The California Superior Court for SF County ruled on Thursday that the initiative to ban circumcision will be removed from San Francisco's November ballot. "The evidence presented is overwhelmingly persuasive that circumcision is a widely practiced medical procedure," wrote Superior Court Judge Loretta Giorgi. "The statute [California Code §460(b)] speaks directly to the issue of local regulation of medical procedures and leaves no room for localities to regulate in this area." [caption id="" align="aligncenter" width="480" caption="Leticia Preza speaks against the proposed circumcision ban July 20, 2011"][/caption] Judge Giorgi continued, "Because the proposed ballot initiative attempts to regulate a medical procedure, the proposed ordinance is expressly preempted. Moreover, it serves no legitimate purpose to allow a measure whose invalidity can be determined as a matter of law to remain on the ballot after such a ruling has been made." The lawsuit was filed by plaintiffs representing community organizations, doctors and Jewish and Muslim families in San Francisco. The litigants are: The Jewish Community Relations Council, The Anti-Defamation League, Leo Fuchs, Rabbi Jonathan Jaffe and Yael Frenkel-Jaffe, Jeremy and Jennifer Benjamin, Dr. Eric Tabas, Dr. Brian McBeth, Sheila Bari, Leticia Preza, and Kashif Abdullah. They were supported in their efforts with Amicus briefs by the American Civil Liberties Union and San Francisco's Medical Society. In addition, the San Francisco City Attorney's office took the rare step of expressing their concerns about the constitutional legality of the issue in a separate brief. Plaintiff Brian McBeth, an Assistant Professor of Emergency Medicine at UCSF, was concerned the measure would subject him and his colleagues to a fine and jail time for performing a routine medical procedure with proven health benefits. "I am pleased with the Court's ruling to protect the integrity of the doctor-patient relationship and keep law enforcement out of these private decisions." Click here to read the full article.

The measure to criminalize circumcision will be withdrawn from the November ballot because it would regulate a medical procedure, a California judge ruled. This is a real victory for physicians, parental choice, and religious freedom. Superior Court Judge Loretta Giorgi in San Francisco upheld her preliminary prohibition on allowing the Male Circumcision Mutilation Initiative to be placed on the ballot, as the measure is prohibited by California’s Business and Professions Code. SFMS have filed an amicus brief on support of opposing the circumcision ban, and have been a member of the coalition to oppose the circumcision ban from the beginning.

The U.S. Department of Health and Human Services (HHS) has unveiled proposed regulations that create a framework to assist states in building health insurance exchanges, a key feature of the federal health reform law. The exchanges are state-based competitive marketplaces where individuals and small businesses can purchase standardized health insurance products beginning in 2014. About 11.5 million people are expected to use them the first year, reaching 24 million by 2019, according to Congressional Budget Office estimates. The proposed rules offer states guidance and options on how to structure their exchanges, giving them the flexibility they need to design exchanges that fit their unique insurance markets. For example, states are allowed to decide whether their exchanges should be local, regional, or operated by a nonprofit organization, how to select plans to participate, and whether to partner with HHS to split up the work.

Twelve states, including California, Connecticut and Maryland, have already enacted laws creating state-based health insurance exchanges. Massachusetts and Utah already had exchanges before the federal law was passed. California established its exchange, the California Health Benefit Exchange, in September 2010. CMA is working with stakeholders to make sure that there is a broad choice of health plans and physicians participating in the exchange. To ensure appropriate access to care, CMA is advocating that the rates be risk-adjusted and adequate to cover the costs of providing care. CMA is also weighing-in on the medically necessary services that must be included in the essential benefits package.

Accountable Care Organizations (ACO) may have grabbed plenty of attention when it comes to coordinated care in Medicare. But the ACO program’s cousin — payment bundling — is also on the way, and maybe sooner than expected. Under the health overhaul law, a large-scale pilot program is to be established to try out payment bundling — a single payment for multiple hospital services from a number of providers received by one patient, rather than the traditional fee-for-service payment system. Dr. Richard Gilfillan, acting director of the new Center for Medicare and Medicaid Innovation at the CMS, said at a Monday policy discussion that the rules implementing bundled payments for Medicare providers will come before their 2013 deadline. In addition, he expects bundled payments to initially focus on the acute- and post-acute-care segments because private-sector initiatives have already succeeded in those areas. The voluntary program is supposed to begin by Jan. 1, 2013, and continue for five years. If it's successful in cutting costs while maintaining or improving quality, the secretary of Health and Human Services could expand the pilot. Source: http://www.modernhealthcare.com/article/20110718/NEWS/307189932/#

The city of San Francisco’s pioneering ban on tobacco sales by pharmacies has survived its latest challenge, a constitutional lawsuit by the Safeway grocery store chain. U.S. District Judge Claudia Wilken of Oakland dismissed a lawsuit in which Pleasanton-based Safeway Inc. claimed the measure was an unconstitutional restriction on its right to conduct a lawful business.   Click here to read the full story. SFMS is a long-time advocate of anti-tobacco legislation and San Francisco’s law banning the sale of tobacco in pharmacies.   Most recently, the SFMS has supported the San Francisco Department of Public Health against the Safeway suit with an amicus brief.