California Medical Association supports the Fair Medical Audits Act of 2015 The California Medical Association (CMA) issued a strong endorsement for the “Fair Medical Audits Act of 2015,” introduced today by U.S. Representative George Holding of North Carolina. The legislation addresses many concerns that physicians have with regard to the extraordinary lack of transparency and expensive, time-consuming and often unfair processes that plague the current Medicare audit program. Representative Holding declared it time to fix the broken audit program: “Put simply, patients achieve the best health outcomes when practicing physicians do just that – practice medicine. My bill will bring transparency ... May 26, 2015 Medicare Federal Legislation, Medicare, Recovery Audit Program, Advocacy, Audits 0 0 Comment Read More »
California seniors' state of health ranks 29th in national health study According to a study released June 20 from America’s Health Rankings, California’s seniors have decreased exercising in the past two years, have begun drinking more alcohol and are experiencing more mental health issues. Over the past two years, California’s senior population decreased exercising and dropped stopped from a national ranking of 18th in the nation to 29th -- this according to a study conducted by the United Health Foundation, a nonprofit arm of the United Health Group, which also owns the insurer United Healthcare. The study tracked 35 measures for senior ... May 26, 2015 Medicare Seniors and Persons with Disabilities, Medicare 0 0 Comment Read More »
Ask the Expert: If Medicare pays for a procedure, does a Medicare Advantage plan also have to pay? The California Medical Association (CMA) has received this question from physician practices many times over the past few years. The answer is – it depends. Title XVIII of the Social Security Act established regulations for the Medicare program, which includes provisions affecting Medicare Advantage (MA) plans. The Centers for Medicare and Medicaid Services (CMS) has interpreted these provisions through the Medicare Managed Care Manual (Chapter 4 – Benefits and Beneficiary Protections). The Manual provides guidance for MA plans under Internet-only manual (IOM) 100-16. These guidelines reflect CMS’ current interpretation ... May 21, 2015 Medicare Medicare Advantage, Medicare 0 0 Comment Read More »
Learn more: Medicare SGR replacement payment system details On April 16, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation, which negates the Medicare sustainable growth rate (SGR) formula, replaces it with new payment options and extends the Children’s Health Insurance Program (CHIP). The bill was passed in a monumental bipartisan action taken by Congress, after a decade of fighting for change by the California Medical Association, the American Medical Association (AMA) and a host of other medical associations. In summary, MACRA permanently repeals the SGR formula and stabilizes Medicare payments ... May 15, 2015 Medicare Medicare, SGR, Sustainable Growth Rate, Federal Legislative Advocacy 0 0 Comment Read More »
CMA urges physicians to thank Congress for SGR vote Congress was able to put differences aside and overwhelmingly pass H.R. 2—historic bipartisan, bicameral Medicare reform legislation—once and for all! The California members of Congress who supported H.R. 2 deserve a hearty "thank you" for their bold action to repeal Medicare's broken sustainable growth rate (SGR) formula and ensure significant reforms are made to Medicare, shifting the focus to better care and better patient outcomes. H.R.2 also extends the expiring Children’s Health Insurance Program. For more details on the bill, click here for the California Medical Association’s (CMA) summary. Only two ... April 29, 2015 Medicare Advocacy, Medicare, SGR, Sustainable Growth Rate, Federal Legislation 0 0 Comment Read More »
Congress passes Medicare payment reform and eliminates SGR Last week, the U.S. Senate overwhelmingly passed H.R. 2 with a 92-to-8 vote, which will completely overhaul the Medicare payment program. This move, which follows the U.S. House of Representatives’ near-unanimous vote two weeks ago, is a monumental, bipartisan action taken by Congress that negates the Medicare sustainable growth rate (SGR) formula and extends the Children’s Health Insurance Program (CHIP). President Obama signed it into law on April 16. The California Medical Association (CMA), along with the American Medical Association (AMA) and other health care organizations, have been fighting to ... April 23, 2015 Medicare Advocacy, CPLH, Medicare, SGR, Sustainable Growth Rate, California Physician's Legal Handbook 0 0 Comment Read More »
How will SGR reform affect Medicare reimbursement? On April 14, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015. The law eliminates the 21 percent physician fee cut that was scheduled to take effect on April 1 as part of the Medicare sustainable growth rate (SGR). The Centers for Medicare and Medicaid Services (CMS) announced that it will immediately begin work to implement the new provisions of the law. In preparation for the possibility that Congress might not act before the April 15 deadline, CMS had instituted a 10-business day processing hold for all impacted ... April 23, 2015 Medicare Legislative Advocacy, Medicare, SGR, Sustanable Growth Rate, Federal Legislation 0 0 Comment Read More »
CMA updates physician guide to getting started with PQRS The California Medical Association (CMA) has just updated the “2015 PQRS and Value-Based Modifier Getting Started Guide,” free for physician members. The Medicare Physician Quality Reporting System (PQRS) was federally mandated by legislation and requires physicians to report quality information to Medicare or suffer a fee reduction in 2015. This guide will assist physicians in determining how to proceed with successful reporting. Contact: Michele Kelly, (213) 226-0338 or mkelly@cmanet.org. April 8, 2015 Medicare Physician Quality Reporting System, PQRS, Valued-Based Payment Modifier, Medicare 0 0 Comment Read More »
Senate delays vote on SGR until April, CMS to delay 21% cuts until mid-month The U.S. Senate failed to take a vote to permanently fix the Medicare sustainable growth rate (SGR) formula and extend the Children’s Health Insurance Program (CHIP) last night and will take the measure up when it returns from a break on April 13. Majority Leader Mitch McConnell (R-KY) said shortly after the budget debate at 3 a.m. on the Senate floor, “It’s encouraging this passed the House with such a large bipartisan majority, and I want to assure we’ll move to it very quickly when we get back…I think ... April 1, 2015 Medicare Medicare, SGR, Sustainable Growth Rate, Federal Legislative Advocacy 0 0 Comment Read More »
CMA applauds U.S. House of Representatives for passing monumental Medicare-CHIP reform in landslide vote, urges U.S. Senate to act swiftly Sacramento – Today, the California Medical Association (CMA) congratulates the U.S. House of Representatives for passing monumental Medicare reform and the Children’s Health Insurance Program (CHIP) extension, and urgently asks their colleagues in the Senate to do the same before spring recess. The 392-37 vote clearly shows that now is the time to make Medicare reform a reality. The legislation, H.R. 2, known as the “The Medicare and CHIP Reauthorization Act,” will reform the broken Medicare sustainable growth rate (SGR) physician payment system and extend the expiring Children’s Health Insurance ... March 26, 2015 Medicare Federal Legislative Advocacy, Medicare, SGR, Sustainable Growth Rate, Federal Legislation 0 0 Comment Read More »
