CMA President's Message: An Awesome Responsibility Leading the California Medical Association (CMA) is an awesome responsibility – one that includes representing physicians in the battles medicine faces in California and nationally; promoting policies that protect our patients, our practices and our ability to care for our communities; and preventing regulations that contribute to the ever-increasing problem of burnout among physicians that is resulting in early retirement or career change, frustrations and even suicide. I believe all physicians are responsible to protect the profession of medicine in the present and for the future. And no one can ... January 30, 2018 President's Message President's Message 0 0 Comment Read More »
Denying patient requests lowers physician ratings, UC Davis study finds Patients who ask for specialist referrals, laboratory tests or certain medications and don’t get them tend to be less satisfied with their physicians than those whose requests are fulfilled, new research from UC Davis Health shows. The study, “Association of Clinician Denial of Patient Requests with Patient Satisfaction," was published in the January 2018 issue of JAMA Internal Medicine. Based on the results, the study’s authors recommend communications training for physicians that fosters positive experiences for patients without agreeing to all requests for particular diagnostics or treatments. “It is common for ... January 30, 2018 General Physician-Patient Relationship, Quality of Care 0 0 Comment Read More »
State Disability Insurance rate increase took effect Jan. 1 Effective January 1, 2018, a number of State Disability Insurance (SDI) program changes took effect, including an increase in the wage replacement rate and an elimination of the seven-day non-payable waiting period. The changes apply to both disability claims and Paid Family Leave (PFL) claims. Patients can use the Employment Development Department’s (EDD) online benefit calculator to determine their new benefit amounts. Physicians should also be aware that there is a new version of the Claim for Paid Family Leave (PFL) Benefits form (DE 2501F). New forms can be ordered ... January 30, 2018 General Paid Family Leave (PFL), State Disability Insurance (SDI) 0 0 Comment Read More »
Anthem dials back modifier 25 payment reduction policy; delays implementation This past fall, Anthem Blue Cross notified physicians in several states that effective January 1, 2018, it would reduce reimbursement of evaluation and management (E&M) services billed with modifier 25 by 50 percent. The California Medical Association (CMA) quickly jumped into action and coordinated with the American Medical Association (AMA) and the American Association of Dermatologists, along with many other state and specialty organizations, to push back on the proposed change. Due to the overwhelming opposition from organized medicine, Anthem recently announced it would reduce the magnitude of its modifier ... January 29, 2018 General, Managed Care Contract Amendment, Economic Advocacy, Payor Contracting, Anthem Blue Cross 0 0 Comment Read More »
Are you being paid correctly under California's new out-of-network billing and payment law? Effective July 1, 2017, California’s new out-of-network billing and payment law (AB 72) requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities, and places limitations on the ability of physicians in such circumstances to collect their full billed charges. The interim rate is the greater of the payor’s average contracted rate or 125 percent of the amount that Medicare reimburses on a fee-for-service basis for the same or similar services in that geographic region. This law ... January 29, 2018 CMA, General Economic Advocacy, AB 72, Medical Provider Networks, Out of Network Care, Provider Networks 0 0 Comment Read More »
Public Health Officer urges county residents to get the flu shot The Public Health Officer is strongly encouraging County residents to get the flu shot. Initial influenza reports have sharply increased nearly 300% in the last week, going from 38 reports to 150 reports. Within the last two weeks, the County has also confirmed three (3) flu-related deaths. “These deaths are a reminder that the flu can be serious and sometimes deadly,” said Dr. Maxwell Ohikhuare, Health Officer. “Flu shots are the most effective protection from the flu, and it’s not too late to get one.” In light of the recent sharp ... January 9, 2018 General, Press Releases Flu Shots, Influenza, Vaccinations 0 0 Comment Read More »
CMA convenes physician wellness committee By advancing initiatives that enhance efficiency, professional satisfaction and the delivery of care, the California Medical Association is committed to helping physicians navigate and succeed in a continually evolving health care environment. As part of that commitment, CMA has made physician wellness and the prevention of professional burnout a core priority. Last year, the CMA House of Delegates named physician burnout one of the most pressing issues facing the practice of medicine – and took it up as one of the five “major issues” at the association’s annual meeting. In ... December 28, 2017 CMA House of Delegates, Physician Wellness 0 0 Comment Read More »
Time to verify your patients' eligibility and benefits for 2018 With the new year soon upon us, physicians are urged to be diligent in verifying patients' eligibility and benefits to ensure they will be paid for services rendered. The beginning of a new year also means that both calendar year deductibles and visit frequency limitations reset. And, with open enrollment, patients may even be covered by a new payor. The new year also brings a host of other challenges that could affect your ability to be paid: On January 1, 2018, Health Net Federal Services (HNFS) will ... December 28, 2017 General Running a Practice, Eligibility 0 0 Comment Read More »
Do you see TRICARE patients? Check out CMA's new toolkit to assist physicians with the transition On January 1, 2018, Health Net Federal Services (HNFS) will begin providing managed care services to 2.9 million TRICARE beneficiaries in the 21 western states, including California. HNFS took over the contract previously held by UnitedHealthcare Military and Veterans’ Services. In preparation for the transition, the California Medical Association (CMA) has prepared a TRICARE Transition Guide to help physicians understand the impact the transition will have on their practices. The guide is available free to members in the CMA resource library. December 28, 2017 Managed Care Health Net, TRICARE 0 0 Comment Read More »
Anthem still not complying with AB 72 interim payment rules, physicians report The California Medical Association (CMA) has continued to receive reports from physician offices that Anthem Blue Cross is not paying the “interim payment” as required under California’s new law (AB 72) limiting out-of-network billing for covered, non-emergent services performed at in-network facilities. CMA has also received reports that Anthem representatives have advised some physicians that its Covered California EPO products are not subject to AB 72, which is incorrect. The new law requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for non-emergent services performed ... December 28, 2017 Managed Care Anthem Blue Cross, AB 72, Economic Advocacy, Out of Network Care 0 0 Comment Read More »
