CMA publishes summary of new health care laws for 2016 The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on Medi-Cal, scope of practice for allied health professionals, public health and residential care facilities for the elderly. This document contains a list of the most significant new health laws of interest to physicians. The California Medical Association has published a summary of the most significant new health laws. For more details, see "Significant New California Laws of Interest to Physicians for 2016." November 20, 2015 General Legislation, Health Law Library, State Legislation 0 0 Comment Read More »
CMS changes enrollment requirements for Part D prescribers Beginning on June 1, 2016, all physicians and other providers who prescribe Medicare Part D drugs must be enrolled in Medicare or have a valid record of opting out. Failure to do so will result in a denial of the pharmacy claim or the beneficiary’s request for reimbursement. The Centers for Medicare and Medicaid Services (CMS) had originally intended to begin enforcing this regulation last June, but the agency delayed implementation to allow sufficient time for beneficiaries and Medicare Part D plans to prepare. All physicians and other prescribers who are ... November 19, 2015 Medicare Medicare, Medicare Part D, Prescription Drugs, Drug Prescribing 0 0 Comment Read More »
Have you checked your medical board profile recently? Physician profiles have been available to the public on the Medical Board of California's website since 1997, as required by Business and Professions Code sections 2027 and 803.1. The California Medical Association encourages physicians to periodically check their profiles for accuracy and to advise the board of any corrections, especially changes to their addresses of record. Making sure your information is accurate is important. Patients use the website to confirm their physician’s information. The medical board has launched a new public information campaign further encouraging patients visit the board's website ... November 19, 2015 General Medical Board of California 0 0 Comment Read More »
American Lung Association launches campaign to raise cancer awareness for women November is Lung Cancer Awareness Month, a time to bring more awareness to the disease. The American Lung Association (ALA) is launching a $10 million campaign to raise lung cancer awareness among women. Every five minutes, a woman in the U.S. is told she has lung cancer. And this year, lung cancer will kill more Americans than any other cancer. Increased attention on this disease is desperately needed, as only 1 percent of women cite lung cancer as a health risk. Lung cancer is, however, a leading cause of cancer deaths, ... November 19, 2015 General Cancer, Lung Cancer, Public Health, American Lung Association 0 0 Comment Read More »
Are you signed up for Medi-Cal's Subscription Service The California Department of Health Care Services (DHCS) last year launched the Medi-Cal Subscription Service (MCSS). Subscribers can sign up to receive monthly digest bulletins and/or as-it-happens "news flashes" for critical or time-sensitive issues. You can tailor your subscription to receive only information on subject matters of interest to you and your practice, including billing, payment and policy rule changes. Subscriptions are free. To sign up, go to www.medi-cal.ca.gov/mcss, select the subject matter areas of interest, and fill in your email and zip code. To help providers more easily access important ... November 19, 2015 Medi-Cal Medi-Cal 0 0 Comment Read More »
Blue Shield fee schedule changes took effect November 1 n August, Blue Shield announced changes to its physician fee schedule that became effective November 1, 2015. In a notice sent to physicians, the insurer said that it was increasing payments for the more commonly billed office visit codes. The new rates are available on the Blue Shield website (go to www.blueshieldca.com/provider and log in, then select the “Professional Fee Schedule” link located under the "Claims" section menu). Physicians can also request a copy of the new fees by completing the allowance review form enclosed with the notice, or ... November 19, 2015 Managed Care Fee Schedule, Blue Shield 0 0 Comment Read More »
Supreme Court to hear ACA challenge by religious nonprofits The U.S. Supreme Court announced last week that it would hear another group of court cases that challenge the Affordable Care Act (ACA) requirement that health plans provide a full range of contraceptive coverage to women at no cost. Under the law, religious institutions, including churches, temples and mosques, are automatically exempt from the ACA's contraceptive coverage requirement and do not have to file any paperwork. Nonprofit faith-based charities and religiously affiliated educational institutions and hospitals, however, must notify the health plan or the U.S. Department of Health and Human ... November 19, 2015 Managed Care Affordable Care Act, Contraception, United States Supreme Court, ACA 0 0 Comment Read More »
Providers who refer, order or prescribe for Medi-Cal beneficiaries must enroll with DHCS Under the Affordable Care Act, all providers who order, refer or prescribe (including but not limited to physicians, nurse practitioners and physician assistants) for Medi-Cal beneficiaries must be enrolled in the Medi-Cal program. Previously, providers needed to enroll only if they wished to furnish (and bill for) covered services for Medi-Cal beneficiaries. If an ordering and/or referring provider (ORP) is not enrolled in Medi-Cal, the "filling providers" (for example, the pharmacy that is filling the patient’s prescription or the specialist you are referring a patient to for treatment) will ... November 19, 2015 Medi-Cal Medi-Cal, Prescription Drugs, Drug Prescribing 0 0 Comment Read More »
CMA Foundation Celebrates "Get Smart About Antibiotics Week" The week of November 16-22, 2015, is "Get Smart About Antibiotics Week" – a campaign to highlight the problem of antibiotic resistance and the importance of appropriate antibiotic use. Every year at least 2 million Americans become infected with antibiotic resistant bacteria and at least 23,000 people die from these infections. This cold and flu season, the California Medical Association (CMA) Foundation's Alliance Working for Antibiotic Resistance Education (AWARE) project reminds physicians and patients to reduce the unnecessary use of antibiotics. AWARE is a long-term project of the California Medical ... November 10, 2015 General antibiotic resistance, CMA Foundation, Get Smart About Antibiotics Week 0 0 Comment Read More »
Ask the expert: If an exchange patient is in the 90-day grace period and fails to pay the premium, is the plan required to pay for services provided? Maybe. Under the Affordable Care Act, exchange enrollees who receive federal premium subsidies to help pay their premiums are entitled to keep their insurance for three months after they have stopped paying their premiums. Insurance ID cards for exchange enrollees do not indicate whether the enrollee is subsidized, but Covered California recently reported that 90 percent of California exchange patients are receiving subsidies, so the likelihood of encountering a patient receiving subsidies is very high. In the first month of the grace period, federal law and California regulations require ... November 10, 2015 Managed Care Grace Period, Exchange plans, Health Insurance Exchange 0 0 Comment Read More »
