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CMS updates EFT authorization agreement

The Office of Management and Budget recently approved changes to the CMS 588, Electronic Funds Transfer (EFT) Authorization Agreement. The revised EFT agreement is available on the CMS Forms List.  As of January 1, 2014, new EFT authorization agreements submitted must be on the new form. Submissions on the old forms will be returned to the applicant.

Did you know you can request reconsideration if you're getting dinged with a 2% Medicare eRx penalty?

Physicians and group practices who were not successful electronic prescribers under the 2012 or 2013 Medicare eRx Incentive Program will be subject to a negative payment adjustment of 2 percent in 2014 on all Medicare Part B claims paid under the physician fee schedule.   The Centers for Medicare and Medicaid Services (CMS) has notified physicians and group practices that did not meet the requirements and will be subject to the 2014 payment adjustment. Some practices have reported that their meaningful use attestation was not taken into consideration as an exemption. ...

Anthem Blue Cross to move eligibility, benefits and claim status inquiry functions to Availity Web Portal in March

Anthem Blue Cross has advised that effective March 14, 2014, patient eligibility, benefits and claim status inquiry functions will transition from its ProviderAccess portal to the Availity web portal. As of that date, practices will only be able to access this information via the Availity web portal.   While BlueCard eligibility, benefits and claim status functions will also transition to Availity, the BlueCard Advisor function that allows practices to determine which Blues plan to send the claim to will continue to be available on the ProviderAccess portal.   In order to access information ...

Surviving the Second Month of Covered California

As of January 15, Covered California reports that more than 625,000 individuals have enrolled in exchange plans. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect. To help answer some of the more common questions, the California Medical Association (CMA) offers this second tip sheet to help physicians survive the second month of Covered California.  Available to members only.

MICRA patient brochure now available in Spanish

The California Medical Association (CMA)-led coalition working to protect California’s landmark Medical Injury Compensation Reform Act (MICRA) has published a patient education brochure to help inform California voters about the ballot initiative being pushed by trial attorneys. The ballot measure would impact access to care for patients, causing community health centers and physician offices across the state to close.   The pamphlet, available in English and Spanish, can be distributed to patients during office visits and will be accompanied by talking points for physicians so you can have meaningful conversations with ...

CMS warns of fraudulent DME suppliers

The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG).   According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies.   These marketing schemes by DME suppliers can include:  •Unsolicited orders for medical equipment or supplies, often with wording ...

Senate pro Tem considering MICRA legislation

As both sides inch closer to a seemingly inevitable ballot war over California’s Medical Injury Compensation Reform Act (MICRA), a key figure in the legislature may be looking to step in before voters can weigh in on the issue. Earlier this month, Darrell Steinberg, president pro tem of the Senate, said that he was “thinking” about carrying a MICRA-related bill during the 2014 cycle. While Steinberg has previously stated that he wanted to see negotiations take place to avoid a costly ballot war between trial lawyers and physicians, the ...

Professionalism courses for physicians and pharmacists coming in February

The Institute for Medical Quality (IMQ) Professionalism Program for Physicians has been scheduled for February 22-23 at the DoubleTree Hotel LAX-El Segundo in Los Angeles.   This program addresses both the legal and ethical dimensions of the practice of medicine in California, and introduces participants to a range of resources to address present or future problems. The course consists of a pre-course assessment, a two-day ethics course and a series of longitudinal assessments to track participants’ progress.   To ensure interactive learning, each program is limited to 12 participants. IMQ is also offering ...

CMA develops simple tool to identify physician participation status in exchange plans

On January 1, 2014, Covered California began providing health coverage to more 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted.   Even if you did not intentionally contract with any exchange ...