Court rules against constitutional attack on MICRA On June 9, the California Court of Appeal based in San Francisco issued its precedential opinion in Chan v. Curran, fully upholding various provisions of California's landmark Medical Injury Compensation Reform Act (MICRA) against constitutional attacks by California’s trial attorneys. The California Medical Association (CMA), together with a broad coalition of health care providers, including the American Medical Association, the California Hospital Association and the California Dental Association, had filed an amicus brief last year supporting the constitutionality of the non-economic damages cap of MICRA. This appeal was the latest in ... June 26, 2015 General Legal Advocacy, MICRA, Amicus Briefs 0 0 Comment Read More »
CMA works to address problems posed by CURES 2.0 launch on June 30 The Department of Justice (DOJ) recently announced that an update to the Controlled Substance Utilization Review and Evaluation System (CURES 2.0) database would go live June 30, but with browser requirements that could potentially cut off access for thousands of prescribers and dispensers. According to the DOJ, CURES 2.0 would require users to have Internet Explorer version 11, Firefox or Chrome Internet browsers installed on their systems in order to access the database. While it is possible for some users to simply update or switch to one of the supported ... June 26, 2015 General Drug Prescribing, EHR, Prescritpion Drugs, CURES 0 0 Comment Read More »
Physicians receiving notice from CHPI encouraged to verify data accuracy by July 31 On May 29, 2015, approximately 18,000 physicians in California were notified of a new quality rating program through the California Healthcare Performance Initiative System (CHPI). CHPI is managed by staff from the Pacific Business Group on Health (PBGH), but has its own board of directors. The letter states that 19 quality measures were constructed using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California and United Healthcare. This claims data includes both commercial and self-funded health plan data from HMO, PPO, POS and Medicare Advantage products. Along with ... June 26, 2015 General Quality Reporting 0 0 Comment Read More »
California State Auditor releases report outlining flaws with Medi-Cal program The California State Auditor’s office released a report on Tuesday expressing a need for better monitoring of the health plans participating in California’s Medicaid program, Medi-Cal, in order to improve beneficiaries’ access to care. Among the key findings of the audit was that the California Department of Health Care Services (DHCS), which administers Medi-Cal, “has not consistently monitored health plans to ensure that they meet beneficiaries’ medical needs—it did not perform any annual medical audits before 2012 and performed medical audits on less than half of the health plans in ... June 26, 2015 Medi-Cal DHCS, Medi-Cal, Network Adequacy, Provider Networks, Department of Health Care Services 0 0 Comment Read More »
CMA Capitol Insight: June 23, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Finding the fix: health care and transportation Democratic lawmakers and Governor Jerry Brown came to agreement on a $115.4 billion spending plan this week, which included billions more for schools, the California State University system and child care, while agreeing to expand Medi-Cal coverage to thousand of undocumented children. Despite some of the details of the landmark agreement, the budget may be more notable for what was not in the spending ... June 26, 2015 General CMA Capitol Insight, Anthony York 0 0 Comment Read More »
Highlights from AMA's 2015 House of Delegates The American Medical Association’s (AMA) House of Delegates tackled a diverse set of resolutions this year that are of interest to California physicians, including medical-only exemptions from school vaccination requirements, electronic health record (EHR) meaningful use, ICD-10 implementation, Medicaid rates and opioid abuse. Given the high level of interest in California’s Senate Bill 277 (Pan), which would eliminate the personal belief exemption for school vaccination requirements in California, AMA adopted a policy calling for immunization for all, and only allowing exemptions where medical reasons contraindicate vaccination. Several other vaccine-related resolutions were ... June 26, 2015 General House of Delegates, American Medical Association 0 0 Comment Read More »
OIG issues fraud alert regarding physician compensation arrangements The Office of Inspector General (OIG) in the Department of Health and Human Services released a Fraud Alert in early June to caution physicians who may be engaged in fraudulent compensation arrangements. The anti-kickback statute prohibits arrangements that result in "improper remuneration" for physicians, such as accepting payment in exchange for referrals. The OIG Alert follows a recent settlement between the OIG and 12 physicians involved in "questionable" medical directorships and office staff arrangements with a chain of diagnostic centers in Texas. Physician compensation allegedly took into account the volume ... June 26, 2015 General U.S. Department of Health and Human Services, Fraud and Abuse 0 0 Comment Read More »
CMS rule reduces Meaningful Use burdens; CMA advocates for more change On June 15, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on proposed rules modifying Stage 1 and Stage 2 Meaningful Use criteria of the federal electronic health records (EHR) incentive programs. Under the federal EHR incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “Meaningful Use” of certified health information technology. The proposed rule aligns Stage 1 and Stage 2 Meaningful Use objectives and measures for 2015 through 2017 with proposed Stage 3 ... June 26, 2015 Managed Care, Medi-Cal, Medicare CMS, EHR, Electronic Health Record, HIT, Meaningful Use 0 0 Comment Read More »
Practice Check-Up: Marketing your practice This is the third in a series of articles aimed at highlighting key areas practices should examine in an effort to improve practice performance. This month we focus on how effectively managing the appointment schedule can have a positive impact on both patient and practice satisfaction. Even with the influx of approximately 6.5 million newly insured patients in California as a result of health reform, many physicians in small and solo practice are concerned that they will be unable to compete with the large groups and large health care ... June 26, 2015 General Practice Resources 0 0 Comment Read More »
New Paid Family Leave benefits form required July 1 In fall 2014, the Employment Development Department (EDD) revised the Claim for Paid Family Leave (PFL) Benefits form (DE 2501F). The initial deadline to discontinue use of the old form (12-03) was May 1, 2015; however, this date was extended to July 1, 2015. Effective July 1, 2015, only the new form, DE 2501F Rev. 1[7-14], will be accepted. To order new forms, practices can visit the EDD Forms and Publications page or call (877) 238-4373 FREE. Physicians are also reminded that they can certify claims for State Disability Insurance (SDI) ... June 26, 2015 General State Disability Insurance (SDI), Paid Family Leave (PFL) 0 0 Comment Read More »
