Medi-Cal provider enrollment moving exclusively to PAVE starting March 5 The Medi-Cal Provider Enrollment Division (PED) recently announced that it will no longer accept paper enrollment forms, effective March 5, 2019. Medi-Cal enrollment applications and forms will move entirely to the e-form application process through the California Department of Health Care Services’ (DHCS) Provider Application and Validation for Enrollment (PAVE) portal. While PAVE was anticipated to eventually replace the paper application process, DHCS moved swiftly to eliminate the paper option for providers after the September PAVE update (3.0). Prior to the announcement, PED did seek feedback from stakeholders including the ... January 30, 2019 Medi-Cal Payor Issues and Reimbursement, Practice Management, Public Payors 0 0 Comment Read More »
Golden Shore Medical Group to shut down following Molina contract termination The California Medical Association (CMA) has learned that Molina Healthcare has terminated its contract with Golden Shore Medical Group. The plan filed requests in late 2018 with the California Department of Managed Health Care (DMHC) to transfer its enrollees to other delegated groups and the request was approved by the Department on January 11, 2019. According to Molina’s block transfer filing with DMHC, the termination was the result of the parties’ inability to agree on contractual terms. As a result of the termination, Golden Shore has announced to its network ... January 24, 2019 General, Managed Care, Medi-Cal Payor Issues and Reimbrsement, Practice Management 0 0 Comment Read More »
CMA working to fix security prescription legislation The California Medical Association (CMA) has heard from dozens of physicians and patients across the state about prescriptions not being filled because the pads the prescriptions were written on were not compliant with a new state law. On January 1, 2019, a new California law took effect that requires all security prescription forms to have a uniquely serialized number. The legislation did not include any transition or grandfathering period to allow for continued use of old controlled substance security prescription forms on or after January 1. Unfortunately, with less than two ... January 24, 2019 CMA, General Drug Prescribing/Dispensing, Licensing & Regulatory Issues 0 0 Comment Read More »
CMA membership reaches all time high of 44k The collective voice of physicians just got a little louder. The California Medical Association (CMA) now has over 44,000 members, after a year of record-setting growth. In 2018, CMA’s active, dues paying membership grew by 6.3 percent, with a 92.2 percent retention rate. According to CMA Vice President of Membership and Marketing Mike Steenburgh, membership growth has been driven by the association’s group recruitment strategy, with several medium-sized groups signing membership agreements throughout the state this year. “We say it all the time –Together we are stronger. When we speak with ... January 22, 2019 CMA Physician Leadership 0 0 Comment Read More »
Federal court halts expanded religious exemption from ACA contraceptive mandate On January 7, 2019, the California Medical Association (CMA), along with other health care provider organizations, filed an amicus brief in support of the State of California in its challenge to federal rules that would expand a group health plan or health insurer's ability to claim a religious or moral objection to opt out of the Affordable Care Act’s (ACA) contraceptive coverage mandate. On January 13, 2019, one day before the effective date, the federal court granted the state’s motion for a preliminary injunction, blocking the rules from going ... January 22, 2019 General Access to Care, Amicus Briefs, Health Care Reform 0 0 Comment Read More »
CMA's online health law library is free to members The California Medical Association (CMA) online health law library contains nearly 5,000 pages of up-to-date legal information on a variety of subjects of everyday importance to practicing physicians. One of CMA's most valuable member benefits, the searchable online library contains all the information available in the California Physician's Legal Handbook (CPLH), an annual publication from CMA's Center for Legal Affairs. CMA members can access the library documents free at cmadocs.org/health-law-library. Nonmembers can purchase documents for $2 per page. CPLH, the complete health law library, is also available for purchase in a ... January 22, 2019 CMA California Physicians' Legal Handbook, Licensing & Regulatory Issues, Practice Management 0 0 Comment Read More »
CMS hosting call for prescribers on new opioid policies on Feb. 14 The Centers for Medicare and Medicaid Services (CMS) implemented new opioid policies for Medicare drug plans effective January 1, 2019. The new policies include safety alerts when patients fill opioid prescriptions and drug management programs for patients at-risk for misuse or abuse of opioids or other drugs. CMS will be hosting a call on Thursday, February 14 from 10:30 a.m. to 12 p.m. Pacific time, to help physicians and other prescribers understand the new policies. During the call, CMS experts will discuss the new policies and answer questions. To ... January 22, 2019 General Drug Prescribing/Dispensing, Professional Development & Education 0 0 Comment Read More »
CMS completes issuance of new Medicare ID cards The Centers for Medicare and Medicaid Services (CMS) has now completed the process of mailing new Medicare cards to beneficiaries across all states and territories. The new Medicare ID cards, required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number, which replaces the previous Social Security-based number. CMS also reports that for the week ending January 11, 2019, fee-for-service health care providers submitted 58 percent of claims with the new MBIs. CMS is allowing a 21-month transition period (which ... January 22, 2019 Medicare MACRA, Practice Management, Public Payors 0 0 Comment Read More »
UnitedHealthcare delays outpatient advanced radiology policy until February 1 Citing the need for additional time for communication and optimal rollout, UnitedHealthcare (UHC) has delayed implementation of its outpatient advanced radiology policy until February 1, 2019. The new UHC policy—originally scheduled for implementation on Jan. 1—requires prior authorization for advanced imaging procedures, including certain magnetic resonance imaging, magnetic resonance angiography and computed tomography imaging procedures, when performed in the outpatient hospital setting. Under UHC’s Outpatient Radiology Notification/Prior Authorization Protocol, a site of care review will be required for these advanced imaging services when performed in the outpatient hospital. Site of care ... January 22, 2019 General, Managed Care Commercial Payors, Patient Care, Practice Management, Radiology 0 0 Comment Read More »
Joint Statement Regarding Security Prescription Forms As of January 1, 2019, California law requires prescription forms for controlled substances to be printed with a uniquely serialized number. Notices explaining the serial number format and reporting requirements have been released by the Department of Justice (DOJ). Additionally, notices to prescribers and pharmacists were issued by the California State Board of Pharmacy (Pharmacy Board), and by the Medical Board of California (Medical Board), yet questions remain about implementation. This joint statement by DOJ, the Pharmacy Board, and the Medical Board is therefore being issued to provide further ... January 14, 2019 General 0 0 Comment Read More »
