CMA files brief in case of intentional retaliatory actions by hospital CEO against physician leader On Monday California Medical Association (CMA) filed an amicus brief with the California Court of Appeal in the case of Michael W. Fitzgibbons, M.D. v. Integrated Health Care Holdings, Inc. (IHHI), arguing that a hospital must be held vicariously liable for the intentional, retaliatory actions of the hospital’s CEO against a vocal physician leader on the hospital’s medical staff. In 2005, troubled Tenet Corp. sold Western Medical Center of Santa Ana (WMC) and three other Orange County hospitals to IHHI. Dr. Fitzgibbons, then chief of WMC’s medical staff, became concerned ... March 27, 2014 General CMA Legal Case List, Legal Advocacy, Amicus Briefs 0 0 Comment Read More »
Three major exchange plans provide guidance for physicians Three major managed care payors offering coverage through Covered California have provided additional information to their contracted providers on their exchange/mirror products. Together, these three payors – Health Net, Anthem Blue Cross and Blue Shield of California – account for approximately 75 percent of enrollment in Covered California products to date. The notices, sent to physicians within the past few weeks, were cobranded with Covered California and contain additional information to help providers navigate the exchange. The Health Net notice, sent on March 7, includes information such as the exchange/mirror products ... March 20, 2014 Managed Care Blue Shield, Covered California, Health Insurance Exchange, Health Net, Anthem Blue Cross 0 0 Comment Read More »
CMA attends California Democratic, Republican Party Conventions to showcase health care efforts The California Medical Association (CMA) sent a large contingent of physicians, medical students and staff to the California Democratic Party Convention in Los Angeles, March 7-9. As the trial lawyers are major Democratic party financial contributors, our presence was critical to the ongoing battle over the Medical Injury Compensation Reform Act (MICRA). Joining the group of 3,000 California Democratic delegates and guests, CMA’s physicians and medical students, donning their crisp white lab coats, had a major presence. Roaming the halls, lining the backs of caucus rooms and speaking to delegates, ... March 20, 2014 General Advocacy, Legislative Advocacy, Professional Liability 0 0 Comment Read More »
IMQ launches online course on reporting child abuse and neglect The California Medical Association Institute for Medical Quality (IMQ) is offering a new online course to prepare physicians for identifying and reporting suspected cases of child abuse and neglect. This program, "Mandated Reporting of Child Abuse and Neglect," is offered through a joint partnership with the Child Abuse Prevention Center, an international training, education, research and resource center dedicated to protecting children and building healthy families. Participants can earn 1.25 AMA PRA Category 1 CreditsTM. Click here to register. IMQ Online Education provides access to courses for AMA PRA Category ... March 20, 2014 General Institute for Medical Quality, Education and Events 0 0 Comment Read More »
Free webinar on new Medi-Cal alcohol screening and prevention benefit Primary care physicians are invited to attend a free webinar that will cover a new Medi-Cal benefit for individuals with alcohol use disorders, as well as those who are at risk of developing these disorders. The webinar, 12 to 1 p.m. on Monday, March 24, will be presented by the California Department of Health Care Services (DHCS) in partnership with Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) experts from the University of California, Los Angeles and L.A. Care Health Plan. Participants will learn more about the SBIRT benefit, ... March 19, 2014 Medi-Cal Continuig Medical Education, Medi-Cal, Webinars, CME 0 0 Comment Read More »
CMS suspends RAC audits, sets up physician safeguards Physicians and hospitals will get a short reprieve from Medicare’s recovery audit contractors (RAC) until next fall, according to the Centers for Medicare & Medicaid Services (CMS). The agency says it is temporarily halting audits as it reevaluates its contracts and implements improvements for physicians. The RAC program is responsible for identifying fraud and waste in the Medicare system by detecting improper Medicare payments. Last month, CMS announced it would pause any new additional document requests (ADR) from RACs until new contracts are settled, in order to reduce provider confusion ... March 19, 2014 Medicare Medicare, RAC, Recovery Audit Contractor, Insurance/Reimbursement 0 0 Comment Read More »
Medicare ICD-10 front-end testing week extended Due to the success of the first week of ICD-10 testing, Noridian has partnered with Centers for Medicare & Medicaid Services (CMS) to continue acceptance testing for EDI submitters and vendors for an indefinite period. The purpose of acceptance testing is to ensure that base system functionality and front end editing have been updated for ICD-10 and are functioning correctly. Acceptance testing will help ensure you are ready for the October 2014 implementation of ICD-10. The California Medical Association (CMA) encourages all direct EDI submitters and vendors to test with Noridian. ... March 19, 2014 Medicare ICD-10, Medicare, Insurance/Reimbursement, Noridian 0 0 Comment Read More »
House-passed SGR repeal with mandate penalty delay is DOA In a 238-181 vote, the U.S. House of Representatives today passed HR 4015, a bill to repeal the Medicare sustainable growth rate (SGR) and put in place a replacement payment system with an amendment offered by House Republican leaders that would pay for the repeal through a five-year delay of the Affordable Care act's individual mandate penalty. Though cheered by House Republicans, the legislation is viewed as "dead on arrival" by policy analysts and health care providers, as its defeat in the U.S. Senate is a near certainty. The move ... March 17, 2014 Medicare Insurance/Reimbursement, Advocacy, Medicare 0 0 Comment Read More »
Report says CURES database provisions in MICRA ballot measure cannot be implemented Today, the Patients, Providers and Healthcare Insurers to Protect Access & Contain Health Costs campaign released a report that raises serious doubts about whether a key provision of the trial lawyers' proposed anti-MICRA ballot measure can be feasibly implemented. Even worse, according to the report, the ballot measure would put physicians and pharmacists in the impossible position of choosing between denying or delaying needed prescription medication to legitimately suffering patients and violating the law. In addition to more than quadrupling MICRA's cap on non-economic damages, the trial attorneys' proposed initiative would ... March 17, 2014 General CURES, MICRA, Professional Liability 0 0 Comment Read More »
CMS wants your input on practice transformation Centers for Medicare & Medicaid Services (CMS) is asking physicians to respond to a questionnaire about the resources physicians will need to make the transition to value-based models of care that can better serve their patients. Comments are due April 8. “We understand you’re trying to run a practice and do a lot of other things, and you’re going to need a lot of support,” CMS Administrator Marilyn Tavenner said last week when she announced the request for information during the American Medical Association’s (AMA) National Advocacy Conference in Washington, ... March 12, 2014 General CMS, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
