Congress allows veterans to seek care outside VA system Congress yesterday sent a $17 billion landmark bill to President Obama that will help U.S. veterans avoid long waits for health care within the U.S. Department of Veterans Affairs (VA). There was overwhelming support in both the Senate (91-3) and House (unanimous) for the bill, which will provide $10 billion in emergency spending over the next three years to allow veterans to seek care from private doctors and other health professionals due to delays in the VA system. Veterans would have access to private doctors if they could not get ... August 4, 2014 General Hospitals/Health Care Facilities, Quality of Care, Veterans, Federal Legislation 0 0 Comment Read More »
Two federal courts issue conflicting rulings on ACA premium subsidies Two federal appeals courts issued conflicting rulings last week on whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The rulings will not, however, impact states like California that run their own exchanges. The U.S. Court of Appeals for the District of Columbia Circuit, in a 2 to 1 vote, majority opinion said that the ACA’s language unambiguously restricts premium subsidies to insurance purchased on exchanges “established by the State,” and that the IRS’ ... August 4, 2014 General Affordable Care Act, Health Insurance Exchange, ACA 0 0 Comment Read More »
CMS issues proposed 2015 Medicare payment rule The Centers for Medicare and Medicaid Services (CMS) recently published the 2015 proposed Medicare physician payment rule in the Federal Register. The proposal contains several notable changes. The rule expands the services eligible for telemedicine reimbursement (psychotherapy services and the annual wellness visit). It also extends the new payment policies for non-face-to-face care coordination. It allows primary care physicians to be paid for care management of Medicare beneficiaries with two or more chronic conditions. These are tasks (including managing lab and imaging reports, medications and care plans in addition ... August 4, 2014 Medi-Cal, Medicare Insurance/Reimbursement, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Medicare's financial outlook improves Trustees overseeing Medicare’s Hospital Insurance Trust Fund, which finances about half the health program for seniors, said Monday in a report that the program won’t run out of money until 2030 – that’s four years later than projected last year and 13 years later than projected at the passage of the Affordable Care Act (ACA). The outlook for Medicare improved largely because of lower-than-expected hospital spending and savings resulting from the ACA. The effect of the new law encouraged providers and Medicare Advantage insurers to deliver care more cost-effectively and ... August 4, 2014 Medicare Affordable Care Act, Medicare, ACA 0 0 Comment Read More »
IOM report says financing for physician residency programs needs overhauling to meet nation's needs A report by the Institute of Medicine shows that the U.S. should significantly reform the federal system for financing physician training and residency programs to ensure that the public’s $15 billion annual investment is producing the doctors that the nation needs. Current financing – provided largely through Medicare – requires little accountability, allocates funds independent of workforce needs or educational outcomes, and offers insufficient opportunities to train physicians in the health care settings used by most Americans, the report says. For decades, teaching hospitals have received the majority of Medicare's funding ... August 4, 2014 General Insurance/Reimbursement, Physician Workforce, Residents and Fellows, Medicare 0 0 Comment Read More »
Early bird deadline for the 2014 NEPO Leadership Summit is July 31 The California Medical Association Foundation and the Network of Ethnic Physician Organizations (NEPO) invite you to attend the 2014 NEPO Leadership Summit, September 19-21 at the new Riverside Conference Center. Register by the July 31 early bird deadline and save $150. The NEPO Summit is an opportunity for physicians, public health professionals and community leaders who work with underserved communities to learn about emerging health care policy issues, share best practices on how to reduce health disparities and increase access to health care services for the populations they serve. The ... July 22, 2014 General NEPO, Network of Ethnic Physician Organizations, Education 0 0 Comment Read More »
California among six states that pay the least for Medicaid beneficiaries, says GAO report According to a report released this week by the U.S. Government Accountability Office (GAO), California is one of six states that spends less than $6,000 per Medicaid (Medi-Cal in California) enrollee per year. The other states include Illinois Alabama, Arkansas, Mississippi and Tennessee. In contrast the report found that eight states, including New York, spend at least $10,500 per beneficiary. The report also found that Medi-Cal fee-for-service pays on average 61 percent of what private insurers in the state pay for the same evaluation and management services, with Medi-Cal ... July 22, 2014 Medi-Cal Insurance/Reimbursement, Medicaid, Access to Care, Medi-Cal 0 0 Comment Read More »
CMA files brief with CA Supreme Court in case that could undermine MICRA's longstanding definition of professional negligence The California Medical Association (CMA), together with other amici, has filed a brief with the California Supreme Court, urging reversal of an appellate court opinion that thwarts the long-standing definition of "professional negligence" in California's Medical Injury Compensation Reform Act (MICRA). The ruling, if allowed to stand as precedent for future cases, could be misused to undermine the goals of MICRA and adversely affect the entirety of the health care system and safety net in California. In this case, Flores vs. Presbyterian Intercommunity Hospital, a hospital inpatient sued for injuries ... July 18, 2014 General Legal Advocacy, MICRA, Professional Liability, Amicus Briefs 0 0 Comment Read More »
Employment Practices Liability Insurance (EPLI) Many members think they have coverage for wrongful termination, harassment, discrimination claims by employees or patients (third party). However, most policies exclude coverage for these types of actions or only provide limited coverage (a contribution to defense costs). The San Bernardino County Medical Society sponsored Employment Practices Liability program includes a unique blend of risk management services and insurance specifically designed to assist physician groups in addressing these important employment issues. Among the features of the program are: Special First-Time Buyers program A Helpline ... July 17, 2014 General EPLI, Employment Practices Liablity Insurance, Mercer 0 0 Comment Read More »
