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CDC encourages antiviral treatment for influenza

With a poorly matched influenza vaccine and influenza activity high across much of the country, the Centers for Disease Control and Prevention (CDC) is urging physicians to prescribe antiviral drugs to patients who are very ill with flu-like symptoms, particularly those over age 65 and those at high risk of complications from the virus. According to the California Department of Public Health (CDPH), flu activity in California is beginning to increase. The first influenza death in the state of a person under the age of 65 for the 2014-2015 season ...

CMA files brief in Medicaid case to be heard by the U.S. Supreme Court

The California Medical Association (CMA) has filed an amicus brief in a Medicaid reimbursement case (Armstrong v. Exceptional Child Center) that will go before the U.S. Supreme Court this year to determine whether Medicaid providers have a cause of action under the Supremacy Clause of the U.S. Constitution to challenge a state’s compliance with Medicaid laws in setting reimbursement rates. CMA established good precedent in the Ninth Circuit appellate district on this specific question in our Medi-Cal rate cut litigation, but the Supreme Court’s ruling in the Armstrong case ...

Measles Health Advisory

HEALTH ADVISORY – January 7, 2015 Measles has been confirmed in seven California residents in 2015 and two Utah residents; all visited Disneyland or Disney California Adventure Park between December 17th and 20th, 2014.  Testing is underway on three additional California residents who also visited Disneyland during this same time period. The California confirmed cases reside in five local health jurisdictions and range in age from 8 months to 21 years. Of the seven confirmed cases, six cases were unvaccinated for measles (2 were too young to be vaccinated, and 1 had received appropriate vaccination (two doses ...

Educational Interventions Offer an Effective Approach to Avoiding Ethical Dilemmas

Physicians regularly grapple with situations that can challenge their ability to maintain an ethical healthcare practice. While many times the choices are clear, some situations require knowledge and skills to avoid problems that may lead to sanctions on a medical license or even loss of practice. Ethical dilemmas are not limited to financial matters, but can arise in communications with and supervision of employees, methods used in advertising and promotion, or in decisions about patient care.   Today, medical group and medical staff leaders and attorneys are taking a proactive ...

Verifying your patients' eligibility and benefits in 2015 may save your practice thousands of dollars

With the new year soon upon us, physicians are urged to be diligent in verifying patients' eligibility and benefits to ensure that you will be paid for services rendered. The beginning of a new year means calendar year deductibles and visit frequency limitations start over. With open enrollment there may also be changes to patients’ benefit plans, or they may even be insured through a new payor. The new year also brings a host of other challenges that could affect your ability to be paid: Medicare patients ...

CMS to hold Medicare claims for first two weeks of January

Last week the Centers for Medicare and Medicaid Services (CMS) announced it would hold claims for services paid under the 2015 Medicare physician fee schedule due to technical errors discovered after the new fee schedule was published. Medicare Administrative Contractors (MACs) will hold claims containing 2015 services for the first 14 calendar days of January 2015 (Thursday January 1 through Wednesday January 14) to allow time for CMS to correct the errors. The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are ...

CMA Capitol Insight: Jan. 5, 2015

CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature .-------------------------------------------------------------------------------- Hot Button Health Care As lawmakers return to Sacramento this week, much is still to be decided about the future of health care reform. State legislators will deal with a number of hot-button issues in the first half of 2015, many of which will have dramatic impacts on California’s health care policy and potentially the future success of the Affordable Care Act. It all begins on Monday when Gov. Jerry Brown ...

2015 antibiotic awareness toolkit now available; download the new mobile app

The Alliance Working for Antibiotic Resistance Education (AWARE) is a long-term project of the California Medical Association (CMA) Foundation, funded by the Centers for Disease Control and Prevention (CDC) through the California Department of Public Health (CDPH). Working with participating health plan partners, the CMA Foundation is able to identify high prescribers of antibiotics and provide targeted education. The 2015 AWARE Provider Toolkit was recently mailed to roughly 30,000 physician high prescribers. Since its inception, AWARE’s goals have aimed to: Increase appropriate prescribing of antibiotics; ...

U.S. Supreme Court to hear ACA subsidy case on March 4

The U.S. Supreme Court has scheduled oral arguments for March 4, 2015, in King v. Burwell; a case that questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The lawsuit has the potential to affect 36 states that use the federal health care exchange, but would not change the subsidies in states like California that run their own exchanges. If the subsidies are struck down, some 5.4 million Americans who signed up for ...

California ACEP publishes safe prescribing handout for patients

The California Medical Association has joined with the California Chapter of the American College of Emergency Physicians to promote a statewide safe prescribing program for patients seen in emergency departments or urgent care facilities. The hope is that this program – motivated by the desire to reduce prescription drug abuse and drug diversion – will lead to better patient care, safer prescribing and fewer unmet expectations. A key portion of this program is a handout that explains safe prescribing to patients, available in both English and Spanish: Also provided ...