CMA Foundation hires health policy leader to head exchange education program for providers The CMA Foundation has hired a health policy leader, Kena C. Burke, MPP, to manage a physician education program aimed at getting physicians up-to-speed on California’s health benefit exchange, Covered California. The program is expected to reach some 200,000 health care providers in the state. This program was made possible thanks to a $1.5 million grant, recently awarded jointly to the California Medical Association, the CMA Foundation, Latino Physicians of California, the California chapter of the American Academy of Pediatrics and a number of county medical societies. As program director, Burke ... September 25, 2013 General Covered California, CMA Foundation, Health Insurance Exchange 0 0 Comment Read More »
Legislative update: Year of challenges, victories This year turned out to be a challenging year for the California Medical Association (CMA). We knew would be a historic year with the implementation of federal health care reform (ACA) and the wave of legislative freshman. We anticipated that many issues would arise as we helped to educate new legislators not only about the ACA, but about the many issues important to the physician community in California. CMA faced an unprecedented number of scope of practice expansion bills introduced in the Legislature. These scope of practice bills were painted ... September 25, 2013 General Advocacy 0 0 Comment Read More »
Medicare transition update September 16, 2013, marked the transition to the new Medicare Administrative Contractor, Noridian. In the first few days, the California Medical Association (CMA) heard about only minor problems with technology, including phone systems that went up and went down, a few issues with the online provider service tool and problems with printing of -PDF files from the Noridian website. Most issues have been resolved. Traffic on the Noridian Provider Contact Center phone line is high, as expected. Wait times are sometimes four to five minutes, but practices report satisfaction with ... September 25, 2013 Medicare Medicare, Noridian, Insurance/Reimbursement 0 0 Comment Read More »
Study finds that ACA Medi-Cal expansion could fuel ER use A retrospective study conducted by researchers at the University of California, San Francisco (UCSF) found that the number of visits to California emergency rooms (ERs) rose by 13.2 percent between 2005 and 2010, from 5.4 million to 6.1 million annually, with a significant 35 percent increase in the number of ER patients insured through Medi-Cal. The authors suggest that the Medi-Cal expansion under the Affordable Care Act (ACA) could further increase these numbers, as millions of additional patients become eligible for Medi-Cal in 2014. Researchers also found that Medi-Cal patients ... September 20, 2013 Medi-Cal Emergency Physicians, Emergency Rooms, Insurance/Reimbursement, Medi-Cal, Medi-Cal Cuts, Access to Care 0 0 Comment Read More »
CMA files a petition with the Supreme Court to block the 10 percent physician reimbursement cut The California Medical Association (CMA) filed a petition today asking the United States Supreme Court to review the Ninth Circuit Court of Appeals ruling that cleared the way for the State of California to implement a 10 percent cut to Medi-Cal provider reimbursement rates. Federal law requires that Medi-Cal patients have the same access to physicians and other health care providers as the general insured public. Despite this law, a three judge panel of the Ninth Circuit ruled that the state could move forward with the rate cuts, passed by ... September 20, 2013 Medi-Cal Advocacy, Medi-Cal, Medi-Cal Cuts, United States Supreme Court, Access to Care, Medi-Cal Lawsuit 0 0 Comment Read More »
Reminder: Changes to Anthem Blue Cross reimbursement policies and claims software become effective November 1 In late July, Anthem Blue Cross sent physicians a notice advising of upcoming changes to the insurer’s reimbursement policies and claims editing software called ClaimsXten. The changes will go into effect on November 1, 2013. Because of these changes, physicians may notice a difference in how certain codes and code pairs are adjudicated. Along with the notice, Anthem provided a comprehensive grid outlining all new, revised and existing reimbursement policies and claims editing rules as well as copies of Anthem’s reimbursement policies. Changes include: denial of 3D rendering CPT codes 76376 ... September 20, 2013 General Anthem Blue Cross, Managed Care, Insurance/Reimbursement 0 0 Comment Read More »
PQRS administrative claims-based reporting deadline is October 15 Physicians who do not successfully participate in the Physician Quality Reporting System (PQRS) this year will be subject to PQRS payment penalties starting in 2015. PQRS is a Centers for Medicare and Medicaid Services (CMS) quality reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals. Physicians who do not report on at least one individual measure in 2013 or elect to participate in the administrative claims reporting option will receive a 1.5 percent payment penalty in 2015. The penalty ... September 20, 2013 General Medicare, Physicians Quality Reporting System, PQRS, Centers for Medicare and Medicaid Services, Insurance/Reimbursement 0 0 Comment Read More »
CMS launches new online ICD-10 implementation guide The Centers for Medicare & Medicaid Services (CMS) recently launched an online ICD-10 implementation guide to help practices of all sizes successfully make the switch to the new ICD-10 coding system, which is used to report medical diagnoses and inpatient procedures. Physicians and payors must begin using the new code sets by October 1, 2014. ICD-10 (The International Classification of Disease tenth revision) is a system of coding created in 1992 as the successor to the previous ICD-9 system. ICD-10 will include new procedures and diagnoses, which the U.S. Department ... September 20, 2013 General CMS, ICD-10, Practice Management 0 0 Comment Read More »
MICRA Update: Victory in the Capitol but the fight goes on California’s legislative session officially wrapped up last week, and because of aggressive advocacy by the California Medical Association (CMA) and action taken by thousands of California physicians, a bill to scuttle the state’s Medical Injury Compensation Reform Act (MICRA) was never introduced. Despite weeks of pandering to members of the Legislature, California’s trial lawyers, along with their front group Consumer Watchdog, were unable to find enough legislators to vote for their greedy and misguided effort at lifting MICRA’s historic protections for their own financial gain. A majority of the Legislature ... September 20, 2013 General Advocacy, Malpractice Insurance, MICRA, Professional Liability 0 0 Comment Read More »
Press - Package of bills to increase number of physicians in rural, underserved areas signed by Governor Brown Sacramento – Two bills that would put more physicians in rural and underserved parts of California were signed by Governor Jerry Brown. SB 21 and AB 1288 were both sponsored by the California Medical Association (CMA). The 2013-14 state budget included a $15 million annual appropriation to fully fund the University of California Riverside School of Medicine (UCR SOM). The Inland Empire, including Riverside and San Bernardino Counties, is experiencing the lowest supply of physicians per capital than any other region of the state. Allocating a continuous funding source for ... September 11, 2013 General Advocacy 0 0 Comment Read More »
