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UnitedHealthcare plans to discontinue payment for consultation services

Citing alignment with a policy implemented by the Centers for Medicare and Medicaid Services (CMS), and in response to misuse of consultation service codes, UnitedHealthcare (UHC) has announced that it will no longer reimburse consultation services for commercial product lines effective October 1, 2017. Consultation services previously represented by CPT codes 99241-99245 and 99251-99255 will now need to be billed utilizing the appropriate evaluation and management (E/M) procedure code that describes the office visit, hospital care, nursing facility care, home service or domiciliary/rest home care. The California Medical Association (CMA), ...

FAQ: Can I maintain a drug-free policy in my office?

With the ongoing implementation of California's Medical Cannabis Regulation and Safety Act of 2015 and passage of the Adult Use of Marijuana Act (AUMA) in 2016, physician offices may increasingly find themselves unsure of whether they are required to make accommodations for employees' use of marijuana, either for medical or recreational purposes. California law does not require any accommodation of the use of medical cannabis on the property or premises of any place of employment or during the hours of employment. Further, the California Supreme Court, in Ross v. Ragingwire ...

Free CME: Patients' right of access under HIPAA

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) has launched a new training module for providers on patients' right of access under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. With limited exceptions, the HIPAA Privacy Rule provides individuals with the right to see and receive copies upon request of the information in their medical and other health records maintained by their health care providers and health plans. The new module provides an in-depth review of the components of the HIPAA right of access ...

August is National Immunization Month

August marks National Immunization Awareness Month (NIAM), a national effort to promote vaccinations and protect children and adults from serious, and sometimes deadly, preventable diseases. According to the Centers for Disease Control and Prevention (CDC), immunizations are one of the top 10 public health accomplishments of the 20th century. Among children born between1994-2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes. As part of this important effort, the California Medical Association (CMA) and its county medical societies are ...

Guillermo J. Valenzuela Foundation Awards $180,00 in Grants to Inland Groups Serving Families, Women in Need

Guillermo J. Valenzuela Foundation Awards $180,000 in Grants to Inland Groups Serving Families, Women in Need Grants by Inland-based foundation support its mission to improve the health of underserved communities in San Bernardino and Riverside Counties. (San Bernardino, CA) -- The Guillermo J. Valenzuela Foundation announced today that it has awarded $180,000 in grants to several local organizations that work to improve the health and well-being of underserved families and women in the Inland Empire. Founded and funded by longtime Inland physician Dr. Guillermo Valenzuela, the 2017 grant awards were provided to ...

Updated payor profiles for 2017 now available

The California Medical Association’s (CMA) Center for Economic Services is publishing updated profiles on each of the major payors in California including Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA, Health Net, UnitedHealthcare, Medicare/Noridian and Medi-Cal. Each profile includes key information on health plan market penetration; a description of the plan’s dispute resolution process; and the name and contact numbers for medical directors, provider relations, and other key contacts.  Don’t waste your time searching the internet for this information – members can download CMA’s Payor Profiles free of charge ...