Anthem Special Investigations Unit may be recouping beyond statutory timeframe In 2011, the California Medical Association (CMA) raised concerns with Anthem’s attempts to recoup money from physicians beyond the statutory timeframe. Through its Special Investigations Unit (SIU), Anthem was pursuing physicians for refunds of payments made outside of the 365-day period allowed by California law. That law permits recoupment of claims older than a year only if the payment was made based on fraud or misrepresentation. CMA determined that Anthem was employing a definition of “misrepresentation” that was much broader than what is allowed under law. CMA thus filed ... June 26, 2015 General, Managed Care Department of Managed Health Care, Recoupment, Anthem Blue Cross 0 0 Comment Read More »
CMA President's Message: A Critical Year for Health Care We haven’t quite hit the halfway mark, but 2015 is already shaping up to be an important year for health care. In just these past few months, legislators have repealed the Medicare sustainable growth rate (SGR), saving physicians from an imminent 21 percent payment cut, and have considered an abundance of new bills aimed at solving several major health issues across the state. The topic of health has been filling front-page headlines at every leading newspaper in California recently, reaffirming my belief that this is truly an exciting time to be ... June 15, 2015 General, Medi-Cal, Medicare President's Message, Physician Leadership 0 0 Comment Read More »
CMA Capitol Insight: June 10, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Long legislative days, dry summer nights It was a frantic week in Sacramento, with hundreds of bills passed by the Senate and Assembly as the Capitol wrestled with deadline week. Last week, it was the house of origin deadline. All bills that started in the Assembly or Senate had to clear that house by Friday. The results were long legislative days, swarms of lobbyists huddled outside the Assembly and Senate chambers, ... June 15, 2015 General CMA Capitol Insight, Anthony York 0 0 Comment Read More »
Strong majority of Californians support requiring vaccinations for school children Some of the key findings in a statewide survey published on June 3 showed that a majority of those surveyed agreed with Senate Bill 277 (Pan), a bill sponsored by the California Medical Association that would eliminate personal belief exemptions and require parents to vaccinate their children before enrolling them in school. According to a survey released yesterday by the Public Policy Institute of California (PPIC), two-thirds of Californians (67 percent) and public school parents (65 percent) say children should not be allowed to attend unless they are vaccinated. Majorities ... June 15, 2015 General Immunization, Public Health, State Legislation, Vaccination, Advocacy, I Heart Immunity 0 0 Comment Read More »
Senate passes bills to regulate e-cigarettes, raise smoking age Two bills aimed at making it harder for California’s youth to use tobacco products passed in the state Senate on Tuesday. Senate Bill 151 (Hernandez) would raise the minimum age for buying cigarettes from 18 to 21. SB 140 (Leno) would regulate e-cigarettes similar to combustible cigarettes, including banning their use in the usual “smoke-free” locations, such as schools, restaurants and hospitals. SB 151 was the first of the two bills heard on the Senate floor. It passed on a 26-8 vote. “We will not sit on the sidelines while big tobacco ... June 5, 2015 General Smoking, Smoking Age, State Legislation, Tobacco, Public Health 0 0 Comment Read More »
DHCS extends meaningful use attestation deadlines for 2014 The Centers for Medicare and Medicaid Services (CMS) published a final rule on September 4, 2014, that revised the meaningful use timeline. Under the rule, eligible professionals can use 2011 Edition certified EHR technology (CEHRT) or a combination of 2011 and 2014 Edition CEHRT for the 2014 EHR reporting period to demonstrate meaningful use. Eligible professionals who were scheduled to begin stage 2 in 2014 will not be required to begin stage 2 until 2015, if they could not fully implement 2014 Edition CEHRT due to delays in availability ... June 5, 2015 General, Medi-Cal EHR, Electronic Health Record, Meaningful Use, Medi-Cal, CMS 0 0 Comment Read More »
CMA submits comments on Meaningful Use Stage 3 to CMS On May 29, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) and the National Coordinator for Health Information Technology on the Meaningful Use Stage 3 notice of proposed rulemaking. Under the federal electronic health records (EHR) incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “meaningful use” of certified health information technology (HIT). The proposed rule, published in the Federal Register on March 30, specifies the final stage of meaningful use criteria that eligible ... June 5, 2015 General Electronic Health Record, Health Information Technology, HIT, EHR, Meaningful Use 0 0 Comment Read More »
CMA changes stance on physician aid in dying, takes neutral position on End of Life Option Act The California Medical Association (CMA) has changed its long-standing position on the issue of physician aid in dying, and has taken a neutral position on Senate Bill 128 (Monning/Wolk), the End of Life Option Act. The organization’s physician leadership decided to change CMA’s decades-old policy after several committee hearings and an extensive amount of discussion by members. A final vote was taken by the CMA Board of Trustees in April, making CMA the first state medical association in the nation to change its stance on physician aid in dying. “The decision ... June 5, 2015 General Physician Aid in Dying, State Legislation, End of Life Issues 0 0 Comment Read More »
Save the date: 2016 Leadership Academy to feature Karl Rove and Donna Brazile Check your calendar and save the date for the 2016 Western Health Care Leadership Academy to be held in San Francisco May 13-15 at the Hilton. The opening session will feature a preview of the 2016 Presidential election and its impacts on health care. Speakers for this session include Karl Rove, former Deputy Chief of Staff and Senior Advisor to President George W. Bush, and Donna Brazile, Al Gore’s campaign manager and Democratic National Committee Vice Chair. Physicians and nurses, medical practice managers and other health care professionals will find ... June 5, 2015 General Western Health Care Leadership Academy 0 0 Comment Read More »
CMA and NORCAL Mutual announce expanded partnership NORCAL Mutual Insurance Company announced this week that it would expand its long-standing relationship with the California Medical Association (CMA). NORCAL Mutual and CMA both share a commitment to protecting physicians and patients, and ensuring the viability of the health care marketplace through advocacy. This partnership will help support the work that CMA does on behalf of its members in the coming year. “NORCAL has always been a strong supporter of the California medical community in a variety of ways, and we are excited to continue and expand our partnership. ... June 5, 2015 General NORCAL Mutual Insurance Company 0 0 Comment Read More »
