CMA calls for investigation into Anthem policy restricting use of sedation during cataract surgery On December 27, 2017, Anthem Blue Cross implemented a clinical guideline that restricts the use of intravenous anesthesia to sedate patients during cataract surgery. The California Medical Association (CMA) believes this drastic change in policy will cause significant patient safety concerns and put patients at risk of serious complications, including blindness. The new policy, “Anesthesia for Cataract Surgery,” deems intravenous anesthesia (including moderate sedation, monitored anesthesia care or general anesthesia) not medically necessary, except in very narrow circumstances. Anthem patients wishing to have any form of intravenous anesthesia during the ... February 5, 2018 General, Managed Care Anthem Blue Cross, Anesthesiology, Contract Amendment, Medical Necessity, Opthalmology 0 0 Comment Read More »
Fake DEA extortion scam resurfaces in California Scam artists posing as U.S. Drug Enforcement Administration (DEA) agents are calling California physicians and consumers as part of an international extortion scheme. While the scam is not new—it’s been making the rounds for the past five years—a number of California physicians have reported recent extortion attempts. The scammers identify themselves as DEA agents or other law enforcement, telling their victims that purchasing drugs via phone or internet is illegal and that enforcement action will be taken against them if they don’t pay a fine, usually thousands of dollars. No DEA ... February 5, 2018 General DEA, Drug Enforcement Administration, Scams 0 0 Comment Read More »
February is Heart Month: Help spread the word Did you know that 1,458,000 people in California have coronary heart disease? Although heart disease is the leading cause of death in the United States, it is largely preventable and there are many things your patients can do to reduce their risk. To mark the start of this year’s #HeartMonth, the National Heart, Lung and Blood Institute (NHLBI) and its The Heart Truth program have developed a toolkit to help raise awareness about heart disease. The toolkit contains educational materials to use in your practice and your community, social media ... February 5, 2018 General Cardiology, Heart Health, Public Health 0 0 Comment Read More »
Health plans terminate contracts with EHS and transition patients to other entities As previously reported, the California Department of Managed Health Care (DMHC) issued a cease-and-desist order on December 26, 2017, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order comes after SynerMed—a company closely affiliated with EHS—was accused of blocking patient access to specialists to hold down costs. EHS has 600,000 patients statewide—90 percent of whom are Medi-Cal managed care patients. As required by DMHC, health plans affected by this order were required to submit a transition plan by January 3, 2018, ... February 5, 2018 Managed Care, Medi-Cal Continuity of Care, Department of Managed Health Care, DMHC, Health Plans, Insurance, Medi-Cal, Payor Contracting 0 0 Comment Read More »
On-Demand Webinar: Understanding Medicare Changes: An Impossible Dream? The California Medical Association (CMA) recently hosted a free webinar examining changes to the Medicare program for 2018 and providing tips for regulatory compliance, presented by the medical director of California’s Medicare contractor, Noridian Healthcare Solutions. The webinar is now available for on-demand viewing in the CMA resource library. This download is free for all. This review includes an overview of the Centers for Medicare and Medicaid Services’ (CMS) new Targeted Probe and Educate (TPE) program, a type of Medicare audit, and its review process; changes to Local Coverage Determinations ... February 5, 2018 CMA, Medicare Government Payors, Medicare, Noridian, Webinars 0 0 Comment Read More »
Free workshops on medical board's new Physician Health and Wellness Program The California Public Protection & Physician Health Inc. (CPPPH) is offering a series of free informational workshops about the Medical Board of California’s new Physician Health and Wellness Program. The workshops will discuss: how the new program will work, when it will be available to physicians, and what role medical group and medical staff well-being committees will play. CPPPH, together with the California Society of Addiction Medicine and California Medical Association (CMA), are encouraging all wellbeing committees and medical staff leaders to attend one of these workshop sessions so they can ... January 30, 2018 General California Public Protectioin and Physician Health, CPPPH, Medical Board of California, Physician Well-being, Physician Wellness 0 0 Comment Read More »
Call for nominations: California Delegation to the AMA The California Medical Association (CMA) is seeking nominations for physicians to serve as at-large delegates and alternates to the American Medical Association (AMA) House of Delegates. Current delegates who are eligible for reappointment must submit an application for the 2018 term. They will not be reappointed if a form is not submitted. We are seeking physicians who are active CMA members and able to serve as delegates or alternates twice a year during the annual (June) and interim (November) meetings of the AMA House of Delegates for a two-year term ... January 30, 2018 CMA, General AMA, American Medical Association, CMA Nominations 0 0 Comment Read More »
Stopgap bill to fund federal government includes 6-year CHIP extension Today, the U.S. Senate voted to end the federal shutdown and keep the government running temporarily for three weeks until February 8. This stopgap bill will give budget negotiators time to develop a final agreement on 2018 fiscal year spending. The House of Representatives is expected to adopt the Senate’s three-week stopgap bill. The bill also includes a six-year extension of the Children’s Health Insurance Program (CHIP) – an important program that serves nearly 2 million children and pregnant women in California, and more than 9 million nationwide. The California ... January 30, 2018 General Federal Legislation, Federal Legislative Advocacy, Maternal and Child Health, State Children's Health Insurance Program 0 0 Comment Read More »
HHS issues "provider conscience" regulations Last week, the U.S. Department of Health and Human Services (HHS) announced it would form a new division within the HHS Office of Civil Rights to focus on provider conscience and religious freedom exemptions. Following this announcement, HHS released a proposed rule that would expand existing protections for physicians and other providers who object to performing certain health care procedures. The proposed rule covers a wide array of existing federal laws that provide conscience protections, including those related to abortion, sterilization, assisted suicide and the performance of advance directives. The California ... January 30, 2018 General Abortion, Regulatory Advocacy, Reproductive issues, U.S. Department of Health and Human Services 0 0 Comment Read More »
California Medical Association Endorses Eleni Kounalakis for California Lt. Governor Today, the California Medical Association (CMA) endorsed Eleni Kounalakis’ 2018 bid to become California’s next Lieutenant Governor. “The California Medical Association is proud to support Eleni Kounalakis for Lieutenant Governor,” said CMA President Theodore M. Mazer, M.D. “Today’s political environment demands leaders focused on pragmatic solutions to improve quality access to health care, address our looming physician shortage crisis and champion public health initiatives. We believe Eleni has the passion, temperament and experience to best represent California’s citizens and interests.” “I am so honored to receive the endorsement of the California ... January 30, 2018 CMA, General Election, Political Advocacy 0 0 Comment Read More »
