DHCS releases duals project toolkit The California Department of Health Care Services (DHCS) has published a physician toolkit to help providers and their patients understand the Cal MediConnect duals demonstration project. The toolkit has been developed in conjunction with Harbage Consulting and various stakeholder groups, including the California Medical Association. The toolkit contains several documents, including an overview and several fact sheets that include information on the following: How to submit crossover claims to Medi-Cal plans Contracting with Cal MediConnect plans How crossover claims ... October 6, 2014 Medi-Cal, Medicare Dual Eligible, Medi-Cal, Medicare, Cal MediConnect 0 0 Comment Read More »
PQRS GPRO registration extended until October 3 The Centers for Medicare and Medicaid services has extended the Physician Quality Reporting System Group Purchasing Reporting Option (GPRO) registration deadline until October 3, 2014, 11:59 PM EDT because of a glitch in the registration system. The deadline was originally supposed to be today, September 30, 2014. The PQRS registration system can be accessed a https://portal.cms.gov/. Group practices can register to participate in the PQRS Group Practice Reporting Option in 2014 via Qualified PQRS Registry, EHR or web interface (for groups with 25 or more eligible professionals only). In order to ... October 1, 2014 Medi-Cal, Medicare PQRS, Quality Reporting, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS launches Open Payments website The Centers for Medicare & Medicaid Services (CMS) today launched its Open Payments website, which allows consumers to see the financial relationships between drug and medical device manufacturers and physicians as reported under the Physician Payments Sunshine Act. The data published online contains 4.4 million payments made between August 1 and December 31, 2013, valued at nearly $3.5 billion and attributable to 546,000 individual physicians and almost 1,360 teaching hospitals. The database is divided into three categories, general payments, research payments and physicians ownership and investments. CMS says that these ... October 1, 2014 General CMS, Physician Payment Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Late program changes could mean Medicare penalties for some in 2015 The Centers for Medicare and Medicaid Services (CMS) has announced that a small subset of physicians participating in the Medicare electronic health records (EHR) Incentive Program may get hit with Medicare penalties next year because the attestation system will not be updated with the expanded hardship exemptions before the October 1 deadline to apply for an exemption. It is uncertain how many participants are at risk, but they are affected by a narrow set of circumstances. The problem ironically stems from changes authorized in August to provide more flexibility in ... September 29, 2014 Medicare EHR, Electronic Health Record, Meaningful Use, CMS 0 0 Comment Read More »
New rules on prescribing hydrocodone combo products take effect October 6 Physicians are reminded that effective October 6, 2014, medicines containing hydrocodone will be reclassified as Schedule II substances, in line with oxycodone and morphine. This reclassification will apply to all drugs that contain both hydrocodone, which by itself was already classified a Schedule II drug, and specified amounts of other substances, such as acetaminophen or aspirin. As Schedule II drugs, patients will be limited to up to a 90-day supply of medication and will have to see a provider to get a refill. (Under the Schedule III classification, a prescription ... September 25, 2014 General Prescription Drugs, Drug Prescribing 0 0 Comment Read More »
Enterovirus D68 confirmed in California; Physicians urged to report unexplained respiratory illnesses to local health department The California Department of Public Health (CDPH) has confirmed four cases of enterovirus D68 (EV-D68) in patients in San Diego (3) and Ventura (1) counties. From mid-August to September 22, 2014, a total of 175 people in 27 states have been confirmed to have respiratory illness caused by EV-D68. More cases are anticipated in the coming weeks. Physicians are urged to consider EV-D68 as a possible cause of acute, unexplained severe respiratory illness, even if the patient does not have fever; and consider laboratory testing of respiratory specimens for enteroviruses ... September 25, 2014 General Public Health, Centers for Disease Control and Prevention 0 0 Comment Read More »
Mandatory flu vaccination in all licensed health care facilities in San Bernardino County Health Advisory Date: September 18, 2014 To: All Licensed Health Care Facilities in San Bernardino County From: Maxwell Ohikhuare, MD, Health Officer Subject: Health Officer Order Regarding Influenza Vaccination of Healthcare Workers Influenza season will begin in the fall. In your roles as leaders in healthcare and mine as the County Health Officer, I know that we share common goals: Minimizing the spread of Communicable Disease like influenza Providing excellent healthcare for our community and Keeping our healthcare workforce healthy The best way ... September 25, 2014 General Immunizations, Influenza, Public Health, Vaccines 0 0 Comment Read More »
CMS opens ICD-10 end-to-end testing to volunteers At the beginning of 2015, the Centers for Medicare and Medicaid Services (CMS) will begin limited Medicare end–to–end testing of ICD-10 billing code submissions to ensure claims with the new codes can be processed from submission to remittance. Earlier this year, Congress pushed back the ICD-10 implementation date a year to October 1, 2015. CMS is looking for volunteers to participate in the testing the week of January 26-30, 2015. From the volunteers, CMS will select a sample of 50 participants for each Medicare Administrative Contractor to represent a broad ... September 22, 2014 Medicare CMS, ICD-10, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Are you ready for the new prescription drug prior authorization form required on October 1? Over the next several months, a new law will take effect that streamlines and standardizes the prior authorization process for prescription drugs. The new law (SB 866) requires all insurers, health plans (and their contracting medical groups/IPAs) and providers to use a standardized two-page form for prior authorizations of prescription medications. The law also requires plans and insurers to make a determination on prescription drug prior authorization requests within two days of receipt, and if they fail to do so the requests will be deemed authorized. The new law does ... September 22, 2014 General Drug Prescribing, Preauthorization, Prescription Drugs 0 0 Comment Read More »
DHCS announces additional delays for some ACA Medi-Cal primary care rate increases The California Department of Health Care Services (DHCS) has released additional information about the timing of the outstanding Affordable Care Act (ACA) Medi-Cal primary care rate increase for certain claim types. Specifically, DHCS had previously announced delays in payment of three types of claims, including certain NICU/PICU services, Child Health and Disability Prevention Program (CHDP) services and crossover claims (also referred to as Medi/Medi claims). Retroactive NICU/PICU claims – At the request of CMA and other stakeholders DHCS will allow claims data to be submitted via ... September 19, 2014 Medi-Cal Child Health and Disability Prevention Program, DHCS, Medi-Cal, CHDP 0 0 Comment Read More »
