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California Medical Association responds to final MACRA implementation rule

The Centers for Medicare and Medicaid Services (CMS) today released the final implementation rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which aims to reform the Medicare physician payment system. The California Medical Association (CMA), American Medical Association (AMA) and nearly every other physician organization supported the bipartisan legislation because it was intended to provide stable payment updates, significantly reduce the quality reporting program burdens, reinstate bonus payments and allow innovative, physician-led alternative payment models. “Physicians, particularly small and rural practices, need a modernized, flexible and ...

Next IMQ CME Essentials Workshop is Dec. 12 in San Mateo

Join the Institute for Medical Quality (IMQ) on Monday, December 12, 2016, for the next CME Essentials Workshop, to be held at the San Mateo County Medical Association in San Mateo (near SFO). This one-day workshop focuses on the fundamentals of planning and evaluating a continuing medical education (CME) activity. The CME Essentials Workshop is designed for individuals who are new to CME or who are seeking a refresher, including physicians (CME chairs, committee members, faculty or speakers); CME coordinators; nurses; and other medical staff and education professionals involved in ...

President's Message from Michael Sequeira, M.D. - October 2016

Dear Friends and Colleagues, Every few years, the opportunity comes along to make a powerful and positive change in the lives, work and futures of California physicians and families. Proposition 56 is one of those transformational measures, and it will appear on this November’s ballot. Most of us recall – vividly – the battle in 2014 over Proposition 46, passage of which would have overturned the MICRA protections. Not only would this have quadrupled the cap on non-economic damages in malpractice suits, but also it would have resulted in physicians having ...

California Medical Association endorses soda tax ballot measures

The California Medical Association (CMA) today announced endorsements for three Bay Area ballot propositions aimed at reducing sugar intake to prevent diabetes and obesity: Measure V in San Francisco (Tax on Distributing Sugar-Sweetened Beverages) proposes a 1-cent per ounce tax that is estimated to generate $14.4 million/year. Measure HH in Oakland (Sugar-Sweetened Beverage Tax) proposes a 1-cent per ounce tax that is estimated to generate $6-8 million/year. Measure 01 in Albany (Sugar-Sweetened Beverage General Tax) proposes a 1-cent per ounce ...

FDA adds boxed warning to hepatitis C drugs

The U.S. Food and Drug Administration (FDA) is warning of serious, potentially life-threatening risks for patients infected with hepatitis B virus who are being treated with certain direct-acting antiviral medicines for hepatitis C virus (HCV). According to the FDA, direct-acting antiviral medicines for hepatitis C virus can reactivate hepatitis B virus. In a few cases, hepatitis B reactivation in patients treated with direct-acting antivirals resulted in serious liver problems or death. As a result, FDA is requiring a boxed warning about the risk of hepatitis B reactivation to be ...

CMA publishes FAQ on controversial new law to end "surprise billing"

In September 2016, Governor Jerry Brown signed into law a controversial bill (AB 72) that will change the billing practices of non-participating physicians providing non-emergency care at in-network hospitals, ambulatory surgery centers and laboratories. While the enactment of AB 72 can never be described as favorable, the end result is a law that puts to rest the issue of so-called “surprise billing” in a way that preserves the ability of physicians to continue collecting their usual rate (as long as they obtain the consent of the patient), implements a statutory ...

Are you in compliance with federal nondiscrimination rule?

The California Medical Association has published answers to the most frequently asked questions regarding the new nondiscrimination rules recently published by the U.S. Department of Health and Human Services Office for Civil Rights. The final rule, which implements the nondiscrimination provision of the Affordable Care Act, Section 1557, requires covered physician practices to post nondiscrimination notices and inform patients with disabilities and limited English proficiency (LEP) about the right to receive communication assistance, including the availability of language assistance services. These requirements aim to provide important protections for individuals with disabilities ...

AMA introduces new MACRA payment model evaluator

The American Medical Association (AMA) has introduced a new online tool to help physicians evaluate the various new Medicare payment models and improve their opportunities for success under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which will go into effect in 2017. The AMA Payment Model Evaluator is a free interactive tool offering initial assessments to help physicians determine how their practices will be impacted by MACRA. Once physicians or medical practice administrators fill out the online questionnaire, they will receive guidance on participating in the MACRA ...

Know Your Rights: Managed care contractual protections

CMA’s “Know Your Rights” series summarizes vital protections under state and federal law that physicians should be aware of in their dealings with payors. Thanks to legislation sponsored by the California Medical Association (CMA), all health plan contracts with physicians are required to be fair, reasonable and consistent with California law and regulations. Contractual clauses that are specifically prohibited cover the following: Claims filing deadlines that are inconsistent with the law (see "Unfair Payment Practice: Timely Filing Denials") Financial incentives to deny, reduce, limit ...

CMA to host webinar on AB 72 out-of-network billing

In September 2016, Governor Jerry Brown signed a controversial bill, Assembly Bill 72, into law. This bill will change the billing practices of non-participating physicians providing non-emergent care at in-network hospitals, ambulatory surgery centers and laboratories. The October 19 webinar will present an overview of the new law, and will help physicians understand the circumstances under which the bill applies, how physicians can continue to charge their usual and customary rates, and how the bill provides an opportunity to improve network adequacy standards. Presented by Janus Norman, California Medical Association (CMA) ...