Medical board gives priority licensing review to physicians practicing in underserved areas The Medical Board of California will give priority review and processing of license applications to any physician who has received or accepted an offer of employment to work in an area of California designated as underserved. In order to be considered for this process, applicants need to submit the initial application forms, fingerprint cards (out-of-state applicants) or Live Scan (California applicants), application fees, primary source documents and supporting documents. Physicians also need to supply the additional documentation: An original signed and dated letter from the applicant to ... September 4, 2014 General Medical Board of California, Rural Health, Licensure 0 0 Comment Read More »
CMA Capitol Insight: Sept. 2, 2014 End of Session The final two weeks of the 2014 legislative session may have been void of the mega-deals of years passed, but there was plenty of last-minute deal-making, inside plays, and highs and lows for the scores of lobbyists who gathered daily outside the Senate and Assembly chambers during the final days. Gov. Jerry Brown has until September 30 to deal with the hundreds of bills that found their way to his desk, and we’re all banking on a few colorful veto messages that have become a Brown trademark. The ... September 4, 2014 General CMA Capitol Insight, Anthony York 0 0 Comment Read More »
DHCS releases Medi-Cal concept paper that proposes risk-based health home models and malpractice subsidies The California Department of Health Care Services (DHCS) has released a proposal in the form of a concept paper for the state’s next 1115 Section Medicaid Waiver for public for comment. California is currently in the fourth year of its current Section 1115 waiver that was approved by the federal government so California could expand Medi-Cal coverage in accordance with the Affordable Care Act in 2010 and implement a variety of delivery reform projects like the duals demonstration project. The concept paper outlines new ideas to modify provider payments and save ... September 4, 2014 Medi-Cal DHCS, Medi-Cal, Affordable Care Act 0 0 Comment Read More »
CMA urges court to protect patient privacy The California Medical Association (CMA), joined by the Litigation Center of the American Medical Association (AMA) and state medical societies, has filed a letter in support of a petition before the California Supreme Court to review a Court of Appeal opinion finding that patients have no reasonable expectation of privacy in their prescription data. In Lewis v. Superior Court (Medical Board of California), the Court of Appeal held that a law allowing law enforcement and other government agencies broad access to the state’s electronic prescription drug monitoring program’s database did ... September 4, 2014 General CURES, Legal Advocacy, Physician-Patient Relationship 0 0 Comment Read More »
Change in prior authorization form for prescription medications becomes effective October 1 Over the next several months, a new law (SB 866) will take effect that streamlines and standardizes the prior authorization process for prescription drugs. The new law requires all insurers, health plans (and their contracting medical groups/IPAs) and providers to use a standardized two-page form for prior authorizations of prescription medications. Additionally, if a health plan or insurer fails to use or accept the prior authorization form, or fails to make a determination within two business days, the prior authorization request is deemed approved. Currently, plans have five business days ... September 4, 2014 General Advocacy, Prescription Drugs, Preauthorization 0 0 Comment Read More »
Are you losing money from virtual credit card payment fees? If your practice accepts virtual credit card (VCC) payments from payors, you put yourself at risk of losing a significant amount of your contractual reimbursement to high interchange fees. When paying claims, some payors have shifted from paper checks to electronic payment methods, including payor-issued VCCs. With this method, a payor sends credit card payment information and instructions to physicians, who process the payments using standard credit card technology. This method is beneficial to payors, but costly for physicians. Health plans often receive cash-back incentives from credit card companies for VCC ... September 4, 2014 General Payors, Practice Resources, Payment 0 0 Comment Read More »
Noridian denies 300,000 claims for E&M services in error Last fall, the Centers for Medicare and Medicaid Services experienced some editing issues with new patient evaluation and management (E&M) codes that resulted in incorrect claim denials. These issues began in October 2013, and were thought to have been corrected in late January 2014. The California Medical Association recently learned, however, that some claims continued to be denied incorrectly through July 15, 2014. In January, Noridian, California's Medicare contractor, began reprocessing claims that had been denied in error and correcting those subjected to overpayment recovery. Unfortunately, while implementing the corrections, ... September 4, 2014 Medi-Cal, Medicare Medicare, Noridian, Billing/Coding 0 0 Comment Read More »
Ask the expert: How long does TRICARE have to request a refund? Recently, physicians may have started to receive TRICARE requests for refunds related to overpayment from the governmental health carrier. As a result, the California Medical Association’s Center for Economic Services has compiled a list of the most frequently asked questions and answers related to these TRICARE refund requests. How long does TRICARE have to request a refund? Pursuant to federal law, TRICARE is authorized to seek refunds of overpayment for dates of service as far back as 10 years, per Title 32: Subtitle A, Chapter: 1, Subchapter M, Part 199.11 - ... September 4, 2014 General Refund Requests, Tricare, Practice Resources 0 0 Comment Read More »
Feds propose compromise to ACA birth control rule to accommodate religious groups Last week, the Obama administration proposed a compromise to provide contraceptive coverage under the Affordable Care Act (ACA) to employees of whose employers object on religious grounds to providing contraceptives to their employees. The administration is hoping to quell the controversy around the ACA contractive coverage that has yielded dozens of lawsuits, while ensuring that all women are able to get coverage of recommended preventive services without cost sharing, as intended under the health care law. “Women across the country deserve access to recommended preventive services that are important to ... September 3, 2014 General ACA, Contraception, Affordable Care Act 0 0 Comment Read More »
Products that contain hydrocodone reclassified to Schedule II The federal government published new rules last week that will govern hundreds of medicines containing hydrocodone. These drugs will be reclassified as Schedule II substances, in line with oxycodone and morphine. This reclassification will apply to all drugs that contain both hydrocodone, which by itself was already classified a Schedule II drug, and specified amounts of other substances, such as acetaminophen or aspirin. As Schedule II drugs, patients will be limited to up to a 90-day supply of medication and will have to see a provider to get a refill. ... September 3, 2014 General Prescription Drugs, Drug Prescribing 0 0 Comment Read More »
