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CMA optimistic as Covered California opens

Sacramento – As Covered California, the state’s Health Benefit Exchange, opened today, California Medical Association (CMA) physicians remain optimistic. Throughout the health care reform debate, CMA strongly advocated for affordable access to care for California’s uninsured and for an expansion of health insurance coverage.   “CMA has long supported access to health care for all patients,” said Paul R. Phinney, M.D., CMA president. “Today marks a positive inflection point in our nation's commitment to access to health care for all Americans   Five categories of plans will be available through Covered California, consisting ...

Don't miss out on increased Medi-Cal payments

The California Department of Health Care Services (DHCS) will soon be implementing rate increases for primary care physicians who treat Medicaid patients, as authorized under the Affordable Care Act. The increase also applies to services provided by physicians to Medi-Cal managed care patients. In order to see the bump in pay, providers must first attest to their eligibility. According to DHCS, less than half of eligible providers have completed the brief self-attestation process as of September 24.   For purposes of this regulation, primary care is defined as family medicine, general ...

Federal regulations bring delays to ACA milestones

Deadlines and milestones relating to the Affordable Care Act (ACA) are beginning to slide, as the federal government gets a better picture of how capable it will be of implementing the massive changes called for in the law. In July, the federal government announced that the penalty on employers for not providing employees health insurance would be delayed until 2015, while also scaling back income verification requirements that would have been used to determine subsidy levels for individuals purchasing coverage through the new insurance marketplaces. The income verification announcement, which came ...

CMA, CMA Foundation partner for exchange's provider education grant program

The California Medical Association (CMA) and the CMA Foundation have submitted a joint application to Covered California, the state’s health benefit exchange, for a portion of the $3 million set to be awarded as part of its provider education grant program. The program is expected to award grants to between three and six statewide organizations that will be responsible for educating health care providers about Covered California and how the exchange will operate come January 2014. CMA's application was submitted jointly with the Latino Physicians of California and the American ...

Plan departures leave questions for California policy holders

While much attention has been given to the successful signing of health plans participating in Covered California’s new online insurance marketplace, it’s worth noting that some major players in the state’s current insurance market are refusing to play ball. In June, both United Healthcare and Aetna announced that they would not be participating in California’s individual market following the end of 2013. In announcing their departures, both companies noted that only a small portion of their overall business was conducted in California, and given the coming changes promised through the ...

Budget deal jump starts special session bills

Almost six months have passed since Gov. Jerry Brown opened a special session on health care reform in California, and members of the state Legislature are now beginning to tie up the final loose ends. Of the three sets of bills put forward under the special session’s parameters, all but one appeared to be stalled indefinitely until members of the Legislature reached a budget deal. These bills, which outlined California’s plans to expand the Medi-Cal program and establish a so-called "bridge plan" between Medi-Cal and exchange plans, were sprung from ...

Physicians are encouraged to check Covered California's provider database in July

As previously reported, there remain some uncertainties around the process of physician contracting with exchange plans. Beginning sometime in July, the exchange should alleviate much of the uncertainty as to who is and is not considered to be an exchange provider. This is because Covered California will be unveiling a centralized online provider database for the first time in July. Using this database, exchange patients will be able to see which providers are included in the respective exchange plans’ networks. This centralized database will also be utilized by the exchange’s eligibility ...

Health Care Reform 2014

Health Care Reform*: 2014 Marks a New Era Health care reform is in full-swing with the heftiest legislation set for 2014 — when health insurance will become available to millions of Americans who were previously uninsured.  Starting January 1, 2014, most Americans will be required to have health insurance and many businesses will be required to offer coverage to their employees. In addition, health insurance exchanges (Covered California) will be available to facilitate access to coverage. Starting in 2014, Americans must have minimum essential coverage or pay a tax penalty.  Options ...

Health Reform Heats Up

More than three years have passed since the Affordable Care Act (ACA) was into law, setting into motion some of the most dynamic and volatile years the nation’s health care industry has ever seen. Since its inception, the law has been a subject of controversy, inspiring hotly contested debates in Washington, D.C., Sacramento and across the entire nation.  For some, this dramatic overhaul of the nation’s health care system represents our national leaders finally making good on the long-overdue promise of “health care for all.” Others claim that the law ...

Medi-Cal extends 2012 EHR attestation deadline to April 30, 2013

Xerox, the vendor in charge of the Medi-Cal electronic health record (EHR) incentive payments has resolved the technical difficulties that were complicating some providers' ability to complete their 2012 attestations. Specifically, the Medi-Cal State Level Registry was not properly allowing some providers who have been designated as members of groups to inherit and utilize the group’s information. As of Friday, March 15, the system is fully functional.   Because of the difficulties and resulting attestation delays, the California Department of Health Care Services (DHCS) has received federal authorization to extend the ...