Reminder: SLR not accepting 2014 meaningful use attestations until April The California Department of Health Care Services reminds physicians that the State Level Registry (SLR) will not be accepting 2014 meaningful use attestations for the Medi-Cal Electronic Health Record (EHR) Incentive Program until April 1, 2014. This restriction only applies to 2014 meaningful use attestations. Physicians who are in the first participation year of the program and are adopting, implementing or upgrading (AIU) to a certified EHR rather than demonstrating meaningful use can submit 2014 AIU attestations beginning January 1, 2014. For more information, visit www.medi-cal.ehr.ca.gov. January 14, 2014 Medi-Cal Department of Health Care Services, EHR, Electronic Health Record, Meaningful Use, Health Information Technology 0 0 Comment Read More »
CMA Medi-Cal Survival Guide helps physicians understand numerous program changes Over the past year, there have been a number of changes for Medi-Cal patients and for the physicians who treat them. There will be more changes in 2014 as well. To help physicians understand the impact these changes will have on their practices, the California Medical Association (CMA) has published a Medi-Cal Survival Toolkit. The toolkit contains a summary on many of the changes, important dates, options for physicians and links to important resources. The toolkit is available to free to members in CMA's online resource library. Contact: CMA's reimbursement helpline, (888) ... November 6, 2013 Medi-Cal Healthy Families, Medi-Cal, Insurance/Reimbursement 0 0 Comment Read More »
DHCS to give webinar on Medi-Cal telehealth billing September 26 The Department of Health Care Services (DHCS) is hosting a telehealth billing webinar on September 26, from 10 to 11 a.m., to help Medi-Cal providers understand how to bill for telehealth services including reimbursement for transmission and facility fees. The webinar is open to all Medi-Cal providers. During the one-hour webinar, DHCS will guide providers in completing accurate claims for timely payment by: defining billable telehealth services; explaining how to fill out claims; listing HCPCS and CPT-4 codes used for telehealth billing; and sharing the updated telehealth section of the ... September 25, 2013 Medi-Cal Medi-Cal, Telemedicine, Webinars, Billing/Coding 0 0 Comment Read More »
Study finds that ACA Medi-Cal expansion could fuel ER use A retrospective study conducted by researchers at the University of California, San Francisco (UCSF) found that the number of visits to California emergency rooms (ERs) rose by 13.2 percent between 2005 and 2010, from 5.4 million to 6.1 million annually, with a significant 35 percent increase in the number of ER patients insured through Medi-Cal. The authors suggest that the Medi-Cal expansion under the Affordable Care Act (ACA) could further increase these numbers, as millions of additional patients become eligible for Medi-Cal in 2014. Researchers also found that Medi-Cal patients ... September 20, 2013 Medi-Cal Emergency Physicians, Emergency Rooms, Insurance/Reimbursement, Medi-Cal, Medi-Cal Cuts, Access to Care 0 0 Comment Read More »
CMA files a petition with the Supreme Court to block the 10 percent physician reimbursement cut The California Medical Association (CMA) filed a petition today asking the United States Supreme Court to review the Ninth Circuit Court of Appeals ruling that cleared the way for the State of California to implement a 10 percent cut to Medi-Cal provider reimbursement rates. Federal law requires that Medi-Cal patients have the same access to physicians and other health care providers as the general insured public. Despite this law, a three judge panel of the Ninth Circuit ruled that the state could move forward with the rate cuts, passed by ... September 20, 2013 Medi-Cal Advocacy, Medi-Cal, Medi-Cal Cuts, United States Supreme Court, Access to Care, Medi-Cal Lawsuit 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 »
Attestation for Medi-Cal primary care rate increase to begin in July The Centers for Medicare & Medicaid Services (CMS) released regulations in early November 2012 implementing rate increases for primary care physicians who treat Medicaid patients. The goal of the increase is to recruit more physicians to treat low-income patients who will be newly eligible for health coverage under the Affordable Care Act (ACA). Under the ACA, primary care physicians will see their reimbursement rates raised to Medicare levels in 2013 and 2014. According to CMS, states must also incorporate the increased payment rates into their contracts with managed care ... July 9, 2013 Medi-Cal ACA, Affordable Care Act, Centers for Medicare & Medicaid Services, CMS, Medi-Cal 0 0 Comment Read More »
Next phase of Healthy Families to Medi-Cal transition scheduled for August 1 Phase 3 of the Healthy Families transition from fee-for-service to Medi-Cal managed care is scheduled for August 1, 2013. This phase will impact approximately 107,000 children who have a Healthy Families plan that does not offer Medi-Cal managed care or subcontract with a Medi-Cal managed care plan, thus requiring them to transition to a new plan. This is the first phase of the Healthy Families transition where patients may be required to change physicians. Enrollment will include consideration of the child’s primary care providers. Affected counties are: ... July 9, 2013 Managed Care, Medi-Cal Managed Care, Medi-Cal, Healthy Families 0 0 Comment Read More »
Budget deal jump starts special session bills Almost six months have passed since Gov. Jerry Brown opened a special session on health care reform in California, and members of the state Legislature are now beginning to tie up the final loose ends. Of the three sets of bills put forward under the special session’s parameters, all but one appeared to be stalled indefinitely until members of the Legislature reached a budget deal. These bills, which outlined California’s plans to expand the Medi-Cal program and establish a so-called "bridge plan" between Medi-Cal and exchange plans, were sprung from ... July 8, 2013 Medi-Cal Health Insurance Exchange, Affordable Care Act, Health Care Reform, Medi-Cal 0 0 Comment Read More »
