Plan departures leave questions for California policy holders While much attention has been given to the successful signing of health plans participating in Covered California’s new online insurance marketplace, it’s worth noting that some major players in the state’s current insurance market are refusing to play ball. In June, both United Healthcare and Aetna announced that they would not be participating in California’s individual market following the end of 2013. In announcing their departures, both companies noted that only a small portion of their overall business was conducted in California, and given the coming changes promised through the ... August 19, 2013 General Covered California, United Healthcare, Aetna, Health Care Reform 0 0 Comment Read More »
DHCS to implement 10 percent Medi-Cal cuts in January 2014 The Department of Health Care Services (DHCS) today announced that it would begin to implement the 10 percent Medi-Cal physician payment rate reduction on October 1, 2013, for Medi-Cal managed care and on January 9, 2014, for fee for service. DHCS also announced that it would be retroactively implementing the cuts for FFS providers to June 1, 2011, when the law authorizing the cuts went into effect. DHCS said it will recoup a percentage of provider payments to recover overpaid funds during the retroactive period. These retroactive payment recoveries will ... August 15, 2013 Medi-Cal Advocacy, Insurance/Reimbursement, Medi-Cal, Access to Care 0 0 Comment Read More »
State delays duals pilot project until April 1 The California Department of Health Care Services (DHCS) announced today that it would delay by three months implementation of the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than April 2014. The project was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state's ... August 15, 2013 Managed Care, Medi-Cal, Medicare DHCS, Medi-Cal, Medicare, Dual Eligible, Insurance/Reimbursement 0 0 Comment Read More »
Medical board to suspend licenses of physicians with delinquent taxes The Medical Board of California will soon be sending notices to physicians who have outstanding tax obligations, warning that their medical licenses may be suspended if they do not pay their tax obligation or enter into a payment plan within 90 days. A new state law, passed in 2011, authorizes the medical board to deny an application for licensure and to suspend the license of any licensee who has outstanding tax obligations due to the Franchise Tax Board (FTB) or the State Board of Equalization (BOE) and appears on either ... August 14, 2013 General Professional Development and Licensure, Tax, Medical Board of California 0 0 Comment Read More »
Dangerous bill putting patients in harm's way barely passes Assembly Committee Sacramento – After an initial vote held SB 491 (Hernandez) in the Assembly Business, Professions & Consumer Protection Committee last week, a reconsideration vote was granted and today the bill moved out of committee. SB 492 (Hernandez), a related bill dealing with expanded scope of practice for optometrists, was held in committee. On behalf of the California Medical Association (CMA) and the Coalition for Patient Access and Quality Care, CMA President Paul R. Phinney, M.D., issued the following statement: “While SB 492 was held in committee, patients should be deeply ... August 14, 2013 General Advocacy, Nurse Practitioners, Scope of Practice 0 0 Comment Read More »
IMQ Launches Online CME Member Benefit The California Medical Association’s Institute for Medical Quality (IMQ) has launched IMQ Online Education, a new source of continuing medical education. IMQ Online Education offers physicians a growing selection of courses, including many needed to maintain licensure, accessible at any time and from any internet-enabled device. Members receive discounted rates on the entire catalog of online CME. IMQ Online Education offers access to a diverse catalog of courses in a variety of formats, lengths and credit levels, organized by subject category for easy browsing. The system is convenient: start a ... August 13, 2013 General CME, IMQ, Institute for Medical Quality 0 0 Comment Read More »
Let Marsh Find You the Right Long-Term Care Insurance You create a brighter future. We work to protect it. Let us help find the right Long-Term Care insurance plan for you, so you can spend time on things that matter the most. People are living longer these days, but as life expectancies increase, so does the risk of serious health problems that could require long-term care. In fact, at retirement age, 70% of Americans will need long-term care and 40% will enter a nursing home.1 And with the average cost for nursing home care in a semiprivate room equating to ... August 9, 2013 General Long-Term Care Insurance, Marsh 0 0 Comment Read More »
Physicians urged to call Gov. Brown and ask him to sign the Maddy EMS Fund bill The California Medical Association (CMA) and the American College of Emergency Physicians (ACEP) are cosponsoring a bill that will extend funding for the Maddy Emergency Medical Services (EMS) Fund. Without this bill (SB 191/Padilla), providers of emergency medical care throughout the state will lose $50 million per year that is currently used to offset the costs incurred for care provided to uninsured patients in hospital emergency rooms (ER). Without this bill, the law that authorizes the Maddy Fund is set to expire on January 1, 2014. Although the bill is ... August 8, 2013 General EMS/MADDY Funds, Access to Care, Advocacy, Emergency Rooms 0 0 Comment Read More »
Public trust in physicians an asset in the coming MICRA fight By now, you’ve likely heard that Consumer Watchdog, a political astroturf group backed heavily by California’s trial attorneys, has thrown its weight behind a ballot initiative that seeks undo major provisions of California’s Medical Injury Compensation Reform Act (MICRA). Should MICRA be touched, it would severely limit access to care of millions of patients across the state. Rest assured, this initiative is misguided and fueled by the trial attorneys' desire to inflate jury awards as a way to increase the legal fees they can collect from their clients. The California Medical Association ... August 8, 2013 General Access to Care, Medical Malpractice, MICRA, Professional Liability 0 0 Comment Read More »
Learn about Noridian's Provider Portal, Endeavor One of the frequently asked questions on the Medicare transition is whether or not Noridian has a product similar to Palmetto’s Online Provider Services (OPS) portal. Noridian does have a similar provider portal called Endeavor. Noridian is conducting web-based workshops on Endeavor. This Medicare Part A and B workshop will be conducted through a web-based training tool that requires an Internet connection. The training will last approximately one hour, including time for questions. Physicians interested in Endeavor are encouraged to attend one of the following workshops: Aug. ... August 7, 2013 Medicare Medicare Transition, Noridian, Webinars, Medicare 0 0 Comment Read More »
