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 »
CalHIPSPO receives Medi-Cal EHR incentive program award The California Department of Health Care Services has awarded the California Health Information Partnership & Services Organization (CalHIPSO), founded by the California Medical Association (CMA), the California Primary Care Association and the California Association of Public Health Hospitals and Health Systems, a Medi-Cal electronic health record (EHR) incentive program technical assistance contract for $15 million. Other organizations also given EHR technical assistance awards include the Health Information Technology Regional Extension Center, the CalOptima Regional Extension Center and Object Health. Over the next three years, these organizations will assist more than ... July 6, 2015 Medi-Cal Electronic Health Record, CalHIPSO, EHR 0 0 Comment Read More »
California Medical Association responds to vote on Senate Bill 323 Sacramento – After today’s Assembly Business and Professions Committee vote, California Medical Association President Luther F. Cobb, M.D., responded with the following statement regarding Senate Bill 323: "Today was a good day for the health of Californians. We commend the Assembly for rejecting SB 323, which would have significantly compromised patient safety. SB 323 would have done nothing to address access to care, and absent a bar on the corporate practice of medicine, adequate physician and medical board oversight, and the extensive training necessary, this legislation would have only put ... July 6, 2015 General SB 323 0 0 Comment Read More »
CMA asks Congress and CMS for two-year grace period for ICD-10 conversion With the implementation of ICD-10 only 90 days away (October 1, 2015), the window for the transition from ICD-9 is rapidly closing for many physician practices. The California Medical Association (CMA), in collaboration with the American Medical Association and other medical associations, sent a letter to the Centers for Medicare and Medicaid Services (CMS) and Congressional leadership urging them to help mitigate the impact of the transition by supporting a two-year grace period whereby physicians would use ICD-10 but not have claims delayed, denied or subject to audits because ... July 6, 2015 General ICD-10, Regulatory Advocacy, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Coalition partners stand together to thank Legislature, Governor Brown for passing and signing Senate Bill 277 Representing tens of thousands of advocates across the state, doctors, parents, school representatives join in Sacramento for one final rally on SB 277. Sacramento – Despite three-digit temperatures, dozens of coalition partners came together to rally one last time for Senate Bill 277 (Pan/Allen). The bill passed out of the State Assembly on Thursday and cleared the final hurdle in the State Senate Monday. Governor Brown signed the bill today. “This is a monumental day for Californians. Senate Bill 277 will help keep kids and communities safe and I thank ... July 6, 2015 General Immunizations, Public Health, I Heart Immunity, Vaccinations 0 0 Comment Read More »
