Los Angeles Daily News publishes op-ed by CMA president The Los Angeles Daily News yesterday published an op-ed by Richard Thorp, M.D., president of the California Medical Association (CMA). In case you missed it, the piece, "Trial lawyer measure would undermine the promise of Covered California," can be read here. January 31, 2014 General MICRA 0 0 Comment Read More »
MICRA patient brochure now available in Spanish The California Medical Association (CMA)-led coalition working to protect California’s landmark Medical Injury Compensation Reform Act (MICRA) has published a patient education brochure to help inform California voters about the ballot initiative being pushed by trial attorneys. The ballot measure would impact access to care for patients, causing community health centers and physician offices across the state to close. The pamphlet, available in English and Spanish, can be distributed to patients during office visits and will be accompanied by talking points for physicians so you can have meaningful conversations with patients on the real impacts the proposed ballot measure would have, if passed. California trial lawyers are attempting to lift MICRA’s 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. A change like that would mean increased health care costs for everyone, and decreased access to care that so many patients count on. The well-funded opponents, led by the trial lawyers, have already poured over a million dollars into the campaign to undo MICRA. The threat against MICRA is more serious now than it has ever been, which is why together, with nearly 1,000 organizations dedicated to protecting MICRA, we must fight back. There is no doubt that physicians understand how catastrophic a measure like this would be for access to affordable health care. To win this fight, voters, our patients – those we interact with everyday in our practices – must understand the fact that protecting MICRA goes hand-in-hand with protecting access to quality health care in California. If you would like to receive brochures for your office, please contact Yna Shimabukuro at yshimabukuro@cmanet.org or (916) 551-2567. January 31, 2014 General MICRA, Patient Education, Professional Liability 0 0 Comment Read More »
CMS warns of fraudulent DME suppliers The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG). According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies. These marketing schemes by DME suppliers can include: •Unsolicited orders for medical equipment or supplies, often with wording such as “We received a call from your patient Jane Doe who wants you to order…” and then lists multiple items on a pre-printed order •Advertisements that Medicare will provide you with payment for patient referrals •Pre-completed medical necessity forms with instructions to just “Sign and Date Here” Physicians are urged to: •Pay careful attention to orders that cross your desk asking for your signature. Review the patient’s medical record before signing an order. •View with a skeptical eye unsolicited orders for patients no longer in your practice or whom you have not seen in a long period of time. •Document in your patient’s medical record the medical justification for any DME ordered for your patient. You also may want to keep a record of the DME you’ve ordered for your patient, similar to (or part of) your patient’s medication list. Suspected abuse may be reported to the OIG at hhstips@oig.hhs.gov, (800) 447-8477 or via fax at (800) 223-2164. January 31, 2014 General Centers for Medicare and Medicaid Services, CMS, Fraud and Abuse, Quality of Care 0 0 Comment Read More »
Senate pro Tem considering MICRA legislation As both sides inch closer to a seemingly inevitable ballot war over California’s Medical Injury Compensation Reform Act (MICRA), a key figure in the legislature may be looking to step in before voters can weigh in on the issue. Earlier this month, Darrell Steinberg, president pro tem of the Senate, said that he was “thinking” about carrying a MICRA-related bill during the 2014 cycle. While Steinberg has previously stated that he wanted to see negotiations take place to avoid a costly ballot war between trial lawyers and physicians, the fact that he would be interested in personally carrying a bill is significant. The legislature’s renewed attention toward MICRA comes after Consumer Watchdog, a trial attorney backed group that has made its public mission to scuttle MICRA, submitted ballot language that would put the issue before voters in November 2014. Among the provisions of Consumer Watchdog’s proposal is a nearly five-fold increase of MICRA’s cap on noneconomic damages. As of now, there has been no MICRA bill introduced by Steinberg or any other member of the legislature. CMA’s lobbying team, however, has already mobilized to strengthen the resolve of our legislative allies. If a bill is introduced we will intensify that mobilization. For more information on CMA’s fight to defend MICRA, or to contribute to the ongoing defense effort, please visit www.cmanet.org/micra. January 27, 2014 General Medical Liability, MICRA, Professional Liability 0 0 Comment Read More »
Professionalism courses for physicians and pharmacists coming in February The Institute for Medical Quality (IMQ) Professionalism Program for Physicians has been scheduled for February 22-23 at the DoubleTree Hotel LAX-El Segundo in Los Angeles. This program addresses both the legal and ethical dimensions of the practice of medicine in California, and introduces participants to a range of resources to address present or future problems. The course consists of a pre-course assessment, a two-day ethics course and a series of longitudinal assessments to track participants’ progress. To ensure interactive learning, each program is limited to 12 participants. IMQ is also offering a concurrent program for pharmacists. For more information, visit www.imq.org. January 27, 2014 General IMG, Institute for Medical Quality, Education and Events 0 0 Comment Read More »
CMA develops simple tool to identify physician participation status in exchange plans On January 1, 2014, Covered California began providing health coverage to more 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted. Even if you did not intentionally contract with any exchange plans, the California Medical Association (CMA) urges physicians to check their participation status. It is very possible that physicians may have been unknowingly opted into an exchange plan network due to the way that major insurance plans have structured their provider agreements. If you've attempted to look up your exchange plan participation status on the Covered California website, you know that it's not a straightforward process. Because it is critical that physicians know what plans they are contracted with, CMA has created a quick and easy tool to look up your exchange plan participation status in just a few clicks. The tool, available to members only, requires simply your first and last name and middle initial and it will tell you which plans list you as a contracting physician (as of September 2013, the most recent data released by Covered California). To access the tool, visit www.cmanet.org/exchange-lookup. Please note: You will be required to login with a member account. If you have not already activated your web account, visit www.cmanet.org/activate. If you need assistance activating your account, contact CMA's member service center at (800) 786-4262 or memberservice@cmanet.org. For more information on Covered California, visit CMA’s exchange resource center at www.cmanet.org/exchange. Physician members and their staff also have free access to CMA’s practice management experts at (888) 401-5911 or economicservices@cmanet.org. January 27, 2014 General Covered California, Health Benefit Exchange, Insurance/Reimbursement, Health Care Reform 0 0 Comment Read More »
CMS to conduct ICD-10 testing in March On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) has announced a limited national testing week for current direct submitters (providers and clearinghouses) from March 3 - 7, 2014. This testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. While participants will not be able to conduct true end-to-end testing at this time, they will be able to test whether the contractor received a claim and learn whether it was accepted or rejected. The testing will not allow participants to determine whether the claim will be paid or if payment will be reduced. Billing experts advise physicians to start preparing for the ICD-10 transition now if they haven’t yet done so. Steps to take include upgrading software systems, testing those updated systems, training staff and updating payer contracts and fee schedules. The American Medical Association (AMA) offers free educational resources that can help physicians get started. The California Medical Association has also partnered with AAPC to provide various ICD-10 training courses to members at a discounted rate. For more information, visit www.cmanet.org/aapc. Registration for the March ICD-10 testing will be required, but currently neither Noridian nor CMS have registration information available. More information is available in on both Noridian’s and CMS’s websites. January 27, 2014 General CMS, ICD-10, Insurance/Reimbursement 0 0 Comment Read More »
Legislative Leadership Conference coming April 22 Mark your 2014 calendars now for the 40th annual California Medical Association (CMA) Legislative Leadership Conference. The conference will take place at the Sheraton Grand Hotel in Sacramento, just three blocks from the State Capitol and across the street from CMA headquarters. This is a unique event for California physicians and is free of charge to all CMA members. Plan to join more than 400 physicians, medical students and CMA Alliance members who will be coming to Sacramento to lobby their legislative leaders as champions for medicine and their patients. Prior to the conference members will receive webinar training on legislation and policy affecting the practice of medicine. Set April 22 aside to become an advocate for your patients and colleagues! To register contact Lucy Garcia at 951-787-7700 or email Lgarcia@sbcms.org. January 27, 2014 General Legislative Leadership Day, State Legislation, Advocacy 0 0 Comment Read More »
Stepping up to leadership conference in San Diego Looking to escape the cold this winter? Don’t miss earlybird pricing for the Stepping Up to Leadership conference in sunny San Diego—these special rates expire January 31! The Stepping Up to Leadership program offered by the Institute for Medical Quality and the PACE Program at UC San Diego trains medical staff leaders in issues of communication, problem-solving, and improving outcomes for patients and staff. Stepping Up to Leadership offers unique hands-on and interactive learning opportunities, excellent faculty, and course work on effective staff leadership, credentialing and privileging, assessing the needs of the organization, using CME effectively, resolving on-call issues, improved communication skills, using quality measures effectively, legal considerations, and managing disruptive or impaired colleagues. The 2014 Stepping Up to Leadership program will take place March 6-8 at the Loews Coronado Bay Hotel in San Diego. A generous grant from the Physicians Foundation allows IMQ and PACE to offer Stepping Up to Leadership at prices as low as $595. For more information on the Stepping Up to Leadership conference, visit http://physician-leadership.org. January 15, 2014 General Events, Leadership 0 0 Comment Read More »
Making sense of Medicare payment changes With the new 2014 fee schedule, the temporary halt to the sustainable growth rate (SGR) cut and an interim .5 percent payment increase, Medicare physicians are understandably confused about what impact these changes will have on their practices. Below is a quick summary of the various Medicare payment changes facing physicians in 2014: 2014 Fee Schedule: While the 2014 Medicare fee schedule contains a 3.7 percent conversion factor increase, the overall fee schedule is budget neutral due to myriad relative value unit (RVU) changes. These changes will impact providers differently depending on their specialty, codes billed and geographic region. The revised 2014 fee schedule is available from California's Medicare contractor, Noridian. Sustainable Growth Rate: Congress recently passed a law stopping the 24 percent Medicare physician payment cut called for the SGR for three months and instead provides a 0.5 percent update through March 31, 2014. The three months gives Congress time to finalize the larger Medicare payment reform legislation. Sequestration: There is no additional sequestration cut for 2014. However, the 2 percent sequestration cut that took effect in April 2013 is still in effect. That cut is expected to remain in place until Congress adopts an alternative deficit reduction framework. As it was last year, the cut will be applied to all fee-for-service (Part A and Part B) claims after determining coinsurance, any applicable deductible and any applicable Medicare secondary payment adjustments. The cut will also be applied to Medicare Advantage plans. E-Prescribing Penalty: Physicians and group practices who were not successful electronic prescribers under the 2012 or 2013 Medicare eRx Incentive Program will be subject to a negative payment adjustment of 2 percent in 2014 on all Medicare Part B claims paid under the physician fee schedule. How will these changes affect me? It is important that physicians understand how a fee schedule can affect their practice’s bottom line so that they can make informed decisions about participation. The California Medical Association (CMA) has developed a simple worksheet to help physicians analyze the impact fee schedule changes may have on their practices based on commonly billed CPT codes. CMA's Financial Impact Worksheet is available free to members in CMA's online resource library. 2014 Medicare participation deadline extended Physicians have until January 31, 2014 to change their Medicare participation status for 2014. The effective date of any decision will be retroactive to January 1, 2014. For more information on physicians' Medicare participation options, see CMA On-Call document #7209, "Medicare Participation (and Nonparticipation) Options." On-Call documents are free to members in the CMA's online health law library at www.cmanet.org/cma-on-call. Nonmembers can purchase documents for $2 per page. January 14, 2014 Medicare Medicare, Insurance/Reimbursement 0 0 Comment Read More »
