Blue Shield data breach affects California doctors The Department of Managed Health Care (DMHC) has notified physicians of a data breach that disclosed the social security numbers as well as names, business addresses, telephone numbers, medical groups and practice areas of over 18,000 physicians who contract with Blue Shield of California. DMHC discovered that Blue Shield of California had inadvertently included physician social security numbers in public rosters provided to DMHC. These rosters are generally public documents and subject to disclosure under the Public Record Act (PRA). As a result, DMHC produced the rosters, including the social ... July 15, 2014 General Department of Managed Health Care, Identity Theft, Blue Shield 0 0 Comment Read More »
Physicians can review Sunshine Act data starting today The Centers for Medicare and Medicaid Services (CMS) announced that starting today physicians can complete part 2 of the registration process to review and dispute disclosures under the Physician Payments Sunshine Act. Physicians have 45 days to review and dispute their data (plus an additional 15 days to resolve disputes). The review and dispute process ends August 27, 2014. The information will be published publicly on September 30, 2014. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including ... July 15, 2014 General Advocacy, Physician Payment Sunshine Act, Regulatory Advocacy, CMS 0 0 Comment Read More »
California Democratic Party to remain neutral on Prop. 46 Backers of Proposition 46, the MICRA lawsuit measure, were dealt another severe blow this weekend when, despite their intense lobbying, the Executive Board of the California Democratic Party rejected their efforts to gain an endorsement, instead voting to remain neutral. Over the course of the three-day meeting, Democratic Party leaders and activists who reviewed Prop. 46 found that, if the initiative were to pass, health care costs would go up, access to care would go down, community clinics would be harmed and personal privacy will be put at risk. Understanding its ... July 15, 2014 General Access to Care, Professional Liability, MICRA 0 0 Comment Read More »
CMS proposes to end Sunshine Act CME exclusion The Centers for Medicare & Medicaid Services (CMS) has decided to eliminate the continuing medical education (CME) exclusion for the Physician Payments Sunshine Act. The news was included in the 2015 Medicare Physician Fee Schedule proposed rule. The Sunshine Act stems from a provision of the Patient Protection and Affordable Care Act. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Any payments, ownership interests and other “transfers of ... July 15, 2014 General Health Care Reform, Physician Payment Sunshine Act, Affordable Care Act 0 0 Comment Read More »
CMA, AMA and others urge CMS to delay new rules authorizing multi-hospital systems to establish system-wide medical staffs The California Medical Association (CMA), the American Medical Association and dozens of other state and specialty medical associations have asked the Centers for Medicare & Medicaid Services (CMS) to delay for one year new Medicare rules that would allow multi-hospital systems to establish system-wide medical staffs. CMA commented extensively on this and prior iterations of this rulemaking expressing serious concerns about the proposed amendments to the CoPs and their impact on medical staff self-governance. CMA believes that medical staff self-governance is a vital part of a carefully crafted system designed ... July 15, 2014 General Medicare, Organized Medical Staff, CMS, Hospital Medical Staff 0 0 Comment Read More »
Change in mailing address for Medi-Cal TAR submissions Effective for dates of service on or after July 1, 2014, all paper treatment authorization requests (TAR) currently being mailed to the Los Angeles Field Office and the Northern and Southern Pharmacy Sections should be mailed to the following address: West Sacramento TAR Processing Center 820 Stillwater Road West Sacramento, CA 95605-1630 Updated provider manual sections will be published in a future Medi-Cal Update. July 15, 2014 General Treatment Authorization Request, Insurance/Reimbursement, Medi-Cal, TAR 0 0 Comment Read More »
FAQ: Do service dogs have to be accommodated in a physician's office? Physicians are asked to accommodate service dogs in their offices with increasing frequency. The law generally requires a place of public accommodation, like a physician's office, to permit service dogs where customers would normally be allowed so long as providing the accommodation is reasonable and necessary. However, what constitutes a service dog is not always obvious as many people also have companion animals or emotional support animals they wish to bring. The law does not require companion animals to be accommodated in the same way as service animals. To help ... July 15, 2014 General ADA/Discrimination, Disabilities, Access to Care, Legal Issues 0 0 Comment Read More »
DEA makes tramadol a Schedule IV drug Effective August 18, 2014, tramadol will be classified as a Schedule IV drug, according to a rule recently published by the U.S. Drug Enforcement Agency (DEA). The drug had been a non-controlled substance under federal law for almost 20 years. According to the DEA, the abuse of tramadol products has increased over the last several years, with it being used as a substitute for other opioids such as hydrocodone. Tramadol is a centrally acting synthetic opioid analgesic used in the management of moderate to moderately severe pain in adults. Tramadol ... July 15, 2014 General Drug Prescribing, Prescription Drugs, Drug Dispensing, Quality of Care 0 0 Comment Read More »
CMA files brief with California Supreme Court in MICRA constitutionality case The California Medical Association (CMA), along with the California Dental Association and the California Hospital Association filed an amicus brief with the California Supreme Court urging the common sense application of our state’s landmark Medical Injury Compensation Reform Act (MICRA), which allows non-economic damage awards up to $250,000 and unlimited economic damage awards for all past and future medical costs, lost wages and earning capacity. This case is just the latest in many legal challenges to MICRA that have been funded by trial lawyer groups from across the country. In ... July 15, 2014 General Legal Advocacy, MICRA, Professional Liability, Amicus Briefs 0 0 Comment Read More »
IMQ Expands Peer Review Services Does your medical staff need help with peer review? The Institute for Medical Quality is expanding its services to include Clinical Case Review of individual cases and Judicial Review services in addition to our existing Comprehensive Peer Review services. Through off-site patient chart review, an IMQ Clinical Case Review consultation provides an objective evaluation of the clinical practice of one or more physician members of a hospital medical staff, physician group, or ambulatory care practice through peer review of selected cases. IMQ's involvement is especially helpful when an organization will ... July 7, 2014 General IMQ, Peer Review Services, Institute for Medical Quality 0 0 Comment Read More »
