SBCMS and Inland Coalition Announce 2016 White Coat Spring Break Internship Program SBCMS and the Inland Coalition are excited to announce the WHITE COAT SPRING BREAK INTERNSHIP program for 2016! We encourage you, as a physician, medical practice, or healthcare professional - to sign up as a host. Your guidance and mentoring of a high school senior on a healthcare pathway will be instrumental in impacting that student's future career choices and opportunities. This, in turn, supports healthcare throughout the entire Inland Empire. Hosts and student interns can sign-up by downloading and returning either the host application or the student intern application no later than February 29, 2016. We look ... December 17, 2015 General Inland Coalition, White Coat Spring Break Internship 0 0 Comment Read More »
CMA Capitol Insight: Dec. 7, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature ______________________________________________________________________________________________________________ Whirlwind of a week Jerry Brown set off for Paris, but redirected his travel through San Bernardino to meet with law enforcement officials and others on the scene of America’s latest mass shooting. The shooting seems to occupy some strange place between the Paris attacks, which were orchestrated by ISIS, and a very American-style, Fort Hood or office place violence incident. One of the shooters pledged her allegiance to ISIS ... December 7, 2015 General CMA Capitol Insight, Anthony York 0 0 Comment Read More »
United Healthcare to delay implementation of multiple procedure payment reductions until March 1 In its December 2015 Network Bulletin, United Healthcare (UHC) announced that the multiple procedure payment reductions scheduled to begin with November 15, 2015, dates of service have been delayed until March 1, 2016. UHC previously announced in August that it would begin applying multiple procedure payment reductions to the following services: Technical component of diagnostic cardiovascular and ophthalmology procedures Professional component of diagnostic imaging services Some endoscopy procedures According to UHC, the new claim edits will apply for UHC commercial claims and ... December 7, 2015 Medicare United Healthcare 0 0 Comment Read More »
Why it's important to verify your patients' eligibility and benefits for 2016 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 means calendar year deductibles and visit frequency limitations reset. With open enrollment there may also be changes to patients’ benefit plans, or 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: Medicare patients can modify ... December 7, 2015 Managed Care Eligibility, Covered California, United Healthcare 0 0 Comment Read More »
Physicians urged to preemptively file for meaningful use hardship exemptions Because of a delay in the publication of regulations governing the Medicare meaningful use program, physicians are being urged to preemptively file for a 2015 hardship exemption to avoid penalties in 2016. Physicians should apply for an exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. Doing so will not preclude physicians from receiving an incentive if they do meet meaningful use requirements, but applying can serve as a safety net in staving off a penalty. In order ... December 7, 2015 Medicare EHR, Meaningful Use, Medicare, CMS, Electronic Health Record 0 0 Comment Read More »
Anthem asking physicians to affirm participation in workers' comp MPNs by Dec. 31 Anthem Blue Cross recently sent a request to physicians who participate in various workers’ compensation medical provider networks (MPN) through their Prudent Buyer agreements, asking them to affirm their continued participation in each of these networks. This request is required as part of the reforms instituted under SB 863, which mandates that MPNs obtain written acknowledgement from each participating physician that the provider elects to be a member of the network. Under the resulting regulations, physicians who have entered into contracts with workers’ compensation payors prior to August 27, 2014, and ... December 7, 2015 Managed Care Medical Provider Networks, MPN, Workers' Compensation, Anthem Blue Cross 0 0 Comment Read More »
CMA to relaunch webinar program; first program on meaningful use scheduled for Jan. 13 Beginning in January, the California Medical Association (CMA) will relaunch its full webinar program, featuring two to three subjects each month. Geared toward both physicians and their staff, the topics will range from everyday practice management—including contracting with payors, claims and reimbursement, and customer service—to timely issues such as MACRA, meaningful use, CMA governance and HIPAA compliance, among many others. The webinars will take place during the lunch hour, from 12 to 1 p.m. Kicking off the new year and start of the 2016 webinar program will be "Patient Engagement ... December 7, 2015 General Patient Education, Webinars, Meaningful Use 0 0 Comment Read More »
United Healthcare issues amendment to physicians participating in Core network United Healthcare (UHC) recently issued a contract amendment to practices participating in the California health benefit exchange through its UHC Core network. The new contract language amends (or replaces) the prior Appendix 2 of the UHC participating physician agreements. UHC also advised the California Medical Association (CMA) that the only option for physicians who wish to opt out of the Core product network is to terminate the underlying UHC commercial agreement. There is no option to opt out of just the Core network. The Core network, introduced earlier this year, ... December 7, 2015 Managed Care Payor Contracting, United Healthcare, Covered California 0 0 Comment Read More »
New law requiring accurate provider directories includes provider obligation to update information On July 1, 2016, a new law will take effect that requires plans and insurers to comply with uniform standards, and provide timely updates, for their provider directories. The law (SB 137) includes multiple components aimed at providing patients with more accurate and complete information to identify which providers are in their payor’s network. Specifically, the law requires: Plans/insurers must offer an online provider directory available to the public, including physicians, without any restrictions or limitations. ... December 7, 2015 Managed Care Network Adequacy, Payor Contracting, Provider Networks, Commercial Payors 0 0 Comment Read More »
Survey: smoking rates remain high in many areas of California UCLA’s latest California Health Interview Survey shows high smoking rates in several large pockets across the state, despite an overall decrease in smoking. Aside from a brief uptick in smoking from 2009 to 2011, the number of smokers in California declined steadily from 15.3 percent in 2003 to 10.8 percent in 2014 — a figure that translates to about 3.4 million smokers currently. However, smoking remains rampant in many portions of the state. Areas with the highest percent of teen and adult smokers included Lake County (26 percent), Yuba County (21 ... December 7, 2015 General Smoking, Tobacco, Public Health, Tobacco Tax 0 0 Comment Read More »
