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Bills introduced to stop IPAB

California Congressman and physician Raul Ruiz, M.D., (D-Palm Springs) and Senate Finance Committee Ranking Member Ron Wyden (D-OR) recently introduced bills that that would prevent the Medicare Independent Payment Advisory Board (IPAB) from moving forward. IPAB was to be a 15-member federal agency with the task of achieving specified savings in Medicare without affecting coverage or quality. It was established by the Affordable Care Act and up until now has not been implemented. The board was charged with making recommendations to reduce per capita spending growth in Medicare if spending ...

Meaningful use reporting deadline pushed back two weeks to March 13

The Centers for Medicare & Medicaid Services (CMS) on Monday announced that physicians would have two additional weeks to register and attest to meaningful use for 2016 and avoid the 2018 penalty. Physicians now have until Monday, March 13, to attest for the 2016 reporting year. Two weeks ago, hospitals also received a similar reprieve. Physicians should note that CMS is only extending the attestation period, not the reporting period, so physicians must have concluded their reporting by December 31, 2016. Although the Medicare meaningful use program is being phased out ...

U.S. District Court blocks Anthem-Cigna merger

A federal judge has blocked the $48 billion mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). The ruling favored the U.S. Department of Justice (DOJ) and 11 states, including California, who argued that the Anthem-Cigna merger would limit price competition and lower the quality of care that Americans receive. “The California Medical Association (CMA) has opposed the Anthem-Cigna mega-merger since day one because it would hurt patients and increase health care costs,” said CMA President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract ...

Large insurers drop barriers to prescribing medications for opioid use disorder

Three of the nation's largest insurers—Aetna, Cigna, and Anthem Blue Cross—have in recent months announced that they will no longer require physicians to seek prior approval before prescribing medication to treat opioid use disorder. These policy changes come as more than 2.2 million people meet the diagnostic criteria for an opioid use disorder. Treatment of opioid use disorder with opioid maintenance therapies has been shown to be cost-effective, safe and successful when used appropriately. Increasing access to treatment is crucial to addressing opioid misuse and overdose, and the California Medical Association ...

ACIP publishes new vaccination schedules for children, adolescents and adults

On February 1, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) published updated immunization schedules for children, adolescents and adults. The 2017 child and adolescent immunization schedule includes several updates including influenza, human papillomavirus (HPV), hepatitis B, Haemophilus influenzae type B (Hib), pneumococcal, meningococcal and diphtheria and tetanus toxoids and acellular pertussis vaccines (DTap). Changes to the 2017 adult immunization schedule include new or revised recommendations for influenza, human papillomavirus, hepatitis B, and meningococcal vaccines. The new schedule was published online, in the Annals of ...

2017 Medicare EHR payment adjustment reconsideration forms due February 28

Eligible physicians who have been identified as being subject to Medicare electronic health record (EHR) payment penalties in 2017 (based on the 2015 reporting period), and believe that determination to be in error, have until February 28, 2017, to submit a reconsideration form to the Centers for Medicare and Medicaid Services (CMS). The reconsideration form can be downloaded from the CMS website. For reconsideration instructions, click here. If you have questions about the reconsideration process, please email pareconsideration@provider-resources.com. For more information on payment adjustments and hardship applications, or for information ...

CMA shares tools and resources on diabetes prevention

The California Medical Association (CMA) has developed a resource page to share tools and resources on diabetes prevention and to help providers connect their patients with diabetes prevention programs recognized by the Centers for Disease Control and Prevention (CDC). CMA’s resource page shares information on the AMA’s Prevent Diabetes STAT toolkit, which providers and care teams can use to identify patients with prediabetes and refer eligible patients to evidence-based diabetes prevention programs approved by the CDC’s National Diabetes Prevention Program. CMA will continue to update this page, highlighting existing programs ...

Self-assessment: How burnt out are YOU?

The American Medical Association's "Preventing Physician Burnout" module has a quick 10-question survey to help physicians determine their workplace stress levels and how they measure up against other physicians. After completing the survey, you will see your results compared to others in your region and in your specialty. The survey is part of AMA's STEPS Forward™ collection, which includes 43 free interactive educational modules aimed at helping physicians redesign their medical practices to minimize stress and reignite professional fulfillment in their work. Continuing medical education credit can be earned from ...

Are you exempt from ICD-10 PQRS penalties in 2016?

On October 1, 2016, new ICD-10 code sets went into effect that will impact the ability of the Centers for Medicare and Medicaid Services (CMS) to process data reported on certain quality measures for the fourth quarter of 2016. Because of this, CMS announced that it will waive 2017 or 2018 Physician Quality Reporting System (PQRS) payment adjustments, if applicable, for any physician or group practice that fails to satisfactorily report for 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for ...

CMS erroneously warns some physicians of 2017 meaningful use penalties

Providers who attested to meaningful use with the Medi-Cal Electronic Health Record (EHR) Incentive Program for program year 2015 are exempt from Medicare payment adjustments in 2017.  Because the California Department of Health Services pushed back the deadline to submit meaningful use applications for the 2015 program year to December 13, 2016, the agency was not able to send information to the Centers for Medicare and Medicaid Services (CMS) regarding 2015 Medi-Cal meaningful use attestations until late in December 2016.  For this reason, some Medi-Cal providers are now erroneously ...