Duals demonstration project delayed in three counties The California Department of Health Care Services (DHCS) has delayed passive enrollment for three of the eight counties affected by the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The project in these three counties—Alameda, Santa Clara and Los Angeles—will begin instead with a voluntary period, during which patients can choose early enrollment with a Medi-Cal managed care plan, or wait until the automatic passive enrollment period, which will begin no earlier than July 1, 2014. The project—known as Cal MediConnect—was authorized by the state in July 2012 ... December 16, 2013 Managed Care Dual Eligible, Insurance/Reimbursement, Medicare, Medi-Cal 0 0 Comment Read More »
House passes budget with three month SGR patch The U.S. House of Representatives today passed a bipartisan two-year budget deal that includes a three-month patch that will stop the 24 percent Medicare physician payment cut that would otherwise take effect January 1, 2014—and replace it with a 0.5 percent payment raise—which will give lawmakers a little more time to finalize the long-term Medicare payment reforms currently making their way through Congress. The budget now goes to the U.S. Senate, which is expected to approve the measure next week. December 13, 2013 Medicare Advocacy, SGR, Sustainable Growth Rate, Medicare 0 0 Comment Read More »
Updates to Covered California, the state's health benefit exchange CMA has updated our exchange toolkit, “CMA’s Got You Covered: A physician’s guide to Covered California, the state’s health benefit exchange.” There are significant updates since we last made updates in September that reflect key developments within the exchange including: • Updates on the grace period • Which plans have exited the exchange • How plans are building their networks • Information on how physicians can check their participation status on the Covered California website • Phone numbers of all of the plans in the event physicians have questions about their participation status December 10, 2013 General Health Care Reform, Health Insurance Exchange, Covered California, Insurance/Reimbursement 0 0 Comment Read More »
Medical board says it is not responsible for 'daily deal marketing cease and desist' letters sent to physicians The Medical Board of California issued a statement last week that it did not author a letter apparently coming from its Discipline Coordination Unit warning physicians to immediately "cease and desist " from conducting any daily deal marketing arrangements with sites such as Groupon, Living Social and Amazon. A number of California physicians have called the medical board stating that they have received these letters dated November 6, 2013, on the medical board’s masthead. These letters are fraudulent and were not generated by the medical board. When the medical board ... December 4, 2013 General Marketing/Advertising, Legal Issues, MBC, Medical Board of California, Professional Development and Licensure 0 0 Comment Read More »
Trial lawyers begin collecting signatures for anti-MICRA ballot initiative Driven by greed and the promise of inflated attorney fees, California trial lawyers have renewed their fight to lift the Medical Injury Compensation Reform Act (MICRA) cap on speculative, non-economic damages, presenting ballot language that seeks to more than quadruple the maximum award for non-economic damages to roughly $1.1 million. If successful, these efforts would be devastating to California’s health care system. More meritless lawsuits will lead to reduced patient access to our health care professionals – and fewer options for affordable, quality health care – especially in rural and ... December 3, 2013 General Advocacy, MICRA, Professional Liability, Medical Malpractice 0 0 Comment Read More »
2014 Medicare fee schedule confirms 24 percent cut Demonstrating yet again how broken the Medicare sustainable growth rate (SGR) formula is, physicians will face a 24 percent Medicare payment cut next year if Congress does not seize the opportunity to put a stop to the formula's annual threat of drastic payment cuts. This figure was confirmed by the Centers for Medicare and Medicaid Services (CMS) last week, when the agency released its final physician fee schedule for 2014. The California Medical Association (CMA) is currently reviewing the final rule, which was released much later than usual because of ... December 3, 2013 Medicare Medicare, SGR, Sustainable Growth Rate, Advocacy, Insurance/Reimbursement 0 0 Comment Read More »
Highlights from AMA's 2013 interim meeting More than 1,000 physicians gathered just outside our nation's capital for the American Medical Association (AMA) interim meeting. The delegates debated a large number of resolutions, establishing new policies related to the Affordable Care Act, culturally and linguistically competent care and the Medicare sustainable growth rate. A number of these resolutions were put forward by the California delegation. Below are highlights of some of the resolutions adopted as policy. Medicare Payment Reform: Following robust discussion in various meeting venues, the AMA House of Delegates passed an amended resolution regarding repeal ... December 3, 2013 General American Medical Association, Cultural Competency, Health Insurance Exchange, ICD-10, Recovery Audit Contractor, SGR, Sustainable Growth Rate, AMA 0 0 Comment Read More »
Covered CA Materials for Your Patients The CMA Foundation (CMAF) and California Medical Association (CMA) have been awarded a grant from Covered California, the state's new health benefit exchange/marketplace. The purpose of the grant is to educate doctors and their health care team about Covered California and resources that are available for patients on where to go for additional information on programs that may be available based on their specific needs. The CMA Foundation, in partnership with San Bernardino County Medical Society, can provide you with patient education materials to distribute to patients asking for ... December 2, 2013 General CMA Foundation, Covered CA, Covered California 0 0 Comment Read More »
