On-Demand Webinar: Understanding Medicare Changes: An Impossible Dream? The California Medical Association (CMA) recently hosted a free webinar examining changes to the Medicare program for 2018 and providing tips for regulatory compliance, presented by the medical director of California’s Medicare contractor, Noridian Healthcare Solutions. The webinar is now available for on-demand viewing in the CMA resource library. This download is free for all. This review includes an overview of the Centers for Medicare and Medicaid Services’ (CMS) new Targeted Probe and Educate (TPE) program, a type of Medicare audit, and its review process; changes to Local Coverage Determinations (LCDs); and CMS’ new “Patients Over Paperwork” initiative, which aims to reduce reporting requirements by simplifying documentation and reducing the hassle factor. This webinar also covers simple coding tips for evaluation and management coding and reimbursement. February 5, 2018 CMA, Medicare Government Payors, Medicare, Noridian, Webinars 0 0 Comment Read More »
Free webinar Nov. 2: POLST eRegistry pilot project The Coalition for Compassionate Care of California (CCCC) is hosting a webinar for health care providers and medical professionals, “POLST eRegistry Pilot Project: 2017 Overview and Update." The free webinar takes place on Thursday, November 2, 2017, from 12-1:30 p.m. This webinar will provide an overview of the California POLST (Physician Orders for Life-Sustaining Treatment) eRegistry pilot project. This project, funded by the California Health Care Foundation, is designed to test implementation, use and sustainability of an electronic POLST registry in two California communities, with electronic POLST forms securely submitted and retrieved by medical providers, including emergency medical providers. For more information or to register, click here. October 19, 2017 General Physician Orders for Life Sustaining Treatment, POLST, Webinars 0 0 Comment Read More »
MACRA 90-day reporting deadline approaching Beginning with the 2017 reporting year, eligible physicians who do not participate in the Medicare Quality Payment Program (QPP) will see a negative 4 percent payment adjustment in 2019. QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA) and administered by the Centers for Medicare and Medicaid Services (CMS). During the 2017 transition year, CMS will allow physicians to select one of three “pick your pace” participation options. Participating at any level in 2017 will ensure that you will not be hit with the 4 percent pay cut in 2019. The most lenient participation option—reporting on one patient, one measure—allows physicians to avoid a penalty by "testing" the program to ensure that their systems are working and that they are prepared for broader implementation in 2018 and beyond. Physicians can choose to report for 90 days and possibly earn a small bonus payment. If you plan to select this 90-day reporting option, your performance period must begin no later than October 2, 2017. Physicians can also choose, if they are ready, to report a full year of data in 2017 and be eligible to receive a modest bonus, depending on their performance. Providers with less than $30,000 in Medicare payments or fewer than 100 Medicare patients are exempt from the reporting requirements in 2017. If you are unsure of your QPP participation status, you can look it up here. FREE assistance for small practices California physicians in practices of 15 or fewer can receive free assistance to prepare and participate in the QPP through the California Health Information Partnership & Services Organization (CalHIPSO). CalHIPSO will help you select the right participation “pace” for your practice, navigate the new landscape, assess performance data and stay informed about the QPP. Contact CalHIPSO now to register for services and receive no-cost technical assistance. CMA MACRA Resource Center To help physicians understand the payment reforms and prepare for the transition, CMA has published a MACRA resource page at www.cmanet.org/macra. There, you will find an overview of MACRA and a comprehensive list of tools, resources and information from CMA, the American Medical Association and CMS. September 27, 2017 Medicare CalHIPSO, MACRA, Medicare, Medicare Quality Payment Program (QPP), Webinars 0 0 Comment Read More »
Webinar: How to challenge the AB 72 interim payment for out-of-network services On July 1, 2017, a new law (AB 72) took effect that changes the billing practices of non-participating physicians providing covered, non-emergent care at in-network facilities including hospitals, ambulatory surgery centers and laboratories. The law was designed to reduce unexpected medical bills when patients go to an in-network facility but receive care from an out-of-network doctor. Under the new law, plans/insurers are required to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities. The interim payment is the greater of either the plan/insurer’s average contracted rate or 125 percent of the Medicare rate. However, the new law does include mechanisms for physicians to challenge the interim payment. The California Medical Association (CMA) is hosting a free members-only webinar on the different options for challenging the interim payment on September 27, 2017. The webinar will include an overview of the dispute options, details on how the AB 72 independent dispute resolution process will work and CMA resources available to assist physician members. CMA has also published a number of resources to help physicians navigate this new system, including a sample letter physicians can use to appeal to the plan/insurer and an FAQ. These resources are available free to members only in our AB 72 Resource Center at www.cmanet.org/ab-72. CMA is aware of the potential adverse impacts of the new law on our physician members and has dedicated significant resources in order to achieve the best possible outcomes for physicians in light of the new billing restrictions. If your practice has experienced a change in payor behavior regarding contract negotiations, claims payment or network adequacy concerns, or is experiencing other challenges, CMA wants to hear from you. For more information, visit www.cmanet.org/ab-72 or call CMA’s Reimbursement Helpline at (888) 401-5911. September 25, 2017 General, Managed Care AB 72, Out of Network Care, Webinars 0 0 Comment Read More »
CMA urges CMS to further reduce MACRA administrative burdens The California Medical Association (CMA) recently submitted comments on proposed 2018 changes to the Medicare Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Though not perfect, CMA is pleased that the Centers for Medicare and Medicaid Services (CMS) has listened to physician feedback and has made changes that will significantly reduce the administrative burdens on physicians, particularly for small and rural practices. We appreciate the agency’s responsiveness to many of our concerns about the ability of physicians to successfully participate in the QPP. Under the proposed rule, 2018 will be another transition year like 2017. This means that physicians who report only one quality measure in 2018 can avoid all penalties in 2020. CMS estimates that under the proposed 2018 MACRA rule, 94 percent of physicians will earn either a positive or neutral payment adjustment in 2020 for the 2018 reporting year. Thirty-seven percent of physicians are expected to be exempt because of the low-volume threshold. The proposal would also allow virtual groups and provide bonus points for physicians treating complex patients. CMA is urging CMS to make additional changes to further reduce administrative burdens while allowing physicians to be innovative and improve care. Among the changes CMA is seeking are a reduction in the number of electronic health record (EHR) measures; expanding the adjustments for complex patients; removing the requirement to report all payer data; and exempting physicians within five years of retirement. CMA is also urging CMS to hold EHR vendors more accountable, particularly for interoperability. Major highlights of the proposed rule include: Continues 2018 as a “Pick Your Pace” transition year, during which physicians can easily avoid all penalties. Provides additional accommodations for small and rural practices, including automatic bonus points for small practices. Expands the total exemption to physicians with $90,000 or less in Medicare Part B allowed charges or 200 or fewer Medicare patients. Allows virtual groups to organize and help small practices pool resources to report successfully. Provides bonus points for physicians treating complex patients, including dual-eligible patients. The flawed “resource use” (physician cost) category will not count again for the 2018 reporting year. Continues to allow use of the 2014 edition of Certified Electronic Health Record Technology. Provides new Advancing Care Information (EHR) hardship exemptions for physicians in small practices. Provides exemptions from all Advancing Care Information (EHR) requirements if a physician’s EHR is decertified. Provides new bonus points for Advancing Care Information (EHR) requirements. Permits physicians to continue to report modified stage 2 meaningful use measures in 2018 instead of new stage 3 measures. Provides new options to use facility-based scoring for facility-based physicians who provide more than 75 percent of their services in an in-patient setting or through the emergency department. For Alternative Payment Models (APM), extends the current, more reasonable nominal financial risk requirement of 8 percent of total Medicare revenue for two more years. Reduces the financial risk requirements for APM medical homes. Reduces reporting burden for the Merit-Based Incentive Payment System and APMs For more details on CMA’s proposed MACRA changes, see CMA’s full comments, which are based on the recommendations of our MACRA Technical Advisory Committee. CMA will be working closely with the American Medical Association (AMA) and CMS to monitor the QPP’s effect on physician practices, the physician-patient relationship and access to care. CMA MACRA Resource Center To help physicians understand the MACRA payment reforms and prepare for the transition, CMA has published a MACRA resource page at www.cmanet.org/macra. There, you will find an overview of MACRA and a comprehensive list of tools, resources and information from CMA, AMA and CMS. Free MACRA assistance for California physicians The Health Services Advisory Group, in partnership with the California Health Information Partnership & Services Organization (CalHIPSO), is providing no-cost technical assistance to physician offices in California to help them prepare for and participate in the MACRA QPP. CalHIPSO is also hosting a CMA webinar on September 20 to answer physician questions about MACRA reporting. September 25, 2017 CMA, EHR, Managed Care CalHIPSO, MACRA, Medicare, Medicare Quality Payment Program, QPP, Webinars 0 0 Comment Read More »
Register today for CMA webinar on mental health in young adults The California Medical Association (CMA) is hosting a one-hour webinar about depression treatment and suicide prevention in young adults on Wednesday, August 16, from 12:15 to 1:15 pm. The presenter, Michelle Famula, M.D., is an Assistant Clinical Professor at the UC Davis School of Medicine Department of Public Health. She has spent the past 30 years providing young adult primary care and developing her interests in sexual, transgender and mental health care. This webinar, "The Pursuit of Happiness: A Practical Approach to Depression Treatment and Suicide Prevention in Young Adults," will present information about the demand for integrated care, barriers to mental health access, communicating with patients and families, and resources for patients in need. It will also emphasize prevention through stigma reduction and early detection of symptoms and risk factors. This webinar is free for CMA members; nonmembers may attend for $99. Click here for more information or to register. Contact: Juli Reavis, (916) 551-2046 or jreavis@cmanet.org. August 9, 2017 CMA, General Depression, Mental Health, Suicide, Webinars 0 0 Comment Read More »
Join CMA to learn how to challenge the interim payment for out-of-network services at in-network facilities On July 1, 2017, a new law (AB 72) took effect that changes the billing practices of non-participating physicians providing covered, non-emergent care at in-network facilities including hospitals, ambulatory surgery centers and laboratories. The law was designed to reduce unexpected medical bills when patients go to an in-network facility but receive care from an out-of-network doctor. The new law requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for non-emergent services performed at in-network health facilities, and places limitations on the ability of physicians in such circumstances to collect their full billed charges. However, it also includes mechanisms for physicians to challenge the interim payment. To dispute the interim payment, physicians must first appeal to the plan/insurer. If the physician is unable to resolve the issue through the payor’s internal appeal process, the new law requires the Department of Managed Health Care (DMHC) and California Department of Insurance to establish an Independent Dispute Resolution Process (IDRP) by September 1, 2017. To view the California Medical Association’s (CMA) comments to the DMHC on the IDRP, click here. CMA has published a number of resources to help physicians navigate this new system, including a sample letter physicians can use to appeal to the plan/insurer and an FAQ. These resources are available free to members only in our AB 72 Resource Center at www.cmanet.org/ab-72. CMA is also hosting a free members-only webinar on the different options for challenging the interim payment on September 27, 2017. The webinar will include an overview of the dispute options, details on how the IDRP will work and CMA resources available to assist physician members. Click here to register for the webinar. If your practice has experienced a change in payor behavior regarding contract negotiations, claims payment or network adequacy concerns, or is experiencing other challenges, CMA wants to hear from you. For more information, visit www.cmanet.org/ab-72 or call our Reimbursement Helpline at (888) 401-5911. August 8, 2017 CMA AB72, Out of Network Care, Regulatory Advocacy, Webinars 0 0 Comment Read More »
CSAM Webinar: How to Build a Controlled-Substances Review Committee in Your Primary Care Clinic The California Society of Addiction Medicine (CSAM) is hosting a webinar, "How to Build a Controlled-Substances Review Committee in Your Primary Care Clinic," to help physicians navigate chronic pain and opioid management. The webinar will take place on Friday, July 28, from 12-1 p.m. Using a case-based format, the webinar will review the basic structure, operations and benefits of creating an internal peer-review committee for complex pain cases. From this event, physicians will understand how to implement, how to interact with and when to use such a committee in their clinics. The webinar will be led by Soraya Azari, M.D., an associate professor at the UCSF School of Medicine. For attending the webinar, physicians can receive 1.0 AMA PRA Category 1 Credit™ toward their continuing medical education requirement. To register or find more information about this upcoming event, click here. This is the 10th in a series of 12 monthly webinars created by CSAM on medication assisted treatments (MAT) for substance abuse disorders in primary care settings. Recordings of past MAT webinars have been archived by the California Health Care Foundation. July 26, 2017 General Continuing Medical Education, Drug Prescribing, Prescription Drugs, Webinars 0 0 Comment Read More »
Webinar: Medical staff self-governance and the Tulare medical staff trial Medical staff self-governance is a vital part of a carefully crafted system designed to ensure the delivery of quality patient care in California hospitals. Join us for a one-hour webinar on Wednesday, September 13, 2017, at 12:15 p.m., for an overview of the rights and responsibilities of the self-governing medical staff under state and federal law, including credentialing, establishing clinical criteria and standards, organizing committees to monitor patient care, reviewing medical records, working with hospital administrators and governing bodies, and peer review, among other things. Presenter: Long Do, CMA legal counsel and director of litigation, will also discuss the recent lawsuit against the Tulare Regional Medical Center for violating the self-governance rights of its medical staff and provide an update on where the case stands. Register today at www.cmanet.org/events. July 24, 2017 CMA, General Hospital Medical Staff, Legal Advocacy, Medical Staff, Medical Staff Self-Governance, Webinars 0 0 Comment Read More »
CHA to host webinar on cancer surgery volumes and patient outcomes The California Hospital Association (CHA) is hosting a webinar to unveil new research on how a hospital’s volume of cancer surgeries impacts patient outcomes. The webinar, “Cancer Surgery Volumes on Outcomes," will take place on July 6, 2017, from 10 a.m.to 12 p.m. The California HealthCare Foundation has partnered with the California Office of Statewide Health Planning and Development, a health services researcher at Stanford and the Cancer Prevention Institute of California on a study to measure the volume of cancer surgeries performed at each hospital for certain cancers for which there is evidence of an association between low volume of surgeries performed and increased mortality/poor patient outcomes. This webinar will include a thorough background of the study and experts who will provide suggested course of actions. California Medical Association members have been offered the discounted CHA member rate of $185. Nonmember registration is $250. For more information or to register, visit www.calhospital.org/cancer-surgery-web. June 21, 2017 General Cancer, Webinars 0 0 Comment Read More »
