Open Payments database available for physician review in April The Centers for Medicare and Medicaid Service (CMS) announced last week that it will make the Open Payments database available to physicians for their review of payments made to them by drug and medical device companies. The Open Payments database is a part of the Physician Payments Sunshine Act, a provision of the Affordable Care Act. 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. Any payments, ownership interests and other “transfers of ... February 18, 2015 Medi-Cal, Medicare Physician Payments Sunshine Act, Affordable Care Act 0 0 Comment Read More »
CMS announces it will work to reduce meaningful use reporting burden After repeated calls for changes from the American Medical Association (AMA), the California Medical Association (CMA) and other physician groups nationwide, the Centers for Medicare and Medicaid Services (CMS) announced that it would address the meaningful use issues raised by providers and make changes to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program to “reduce the reporting burden, while supporting the long term goals of the program.” CMS said it would issue new rules governing the program this spring. Beginning January 1, 2015, Medicare physicians who have not ... February 5, 2015 Medi-Cal, Medicare CMS, EHR, Electronic Health Records, Meaningful Use, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
NEJM study shows primary care rate increase for Medicaid patients increased access to care A study published in the New England Journal of Medicine last week shows that the increase in Medicaid reimbursement for primary care providers, a key provision of the Affordable Care Act (ACA), resulted in a 7.7 percent increase in new patient appointment availability without longer wait times. The study, conducted by the University of Pennsylvania and the Urban Institute, used “secret shoppers” to call primary care doctors offices seeking new appointments in 10 states: Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania and Texas. Calls were made in ... February 4, 2015 Medi-Cal Affordable Care Act, ACA, Medi-Cal, We Care for California 0 0 Comment Read More »
CMS announces it will shorten meaningful use reporting to 90 days in 2015 After repeated calls for changes from physician groups nationwide, the Centers for Medicare and Medicaid Services (CMS) announced it would issue new rules this spring to shorten the meaningful use reporting period in 2015 to 90 days for providers under the Medicare and Medicaid Electronic Health Record Incentive Programs. The new rule is intended to be “responsive to provider concerns about software implementation, information exchange readiness, and other related concerns in 2015,” wrote CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., in a blog published on the CMS ... January 30, 2015 Medi-Cal, Medicare CMS, EHR, Electronic Health Record, Meaningful Use, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CalHIPSO seeks physicians to sign up for free practice transformation assistance The California Health Information Partnership and Services Organization (CalHIPSO) is applying for a grant from the Center for Medicare and Medicaid Services (CMS) to give California physicians access to free health practice improvement tools and services that would normally be cost prohibitive. The California Medical Association was a founding member of CalHIPSO, which was established in 2009 as a federally designated Regional Extension Center to provide education, outreach and technical assistance to help physicians select and implement electronic health records. To win this grant, CalHIPSO must show commitment and interest ... January 22, 2015 Medi-Cal, Medicare Health Information Technology, CalHIPSO, HIT 0 0 Comment Read More »
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 ... January 22, 2015 Medi-Cal Medicaid, Amicus Briefs, Legal Advocacy, Medi-Cal 0 0 Comment Read More »
DHCS identifies glitch in UCR web app for CHDP primary care rate increase payments The California Department of Health Care Services (DHCS) has identified an error in its web application that was designed to allow physicians the ability to enter their usual and customary rates (UCR) for Child Health and Disability Prevention Program Services (CHDP) claims. Physicians who already entered their UCR data prior to November 26, 2014, will need to return to the portal and reenter their information. The web app was developed to address a problem with the Affordable Care Act primary care rate increase unique to CHDP providers. Before the rate increases ... December 9, 2014 Managed Care, Medi-Cal Medi-Cal, Pediatrics, Affordable Care Act, Department of Health Care Services 0 0 Comment Read More »
CMS starts ICD-10 claims testing this week On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) will be conducting a national testing week, from November 17 to 21, 2014. This testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. While participants will not be able to conduct true end-to-end testing at this ... November 17, 2014 Medi-Cal, Medicare CMS, ICD-10, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Medicare finalizes fee schedule changes for 2015 The Centers for Medicare and Medicaid Services (CMS) published its 2015 Medicare Physician Fee Schedule final rule Thursday in the Federal Register. The 1,200 word payment rule contains several notable changes. As earlier proposed, the rule expands the services eligible for telemedicine reimbursement and extends the new payment policies for non-face-to-face care coordination. It allows primary care physicians to be paid for care management of Medicare beneficiaries with two or more chronic conditions. These are tasks (including managing lab and imaging reports, medications and care plans in addition to talking ... November 17, 2014 Medi-Cal, Medicare , Fee Schedule, Medicare, Centers for Medicare and Medicaid Services, CMS 0 0 Comment Read More »
Medi-Cal UCR web app for CHDP primary care rate increases now available; deadline to submit is Nov. 28 The California Department of Health Care Services (DHCS) has taken steps to correct a problem with the Affordable Care Act primary care rate increase unique to Child Health and Disability Prevention Program Services (CHDP) providers. Before the rate increases were implemented, some practices were previously instructed by DHCS to bill 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 process claims at ... November 14, 2014 General, Medi-Cal Child Health and Disability Prevention Program, DHCS, Medi-Cal, Affordable Care Act 0 0 Comment Read More »
