic parties, including the Los Angeles
County Democratic Party – the largest in the state.
To further reach leaders around the state, a contingent of
physicians and staff also attended the California Republican
Party Convention, speaking to delegates about the critical
importance of continuing to support MICRA, and earning
their “No on 46” endorsement.
As soon as the ballot measure was officially dubbed
Proposition 46, the campaign swung into high gear.
For hours every day, CMA fulfilled orders for campaign
materials, ultimately sending out nearly 3 million lab coat
cards, 300,000 brochures and over 1,000 office kits (plus
buttons, stickers, posters and more) to physicians’ offices
and hospitals around the state. Physician leaders (especially
then CMA President Richard Thorp, M.D.) and staff traveled
around the state to speak to nearly 200 hospitals, specialty
societies and community groups across the state.
Since its inception, MICRA has
been habitually attacked in the
courts with cases attempting to
undermine its broad scope and
constitutionality. In 2014, CMA’s
legal team remained vigilant,
defending MICRA in various cases
that threatened to circumvent
its protections and to diminish
its benefits to health care in
California.
WINN V. PIONEER MEDICAL
GROUP - CMA, along with AMA, filed
a brief with the California Supreme Court
in an important case that draws the line
between medical malpractice and elder
abuse claims. CMA’s brief argued that the
plaintiff’s elder abuse claims were a veiled
attempt to reclassify acts of professional
negligence in order to circumvent MICRA.
CHAN V. CURRAN, M.D. - CMA
and AMA filed an amicus brief supporting
the constitutionality of MICRA’s non-
economic damages cap and rejecting
the plaintiff’s claims that MICRA violates
the constitutional right to a jury trial, due
process and equal protection. CMA’s brief
argued that to strike down MICRA would
contravene decades of California law,
directly violate Supreme Court precedent
and contradict the Legislature’s stated
purpose in enacting the limitation on non-
economic damages.
HUGHES V. PHAM - Nearly two
years after filing a brief (together with
AMA) to support the constitutionality of
MICRA’s cap on non-economic damages,
the Court of Appeal issued its unpublished
ON THE MICRA
LEGAL FRONT
ACHIEVING VICTORY

True team effort
One of the secret weapons of the campaign effort, the
size and diversity of the No on 46 coalition, grew every
day. The breadth of the coalition – which included labor,
business, local government, health providers, community
clinics, Planned Parenthood, ACLU, NAACP, taxpayers,
teachers, firefighters and more – underscored the depth
of problems with the measure, and its far-reaching
impacts beyond the health care system.
In addition to the groups on the ground talking to voters
about the deception and trickery behind Prop. 46, every
major editorial board in California opposed the initiative.
The Los Angeles Times said, the measure’s methods “are
too flawed to be enacted into law.” The San Francisco
Chronicle said the measure “overreached in a decidedly
cynical way.” The Orange County Register, UT San Diego,
San Jose Mercury News, Monterey County Herald,
Sacramento Bee and dozens of other newspapers
echoed these sentiments.
The efforts of CMA and county medical
associations across the state were
a tremendous showing of
what organized medicine
can do for the future of
health care, the quality
of medicine and the
dedication to patients
everywhere. Working
together to spread
the truth about
Prop. 46, building
coalitions across
communities and
standing strong as one
united voice is what helped
carry us to victory. This was
one of the most contentious and
high-stakes ballot fights in California
history and California’s physicians rose to the
occasion.
decision upholding that constitutionality.
The court’s opinion is consistent with the
position advocated by CMA in its brief,
which noted that MICRA was enacted to
reduce the cost of medical malpractice
litigation and assure the continued
availability of medical care throughout the
state.
RASHIDI V. MOSER, M.D. - CMA
and other organizations filed an amicus
brief in the California Supreme Court
urging the common sense application of
MICRA for the purpose of reducing the
costs of health care litigation. The case
questioned whether MICRA’s cap on
non-economic damages limits damages
awarded by a court only, or whether it
limits all recovery in a case, including
settlement. The Supreme Court filed an
opinion in December 2014 addressing the
narrow legal issue presented, without
questioning the scope of MICRA or its
constitutionality.
FLORES V.
PRESBYTERIAN
INTERCOMMUNITY
HOSPITAL - CMA, together
with other amici, filed a brief
with the California Supreme Court
urging reversal of an appellate court
opinion that threatens to erode the
long-standing definition of “professional
negligence” in MICRA. CMA argued that
the Court of Appeal’s decision was wrong
in failing to apply MICRA’s statutory
definition of professional negligence to
include negligence that occurs while a
health care provider is providing services
within the scope of licensure.
ON THE MICRA
LEGAL FRONT
CMA
MEMBERSHIP
TOPS 40,000
For the fourth year in a row, CMA has seen a
notable membership increase. In 2014, total
CMA membership grew 3 percent to 40,664
(including physicians, medical students,
residents and retired physicians),
representing all modes of practice
from across the state.

$10 MILLION
REASONS
to be a CMA
member
CMA’s Center for Economic
Services (CES) has now recouped
$10 million from payors on behalf
of CMA member physicians.
These monies, recovered over
the last five years, represent
actual physician reimbursements
that would have likely gone
unpaid without the intervention
of the CES team. CES provides
CMA members with one-on-one
practice management assistance
for billing, contracting and
reimbursement issues that may
arise.
CMA’s Got
You Covered
Even before Covered California officially began providing coverage on January
1, 2014, CMA jumped into action to help its members better prepare to
navigate the turbulent waters of the Affordable Care Act (ACA). With lingering
confusion over exchange plan contracting, CMA urged physicians to check
their participation status with exchange plan networks. After hearing from our
members that the Covered California cross-plan directory was plagued with
inaccuracies, CMA created a quick and easy tool for practices to look up their
exchange participation status with each plan. Additionally, CMA published
a series of practice tip sheets, “Surviving Covered California,” that included
answers to commonly asked questions. CMA staff also conducted almost 50
live seminars on the exchange to help physicians survive the implementation
of Covered California.
Also recognizing the confusion surrounding the ACA’s “grace period” provision,
CMA published an FAQ sheet dedicated entirely to helping physicians make
sense of the issue, as well as a patient FAQ that practices can use to answer
the most common patient questions about Covered California. CMA also
successfully advocated with DMHC to secure important physician protections
during the second and third months of the exchange grace period.
To further understand the depth of confusion surrounding the exchange, CMA
surveyed physicians about their contracting experience with Covered California
plans. The survey, which resulted in an unprecedented response from over
2,300 physicians in less than two days, showed that health plan contracting
practices, such as all-products clauses, vague and confusing contractual
language and silent amendments, were the primary contributors to the current
state of network confusion for providers. CMA then used this information to
inform further legislative and regulatory advocacy efforts throughout the year,
including AB 2400 (see “Fighting for Physicians”).
Partially as a result of CMA advocacy in this matter, DMHC conducted a
“non-routine audit” of Anthem Blue Cross and Blue Shield of California to
investigate the accuracy of the plans’ provider directories, during which DMHC
ultimately determined that both plans’ provider directories were misleading
and violated state law.

2014 WHC Leadership Academy

On Election Day 2014, CMA was proud to congratulate
a number of CALPAC-supported candidates, including
Sacramento pediatrician and then Assemblyman Richard
Pan, M.D., who won a hotly contested state Senate seat.
Although his opponent, a trial lawyer himself, had spent
more than 30 years as a career politician, CMA built a
strong coalition of labor and business allies to put together
a full-fledged campaign that helped Dr. Pan to victory.
CMA emerged from the election with a perfect score on
the six independent expenditure campaigns for endorsed
candidates. In total, the 15 CMA-endorsed candidates for
state Senate all won their election. In the state Assembly,
65 out of our 70 endorsed candidates triumphed. For more
information on CALPAC and how to support physician-
friendly candidates, see “Get Involved.”
WIN FOR PHYSICIAN-FRIENDLY CANDIDATES
Education
and advocacy
On behalf of its physician members, CMA waded into the depths
of additional health care regulations and changes, producing
resource guides and informational articles throughout the year,
as well as advocating for important changes. One major area of
educationincludedregisteringandreviewingdataforthePhysician
Payments Sunshine Act, as well as advocating for changes to the
dispute resolution process.
Resources and advocacy were provided around the myriad
Medicare incentive and penalty programs (including meaningful
use and electronic health records), implementation of new claim
and prior authorization forms, recent changes to the Medi-Cal
program, the transition to ICD-10, and workers’ compensation
reform.
In 2014, CMA continued its advocacy efforts around the
Coordinated Care Initiative. As a result of these efforts, DHCS
released new continuity of care rules that require plans to do
more to preserve the physician/patient relationship. In addition,
CMA pushed for information from the state specifically geared
toward physicians to help them treat and maintain relationships
with their dual-eligible patients. As a result, the state released a
valuable Physician Toolkit that discusses billing, continuity of care
and care coordination.
In June, CMA’s Council on Scientific and Clinical Affairs produced
aneducationalpaper,PrescribingOpioids:CareAmidControversy.
The paper summarizes the findings of a panel of physician experts
and presents an up-to-date, clinically relevant overview of opioid
prescribing practices. CMA also worked to ensure that the Medical
Board’s 2014 update of their Guidelines for Prescribing Controlled
Substances for Pain were consistent with the CSA paper.
The 2014 Western Health Care Leadership Academy also
provided valuable education and insights for California
physicians, who heard from a diverse panel of industry experts
on the changing dynamics of the health care marketplace
and how to contain health care costs through innovation and
integration. Keynote speaker, former Secretary of State Hillary
Rodham Clinton (live via satellite), urged physicians to work
together to help advance meaningful health care delivery and
payment reform. Attendees also had the chance to hear from
Covered California Executive Director Peter Lee, who told
attendees that he recognizes that the ACA rollout was bumpy,
but that he looked forward to working with physicians during
this a new era of health care.
Supporting
public health
In 2014, California experienced several public health
incidents – all of which CMA strived to keep its members
informed about. With rates of pertussis more than doubled,
the emergence of enterovirus D68 and the Disneyland
measles outbreak, CMA produced important news bulletins
with information about relevant symptoms and treatments.
During its House of Delegates in December 2014, CMA’s
members emphasized their commitment to dealing with
the health hazards of tobacco, passing five tobacco-related
resolutions. At the same time, CMA dedicated itself to an
unprecedented coalition of health care groups (dubbed
“Save Lives California”) seeking to increase the tobacco tax by
$2-per-pack by the end of 2016 to save lives and to defray the
cost of diseases caused by smoking.
CMA’S GOT YOU COVERED

Officers
Luther F. Cobb, M.D., FACS (President); Steven E. Larson, M.D., MPH, FACP (President-Elect); Theodore M. Mazer, M.D.
(Speaker, House of Delegates); Lee T. Snook, M.D. (Vice-Speaker, House of Delegates); David Aizuss, M.D. (Board
Chair); Robert E. Wailes, M.D. (Board Vice-Chair); and Richard E. Thorp, M.D., FACP (Immediate Past President).
Trustees
Jerry Abraham, M.D.; Virgil M. Airola, M.D.; Mark Ard (Student); Barbara J. Arnold, M.D.; Patricia L. Austin, M.D.; Richard
S. Baker, M.D.; Robert A. Bitonte, M.D.; Peter N. Bretan, M.D.; Douglas P. Brosnan, M.D.; Victor C. Ching, M.D.; Jack
Chou, M.D.; James C. Cotter, M.D.; Thomas M. Dailey, M.D.; Sergio R. Flores, M.D.; C. Freeman, M.D.; Anupam Gupta,
M.D.; Catherine A. Gutfreund, M.D.; Ruth Haskins, M.D.; Donaldo Hernandez, M.D.; Vito D. Imbasciani, M.D.; Ralph
Kingsford, M.D.; Mark H. Kogan, M.D.; Howard R. Krauss, M.D.; Robert G. Pugach, M.D.; Michele E. Raney, M.D.; Albert
Ray, M.D.; Peter S. Richman, M.D.; Lytton W. Smith, M.D.; Simpson K. So, M.D.; Tanya W. Spirtos, M.D.; James J. Strebig,
M.D.; Ronald C. Thurston, M.D.; and Shannon Udovic-Constant, M.D.
The CMA Board of Trustees is made up of CMA’s seven elected officers, elected trustees from CMA’s 11 districts, as
well as elected trustees representing various councils, sections and mode of practice forums.
Board of
Trustees

The California Medical Association and California
Medical Association Foundation would like to thank
the following corporate partners who, as members
of the Corporate Leadership Council (CLC), support
our endeavors and enable us to continue to
provide educational programs for members of the
association and our communities.
Platinum Level Members
Novo Nordisk
The Doctors Company
NORCAL Mutual
PhRMA
Genentech
AstraZeneca
AbbVie
Gold Level Members
Allergan
Boston Scientific Corporation
MIEC
Union Bank
Silver Level Members
Pfizer, Inc.
Lilly USA
Bronze Level Member
Purdue Pharma L.P.
UnitedHealthcare
Partners
CMA members are able to receive more than the
investment of their dues by accessing the following
member-only discounts and services:
Financial Services
- Personal and professional banking services – Union Bank
Personal and Professional Insurance
- Medical, workers’ compensation, life, disability, long-
term care insurance products – Mercer Health
Benefit Insurance Services
- Home and auto insurance – Mercury Insurance
Professional Development Resources
- CME tracking/credentialing – Institute for Medical
Quality
- ICD-10 educational programs – AAPC, Inc.
Practice Management Resources
- Secure messaging phone app – DocbookMD
- Waste management – EnviroMerica
- Physician practice website – Mayaco Design and
Marketing
- HIPAA Compliance Online Toolkit – PrivaPlan
- Secure Rx prescription pads – Rx Security
- Office supplies and more – Staples Advantage
- Educationally based lab accreditation program – COLA
Others
- Magazine subscriptions – Buymags.com
- Car rental discounts – Hertz Avis
For more details, visit
www.cmanet.org/benefits.
Member-Only Discounts

House of Delegates
Physician members set the policies that guide CMA.
Submitting resolutions to the House of Delegates (HOD) is
the most direct way for members to get involved. As CMA’s
legislative body, the House meets once a year to establish
policies on key issues that affect the practice of medicine,
from physician reimbursement to quality standards to
critical matters of public health. Each year, over 700
delegates representing all specialties, modes of practice and
geographic regions of the state debate and take action on
nearly 100 resolutions, each authored by members like you.
The House functions very much like state and federal
legislative bodies. Prior to debating resolutions, each is
discussed and debated in one of six reference committees.
All member physicians (not just delegates) are welcome to
attend the annual meeting and testify on any of that year’s
resolutions. Resolutions are available for review prior to the
meeting on www.cmanet.org, where members may also
post written testimony. The 2015 House of Delegates will
take place October 16-18 in Anaheim.
Policies adopted at HOD determine the organization’s
priorities for the year, guiding CMA’s legal, legislative and
economic advocacy. Because California is often at the
forefront of new health care trends, the policy set every
year at HOD plays a direct and substantial role in shaping
the future of medicine, not just in California, but across the
nation. Examples include policy to fight the AIDS epidemic
on many fronts (providing care, disease prevention, public
education and legislation), as well as policies to promote
cancer research, fight the war against tobacco and promote
physician diversity.
Councils, Committees, Sections
and Forums
CMA depends on its members’ expertise to make smart
policy choices. If you’re an expert in medical ethics,
workers’ compensation, professional licensure or other
topics related to the practice of medicine, you could serve
on one of CMA’s standing councils and committees. CMA
members can also get involved with their sections or
forums (determined by your membership type), serving as
officers, trustees or HOD delegates.
Community Health Education
The CMA Foundation acts as a bridge linking physicians to
their communities. The Foundation’s Physicians for Healthy
Communities Initiative trains “physician champions” to
promote healthy eating and active living, directly impacting
the long-term health of their communities. Through the
CMA Foundation, all physicians can become key players in
the effort to improve California’s public health.
Legislative Key Contacts
Personal contact with elected representatives makes a big
difference – sometimes all the difference – in how votes are
cast in Sacramento and Washington, D.C. By becoming a
legislative key contact, you will advocate on behalf of your
profession and patients to elected officials on the state
and federal level. This is an important part of lawmakers’
educational process, ensuring their votes are guided in the
right direction on critical bills from the experts serving on
the front lines of health care.
CALPAC
CMA’s Political Action Committee (CALPAC) helps
physicians get involved in the state legislature and in
Congress, where public policy decisions are made.
CALPAC supports hundreds of candidates and legislators
who understand and embrace our philosophy and vision
of the future of health care. Please join your colleagues in
supporting CALPAC and help strengthen our political voice.
Visit www.calpac.org for more details.
CMA, the voice of California physicians, relies on the involvement of members to communicate the physician
vision of medical care to the public, to lawmakers and to the regulators who determine how medicine is prac-
ticed. Learn about all CMA’s programs and member opportunities by calling our member service center at (800)
786-4CMA (4262).
Get Involved

The financial statements on the following pages, audited by independent certified public accountants Gilbert Associates, Inc.,
present the consolidated financial position of the California Medical Association as of December 31, 2013. (The 2014 audited
financial statement will be available in late 2015 and will be published in next year’s annual report.)
Financial
Statements
Independent Auditors’ Report
We have audited the accompanying consolidated financial
statements of California Medical Association, Inc. and
Affiliates (the Association), which comprise the consolidated
statements of financial position as of December 31, 2013
and 2012, and the related consolidated statements of
activities and cash flows for the years then ended, and the
related notes to the consolidated financial statements.
Management is responsible for the preparation and fair
presentation of these consolidated financial statements
in accordance with accounting principles generally
accepted in the United States of America; this includes
the design, implementation, and maintenance of internal
control relevant to the preparation and fair presentation of
consolidated financial statements that are free from material
misstatement, whether due to fraud or error.
Our responsibility is to express an opinion on these
consolidated financial statements based on our audits. We
did not audit the financial statements of California Medical
Association Foundation, an affiliate, which statements reflect
total assets of $2,600,584 and $3,385,442 as of December
31, 2013 and 2012, respectively, and total revenues of
$1,141,622 and $2,507,177, respectively, for the years then
ended. Those statements were audited by other auditors
whose report has been furnished to us, and our opinion,
insofar as it relates to the amounts included for California
Medical Association Foundation, is based solely on the
report of the other auditors. We conducted our audits in
accordance with auditing standards generally accepted
in the United States of America. Those standards require
that we plan and perform the audits to obtain reasonable
assurance about whether the consolidated financial
statements are free from material misstatement.
An audit involves performing procedures to obtain audit
evidence about the amounts and disclosures in the
consolidated financial statements. The procedures selected
depend on the auditor’s judgment, including the assessment
of the risks of material misstatement of the consolidated
financial statements, whether due to fraud or error. In
making those risk assessments, the auditor considers
internal control relevant to the entity’s preparation and fair
presentation of the consolidated financial statements in
order to design audit procedures that are appropriate in
the circumstances, but not for the purpose of expressing
an opinion on the effectiveness of the entity’s internal
control. Accordingly, we express no such opinion. An audit
also includes evaluating the appropriateness of accounting
policies used and the reasonableness of significant
accounting estimates made by management, as well as
evaluating the overall presentation of the consolidated
financial statements.
We believe that the audit evidence we have obtained is
sufficient and appropriate to provide a basis for our audit
opinion. In our opinion, based on our audits and the report
of other auditors, the consolidated financial statements
referred to above present fairly, in all material respects, the
financial position of California Medical Association, Inc.
and Affiliates as of December 31, 2013 and 2012, and the
changes in their net assets and their cash flows for the years

ASSETS 12/31/13 12/31/12
CURRENT ASSETS:
Cash and cash equivalents . . . . . . . . . . . . . . . . . . . . . $3,889,491. . . . . . . . . . . . . . . . . . . $4,334,831
Short-term investments. . . . . . . . . . . . . . . . . . . . . . . . . . 846,992. . . . . . . . . . . . . . . . . . . . . 864,000
Accounts receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,078,175. . . . . . . . . . . . . . . . . . . . . 590,015
Interest receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273. . . . . . . . . . . . . . . . . . . . . . 18,442
Prepaid expenses and other current assets. . . . . . . . . 442,272 . . . . . . . . . . . . . . . . . . . . . . 415,312
Total current assets. . . . . . . . . . . . . . . . . $6,257,203 . . . . . . . . . . . . . . . . . . $6,222,600
NON-CURRENT ASSETS:
Long-term investments. . . . . . . . . . . . . . . . . . . . . . . . 26,554,857. . . . . . . . . . . . . . . . . . . 24,577,739
Investment in Health Property Associates. . . . . . . . . . 1,406,407. . . . . . . . . . . . . . . . . . . . 1,401,866
Pension plan asset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,346,539
Property and equipment, net . . . . . . . . . . . . . . . . . . . . 8,250,532 . . . . . . . . . . . . . . . . . . . 8,584,788
Total non-current assets. . . . . . . . . . . . . $37,558,335. . . . . . . . . . . . . . . . . . $34,564,393
TOTAL ASSETS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $43,815,538. . . . . . . . . . . . . . . . $ 40,786,993
LIABILITIES AND NET ASSETS
CURRENT LIABILITIES:
Accounts payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $973,260. . . . . . . . . . . . . . . . . . $ 1,091,391
Accrued expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 687,094. . . . . . . . . . . . . . . . . . . . . 643,578
Deferred revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,846,840. . . . . . . . . . . . . . . . . . . . 5,652,189
Margin loan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,980,000. . . . . . . . . . . . . . . . . . . 2,650,000
Current portion of loan payable. . . . . . . . . . . . . . . . . . . . 142,889. . . . . . . . . . . . . . . . . . . . . 134,186
Accrued interest payable. . . . . . . . . . . . . . . . . . . . . . . . . . . 22,219. . . . . . . . . . . . . . . . . . . . . . 22,945
Deferred compensation . . . . . . . . . . . . . . . . . . . . . . . . . . 339,574 . . . . . . . . . . . . . . . . . . . . . . 371,156
Total current liabilities. . . . . . . . . . . . . . . $14,991,876 . . . . . . . . . . . . . . . . . $10,565,445
NON-CURRENT LIABILITIES:
Loan payable, net. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3,965,818. . . . . . . . . . . . . . . . . . . . 4,108,707
Accrued pension liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1,580,517
Total non-current liabilities. . . . . . . . . . . . . . . . . . . . . . 3,965,818 . . . . . . . . . . . . . . . . . . . 5,689,224
Total liabilities . . . . . . . . . . . . . . . . . . . . . . $18,957,694. . . . . . . . . . . . . . . . . $16,254,669
NET ASSETS:
Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,672,258. . . . . . . . . . . . . . . . . . 21,683,007
Temporarily restricted. . . . . . . . . . . . . . . . . . . . . . . . . . . 1,476,430. . . . . . . . . . . . . . . . . . . . 2,140,161
Permanently restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . 709,156 . . . . . . . . . . . . . . . . . . . . . 709,156
Total net assets . . . . . . . . . . . . . . . . . . . . $24,857,844. . . . . . . . . . . . . . . . . $24,532,324
TOTAL LIABILITIES AND NET ASSET . . . . . . . . . . . $43,815,538. . . . . . . . . . . . . . . . . . $40,786,993
Consolidated Statements
of Financial Position
then ended in accordance with
accounting principles generally
accepted in the United States of
America.
Our audits were conducted
for the purpose of forming an
opinion on the consolidated
financial statements taken
as a whole. Supplemental
schedules in the full report
are presented for the purpose
of additional analysis and
are not a required part of
the consolidated financial
statements. Such information
is the responsibility of
management and was derived
from and relates directly to the
underlying accounting and
other records used to prepare
statements. The information
has been subjected to the
auditing procedures applied in
the audits of the consolidated
financial statements and certain
additional procedures, including
comparing and reconciling
such information directly to
the underlying accounting
and other records used to
prepare the consolidated
financial statements or to
statements themselves, and
other additional procedures
in accordance with auditing
standards generally accepted
in the United States of
America. In our opinion, the
information is fairly stated in
all material respects in relation
to the consolidated financial
statements as a whole.
/s/ Gilbert Associates, Inc.
September 9, 2014

UNRESTRICTED NET ASSETS: 1/1/13 – 12/31/13 1/1/12 – 12/31/12
REVENUES:
Membership dues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,230,691. . . . . . . . . . . . . . . . . . $ 10,863,813
Investment income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,019,986. . . . . . . . . . . . . . . . . . . . 2,960,789
IMQ revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,300,738. . . . . . . . . . . . . . . . . . . . . 1,845,747
Program revenue and contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,137,737. . . . . . . . . . . . . . . . . . . . 2,609,192
Income from Health Property Associates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340,947. . . . . . . . . . . . . . . . . . . . . . 335,132
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551,693. . . . . . . . . . . . . . . . . . . . . . 518,666
Net assets released from restrictions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,504,000. . . . . . . . . . . . . . . . . . . . . 1,555,059
Total revenues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $23,085,792. . . . . . . . . . . . . . . . . . $20,688,398
EXPENSES:
Member services:
CMA program expenses:
MICRA, Political Education, and Physicians’ Issues Committee. . . . . . . . . . . . . 6,057,850. . . . . . . . . . . . . . . . . . . . . . 917,090
Government relations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,082,753. . . . . . . . . . . . . . . . . . . . . 1,658,421
Public and member relations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,736,739. . . . . . . . . . . . . . . . . . . . . 1,278,359
Legal affairs and economic services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,648,535. . . . . . . . . . . . . . . . . . . . . 1,541,999
Policy and analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,512,672. . . . . . . . . . . . . . . . . . . . . 1,595,481
Component medical society services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 834,351. . . . . . . . . . . . . . . . . . . . . . 479,349
CMAF grants and program expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,277,527. . . . . . . . . . . . . . . . . . . . . 1,950,827
IMQ program expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 749,126. . . . . . . . . . . . . . . . . . . . . . . 695,117
Total member services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15,899,553. . . . . . . . . . . . . . . . . . . $10,116,643
Supporting services:
CMA supporting expenses:
Operational support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,099,795. . . . . . . . . . . . . . . . . . . . . 3,534,787
Physician governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,303,762. . . . . . . . . . . . . . . . . . . . . 1,670,720
Finance and administration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,124,714. . . . . . . . . . . . . . . . . . . . . 1,049,727
Executive management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 980,538. . . . . . . . . . . . . . . . . . . . . 1,723,341
Affiliate administrative expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,301,044. . . . . . . . . . . . . . . . . . . . 2,040,858
Total supporting services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $9,809,853. . . . . . . . . . . . . . . . . . . $10,019,433
Total expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25,709,406. . . . . . . . . . . . . . . . . . $20,136,076
INCOME (LOSS) FROM OPERATIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ($2,623,614). . . . . . . . . . . . . . . . . . . . . $552,322
Pension-related changes other than net periodic benefit cost. . . . . . . . . . . . . . 3,317,813. . . . . . . . . . . . . . . . . . . . . . 572,373
CALPAC contribution revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,232,285. . . . . . . . . . . . . . . . . . . . . 1,245,724
CALPAC contribution expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (937,233). . . . . . . . . . . . . . . . . . . . (1,105,340)
CHANGE IN UNRESTRICTED NET ASSETS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $989,251. . . . . . . . . . . . . . . . . . . $1,265,079
TEMPORARILY RESTRICTED NET ASSETS:
Grants and contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,726,301. . . . . . . . . . . . . . . . . . . . . 1,280,108
Investment income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113,968. . . . . . . . . . . . . . . . . . . . . . . 110,051
Net assets released from restrictions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2,504,000). . . . . . . . . . . . . . . . . . . . (1,555,059)
CHANGE IN TEMPORARILY RESTRICTED NET ASSETS. . . . . . . . . . . . . . . . . . . . . ($663,731). . . . . . . . . . . . . . . . . . . ($164,900)
CHANGE IN NET ASSETS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325,520. . . . . . . . . . . . . . . . . . . . . 1,100,179
NET ASSETS, Beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,532,324. . . . . . . . . . . . . . . . . . . . 23,432,145
NET ASSETS, End of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $24,857,844. . . . . . . . . . . . . . . . . . $24,532,324
Consolidated Statements of Activities
FINANCIAL STATEMENTS

CASH FLOWS FROM OPERATING ACTIVITIES: 1/1/13 – 12/31/13 1/1/12 – 12/31/12
Change in net assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $325,520. . . . . . . . . . . . . . . . . . . . $1,100,179
Reconciliation to net cash used by operating activities:
Net gain on investments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3,427,306). . . . . . . . . . . . . . . . . . . . (2,507,614)
Depreciation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 766,864. . . . . . . . . . . . . . . . . . . . . . 795,397
Loss on disposal of property and equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,787. . . . . . . . . . . . . . . . . . . . . . . 26,841
Income from Health Property Associates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (340,947). . . . . . . . . . . . . . . . . . . . . (335,132)
Changes in:
Accounts receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (488,160). . . . . . . . . . . . . . . . . . . . . . 107,370
Interest receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,169. . . . . . . . . . . . . . . . . . . . . . . . 7,780
Prepaid expenses and other current assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (26,960). . . . . . . . . . . . . . . . . . . . . (145,854)
Accounts payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (118,131). . . . . . . . . . . . . . . . . . . . . . 154,639
Accrued expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43,516. . . . . . . . . . . . . . . . . . . . . (150,812)
Deferred revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194,651. . . . . . . . . . . . . . . . . . . . . . 294,542
Accrued interest payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (726). . . . . . . . . . . . . . . . . . . . . . . . . (681)
Deferred compensation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (31,582). . . . . . . . . . . . . . . . . . . . . . . (8,791)
Pension plan asset/liability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2,927,056). . . . . . . . . . . . . . . . . . . . . . (102,511)
Net cash used by operating activities. . . . . . . . . . . . . . . . . . . . . . . . . . ($6,008,361). . . . . . . . . . . . . . . . . . . ($764,647)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of investments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (9,494,482). . . . . . . . . . . . . . . . . . . . (7,425,412)
Proceeds from sales of investments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,961,678. . . . . . . . . . . . . . . . . . . . . 6,524,117
Proceeds from Health Property Associates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336,406. . . . . . . . . . . . . . . . . . . . . . 330,000
Purchases of property and equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (436,395). . . . . . . . . . . . . . . . . . . . (1,155,446)
Net cash provided (used) by investing activities. . . . . . . . . . . . . . . . . $1,367,207. . . . . . . . . . . . . . . . . . ($1,726,741)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from margin account. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,080,000. . . . . . . . . . . . . . . . . . . . 4,050,000
Payments on margin account. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(4,750,000). . . . . . . . . . . . . . . . . . . (2,950,000)
Principal payments on loan payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(134,186). . . . . . . . . . . . . . . . . . . . . (126,014)
Net cash provided by financing activities. . . . . . . . . . . . . . . . . . . . . . . $4,195,814. . . . . . . . . . . . . . . . . . . . $973,986
CHANGE IN CASH AND CASH EQUIVALENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(445,340). . . . . . . . . . . . . . . . . . . (1,517,402)
CASH AND CASH EQUIVALENTS, Beginning of year. . . . . . . . . . . . . . . . . . . . . . . 4,334,831. . . . . . . . . . . . . . . . . . . . 5,852,233
CASH AND CASH EQUIVALENTS, End of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,889,491. . . . . . . . . . . . . . . . . . . $4,334,831
SUPPLEMENTAL CASH FLOW INFORMATION
Interest paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $306,946. . . . . . . . . . . . . . . . . . . . . $292,153
Taxes paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $4,000. . . . . . . . . . . . . . . . . . . . . . $11,400
Consolidated Statements of Cash Flows

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CMA Center for Economic Services
1201 J Street, #200, Sacramento, CA 95814
economicservices@cmanet.org • 916/551-2061
In this issue:
Aetna to require additional accreditation require-
ments in order to be paid for certain surgical
pathology services
1
Update on two Anthem Blue Cross issues pending
with the Department of Managed Health Care 1
Meet Your CMA Center for Economic Services
Advocate: Mark Lane
2
CMA Advocacy at Work
2
Urgent survey response requested
3
Aetna erroneously terminates providers from
California network
3
Document, Document, Document
3
United Healthcare announces extension of HIPAA
5010 enforcement
4
What’s a COHS?
4
Save the Date
4
Act now to avoid the 2013 e-prescribing pen-
alty
5
Payor Updates
5
Health plan provider newsletters
5
May 2012
Medical-Legal Library
(Formerly CMA On-Call)
In this publication, you will find references to
“medical-legal” documents. The California
Medical Association’s (CMA) online medical-legal
library contains over 4,500 pages of medical-
legal, regulatory, and reimbursement information.
Medical-legal documents are free to members
and can be found in CMA’s online resource
library, http://www.cmanet.org/resource-library.
Nonmembers can purchase medical-legal docu-
ments for $2 per page.
CMA resources
When you see this icon, that means
there are additional resources avail-
able free to California Medical Asso-
ciation (CMA) members at the CMA website.
To access any of these resources, visit
http://www.cmanet.org/ces.
CPR • May 2012 • Page 1 of 5
CMA Practice Resources (CPR) is a free monthly bulletin from the
California Medical Association’s Center for Economic Services. This bulletin is
full of tips and tools to help physicians and their office staff improve practice
SUBSCRIBE TO CPR OR ANY OTHER CMA NEWSLETTERS: To stay up to date, sign
up for free subscriptions at www.cmanet.org/newsletters.
SPREAD THE WORD: Please forward this bulletin to your coworkers and colleagues.
Aetna to require additional accreditation requirements
in order to be paid for certain surgical pathology ser-
vices
Aetna recently notified physicians that, effective August 1, 2012, practices per-
forming in-office pathology testing will be required to be both Clinical Labora-
tory Improvement Amendments (CLIA) certified and accredited with the Col-
lege of American Pathologists (CAP).
In a letter to physicians, Aetna claims that the change is consistent with the
Centers for Medicare Medicaid Services (CMS) recognition of CAP as an
approved accreditation organization for non-hospital anatomic pathology test-
ing.
The California Medical Association has voiced concerns with the implemen-
tation of this policy and has asked Aetna to explain the need for dual certifica-
tion. Although CMS may recognize CAP as an approved accreditation organiza-
tion, CMS does not require both a CLIA certification and a specialty society
accreditation to perform in-office pathology testing services. Further, CMA
expressed concerns with the ability of physicians to obtain the CAP accredita-
tion prior to the deadline imposed by Aetna. According to CAP, the accredita-
tion process takes approximately 90 days. Additionally, the process of obtaining
a secondary accreditation can be very costly for practices.
In addition to their contact with Aetna on this issue, CMA is working close-
ly with the American Medical Association (AMA) and several other state and
specialty medical societies. Stay tuned for further details.
Practices with questions about the letter can contact Tammy Gaul, senior
network manager at Aetna at (215)775-6604.
Contact: CMA reimbursement help line, (888) 401-5911 or mlane@cmanet.org
Update on two Anthem Blue Cross issues pending with
the Department of Managed Health Care
DMHC claims audit
As previously reported, on Jan. 12, 2012 the Department of Managed Health
Care (DMHC) ordered Anthem Blue Cross to reprocess provider claims, with
interest, dating back to 2007.
The order is based on 2008 DMHC audits of the seven largest health plans
in California. These audits found violations of claim payments above the thresh-
old allowed under California law at all seven health plans.
As a result, DMHC assessed administrative fines, required the plans to pay
providers the money they were owed and mandated that plans demonstrate
CMA Center for Economic Services1201 J Street, #200, Sacramento, CA 95814economicservices@cmanet.org • 916/551-2061
In this issue:
Aetna to require additional accreditation require-ments in order to be paid for certain surgicalpathology services
1Update on two Anthem Blue Cross issues pendingwith the Department of Managed Health Care 1Meet Your CMA Center for Economic ServicesAdvocate: Mark Lane
2CMA Advocacy at Work
2Urgent survey response requested
3Aetna erroneously terminates providers fromCalifornia network
3Document, Document, Document 3United Healthcare announces extension of HIPAA5010 enforcement
4What’s a COHS?
4Save the Date
4Act now to avoid the 2013 e-prescribing pen-alty
5Payor Updates
5Health plan provider newsletters 5
May 2012
Medical-Legal Library
(Formerly CMA On-Call)In this publication, you will find references to“medical-legal” documents. The CaliforniaMedical Association’s (CMA) online medical-legallibrary contains over 4,500 pages of medical-legal, regulatory, and reimbursement information.Medical-legal documents are free to membersand can be found in CMA’s online resourcelibrary, http://www.cmanet.org/resource-library.Nonmembers can purchase medical-legal docu-ments for $2 per page.
CMA resourcesWhen you see this icon, that meansthere are additional resources avail-able free to California Medical Asso-ciation (CMA) members at the CMA website.To access any of these resources, visithttp://www.cmanet.org/ces.
CPR • May 2012 • Page 1 of 5
CMA Practice Resources (CPR) is a free monthly bulletin from the
California Medical Association’s Center for Economic Services. This bulletin is
full of tips and tools to help physicians and their office staff improve practice
SUBSCRIBE TO CPR OR ANY OTHER CMA NEWSLETTERS: To stay up to date, sign
up for free subscriptions at www.cmanet.org/newsletters.SPREAD THE WORD: Please forward this bulletin to your coworkers and colleagues.
Aetna to require additional accreditation requirementsin order to be paid for certain surgical pathology ser-vices
Aetna recently notified physicians that, effective August 1, 2012, practices per-
forming in-office pathology testing will be required to be both Clinical Labora-
tory Improvement Amendments (CLIA) certified and accredited with the Col-
lege of American Pathologists (CAP).In a letter to physicians, Aetna claims that the change is consistent with the
Centers for Medicare Medicaid Services (CMS) recognition of CAP as an
approved accreditation organization for non-hospital anatomic pathology test-
ing.
The California Medical Association has voiced concerns with the implemen-
tation of this policy and has asked Aetna to explain the need for dual certifica-
tion. Although CMS may recognize CAP as an approved accreditation organiza-
tion, CMS does not require both a CLIA certification and a specialty society
accreditation to perform in-office pathology testing services. Further, CMA
expressed concerns with the ability of physicians to obtain the CAP accredita-
tion prior to the deadline imposed by Aetna. According to CAP, the accredita-
tion process takes approximately 90 days. Additionally, the process of obtaining
a secondary accreditation can be very costly for practices.In addition to their contact with Aetna on this issue, CMA is working close-
ly with the American Medical Association (AMA) and several other state and
specialty medical societies. Stay tuned for further details.Practices with questions about the letter can contact Tammy Gaul, senior
network manager at Aetna at (215)775-6604.Contact: CMA reimbursement help line, (888) 401-5911 or mlane@cmanet.org
Update on two Anthem Blue Cross issues pending withthe Department of Managed Health Care
DMHC claims audit
As previously reported, on Jan. 12, 2012 the Department of Managed Health
Care (DMHC) ordered Anthem Blue Cross to reprocess provider claims, with
interest, dating back to 2007.
The order is based on 2008 DMHC audits of the seven largest health plans
in California. These audits found violations of claim payments above the thresh-
old allowed under California law at all seven health plans.As a result, DMHC assessed administrative fines, required the plans to pay
providers the money they were owed and mandated that plans demonstrate

CMA and the 38 county medical societies are a team, working together to solve physicians’ professional and practice
management issues, and to provide advocacy at the local, state, and national levels. Membership starts with your
county society; there, dues are collected, and the professional staff works closely with physician leadership to
present the face of organized medicine at the local level.
County societies are busy places, a resource for physicians and the public. The societies administer member
benefits, interact with community and public officials, organize physician education and public health programs,
publish magazines and newsletters, and provide physician referral and public resource helplines.
Alameda-Contra Costa
Medical Association
(510) 654-5383
Butte-Glenn Medical Society
(530) 342-4296
Central Coast Medical Association
(formally Santa Barbara County Medical Society and
San Luis Obispo County Medical Association)
(805) 683-5333
Fresno-Madera Medical Society
(559) 224-4224
Humboldt-Del Norte County
Medical Society
(707) 442-2367
Imperial County Medical Society
(760) 554-1901
Inyo-Mono County Medical Society
(916) 551-2541
Kern County Medical Society
(661) 325-9025
Kings County Medical Society
(559) 582-0310
Lassen-Plumas-Modoc-Sierra County
Medical Society
(530) 258-4116
Los Angeles County Medical
Association
(213) 683-9900
Marin Medical Society
(707) 525-4375
Mendocino-Lake County Medical
Society
(707) 525-4375
Merced-Mariposa County Medical
Society
(209) 723-2976
Monterey County Medical Society
(831) 455-1008
Napa County Medical Society
(707) 255-3622
North Valley Medical Association
(530) 247-0293
Orange County Medical Association
(949) 398-8100
Placer-Nevada County Medical
Society
(530) 822-7770
Riverside County Medical Association
(951) 686-3342
San Benito County Medical Society
(831) 635-0604
San Bernardino County
Medical Society
(909) 273-6000
San Diego County
Medical Society
(858) 565-8888
San Francisco Medical Society
(415) 561-0850
San Joaquin Medical Society
(209) 952-5299
San Mateo County
Medical Association
(650) 312-1663
Santa Clara County
Medical Association
(408) 998-8850
Santa Cruz County Medical Society
(831) 479-7226
Sierra-Sacramento Valley
Medical Society
(916) 452-2671
Siskiyou County Medical Society
(530) 247-0293
Solano County Medical Society
(707) 255-3622
Sonoma County Medical Association
(707) 525-4375
Stanislaus Medical Society
(209) 527-1704
Tehama County Medical Society
(530) 247-0293
Tulare County Medical Society
(559) 627-2262
Tuolumne County Medical Society
(209) 586-5431
Ventura County Medical Association
(805) 484-6822
Yuba-Sutter-Colusa County
Medical Society
(530) 673-6894
County Medical Societies

2015 ICD-10-CM
Code Set Boot Camps
• ICD-10 format and structure
• Complete in-depth ICD-10 guidelines
• Nuances found in the new coding
system, with coding tips
TRAINING FOCUSES ON:
Learn to code for ICD-10-Clinical Modification (ICD-10-CM) and prepare for the ICD-10 Proficiency Assessment.
Training is led by a certified AAPC instructor and is provided onsite in a classroom format. Conducted over two days,
attendees will receive 16 hours of intensive general ICD-10 code set training along with hands-on coding exercises.
• 16 CEUs
• AAPC ICD-10-CM Code Set Course Manual
• AAPC ICD-10-CM Code Set Draft Book
• AAPC Online ICD-10-CM Proficiency
Assessment
(Required for current AAPC CPCs to maintain their credential)
• Access to AAPC’s Online ICD-10-CM
Assessment Training Course through
December 31, 2015
WHAT’S INCLUDED:
• $399 for CMA members members’ staff
• $499 for CA-MGMA members
• $599 for non-members
*Comparable AAPC ICD-10 Boot Camp Costs $799
PRICING:
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for updated information and new boot camps being added.
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AAPC, please visit: www.cmanet.org/AAPC
Stockton. . . . August 10-11
(French Camp)
Modesto. . . . August 12-13
Redding . . . . August 24-25
Eureka . . . . . August 26-27
Santa Maria . . . . . . . . .TBA
Roseville . . . . . . . . . . .TBA
Fresno . . . . . . . June 15-16
Napa. . . . . . . . . June 18-19
Irvine . . . . . . . . June 23-24
San Diego . . . . June 25-26
San Jose . . June 30-July 1
Redlands . . . . . . . .July 7-8
Los Angeles . . . . . .July 8-9
Santa Rosa. . . . .July 13-14
Torrance. . . . . . .July 14-15
Sacramento . . . .July 15-16

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