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MACRA webinar now available on-demand

A recording of the California Medical Association’s (CMA) recently held webinar – MACRA: What Is CMA Doing to Improve It? What Steps Can You Take to Prepare Now? – is now available to download in CMA’s online resource library. The webinar is available free to members; the cost is $99 for nonmembers. In this webinar, CMA Vice President of Federal Government Relations Elizabeth McNeil provides a brief overview of the new Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) payment changes. She also discusses CMA’s advocacy efforts with the ...

United Healthcare extends clinical data submission deadline to Sept. 2

At the request of the California Medical Association (CMA), United Healthcare (UHC) has delayed the expansion of its Clinical Data Submission Protocol in California. Originally scheduled to take effect July 1, the expansion will now be pushed back until September 2. First introduced in 2015, the program originally targeted only Medicare benefit plans and required physicians to submit all laboratory test results for UHC Medicare patients. The expansion of the program will require practices to submit laboratory tests for all UHC Medicaid and commercial benefit plans. For more information about ...

Noridian reports low response rate for Medicare Part B revalidations

Noridian, Medicare’s administrative contractor for California, reports that only 19 percent of physicians have responded to the most recent Medicare Part B revalidation notices. Noridian is in the process of deactivating Medicare billing privileges for physicians who received a revalidation notice from Noridian but did not turn in a completed application to the Centers for Medicare and Medicaid Services (CMS) prior to the most recent deadline of May 31. If you are deactivated for failure to respond to a revalidation notice, you must submit a reactivation application. The date ...

Noridian begins deactivation of providers who failed to revalidate

The due date for physicians to revalidate their Medicare enrollment information has passed for the most recent cycle of physician revalidation required by the Centers for Medicare and Medicaid Services (CMS). Physicians who received a revalidation notice from Noridian, CMS’ Medicare contractor for California, and who did not turn in a completed application to CMS prior to the May 31 deadline, will have their Medicare billing privileges deactivated. If you are deactivated for failure to respond to a revalidation notice, you must submit a reactivation application. The date of receipt ...

Reminder: CMS meaningful use hardship exception deadline is July 1

Physicians should be aware that July 1, 2016, is the extended deadline for physicians to file hardship exception applications from the electronic health record incentive program meaningful use requirements. In mid-December 2015, Congress adopted a last-minute bill that gave the Centers for Medicare and Medicaid Services (CMS) the authority to grant a blanket exception for all eligible physicians who applied for an exception from the 2015 meaningful use penalties. CMS reports the extension is being granted “so providers have sufficient time to submit their applications to avoid adjustments to their Medicare ...

DHCS suspends planned passive enrollment for duals project

The Department of Health Care Services (DHCS) announced last week that it would not move forward with its planned annual passive enrollment of dual eligible beneficiaries under the Coordinated Care Initiative (CCI) after it received feedback from the California Medical Association (CMA) and 40 other stakeholders asking the agency to pursue enrollment strategies that support voluntary "opt-in" enrollment. Instead, DHCS said it will implement a voluntary "opt-in" enrollment effort beginning in July 2016. The new streamlined enrollment strategy will include mandatory Managed Medi-Cal Long-Term Supports and Services (MLTSS) plan enrollment. ...

Maintaining your Medicare opt-out status

Physicians who intend to opt-out, or who have previously opted-out of Medicare, should be aware of changes to the Medicare opt-out period as a result of the Medicare Access and CHIP Reauthorization Action of 2015 (MACRA).   Validated opt-out affidavits signed on or after June 16, 2015, will automatically renew every two years. Previously, physicians who opted out of the program would have to renew their affidavit every two years to maintain their opt-out status. Under the new rules, affidavits will automatically renew every two years unless the physician cancels ...

CMS releases draft MACRA regulations

The Centers for Medicare and Medicaid Services (CMS) on Wednesday released a 962-page proposed rule that lays out the agency's plan for implementing last year's groundbreaking Medicare reform law, the Medicare Access and CHIP Reauthorization Act (MACRA). Ahead of CMS’ release of the rule, physician leaders testified before the U.S. House of Energy and Commerce Committee’s Subcommittee on Health during a special MACRA hearing last week. The physicians expressed cautious optimism and said the law represents a critical opportunity to enhance flexibility and innovation in health care that can lead ...

Physicians show cautious optimism for MACRA during Capitol Hill meeting

Physician leaders expressed cautious optimism for the landmark Medicare payment reform law (known as MACRA) during a key congressional committee hearing on April 19. The physicians said the law represents a critical opportunity to enhance flexibility and innovation in health care that can lead to improved care and better outcomes for patients, but the law also needs to allow physicians to focus on practicing medicine by aligning and simplifying quality reporting programs. “MACRA makes significant improvements over the current system, including the repeal of the flawed sustainable growth rate formula ...

CSU and palliative care coalition launch eduction programs on advance care planning and billing

In response to the nation’s growing demand for physicians trained in advance care planning conversations, the California State University Institute for Palliative Care has partnered with the Coalition for Compassionate Care of California to co-design a comprehensive continuing education curriculum for health care professionals. New this year, Medicare providers can be reimbursed for advance care planning conversations with patients. The newly implemented reimbursement provides an impetus for clinicians to spend time exploring patient health care preferences and documenting goals of care. “Patients want to have these conversations with their providers, and ...