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Joint Statement Regarding Security Prescription Forms

As of January 1, 2019, California law requires prescription forms for controlled substances to be printed with a uniquely serialized number. Notices explaining the serial number format and reporting requirements have been released by the Department of Justice (DOJ). Additionally, notices to prescribers and pharmacists were issued by the California State Board of Pharmacy (Pharmacy Board), and by the Medical Board of California (Medical Board), yet questions remain about implementation. This joint statement by DOJ, the Pharmacy Board, and the Medical Board is therefore being issued to provide further ...

Newsom's first budget puts health care access, costs front and center

SACRAMENTO -- Gov. Gavin Newsom released his first state budget proposal on Thursday, including a number of new goals and programs aimed at making health care more affordable and accessible to all Californians. The governor is following through on a key campaign promise by investing more than $1 billion in Proposition 56 tobacco tax revenue to increase access for Medi-Cal patients. That investment will help make it easier for low-income patients throughout California to see a physician and make Medi-Cal coverage more meaningful and effective for patients.  Much of Newsom’s health ...

Gov. Newsom signs executive order expanding health care access

Within hours of being sworn in as California’s 40th governor on Monday, Gavin Newsom signed an executive order that will help control health care costs and expand access to care for millions of Californians. Gov. Newsom announced the creation of the nation’s first state-run purchasing program for prescription drugs to help bring down costs via bulk purchasing. He also announced his intention to expand Medi-Cal coverage to undocumented Californians up to age 26. (California current allows anyone under age 19 to receive Medi-Cal benefits, regardless of immigration status.) The governor also ...

CMA and AMA urge exemptions from Open Payments reporting

The American Medical Association, the California Medical Association (CMA) and more than 80 other health care organizations recently submitted a joint letter in response to a request from the Centers for Medicare and Medicaid Services (CMS) for feedback on the Open Payments Program reporting requirements. Under the Open Payments program, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. The joint letter urges CMS to exempt journal reprints and medical textbooks from “Open Payments” ...

New Laws 2019: What physicians need to know

The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on health care coverage, drug prescribing, public health and mental health issues. To help physicians understand the most significant new health laws, the California Medical Association has published its annual new laws round up, “Significant New California Laws of Interest to Physicians for 2019.” This document is free to all interested parties.

ABMS seeking physician comments on Maintenance of Certification reform

In 2017, the American Board of Medical Specialties (ABMS) and its 24 member boards launched a major initiative—Continuing Board Certification: Vision for the Future Commission—to re-envision the future of continuing board certification. The commission recently released its draft report, which includes the key findings and recommendations for reforming how ABMS specialty boards operate continuing certification programs. The draft report is open for public comment until Tuesday, Jan. 15, 2019, at 9:00 p.m. Pacific Time. The California Medical Association (CMA) is encouraging physicians to review the recommendations and provide comments on ...

California Physicians Congratulate Governor-elect Newsom, Lieutenant Governor-elect Kounalakis

Today, voters chose Gavin Newsom and Eleni Kounalakis to serve as California’s next Governor and Lieutenant Governor. In response, California Medical Association (CMA) President David H. Aizuss, M.D. issued the following statement: “The voters have decided, and CMA is proud to congratulate Governor-elect Newsom and Lt. Governor-elect Kounalakis for their respective wins tonight. “Governor-elect Newsom has a distinguished track record in championing health care for all, and Lieutenant Governor-elect Kounalakis showed voters that she has the passion and experience to help push California forward. We look forward to their continued leadership ...

Prop. 56 webinar: Are you getting your share of the supplemental Medi-Cal funds?

The California Health Care, Research and Prevention Tobacco Tax Act of 2016 (Prop. 56) created new revenues dedicated to the Medi-Cal program. Physicians receive supplemental payments in both fee-for-service and Medi-Cal managed care when providing Medi-Cal services under certain CPT codes. A total of $325 million was allocated for physician payments in the budget for 2017-18, with $488 million proposed for 2018-19. The California Medical Association (CMA) is hosting a webinar with the California Department of Health Care Services on Wednesday, November 7, to discuss the status of distribution of ...

Coding Corner: Separate reporting of pre-intra- and post-procedure work

“Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billing. This month’s tip comes from G. John Verhovshek, the managing editor for AAPC, a training and credentialing association for the business side of health care. The global surgical package includes all “necessary services normally furnished” by a provider “before, during, and after a procedure,” as defined by the Centers for Medicare & Medicaid Service (CMS). When a provider is responsible for only a portion of the global package (e.g., an emergency department physician initiates fracture care, ...

UnitedHealthcare to implement outpatient advanced radiology policy

Effective January 1, 2019, UnitedHealthcare (UHC) will require prior authorization for certain advanced imaging procedures when performed in the outpatient hospital setting. As highlighted in the UnitedHealthcare Network Bulletin October 2018, certain magnetic resonance imaging, magnetic resonance angiography and computed tomography imaging procedures will now be subject to a site of care review when performed in the outpatient hospital under UHC’s Outpatient Radiology Notification/Prior Authorization Protocol. Site of care reviews will not be done as part of the prior authorization process if a procedure will be performed in a free-standing diagnostic ...