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Ask the Expert: Can my PA/NP see my patients when I'm on vacation?

Summer generally means vacations for everyone, and physicians are no exception. But what happens to patients when their physicians are on vacation? There are options for physician offices to continue to provide care to their patients, but the question that seems to come up annually is whether the physician assistant (PA) or nurse practitioner (NP) can provide services when the physician is out of the office and still bill as “incident to” services. The answer is no. The Centers for Medicare and Medicaid Services (CMS) states that to qualify as ...

Noridian announces new audits

Noridian, California's Medicare administrative contractor, has announced it will be conducting service-specific targeted audits of procedure codes 99205 and 99233 when rendered by providers with specific specialties: 99205 performed by cardiology (Centers for Medicare and Medicaid Services specialty designation 06) and pulmonary (29) 99233 performed by internal medicine (11) and hematology/oncology (83) Noridian conducts these targeted reviews based on data analysis. An analysis of these procedure codes, when performed by physicians in these specialties, indicated a higher utilization by California providers when compared ...

AMA expands initiative to transform medical education

The American Medical Association (AMA) announced that it will seek to triple the number of medical schools participating in its Accelerating Change in Medical Education Consortium, launched in 2013 to reshape medical education in the United States. AMA will provide $1.5 million over the next three years to fund up to 20 additional projects that support a significant redesign of undergraduate medical education. Interested medical schools must submit their proposals by September 16, 2015. The goal of the initiative is to work toward a significant redesign of undergraduate medical education ...

Spending for federal health programs is expected to remain 'modest' over the next 10 years

Total health care spending growth for federal health programs such as Medicare and Medicaid is expected to average 5.8 percent in aggregate over 2014-2024, according to a report published by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. The authors noted that this rate of growth is still substantially lower than the 9 percent average rate seen in the three decades before 2008.   “Growth in overall health spending remains modest even as more Americans are covered, many for the first time. Per-capita spending and medical ...

Covered California statewide premium costs to rise 4 percent in 2016

Californians insured through Covered California, the state’s health benefit exchange, will see their premiums rise an average of 4 percent in 2016, less than last year’s increase of 4.2 percent. However, consumers in some Bay Area and Sacramento counties will see higher premium increases—up to 8.2 percent in Sacramento and 12.8 percent in Santa Cruz, Monterey and San Benito—while Southern California counties will see increases of around 1.8 percent. However, Covered California Executive Director Peter Lee noted that consumers can see their premiums drop an average of 4.5 percent – ...

CMS releases proposed 2016 Medicare physician fee schedule

The Centers for Medicare and Medicaid Services (CMS) recently released the 2016 proposed Medicare physician payment rule. The rule reflects the 0.5 percent increase in payment as of July 1, 2015, and the additional 0.5 percent increase in payment on January 1, 2016, recently adopted by Congress. Overall, Medicare will pay physicians nearly $700 million more in 2016 than they will have paid in 2015. Most notable in the payment rule is CMS’ proposal to pay for advance care planning and end-of-life counseling. The fee schedule would establish two new ...

House passes bill to increase funding for medical research and speed FDA approvals

Last week, the U.S. House of Representatives voted overwhelmingly (344-77) to pass a bill known as the "21st Century Cures Act," which would boost federal funding for medical research and speed up Food and Drug Administration (FDA) approvals for many new drugs and medical devices. The bill, HR 6, will give $8.75 billion to the National Institutes of Health (NIH) for research and another $550 million to the FDA over the next five years. A scaled-down bill has been introduced in the U.S. Senate and there are hopes that it ...

Six tobacco bills to be taken up during special session on health

Six bills aimed at saving lives and reducing the cost of tobacco-related diseases on California’s health system will be taken up during the Legislature’s second special session to address health care — a meeting ordered by Gov. Jerry Brown. Some of the bills being proposed are the same as those introduced in the Capitol earlier this year, including bills to add e-cigarettes to the existing tobacco products definition and to increase the age of sale for tobacco products to 21. Other bills introduced would allow local jurisdictions to tax tobacco ...

Senate panel pushes HHS to delay stage 3 meaningful use

The Senate Health, Education, Labor and Pensions Committee is asking the U.S. Department of Health and Human Services (HHS) to delay the stage 3 meaningful use rules, its chairman, Lamar Alexander (R-Tenn.) said during a news conference Thursday. The Centers for Medicare and Medicaid Services (CMS) issued proposed rules for stage 3 in March 2015. What's concerning providers is that this stage differs from the others in the degree to which a medical provider, to fulfill its requirements, must depend on other providers to document electronically that they have fulfilled ...

Early bird deadline for NEPO Building Healthy Communities Summit is August 17

Register for the 2015 Building Healthy Communities Summit by August 17 to save $100! Hosted by the California Medical Association Foundation’s Network of Ethnic Physician Organizations (NEPO), this year’s event will take place on September 18-20, 2015, at the Riverside Conference Center. The Summit is an opportunity for physicians, public health professionals and community leaders who work with underserved communities to learn about emerging health care policy issues and share best practices on how to reduce health disparities and increase access to health care services for the populations they ...