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Save Lives California files two ballot initiatives to raise California's tobacco tax

An initiative filed with the Attorney General’s Office on May 4 may give California voters the final say on a proposal that would raise the state’s tobacco tax by $2 per pack. The Save Lives California Coalition filed two ballot initiatives with the Attorney General. Both would direct revenue from a new tobacco tax into smoking prevention, cures for tobacco-related diseases and reinforcing the state’s health care system. The only difference between them is that one includes a tax hike on e-cigarettes in addition to combustible cigarettes. The filing is the ...

Governor's revised budget contains no significant increases for Medi-Cal

On May 14, Governor Jerry Brown released his revised budget for fiscal year 2015-16, which includes an increase in overall expenditures from the General Fund to $115.3 billion, but does not include any significant increases to Medi-Cal provider reimbursement rates. Overall, the revised plan contains $169 billion in total state spending, up from $164.7 billion in January. The total includes $46.9 billion in special funds and $6.8 billion in bond funds. The California Medical Association and other stakeholders continue to point out that beneficiaries of the Medi-Cal program are having ...

Institute for Medical Quality offers grants for opioid training

In continuing efforts to address the serious issues related to the misuse of prescription opioids, the California Medical Association’s Institute for Medical Quality (IMQ) is participating in a second round of funding to make available grants to continuing medical education (CME) providers who conduct Food and Drug Administration (FDA)-approved opioid training for physicians, pharmacists and other health care providers. On July 9, 2012, the FDA launched a risk evaluation and mitigation strategy (REMS) for extended-release and long-acting opioid medications. IMQ participates in REMS as part of the Collaborative on REMS ...

Survey: ER visits continue to climb under Affordable Care Act

A recent survey conducted by the American College of Emergency Physicians (ACEP) shows that emergency room (ER) visits are continuing to climb since the implementation of the Affordable Care Act (ACA), despite predictions that the law would result in less crowding. According to a news release, about three-quarters of the 2,098 ER physicians surveyed said that visits have risen since January 2014 — a significant increase from a year earlier, when less than half said they saw an upturn. More than one-quarter reported “significant increases in all emergency patients” since ...

Covered California board proposes to cut budget because of slower enrollment

Due to tepid enrollment numbers, Covered California’s board of directors has proposed to spend $58 million less in 2016, slashing its marketing and outreach program by 33 percent. Open enrollment in Covered California fell short of its goal of 1.7 million this year, ending with the number of enrollees at 1.4 million. Additionally, the exchange must pay its own way in the future after receiving $1 billion in federal money. And while it still has some $290 million in reserve for 2016, the exchange projects that fewer than 1.5 million ...

Learn more: Medicare SGR replacement payment system details

On April 16, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation, which negates the Medicare sustainable growth rate (SGR) formula, replaces it with new payment options and extends the Children’s Health Insurance Program (CHIP). The bill was passed in a monumental bipartisan action taken by Congress, after a decade of fighting for change by the California Medical Association, the American Medical Association (AMA) and a host of other medical associations. In summary, MACRA permanently repeals the SGR formula and stabilizes Medicare payments ...

Changes to Anthem Blue Cross reimbursement policies and claims software

Anthem Blue Cross recently notified physicians of upcoming changes to the insurer’s reimbursement policies and claims editing software, called ClaimsXten. The changes will go into effect on July 1, 2015. Because of these changes, physicians may notice a difference in how certain codes and code pairs are adjudicated. Along with the notice, Anthem provided a comprehensive grid outlining the new, revised and existing reimbursement policies and claims editing rules as well as copies of Anthem’s reimbursement policies. The changes include additions to the types of service Anthem will consider bundled ...