CMA now accepting online testimony for 2015 House of Delegates The California Medical Association’s (CMA) 2015 House of Delegates (HOD) will convene at the Disneyland Hotel in Anaheim, October 16-18. The HOD meets annually to establish broad policy on current major issues and elect CMA officers, including president-elect, speaker and vice speaker. The resolutions that will be discussed at this year's meeting are now available for review and comment online at www.cmanet.org/hod. Testimony is open to all members, and is not limited to members of the House of Delegates. For the first time, testimony this year will only take place online ... September 23, 2015 General House of Delegates, CMA Policy 0 0 Comment Read More »
CMA defeats bill that would have transferred negotiating power to health plans at the expense of physicians The California Medical Association (CMA) has defeated a bill that would have drastically changed the current health care marketplace by allowing a massive transfer of negotiating power to the health plans at the expense of physicians. Assembly Bill 533 was an attempt to shield patients from billing disputes between providers and health plans and would have required non-contracted physicians and dentists to accept Medicare rates as payment in full when performing services in a contracted or “in-network” facility. Although CMA is in favor of removing patients from billing disputes between ... September 23, 2015 Managed Care Advocacy, Medical Provider Networks, State Legislation, Health Plans 0 0 Comment Read More »
CMA Capitol Insight: Sept. 15, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. The end of the road After years of having his way in the state legislature, Gov. Jerry Brown suffered a series of defeats at the end of this legislative year. Some came at the hands of Republicans – like Brown’s failure to muster support for new gasoline taxes to pay for road construction and repairs. Others were handed out by fellow Democrats, including a cluster of members in the ... September 23, 2015 General CMA Capitol Insight, State Legislature, Anthony York 0 0 Comment Read More »
Students to Service Loan Repayment Program Application Webinar Interested in applying to the National Health Service Corps (NHSC) Students to Service Loan Repayment Program, but have questions about the application process and program requirements? If so, this webinar is for you! You will need to join online and by phone. • Use this link to log into the webinar as a guest • Dial-in: 1-888-566-6151 Passcode: 4221465 NHSC staff members will be available to answer any questions you may have. Learn more about the program and access other helpful application resources. September 15, 2015 General National Health Service Corps, NHSC, S2S LRP, Students to Service Loan Repayment Program 0 0 Comment Read More »
NPs and PAs can sign POLST forms beginning in 2016 A new law (Assembly Bill 637) recently signed by Gov. Jerry Brown will allow nurse practitioners (NP) and physician assistants (PA), under the direction of a physician and within their scope of practice, to sign Physician Orders for Life-Sustaining Treatment (POLST) forms and make them actionable medical orders. The law goes into effect on January 1, 2016. The POLST form is a legally recognized document that outlines a plan of care reflecting patients’ wishes concerning medical treatment and interventions toward the end of their lives. The California Medical Association (CMA) co-sponsored ... September 9, 2015 General Advocacy, Nurse Practitioners, Physician Assistants, End of Life Issues, POLST 0 0 Comment Read More »
IMQ offers judicial review service to hospitals In the case of certain disciplinary actions, physicians are entitled by California law to a fair hearing by their peers. The California Medical Association's Institute for Medical Quality's (IMQ) Judicial Review program helps hospitals meet that requirement by providing qualified, independent physicians to serve on panels. Hospitals sometimes struggle to create unbiased judicial review panels and often have difficulty finding physicians without any perceived conflict of interest who are available to serve on consecutive days. IMQ meets that need by providing three or more qualified, independent physician panelists to hear ... September 8, 2015 General Peer Review, Institute for Medical Quality 0 0 Comment Read More »
Field Poll: Nearly two-thirds of California voters support $2 per pack tobacco tax hike A proposal to raise California’s tobacco tax by $2 per pack is supported by an overwhelming majority of the state’s voters, according to a new Field Poll. The poll, released Aug. 26, shows over two-thirds of California voters support of a $2 tobacco tax hike, with 50 percent of those surveyed saying they strongly favor the increase. The poll was conducted between June 25 and July 16 by way of phone calls. The positive findings reflect the opinions of many health and labor advocates across the state, who believe boosting California’s ... September 8, 2015 General Tobacco, Tobacco Tax, Public Health 0 0 Comment Read More »
United Healthcare identifies physician chemotherapy claims processing error UnitedHealthcare (UHC) has identified an error in the processing of physician claims related to its Injectable Outpatient Chemotherapy Prior Authorization program requirement, which became effective June 1, 2015. Between June 1 and July 18, 2015, incorrect denials of “lack of prior authorization” may have been generated for injectable chemotherapy claims submitted with valid authorizations on file or submitted for patients with self-insured employer policies where preauthorization of injectable chemotherapy is not required. UHC has advised that a system fix was implemented on July 18, 2015, and all claims after ... September 8, 2015 General, Managed Care Cancer; United Healthcare 0 0 Comment Read More »
DHCS implements period of "deemed eligibility" for Cal MediConnect plans Effective September 1, 2015, Cal MediConnect will have the option to offer a one- or two-month period of “deemed eligibility,” defined as a grace period, to beneficiaries that lose Medi-Cal eligibility due to a change in circumstance. Cal MediConnect plans have the option to, but are not required to, offer this “grace period." According to the 2013 Medicare-Medicaid Plan Enrollment and Disenrollment Guidance, a Cal MediConnect plan may choose to provide a one- or two-month period of deemed continued eligibility for individuals who lose Medicaid eligibility, if the individual ... September 8, 2015 Medi-Cal Cal MediConnect 0 0 Comment Read More »
United Healthcare to implement several new multiple procedure payment reductions effective November 15 In its August 2015 Network Bulletin, United Healthcare (UHC) announced that, beginning with November 15, 2015, dates of service, multiple procedure payment reductions (MPPR) will be applied to several types of services, including: Technical component of diagnostic cardiovascular and ophthalmology procedures Professional component of diagnostic imaging services Some endoscopy procedures UHC reports that it is implementing the reductions to better align with the Centers for Medicare & Medicaid Services (CMS). The new claim edits will apply for UHC commercial claims. ... September 8, 2015 Managed Care United Healthcare 0 0 Comment Read More »
