CMS publishes 2014 open payment data On June 30, the Centers for Medicare & Medicaid Services (CMS) published the 2014 Open Payments data of financial transactions between drug and medical device makers and health care providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals nationwide, totaling $6.49 billion. The Sunshine Act requires drug and medical device manufacturers and group purchasing organizations to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Last year’s inaugural launch of ... July 14, 2015 Medi-Cal, Medicare CMS, Physician Payments Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMA Foundation awards 8 new Medical Student Community Leadership Grants The California Medical Association (CMA) Foundation's Medical Student Community Leadership Grant Program supports health-related educational, advocacy, community service and other outreach programs that enhance the well-being of California communities. Grant applications are reviewed on a semi-annual basis; the next application deadline is October 30, 2015. The CMA Foundation is proud to announce eight exciting newly-funded programs! MedDiction.com – Medical Student Resource and Dictionary: Students at the UCSF School of Medicine will be creating a simple medical dictionary and medical education resource site that caters specifically to medical ... July 13, 2015 Awards, General Medical Students, CMA Foundation 0 0 Comment Read More »
CMA Foundation's 2015 Leadership Awards: Call for nominations The California Medical Association (CMA) Foundation and its Network of Ethnic Physician Organizations (NEPO) are seeking nominations for the 2015 Leadership Awards, which celebrate the efforts of extraordinary individuals and organizations who make a difference in the health of Californians. The four awards include: The Ethnic Physician Leadership Award This award recognizes an individual physician for his or her contributions toward the health of various ethnic communities, who has shown great success in eliminating health disparities, addressing access to care, and improving cultural competency and patient advocacy. The purpose of the award ... July 13, 2015 Awards, General CMA Foundation, NEPO, Network of Ethnic Physician Organizations, Awards 0 0 Comment Read More »
CMA Capitol Insight: July 6, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Signatures and special sessions A controversial measure was signed into law last week by Gov. Jerry Brown – Senate Bill 277 (Pan), which eliminates the personal belief exemption from mandatory vaccinations for all public school children. The real question now is what comes next. Brown’s signature sets off a 90-day clock for opponents of the bill to qualify a referendum. If the requisite signatures are gathered, the measure would not ... July 13, 2015 General Anthony York, CMA Capitol Insight 0 0 Comment Read More »
CMS announces changes to make Medicare ICD-10 transition less disruptive for physicians The Centers for Medicare & Medicaid Services (CMS) announced that it will provide a one-year grace period during which it will allow for flexibility in the claims payment, auditing and quality reporting processes as the medical community gains experience using the new ICD-10 code set. The ICD-10 implementation date of October 1, 2015, has not changed. The changes announced include: Claim denials: Medicare review contractors will not deny claims based solely on the specificity of the ICD-10 diagnosis code as long as a valid code from the right family of codes ... July 13, 2015 Managed Care, Medicare CMS, ICD-10, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
SBCMS Accepting Resumes for Executive Director Position Looking for a rewarding place to work with a sophisticated work environment while working effectively with physician leaders? San Bernardino County Medical Society (SBCMS) is currently accepting resumes for the position of Executive Director. The Executive Director is responsible for the overall management and operation and oversight of the SBCMS and its subsidiary and ancillary organizations. Salary and benefits will be competitive and negotiable commensurate with qualifications and experience. Interested candidates should submit a cover letter describing their interest in and qualifications for the position; a resume, references, and ... July 13, 2015 General executive director 0 0 Comment Read More »
Slight increase to Medicare reimbursement rates effective as of July 1 A 0.5 percent physician payment increase will go into effect for dates of service from July 1 through December 31, 2015. This mid-year increase is a result of the Medicare Access and CHIP Reauthorization Act. The Centers for Medicare & Medicaid Services released the updated RVU files reflecting the payment increase and new conversion factor, $35.9335 (previously $35.7547). Noridian, the Medicare Administrative Contractor for California, has posted the new fee schedule that will be in effect from July 1 through December 31, 2015. There will be an additional 0.5 ... July 6, 2015 Medicare Medicare 0 0 Comment Read More »
Anthem Blue Cross announces further changes to reimbursement policies and claims software Anthem Blue Cross recently notified physicians of additional upcoming changes to its reimbursement policies and claims editing software, ClaimsXten. The additional changes, scheduled to go into effect on September 14, 2015, come less than 90 days after Anthem’s most recent set of changes were implemented in July, and less than a month prior to the implementation of ICD-10. Anthem states that the additional changes are necessary to bring its claims editing system in line with correct coding guidelines. Anthem did not provide a detailed listing of all the incorporated changes; ... July 6, 2015 General, Managed Care Anthem Blue Cross, Insurance/Reimbursement 0 0 Comment Read More »
Aetna issues physician terminations over frequency of E/M visits The California Medical Association (CMA) has received several reports from physicians in the San Francisco Bay Area that they’ve received contract termination notices from Aetna due to their above-average use of high-level Evaluation and Management (E/M) codes. The termination letters, issued by Aetna in mid-January, advised physicians that upon review of claims for a one year period, their usage of high level E/M codes was “significantly outside the norm” of comparative physicians within their market. CMA has learned that approximately 40 physicians within the Northern California Aetna PPO network were ... July 6, 2015 General Billing/Coding, Coding and Documentation, Practice Resources, Aetna 0 0 Comment Read More »
CMA works to address problems posed by CURES 2.0 launch on July 1 The Department of Justice (DOJ) announced last week that an update to the Controlled Substance Utilization Review and Evaluation System (CURES) database would go live July 1, but with browser requirements that could potentially cut off access for thousands of prescribers and dispensers. According to the DOJ, CURES 2.0 would require users to have Internet Explorer version 11, Safari, Firefox or Chrome Internet browsers installed on their systems in order to access the database. In response to member concerns, the California Medical Association (CMA) met with DOJ to discuss the browser ... July 6, 2015 General Drug Prescribing, EHR, Prescription Drugs, CURES 0 0 Comment Read More »
