Practices encouraged to take DHCS Medi-Cal provider satisfaction survey The Department of Health Care Services (DHCS) is conducting a customer service satisfaction survey for Medi-Cal providers. The purpose is to determine the effectiveness of the program's provider relations activities, including the telephone service center, cash control unit, regional representatives, publications and provider seminars/trainings. The survey is completely confidential and anonymous. Your responses to will help Medi-Cal understand how providers can be better supported, and will shape future customer service improvement efforts. The survey will take approximately 20 minutes to complete and will be open until September 6, 2016. Click here to ... August 12, 2016 Medi-Cal Medi-Cal, DHCS 0 0 Comment Read More »
DEA denies petition to reschedule cannabis but relaxes restriction on research The U.S. Drug Enforcement Agency (DEA) denied a request to remove cannabis from its schedule 1 classification, despite the fact that 25 states, including California, have approved the medical use of cannabis for a growing list of health conditions. According to the DEA, cannabis remains a schedule I controlled substance because it does not meet the criteria for currently accepted medical use in treatment in the United States, there is a lack of accepted safety for its use under medical supervision, and it has a high potential for abuse. However, recognizing ... August 12, 2016 General Medical Marijuana 0 0 Comment Read More »
California Medical Association endorses Proposition 58 The California Medical Association (CMA) today announced an endorsement of Proposition 58, California’s “Language Education Acquisition and Readiness Now” ballot initiative that gives local school districts and their academic staff the option of providing bilingual education. Forty-four percent (44%) of California residents over the age of five speak a language other than English at home, and numerous studies support the need for multilingual health care providers. A 2015 report from UCLA’s Center for the Study of Latino Health and Culture found a shortage of health care professionals who have the ... August 12, 2016 CMA Ethnic Diversity, Political Advocacy, Ballott Measures 0 0 Comment Read More »
California Medical Association endorses Proposition 63 The California Medical Association (CMA) today announced an endorsement of Proposition 63, California’s “Safety for All” ballot initiative to reduce gun violence in California. More than 300 Americans are shot each day, and firearms kill over 32,000 Americans each year. In 2013, over 6,000 Californians were hospitalized or treated in emergency rooms for nonfatal gunshot wounds, including 1,275 children and teens. “Far too often, physicians become firsthand witnesses to the horrific aftermath of gun-related tragedies,” CMA President Steve Larson, M.D., MPH, said. “We see it in our hospitals, clinics and on ... August 12, 2016 CMA Guns, Political Advocacy, Ballot Measures 0 0 Comment Read More »
CMA now accepting online testimony for fourth quarter resolutions At the close of the California Medical Association (CMA) 2015 House of Delegates, new governance reforms took effect. One of the most significant changes to the bylaws allow for the submission of resolutions for debate and discussion throughout the year. In accordance with the new rules, there are now 11 resolutions online for member consideration in the fourth quarter of the year-round resolution process. They are posted at www.cmanet.org/hod and will be available for comment until September 4, 2016. Resolutions to be considered in Q4 include: 111-16: ... August 12, 2016 CMA House of Delegates 0 0 Comment Read More »
Learn tips for improving advance care planning with diverse populations during Aug. 16 call As part of its Advance Care Planning Initiative, the Coalition for Compassionate Care of California (CCCC) hosts a monthly forum to discuss successful advance care planning efforts and share ideas about what is working to improve conversations and processes in both health care and community settings. The next call will take place on Tuesday, August 16, from noon to 1 p.m. Facilitated by Shirley Otis-Green, CCCC clinical director of consulting services, the topic is “Facilitating Culturally Congruent Conversations.” During the call, guest speakers will discuss practical tips and tools for ... August 9, 2016 General Health Disparities, Advanced Care Planning 0 0 Comment Read More »
New online Medi-Cal provider enrollment portal launch planned for October 2016 The California Department of Health Care Services (DHCS) plans to launch its new Medi-Cal provider enrollment system in October. The Provider Application and Validation for Enrollment (PAVE) system will transform provider enrollment from a manual paper-based process to a web-based portal that providers can use to complete and submit their applications and verifications and to report changes. PAVE will improve the provider enrollment experience by minimizing errors, improving the application process and significantly reducing the time required to process provider enrollments. Testers needed DHCS is seeking Medi-Cal fee-for-service providers who are ... August 9, 2016 Medi-Cal Medi-Cal Provider Enrollment, Medi-Cal 0 0 Comment Read More »
UHC to require prior authorization for select outpatient surgical procedures As indicated in its July 2015 Network Bulletin, United Healthcare (UHC) will begin requiring prior authorization for certain surgical procedures done in a hospital outpatient setting effective October 1, 2016. The new prior authorization requirement includes procedure codes in cardiovascular, cosmetic and reconstruction, ophthalmology, and ENT (ear, nose and throat) specialties. Prior authorization will not be required to perform the identified procedures if done in an in-network ambulatory surgery center. For a complete listing of procedures requiring prior authorization, physicians can access the Prior Authorization for Outpatient Surgical Procedures FAQ ... August 9, 2016 Managed Care United Healthcare, Preauthorization 0 0 Comment Read More »
Health Net Federal Services awarded Tricare contract beginning late 2017 Health Net Federal Services (HNFS) has been awarded the contract for managed care support (MCS) for the Tricare West Region, replacing the current MCS contractor, United Military and Veteran Services. Under the $17.7 billion contract, HNFS will provide direct medical care and administrative support services to Tricare beneficiaries throughout the 19 state western region, which includes California. According to HNFS, a nine-month transition period is expected, with an anticipated start of health care delivery sometime in mid-2017. HNFS has been the managed care contractor for the Tricare North Region since ... August 9, 2016 Managed Care Tricare, Health Net 0 0 Comment Read More »
Blue Shield implements system fix to correctly pay HPV9 claims Under the Affordable Care Act, health plans are required to provide “first dollar” coverage for preventive services. This means that the plan cannot apply patient cost sharing, such as copays, coinsurance or deductibles, to these services. However, in September 2015, the California Medical Association (CMA) was alerted by a physician practice that Blue Shield of California was applying patient cost sharing when it processed HPV9 claims with CPT code 90651. CMA escalated the issue to Blue Shield and has been working with the payor since then to correct the ... August 9, 2016 Managed Care Affordable Care Act, Blue Shield, ACA 0 0 Comment Read More »
