California Immunization Coalition Summit coming in April The 2015 California Immunization Summit will be held in April 26-27 in Riverside. This annual summit is an opportunity for physicians to learn about community-based programs that have increased vaccination rates, and how to adapt and apply key lessons from successful programs. The summit is presented by the California Immunization Coalition, a public-private partnership dedicated to achieving and maintaining full immunization protection for all Californians to promote health and prevent serious illness. This year's program, “Ready, Set, Vaccinate!” includes keynote speaker William L. Atkinson, M.D., MPH, Immunization Action Coalition Associate ... March 23, 2015 General Public Health, Vaccination, Immunization 0 0 Comment Read More »
Hundreds of California medical students learn where they will continue training Sacramento – Friday, March 20, 2015, is national “Match Day.” Hundreds of California medical students will learn whether they can begin their medical practice in state, or if they will be forced to leave California to complete their training to become fully licensed physicians. Medical students select a residency program based on the medical specialty they plan to pursue as well as the specifics of a program, which may include particular aspects of training or geography. “Match Day is a pivotal point in a medical student’s career,” said California Medical Association ... March 23, 2015 General Match Day, Medical Students, Residents and Fellows, Graduate Medical Education 0 0 Comment Read More »
New study concludes that vaccine refusal helped fuel Disneyland measles outbreak A new study conducted by research teams from MIT and Boston Children’s Hospital has concluded that parental resistance to vaccinations played a role in the Disneyland measles outbreak that started in January. The analysis, published in JAMA Pediatrics, showed that the highly contagious disease has spread to seven states and two other countries, largely because parents did not vaccinate their children. The study’s authors used simple math to determine that the vaccination rate among people who were exposed to measles during the outbreak was no higher than 86 percent, and might ... March 23, 2015 General Measles, Public Health, Vaccination, Immunization 0 0 Comment Read More »
Preorder the 2015 California Physician's Legal Handbook by April 15 and save 10% The California Medical Association (CMA) Center for Legal Affairs is happy to announce the upcoming release of the updated California Physician's Legal Handbook (CPLH) for 2015. CPLH is the premier California health law publication with 46 chapters of comprehensive legal information, including current laws, regulations and court decisions related to the practice of medicine. CPLH, available in a multi-volume print format, as an online subscription or a combination of print/online, is updated annually by CMA attorneys to include the most recent changes in health law. CPLH 2015 includes new and ... March 19, 2015 General CPLH, California Physician's Legal Handbook 0 0 Comment Read More »
Medicare RAC court case keeps collections on uncertain footing The U.S. Court of Appeals for the Federal Circuit issued a decision in early March in a case filed by one of the Medicare Recovery Audit Contractors (RAC) after the Centers for Medicare and Medicaid Services (CMS) changed the timing for the payment of contingency fees on collections. The decision means the auditing program will be put on hold until CMS determines how to contract with its RACs. The RAC program is responsible for identifying fraud and waste in the Medicare system by detecting improper Medicare payments. Since 2008, when ... March 18, 2015 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, Medicare, Recovery Audit Contractor, Audits 0 0 Comment Read More »
New fee reduction for Workers' Compensation Independent Medical Review and Independent Bill Review submissions The California Department of Industrial Relations (DIR) announced that fees for submission of an Independent Medical Review (IMR) or Independent Bill Review (IBR) for workers’ compensation were reduced effective January 1, 2015. The following table summarizes the reduction in fees. Fee prior to December 31, 2014 ... March 17, 2015 General Insurance/Reimbursement, Department of Industrial Relations, Workers' Compensation 0 0 Comment Read More »
Anthem system error results in missing remittances In early February, the California Medical Association (CMA) began receiving reports from practices of missing Anthem Blue Cross remittances. CMA escalated the issue to the payor and has since learned that a system issue is to blame for the missing electronic remittance advices (ERA). Anthem reports that the problem began in mid-December and affected ERAs for exchange/mirror and Federal Employee Program (FEP) claims. Somehow, the ERA function was turned off in the Anthem system for these product types. So, while practices received the money for the affected claims through ... March 17, 2015 Managed Care Anthem Blue Cross, Insurance/Reimbursement, Managed Care 0 0 Comment Read More »
Is your Medicare practice information up-to-date? The February issue of CMA Practice Resources (CPR) contained an article discussing the importance of maintaining up-to-date practice demographic information with contracted managed care payors (see “Ensure your practice information is up-to-date with contracted payors”). This advice applies equally to government payors, such as Medicare, that you are enrolled in. Medicare administrative contractors (MAC), such as Noridian in California, obtain practice contact information from a practice’s Medicare enrollment application, from either the Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or through a paper application. The MAC may contact ... March 17, 2015 Medicare Practice Resources, Medicare 0 0 Comment Read More »
DWC implements annual changes to workers' compensation physician fee schedule The California Division of Workers’ Compensation (DWC) has implemented its annual adjustments to the California workers’ compensation resource-based relative value scale (RBRVS) fee schedule effective for dates of service on or after March 1, 2015. Under the RBRVS Physician Fee Schedule regulations, located under “Physician services” on DWC’s Official Medical Fee Schedule (OMFS) webpage, the calculations to determine maximum allowable amounts for each code incorporate a number of factors, including the assigned relative value units for each code along with the yearly adjusted conversion factor determined by DWC. DWC ... March 17, 2015 General RBRVS, Resource Based Relative Value System, Workers' Compensation 0 0 Comment Read More »
DHCS identifies another glitch in issuing primary care rate increase for CHDP claims The California Department of Health Care Services (DHCS) has experienced various difficulties issuing the Affordable Care Act primary care rate increase funds on Child Health and Disability Prevention (CHDP) Program claims. Before the rate increases were implemented, some practices had been instructed by DHCS to bill CHDP claims at their Medi-Cal rates. This caused concern – based on DHCS’s pricing logic of paying the lesser of Medicare’s rate or the billed charges – that some practices would not qualify for the retroactive increases once the systems were updated to ... March 17, 2015 Medi-Cal, Medicare CHDP, Child Health and Disabilityh Prevention Program, Affordable Care Act, DHCS 0 0 Comment Read More »
