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HHS announces new rule that gives patients direct access to lab test results

Patients will soon be able to obtain their medical test results directly from the laboratory, rather than having to request a copy from their physician's office, according to a new rule announced Monday by the U.S. Department of Health and Human Services (HHS).   The rule is part of a broader effort to give Americans more control over their health care. It supersedes state law and will have particular significance in 13 states that currently prohibit labs from releasing test results directly to patients. Current California law allows the release of ...

Noridian sends out another wave of Medicare revalidation requests

As called for under the Affordable Care Act (ACA), Medicare Administrative Contractors (MACs) have been requiring physicians to revalidate their Medicare enrollments. Between now and March 23, 2015, MACs will continue reaching out to physicians, notifying them of the need to revalidate. The most recent round of revalidations requests went out by December 30, 2013.   The revalidation requirement is necessitated by new screening criteria called for under the ACA. Newly enrolling and revalidating providers will be placed in one of three screening categories representing the level of risk to the ...

CMA releases fact sheets regarding Covered California grace period, updates toolkit

Recognizing the Affordable Care Act’s “grace period” provision to be one of the most confounding provisions of the law, the California Medical Association (CMA) has published an FAQ sheet dedicated entirely to helping physicians make sense of the issue.   The fact sheet, “Covered California: Understanding the Grace Period for Subsidized Exchange Enrollees," is available through CMA’s exchange resource center.   Federal law allows Covered California enrollees who receive financial subsidies to keep their health insurance for three months, even if they have stopped paying their premiums. This is known as the “grace ...

CMS updates EFT authorization agreement

The Office of Management and Budget recently approved changes to the CMS 588, Electronic Funds Transfer (EFT) Authorization Agreement. The revised EFT agreement is available on the CMS Forms List.  As of January 1, 2014, new EFT authorization agreements submitted must be on the new form. Submissions on the old forms will be returned to the applicant.

Did you know you can request reconsideration if you're getting dinged with a 2% Medicare eRx penalty?

Physicians and group practices who were not successful electronic prescribers under the 2012 or 2013 Medicare eRx Incentive Program will be subject to a negative payment adjustment of 2 percent in 2014 on all Medicare Part B claims paid under the physician fee schedule.   The Centers for Medicare and Medicaid Services (CMS) has notified physicians and group practices that did not meet the requirements and will be subject to the 2014 payment adjustment. Some practices have reported that their meaningful use attestation was not taken into consideration as an exemption. ...

Anthem Blue Cross to move eligibility, benefits and claim status inquiry functions to Availity Web Portal in March

Anthem Blue Cross has advised that effective March 14, 2014, patient eligibility, benefits and claim status inquiry functions will transition from its ProviderAccess portal to the Availity web portal. As of that date, practices will only be able to access this information via the Availity web portal.   While BlueCard eligibility, benefits and claim status functions will also transition to Availity, the BlueCard Advisor function that allows practices to determine which Blues plan to send the claim to will continue to be available on the ProviderAccess portal.   In order to access information ...

Surviving the Second Month of Covered California

As of January 15, Covered California reports that more than 625,000 individuals have enrolled in exchange plans. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect. To help answer some of the more common questions, the California Medical Association (CMA) offers this second tip sheet to help physicians survive the second month of Covered California.  Available to members only.