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Medicare locality reform ("The California GPCI Fix") clears House Congressional Committee as part of the Medicare SGR overhaul legislation

On July 31, the House Energy and Commerce Committee voted unanimously to approve a BIPARTISAN Medicare Sustainable Growth Rate (SGR) overhaul legislation, H.R. 2810.  Included in the bill is the CMA-sponsored California Medicare locality reform known as the “California GPCI Fix.”  The California locality provision is a compromise between Committee Chairman Fred Upton (R-MI) and Ranking Democrat Henry Waxman (D-CA) who insisted the California update be part of the committee bill.  It is based on legislation by Congressman Sam Farr (D-Santa Cruz/Monterey) and Darrell Issa (R-San Diego) who are ...

CMA urges CMS to postpone changes to QIO program

The Centers for Medicare and Medicaid Services (CMS) recently called for public comments on how it can best organize the national cadre of Medicare Quality Improvement Organization (QIO) contractors. The mission of the QIO program is to improve the effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. Currently, CMS contracts with one organization in each state to serve as that state's QIO contractor. QIOs are private, mostly not-for-profit organizations, staffed by physicians and other health care professionals who are trained to review medical care, help beneficiaries with ...

CMA files amicus brief in physician whistle-blower case

Last week, the California Medical Association (CMA) and the American Medical Association (AMA) filed an amicus curiae brief in the California Supreme Court to urge for broad protection of physician whistleblowers in hospitals. The brief focuses on a medical staff physician’s rights as a whistleblower under Health & Safety Code section 1278.5. In the case, Fahlen v. Sutter Central Valley Hospitals et al., the plaintiff physician alleged that his staff privileges were terminated in retaliation for reporting nursing errors and insubordination to the hospital. He sued the hospital under section ...

House committee releases bipartisan Medicare SGR reform bill

Three congressional committees have been hard at work over the past few months on legislation that would eliminate the desperately broken Medicare sustainable growth rate (SGR) formula that is used to determine physician payment rates. On Friday, the health subcommittee of the U.S. House of Representatives Energy and Commerce Committee's health subcommittee released its bill to repeal the SGR. One Tuesday the bill was approved by the subcommittee and now heads to the full committee for consideration. The House Ways and Means Committee and the Senate Finance Committee have ...

CMA publishes Medicare quality reporting guide

The Medicare Physician Quality Reporting System (PQRS) is a reporting program that uses a combination of incentive payments and payment reductions to promote reporting of quality information by eligible professionals. Up until now, this program has been voluntary and physicians have received bonuses for participating. That's about to change. Failure to participate now means physicians could face significant penalties in 2015 and beyond. Find out more in CMA's new guide, "Getting Started with the Medicare Physician Quality Reporting System." The guide is avaialble to members only. Contact: CMA's reimbursement help line, (888) ...

Get involved: Submit a resolution to the 2013 House of Delegates

The most effective way an individual member can influence CMA's policies and activities is to submit resolutions to the House of Delegates, the association's legislative body. The delegates meet annually to debate and act on resolutions and reports dealing with myriad medical practice, public health, and CMA governance issues. This year's annual meeting is October 11-13 at the Disneyland Hotel in Anaheim, and the deadline to submit resolutions is August 12. Any CMA member may author a resolution, but a delegate, alternate delegate, component medical society, or specialty delegation must ...

CMA Launches Exchange Resource Center

In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the individual and small group health insurance markets and, beginning in 2014, will provide health insurance to much of the nation's uninsured. Under the ACA, two-thirds of California's uninsured may be eligible to purchase coverage through the health benefit exchange. The exchange's goal is to begin open enrollment on October 1, 2013 – with coverage beginning on January 1, 2014. To help educate physicians about the exchange and ensure that they are ...

Medicare Transition Update: Noridian adds additional Meet and Greet Workshops

At the request of the California Medical Association (CMA) and other organizations in California, Noridian has added seven additional Meet and Greet Workshops throughout the state. Transition of the Medicare Administrative Contract from Palmetto GBA to Noridian is scheduled for September 16, 2013 (Part B). Following is the list of locations in California: July 9-11 ...

Extra! Extra! Read all about it! New Medicare transition webpage available

As the California Medical Association (CMA) has previously reported, administration of the Medicare contract will change to Noridian Healthcare Solutions effective September 16, 2013 (Part B). In response to this important change, CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access the most recent updates and important information regarding the transition in one easy-to-access to location.

Attestation for Medi-Cal primary care rate increase to begin in July

The Centers for Medicare & Medicaid Services (CMS) released regulations in early November 2012 implementing rate increases for primary care physicians who treat Medicaid patients. The goal of the increase is to recruit more physicians to treat low-income patients who will be newly eligible for health coverage under the Affordable Care Act (ACA). Under the ACA, primary care physicians will see their reimbursement rates raised to Medicare levels in 2013 and 2014. According to CMS, states must also incorporate the increased payment rates into their contracts with managed care ...