United Healthcare extends clinical data submission deadline to Sept. 2 At the request of the California Medical Association (CMA), United Healthcare (UHC) has delayed the expansion of its Clinical Data Submission Protocol in California. Originally scheduled to take effect July 1, the expansion will now be pushed back until September 2. First introduced in 2015, the program originally targeted only Medicare benefit plans and required physicians to submit all laboratory test results for UHC Medicare patients. The expansion of the program will require practices to submit laboratory tests for all UHC Medicaid and commercial benefit plans. For more information about ... July 14, 2016 General Medicare, United Healthcare, Clinical Laboratories 0 0 Comment Read More »
UC Riverside School of Medicine receives $2.3 million grant to address region's poor chronic disease metrics The School of Medicine at the University of California, Riverside, has received a five-year, $2.3 million grant from the Health Resources and Services Administration Primary Care Training and Enhancement Program. The grant will allow the medical school to help transform the local health care system by embedding continuous quality improvement in inland Southern California primary care practices. “We will deploy a research curriculum to equip medical students, residents, practicing physicians and pharmacists with the population health skills needed to address inland Southern California’s poor chronic disease metrics and health care ... July 14, 2016 General Primary Care, UC Riverside, Underserved Communities, Medical Students 0 0 Comment Read More »
Updated payor profiles available The California Medical Association’s (CMA) Center for Economic Services has published updated profiles on each of the major payors in California including Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA, Health Net, United Healthcare, Medicare/Noridian and Medi-Cal. Each profile includes key information on health plan market penetration; a description of the plan’s dispute resolution process; and the name and contact numbers for medical directors, provider relations, and other key contacts. Don’t waste your time searching the internet for this information – members can download CMA’s Payor Profiles free ... July 14, 2016 Managed Care Payors, Payor Profiles 0 0 Comment Read More »
Noridian reports low response rate for Medicare Part B revalidations Noridian, Medicare’s administrative contractor for California, reports that only 19 percent of physicians have responded to the most recent Medicare Part B revalidation notices. Noridian is in the process of deactivating Medicare billing privileges for physicians who received a revalidation notice from Noridian but did not turn in a completed application to the Centers for Medicare and Medicaid Services (CMS) prior to the most recent deadline of May 31. If you are deactivated for failure to respond to a revalidation notice, you must submit a reactivation application. The date ... July 14, 2016 Medicare Noridian, Medicare 0 0 Comment Read More »
CMA publishes guide on new provider directory accuracy law On July 1, 2016, a new law took effect that requires plans to ensure that their physician directories are accurate and up-to-date. The law (SB 137) includes multiple components aimed at providing patients with more accurate and complete information to identify which providers are in their payors' networks. The California Medical Association (CMA) has published a new guide to help physicians understand the new law, and what they need to do to avoid penalties. The guide, "What Physicians Need to Know to Avoid Penalties Under the New Provider Directory Accuracy ... July 14, 2016 General, Managed Care Provider Directory Accuracy Law, Provider Directories 0 0 Comment Read More »
CDPH publishes FAQ on ordering and interpreting Zika lab tests The California Department of Public Health (CDPH) Viral and Rickettsial Diseases Laboratory has published an FAQ designed to answer providers’ frequently asked questions about ordering and interpreting Zika laboratory tests and tests for other flaviviruses. Because the way Zika test results are applied to clinical care is rapidly changing, CDPH published this document to clarify the Centers for Disease Control and Prevention’s most recent recommendations. Additionally, the FAQ addresses the current limitations of commercial laboratory testing for Zika in California. To read the FAQ, click here. If you have additional questions about ... July 14, 2016 General CDC, Department of Public Health, Zika Virus, Blood Testing 0 0 Comment Read More »
Have you gotten an information request from BetterDoctor? The California Medical Association (CMA) has received several inquiries over the past few weeks from practices concerned about the validity of requests for information from a company called BetterDoctor. As you may know, a new law took effect July 1 that requires payors to ensure that their physician directories are accurate and up-to-date. BetterDoctor is a vendor working on behalf of a number of plans on a pilot project to ensure the accuracy of their physician directories as required under the new law. Practices are encouraged to respond to the ... July 14, 2016 Managed Care Provider Directories, Provider Directory Accuracy Law 0 0 Comment Read More »
CMA releases 2016 annotated Model Medical Staff Bylaws The California Medical Association (CMA) has released its 2016 Model Medical Staff Bylaws. These bylaws are the definitive guide for medical staffs, providing details on professional and legal structures to support effective medical staff operations and self-governance. The model bylaws are fully annotated to provide background information on critical provisions, including explanations of relevant state and federal laws, hospital accreditation standards, and other explanatory information. The 2016 Model Medical Staff Bylaws are available free to any medical staff with an active membership in CMA’s Organized Medical Staff Section (OMSS). If your ... July 14, 2016 CMA, General Medical Staff, Medical Staff Bylaws, Organized Medical Staff, Hospital Medical Staff 0 0 Comment Read More »
Tobacco Tax Initiative Qualifies for November 2016 Ballot The California Healthcare, Research and Prevention Tobacco Tax Act of 2016 has officially qualified for the November ballot as Proposition 56. The California Secretary of State confirmed that the measure qualified, after a random sampling of the 1 million signatures submitted by Save Lives California showed that the campaign had more than the 585,407 signatures necessary to earn a spot on the ballot. Reaching 1 million signatures is a tremendous achievement for the coalition and a testament to its strength. But the road to November won’t be easy. Big Tobacco ... July 13, 2016 General Prop 56, Save Lives CA, tobacco tax initiative, Yes on 56 0 0 Comment Read More »
CMA/SBCMS Publishes MACRA Resource Center On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), changing the health care financing system in the most significant and far-reaching way since the program's inception in 1965. To help physicians understand the MACRA payment reforms, and what they can do now to start preparing for the transition, the California Medical Association (CMA) has published a MACRA resource center. There you will find an overview of MACRA, and a comprehensive list of tools, resources and information from CMA, the American Medical ... July 13, 2016 General CMA MACRA Resource Center, MACRA 0 0 Comment Read More »
