CMS completes issuance of new Medicare ID cards The Centers for Medicare and Medicaid Services (CMS) has now completed the process of mailing new Medicare cards to beneficiaries across all states and territories. The new Medicare ID cards, required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number, which replaces the previous Social Security-based number. CMS also reports that for the week ending January 11, 2019, fee-for-service health care providers submitted 58 percent of claims with the new MBIs. CMS is allowing a 21-month transition period (which ... January 22, 2019 Medicare MACRA, Practice Management, Public Payors 0 0 Comment Read More »
UnitedHealthcare delays outpatient advanced radiology policy until February 1 Citing the need for additional time for communication and optimal rollout, UnitedHealthcare (UHC) has delayed implementation of its outpatient advanced radiology policy until February 1, 2019. The new UHC policy—originally scheduled for implementation on Jan. 1—requires prior authorization for advanced imaging procedures, including certain magnetic resonance imaging, magnetic resonance angiography and computed tomography imaging procedures, when performed in the outpatient hospital setting. Under UHC’s Outpatient Radiology Notification/Prior Authorization Protocol, a site of care review will be required for these advanced imaging services when performed in the outpatient hospital. Site of care ... January 22, 2019 General, Managed Care Commercial Payors, Patient Care, Practice Management, Radiology 0 0 Comment Read More »
Joint Statement Regarding Security Prescription Forms As of January 1, 2019, California law requires prescription forms for controlled substances to be printed with a uniquely serialized number. Notices explaining the serial number format and reporting requirements have been released by the Department of Justice (DOJ). Additionally, notices to prescribers and pharmacists were issued by the California State Board of Pharmacy (Pharmacy Board), and by the Medical Board of California (Medical Board), yet questions remain about implementation. This joint statement by DOJ, the Pharmacy Board, and the Medical Board is therefore being issued to provide further ... January 14, 2019 General 0 0 Comment Read More »
Newsom's first budget puts health care access, costs front and center SACRAMENTO -- Gov. Gavin Newsom released his first state budget proposal on Thursday, including a number of new goals and programs aimed at making health care more affordable and accessible to all Californians. The governor is following through on a key campaign promise by investing more than $1 billion in Proposition 56 tobacco tax revenue to increase access for Medi-Cal patients. That investment will help make it easier for low-income patients throughout California to see a physician and make Medi-Cal coverage more meaningful and effective for patients. Much of Newsom’s health ... January 14, 2019 General Access to Care, Public Health 0 0 Comment Read More »
Gov. Newsom signs executive order expanding health care access Within hours of being sworn in as California’s 40th governor on Monday, Gavin Newsom signed an executive order that will help control health care costs and expand access to care for millions of Californians. Gov. Newsom announced the creation of the nation’s first state-run purchasing program for prescription drugs to help bring down costs via bulk purchasing. He also announced his intention to expand Medi-Cal coverage to undocumented Californians up to age 26. (California current allows anyone under age 19 to receive Medi-Cal benefits, regardless of immigration status.) The governor also ... January 14, 2019 General Access to Care, Public Health 0 0 Comment Read More »
CMA and AMA urge exemptions from Open Payments reporting The American Medical Association, the California Medical Association (CMA) and more than 80 other health care organizations recently submitted a joint letter in response to a request from the Centers for Medicare and Medicaid Services (CMS) for feedback on the Open Payments Program reporting requirements. Under the Open Payments program, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. The joint letter urges CMS to exempt journal reprints and medical textbooks from “Open Payments” ... January 14, 2019 CMA, General Practice Management, Public Payors 0 0 Comment Read More »
2019 Q1 reports open for comments The California Medical Association (CMA) is now accepting comments on council reports for the first quarter of 2019. The reports represent recommendations from CMA's various councils—informed by testimony from CMA members—that will go before the Board of Trustees at its first quarter 2019 meeting. These council reports are available online and open for further comment and discussion through January 20, 2019. If you have any feedback that you think would be critical for the board to consider, now is your opportunity to make your voice heard. To view the reports and/or to ... January 14, 2019 CMA Physician Leadership 0 0 Comment Read More »
New Laws 2019: What physicians need to know The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on health care coverage, drug prescribing, public health and mental health issues. To help physicians understand the most significant new health laws, the California Medical Association has published its annual new laws round up, “Significant New California Laws of Interest to Physicians for 2019.” This document is free to all interested parties. January 14, 2019 CMA, General Health Care Reform, Public Health 0 0 Comment Read More »
CMA recoups $29 million on behalf of physician members California physicians have a powerful ally when it comes to dealing with problematic payors—the California Medical Association (CMA) Center for Economic Services (CES). Staffed by practice management experts with a combined experience of more than 125 years in medical practice operations, the CES team has recovered $29 million from payors on behalf of its physician members over the past 10 years. In 2018, CES had a record year, recovering nearly $11 million from payors on behalf of physician members, up from $3 million in 2017. This is money that would ... January 14, 2019 CMA Payor Issues and Reimbursement, Practice Management 0 0 Comment Read More »
ABMS seeking physician comments on Maintenance of Certification reform In 2017, the American Board of Medical Specialties (ABMS) and its 24 member boards launched a major initiative—Continuing Board Certification: Vision for the Future Commission—to re-envision the future of continuing board certification. The commission recently released its draft report, which includes the key findings and recommendations for reforming how ABMS specialty boards operate continuing certification programs. The draft report is open for public comment until Tuesday, Jan. 15, 2019, at 9:00 p.m. Pacific Time. The California Medical Association (CMA) is encouraging physicians to review the recommendations and provide comments on ... January 14, 2019 CMA, General Licensing & Regulatory Issues 0 0 Comment Read More »
