All CMA-sponsored bills survive key committee deadline All of the bills sponsored by the California Medical Association (CMA) this year have survived a key deadline, passing out of policy committees so that they can continue through the legislative process. Measures that did not receive committee approval were shelved for the year. More details about CMA's sponsored bill package are below: AB 2121 (Gonzalez) – Responsible Beverage Service Training This bill seeks to help reduce alcohol service to intoxicated individuals and to reduce drunk driving by requiring establishments that serve alcohol to employ servers and managers who have received responsible beverage service training. Status: Passed Assembly Governmental Organization Committee AB 2209 (Bonilla) – Prohibiting Secret Treatment Plans This bill prohibits health insurance plans from developing and implementing clinical care "pathways" that dictate how medical professionals practice medicine. Status: Passed Assembly Health Committee SB 867 (Roth) – Emergency Medical Services Current law requires a portion of certain infractions and fines to be donated in the Maddy Emergency Medical Services Fund, which provides reimbursement to physicians who treat uninsured patients. This bill would remove the sunset date on the program, making it a permanent program. Status: Passed Senate Public Safety Committee SB 1177 (Galgiani) – Physician and Surgeon Health and Wellness Program This bill will reestablish a Physician Health and Wellness Program for California physicians suffering from substance abuse, mental and behavioral health issues. Status: Passed Senate Business and Professions Committee For more information on these and other bills of interest to physicians, subscribe to CMA’s Legislative Hot List at www.cmanet.org/newsletters. April 28, 2016 CMA, General Emergency Services, State Legislative Advocacy, Alcohol, Physician Wellness 0 0 Comment Read More »
Tragic deaths of two medical students at the hands of drunk driver inspires sponsored legislation for 2016 session The California Medical Association (CMA) has announced its sponsored bill package for the 2016 legislative session. Among them is a bill inspired by the tragic deaths last year of two medical students from the University of California, San Diego (UCSD), at the hands of a drunk driver. In May 2015, two UCSD medical students were killed by a drunk driver going the wrong way, causing a collision that killed two medical students and injured three others. In the wake of the accident, classmates of the victims worked with Assemblywoman Lorena Gonzalez and CMA to develop legislation (Assembly Bill 2121) that would better equip servers and bartenders to identify signs of overconsumption and intervene before tragedy strikes. “Responsible beverage service training can't bring back our brilliant, compassionate classmates, but it can prevent other communities from having to mourn the senseless loss of loved ones to drunk drivers,” said Daniel Spinosa, one of the victims’ classmates at UCSD School of Medicine. “This bill will empower bartenders and servers to save lives. We wish it had been law years ago.” More details about CMA's sponsored bill package are below: AB 2121 (Gonzalez) – Responsible Beverage Service Training This bill seeks to help reduce alcohol service to intoxicated individuals and to reduce drunk driving by requiring establishments that serve alcohol to employ servers and managers who have received responsible beverage service training. AB 2209 (Bonilla) – Prohibiting Secret Treatment Plans This bill prohibits health insurance plans from developing and implementing clinical care "pathways" that dictate how medical professionals practice medicine. SB 867 (Roth) – Emergency Medical Services Current law requires a portion of certain infractions and fines to be donated in the Maddy Emergency Medical Services Fund, which provides reimbursement to physicians who treat uninsured patients. This bill would remove the sunset date on the program, making it a permanent program. SB 1177 (Galgiani) – Physician and Surgeon Health and Wellness Program This bill will reestablish a Physician Health and Wellness Program for California physicians suffering from substance abuse, mental and behavioral health issues. For more information on these and other bills of interest to physicians, subscribe to CMA’s Legislative Hot List at www.cmanet.org/newsletters. March 31, 2016 General Advocacy, Emergency Services, Physician Wellness, State Legislation, Alcohol 0 0 Comment Read More »
Anthem Blue Cross to review level 5 emergency room claims Anthem Blue Cross announced in its December Professional Network Update that, beginning January 1, 2016, it will initiate a pre-payment review of level 5 emergency department visits billed with CPT 99285 or G0384. Anthem has advised CMA that it will focus on level 5 emergency department visits that are billed in combination with diagnosis codes that “are an unlikely combination for high level visits.” The payor will exclude claims billed with critical care, observation or inpatient admissions. Claims with CPT codes 99285 and G0384 that are selected by Anthem for pre-payment review will be pended and, if records are not included with the claim, a request for medical records will be generated. Anthem will review the records to verify that the documentation supports the level of service billed per CPT guidelines. Anthem has advised CMA that if it does not believe, after review of the records, that the documentation supports the level billed, it will pay the claim based on the evaluation and management (E/M) level supported. The explanation code will reflect this action. Providers will have the ability to dispute the findings through the normal provider dispute resolution process. February 3, 2016 General Emergency Departments, Emergency Rooms, Emergency Services, Anthem Blue Cross 0 0 Comment Read More »
Gov. Brown signs Maddy bill to extend ER funding for the uninsured California Governor Jerry Brown signed SB 191, a bill that extends funding for Maddy Emergency Medical Services (EMS). This fund is used to offset the costs incurred for care provided to uninsured patients in hospital emergency rooms. The California Medical Association (CMA) and the American College of Emergency Physicians cosponsored the bill. The law that authorizes the Maddy Fund was set to expire on January 1, 2014. Without this bill providers of emergency medical care throughout the state would have lost $50 million per year that is currently used to offset the costs of uncompensated emergency care. The Maddy Fund was established over 20 years ago as a means of providing critical resources for the delivery of emergency medical care to the uninsured. The funds are managed at the county level, with funding generated through the assessment of an additional penalty of $2 for every $10 collected in fines, penalties and forfeitures for criminal offenses. Emergency room physicians who treat uninsured patients who are unable to pay for their care can submit a claim to their county Maddy Fund for partial reimbursement. October 8, 2013 General Advocacy, EMS, Maddy Funds, Emergency Services 0 0 Comment Read More »
