Blue Cross adds 3D mammography to preventative care coverage Anthem Blue Cross recently updated its preventive coverage policy on screening digital breast tomosynthesis (DBT or 3D mammography). Beginning with June 6, 2017, dates of service for individual, small group and large group health plans, 3D mammography for screening purposes will be covered at 100 percent, with no member cost share (copayments, deductibles or coinsurance). Anthem National Account plans will be updated to reflect this update beginning August 1, 2017. This follows a February 2017 change Anthem made to archive its prior policy on 3D mammography, which deemed the procedure ... July 21, 2017 Managed Care Anthem Blue Cross 0 0 Comment Read More »
UnitedHealthcare to implement new drug testing reimbursement policy UnitedHealthcare has advised that it will implement a new drug testing reimbursement policy for commercial members effective for dates of service on or after September 1, 2017. The new policy will only allow one Presumptive Drug Class procedure per drug class (codes 80305, 80306 and 80307) per member, per date of service, whether submitted by the same or different provider. The policy will also only allow one Definitive Drug Class procedure per drug class (codes G0480, G0481, G0482, G0483 and G0659) per member, per date of service, whether submitted ... July 21, 2017 Managed Care Drug Testing, UnitedHealthcare 0 0 Comment Read More »
Have you received a termination notice from Blue Cross recently? The California Medical Association (CMA) has heard from several physicians who have received unexpected termination notices from Anthem Blue Cross. The notices, which specify no cause for termination, appear directed only to physicians who refer to out-of-network ambulatory surgical centers. If you have recently received a similar termination notice from Anthem Blue Cross, CMA wants to hear from you. Please contact CMA's Reimbursement Helpline at (888) 401-5911 or economicservices@cmanet.org. July 21, 2017 Managed Care Anthem Blue Cross 0 0 Comment Read More »
CMA urges strong regulatory system for medical cannabis In 2015, the legislature passed and the governor signed into law a series of bills to create a licensing and regulatory framework for medical cannabis. The Bureau of Medical Cannabis Regulation and California Department of Public Health (CDPH) have issued proposed regulations as they begin to construct the medical cannabis regulatory system. The California Medical Association (CMA) submitted written comments on the proposed medical cannabis regulations, which will affect medical cannabis dispensaries, manufacturers, distributors and transporters. While California became the first state to decriminalize the cultivation and use of medical cannabis ... July 21, 2017 General Medical Marijuana, Regulatory Advocacy, Adult Use of Maijuana 0 0 Comment Read More »
Assembly bill would temporarily suspend lab renewal fees The California Legislature is considering a bill (AB 658) that would temporarily suspend the state's clinical laboratory license renewal fees for two years, 2018 and 2019. The bill is a result of an audit that found that the California Department of Public Health (CDPH) had collected millions more in laboratory fees than it had spent operating the Laboratory Field Services (LFS) branch. The fund’s current reserves exceed $22 million. Under state law, however, CDPH cannot suspend or refund these fees. This proposed legislation will only suspend renewal fees and would not ... July 21, 2017 General Clinical Laboratories 0 0 Comment Read More »
Significant improvements in 2018 MACRA rule The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Though not perfect, the California Medical Association (CMA) is pleased that CMS has listened to physician feedback and has made changes that will significantly reduce the administrative burdens on physicians, particularly for small and rural practices. Under the proposed rule, 2018 will be another transition year like 2017. This means that physicians ... July 21, 2017 Managed Care, Medicare CMA, MACRA, Medicare, Regulatory Advocacy 0 0 Comment Read More »
CMA to tackle three major issues at 2017 annual meeting The 146th Annual Session of the California Medical Association (CMA) House of Delegates (HOD) will tackle three major issues when it convenes October 21-22, 2017, at the Disneyland Hotel in Anaheim. The HOD establishes broad policy on current major issues that have been determined to be the most important issues affecting members, the association and the practice of medicine. Discussions on these major issues are now available for comment. All members are welcome to submit comments online at www.cmanet.org/hod. This year's major issues are: Health Care Reform ... July 21, 2017 CMA House of Delegates 0 0 Comment Read More »
