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Tip: Get ready for the new Medicare beneficiary cards and ID numbers

The Centers for Medicare and Medicaid Services (CMS) will begin mailing new identification cards to California Medicare beneficiaries between April and June 2018, as required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The new cards will contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number replacing the current Social Security-based number.   CMS will allow a 21-month transition period beginning April 2018, where health care providers will be able to use either the patient’s current Medicare number or the patient’s new Medicare number. CMS has developed ...

CMA advocacy results in DHCS revaluing two CPT codes

The California Medical Association (CMA) received a call from a physician member with concerns that the California Department of Health Care Services (DHCS) had priced a CPT code for destruction of up to 14 benign skin lesions (CPT 17110) at a higher level than it priced a more complex procedure for the destruction of 15 or more lesions (CPT 17111). CMA escalated the issue to DHCS so it could investigate. Upon further inspection and months of discussions, DHCS announced in October that it was increasing reimbursement on both codes, resulting ...

Physicians encouraged to warn patients of new Medicare scam

Seniors in California are being targeted by a new Medicare card phone scam. Medicare beneficiaries are getting calls from scammers telling them their new Medicare card will arrive between April and June 2018, which is true.   However, they go on to state beneficiaries must first buy a temporary card for $5.00 to $50.00 and provide personal information before they receive their new Medicare card. THIS IS NOT TRUE. It is true that Medicare is issuing a newly designed Medicare card, which will contain the unique, randomly assigned Medicare Beneficiary Identification (MBI) ...

Slate of SBCMS Leadership 2018-2019

The Nominating Committee held a conference call on January 22, 2018 at 6:00 p.m. Members in attendance were Michael Sequeira, MD (Chair); Eric Hansen, DO; Mark Bai, MD; Christopher Tsai, MD; Marti Baum, MD; SBCMS Staff Alison Elsner, Linda Sue Myers, Jenise Solorio, and Soteria Cobb.  The final vote to approve this slate will take place at the SBCMS board of directors' meeting on March 26, 2018. Click here for the slate of nominees. OFFICERS: Damodara Rajasekhar, M.D. as President – Pediatrician, Apple Valley Mark Bai, M.D. as President-Elect:- Family Medicine, So. Cal Permanente Christopher ...

10 Things to Do and Know About MIPS Reporting Deadlines

Deadlines are fast approaching if you plan to submit data for the 2017 Merit-based Incentive Payment System (MIPS) performance period. Don’t wait until the last minute to submit your data.  Submit early and often. The two key dates are: March 16 at 8 pm Eastern time for group reporting via the CMS web interface March 31 for all other MIPS reporting, including via qpp.cms.gov Now is the time to act. Here are the top 10 things you need to do and know ...

CMS proposes 1.84% Medicare Advantage payment increase

The Centers for Medicare and Medicaid Services (CMS) has proposed increasing baseline Medicare Advantage payment rates for 2019 by an average of 1.84 percent. According to CMS, the proposed payment increase is based on better use of encounter data and changes to the risk adjustment model used to pay for aged and disabled beneficiaries. Medicare Advantage is at an all-time high, with approximately one-third of all Medicare beneficiaries enrolled in a Medicare managed care plan. Enrollment has more than doubled over the past decade. CMS is accepting comments on the proposal until ...

New Anthem anesthesia policy can have blinding consequences

A policy change made by health insurer Anthem, Inc. could result in increased risk for many patients – up to and including blindness – if not immediately rescinded, according to physicians’ groups. The California Academy of Eye Physicians and Surgeons (CAEPS) and the California Society of Anesthesiologists (CSA) have sent letters to Anthem Inc. requesting that they immediately rescind a new policy that deems Monitored Anesthesia Care (MAC) “not medically necessary” during “routine” cataract surgery – a move seen as endangering patients. These were followed up with complaints to the ...

Register today for IMQ's Stepping Up to Leadership Conference

The Institute for Medical Quality’s (IMQ) Stepping Up to Leadership conference will be held at the Paradise Point Resort and Spa in San Diego on February 22-23, 2018.  This program is widely recognized as the “go to” course for acquiring knowledge and skills to successfully lead a medical staff. Offered in conjunction with the University of California, San Diego PACE Program, the program was developed in response to a commonly expressed need for better, more practical hands-on training for medical staff leaders.  In addition to interactive training in communicating and handling ...

State awards $30.5 million in primary care residency program funding

The California Healthcare Workforce Policy Commission awarded upwards of $30.5 million to support more than 175 primary care residency slots for the 2017 cycle of the Song Brown Healthcare Workforce Training Program. A record number of applications were received this year, in large part due to the additional physician workforce funding secured by the California Medical Association (CMA) through the state budget. In 2016, the California legislature passed a budget that committed $100 million over three years ($33 million each year) in health care workforce funding. Although Governor Brown proposed ...

Take the #MoveWithHeart pledge

This American Heart Month, the California Medical Association is joining the National Heart, Lung, and Blood Institute in a national pledge to #MoveWithHeart. We invite you to submit a pledge by recording a video of yourself and upload it to Twitter or Instagram using #MoveWithHeart or go to www.MoveWithHeartPledge.com. Participate in just three simple steps: Record a short video of yourself saying “I pledge to move more for my heart health.” Share it on Twitter or Instagram using #MoveWithHeart. Challenge friends ...