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 »
AMA and CMA efforts to secure adequate funding for GME continue In an effort to increase the number of medical residency slots and to help address the national physician shortage, delegates to the American Medical Association (AMA) renewed their support for alternative funding sources for graduate medical education (GME). AMA also adopted policy to explore additional funding models for GME beyond those examined in the Institute of Medicine’s 2014 report on GME governance and financing. Under the new policy, AMA will encourage insurance payors and foundations to enter into partnerships with state and local agencies, as well as academic medical centers ... December 7, 2015 General Graduate Medical Education, Physician Workforce, GME, Physician Supply 0 0 Comment Read More »
ACA results in $2.4 billion in consumer rebates since 2011 American consumers have received more than $2.4 billion in premium rebates since 2011 because of the Affordable Care Act (ACA), according to a recent report from the Centers for Medicare and Medicaid Services (CMS) . The rebates are the result of the ACA provision that requires health insurance companies to spend at least 80 percent of premium dollars on health care. In 2014 over 5.5 million consumers received nearly $470 million in rebates, for an average of $129 per family. California consumers received approximately $98 million in rebates for a ... December 7, 2015 Managed Care Affordable Care Act, Medical Loss Ratio 0 0 Comment Read More »
CMA urgers CMS to implement less burdensome, physician-led MACRA payment models The California Medical Association (CMA) is urging the Centers for Medicare and Medicaid Services to adopt principles that will assure access to high-quality care for all Medicare patients during the transition to the alternative payment models included in the Medicare payment reform legislation. In April, President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA), which repeals the badly broken Medicare sustainable growth rate formula and replaces it with new payment systems. After more than a decade of fighting for change by CMA and others in organized ... December 7, 2015 Medicare MACRA, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
United Healthcare to delay Premium Designation assessment until January 2017 United Healthcare (UHC) has announced it will delay the next version of its Premium Designation physician quality and cost assessment program until January 2017. The program uses clinical information from health care claims to evaluate physicians against various quality and cost-efficiency benchmarks. Originally scheduled to publish its latest results in January 2016, UHC has stated it is delaying in order to allow for improvements to the quality measures and cost-efficiency metrics in response to feedback provided by physicians. This means that the currently posted ratings will remain in place through ... December 7, 2015 Managed Care Quality reporting, United Healthcare, Quality of Care 0 0 Comment Read More »
CMA Capitol Insight: Nov. 24, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. _________________________________________________________________________________________________________________ Ripples across the pond The terrorist attacks in Paris have reverberated through the political world, changing the tenor and tone of the American presidential contest and setting off a debate in statehouses around the country about housing Syrian refugees. Gov. Jerry Brown has said he would like to see California maintain its “traditional role as a place of asylum,” breaking with other governors who have warned that admitting Syrian refugees ... December 7, 2015 General CMA Capitol Insight, Anthony York 0 0 Comment Read More »
DWC reinstates requirement to pay lien activation fees for Workers' Compensation claims The Division of Workers’ Compensation (DWC) recently announced that beginning November 9, 2015, the lien activation fees mandated under the Senate Bill 863 workers' compensation reforms will be reinstituted. This announcement comes in the wake of the Ninth Circuit United States Court of Appeals decision to uphold the constitutionality of the lien activation fees and subsequent dismissal of the preliminary injunction imposed as part of the Angelotti Chiropractic, Inc., et al. v. Baker, et al. case. Under this order, any affected lien claimant who files a Declaration of Readiness or appears ... December 7, 2015 General Workers' Compensation 0 0 Comment Read More »
