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Highlights from AMA's 2014 interim meeting

The nation’s physicians gathered at the 2014 American Medical Association (AMA) interim meeting in Dallas, Texas, this past week. The delegates debated a large number of resolutions, establishing new policies related to the worldwide Ebola epidemic, expanded network access for the Affordable Care Act and electronic health records. A number of these resolutions were put forward by the California delegation. Below are highlights of some of the resolutions adopted as policy. Ebola: Resolution 925 put forth by the California delegation was incorporated into AMA policy that calls on AMA to ...

CMS starts ICD-10 claims testing this week

On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) will be conducting a national testing week, from November 17 to 21, 2014. This testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. While participants will not be able to conduct true end-to-end testing at this ...

Physicians encouraged to familiarize themselves with exchange plan changes heading into Covered California open enrollment

Covered California began enrollment for its second year on November 15 and exchange officials are predicting a 45 percent jump in enrollment, from 1.2 million in 2014 to 1.7 million in 2015. Last year, open enrollment was a six-month process, this year it will be half as long, starting Nov. 15 and ending Feb. 15. In anticipation of this year's open enrollment, some payors have updated their exchange plan offerings for 2015, including plan types and plan names. The California Medical Association (CMA) will be publishing details of these changes ...

2014 election wrap up: Physician-friendly candidates win majority of their races

On Election Day, the California Medical Association (CMA) made history by resoundingly defeating the trial attorneys' attempt to overturn California's Medical Injury Compensation Reform Act (MICRA) protections. This was one of the most contentious and high-stakes ballot fights in California history. The voters sent a clear message: Californians simply don’t want to increase health care costs and reduce health access so trial attorneys can file more lawsuits. But the Election Night celebration was not limited to Prop. 46: CMA’s priority candidates also performed exceedingly well. CMA participated in "independent expenditure" ...

Medicare finalizes fee schedule changes for 2015

The Centers for Medicare and Medicaid Services (CMS) published its 2015 Medicare Physician Fee Schedule final rule Thursday in the Federal Register. The 1,200 word payment rule contains several notable changes. As earlier proposed, the rule expands the services eligible for telemedicine reimbursement and extends the new payment policies for non-face-to-face care coordination. It allows primary care physicians to be paid for care management of Medicare beneficiaries with two or more chronic conditions. These are tasks (including managing lab and imaging reports, medications and care plans in addition to talking ...

ACA meets goal of covering more Americans

A little over 10 million uninsured have gained health care coverage throughout the U.S., either through Medicaid or state and federal exchanges, since the Affordable Care Act (ACA) coverage expansion programs opened for enrollment last year, according to a new report from U.S. Department of Health And Human Services’ (HHS). According to the report, the uninsured rate among adults ages 18 to 64, as of June 2014, was 15.1 percent, down 5 percent from September 2013. The percentage of those with health coverage improved most among blacks and Latinos throughout the ...

Ask the Expert: Do I enter a qualifier in box 14 of the claim form if the patient has Medicare prime and a secondary insurance?

Recently a number of practices have inquired as to whether Medicare requires the three-digit qualifier to be populated in item/box 14 when submitting a claim. Item/box 14, Date of Current Illness, Injury, or Pregnancy (LMP), identifies the first date of onset of illness, the actual date of injury, or the last menstrual period (LMP) for pregnancy, and contains a field allowing one of two qualifiers to be entered. 431: Onset of Current Symptoms or Illness 484: Last Menstrual Period The Medicare Claims Processing ...

Counting down to ICD-10 implementation

With less than a year until the October 1, 2015, implementation date for ICD-10, physicians should be evaluating the readiness of their practices to transition to the new code set. The one-year delay in implementation came as a welcome reprieve for many physician practices that were struggling to meet the October 2014 deadline. The extent to which physician practices made positive use of the delay remains to be seen. ICD-10 (The International Classification of Disease tenth revision) is a system of coding created in 1992 as the successor to the ...

CMA names Luther Cobb, MD as 147th president

Sacramento – Humboldt County physician Luther Cobb, M.D. has been installed as the 147th President of the California Medical Association (CMA), taking the reins from Immediate Past President Richard Thorp, M.D. Dr. Cobb takes office on the heels of the momentous defeat of Proposition 46, a campaign in which doctors and health care providers across California rallied together to oppose the measure that ultimately failed 33-67 percent. “What a thrilling time to be assuming the role of CMA president,” said Dr. Cobb. “The health care community has stood tall ...

Supreme Court to hear ACA subsidy case

Last Friday, the U.S. Supreme Court unexpectedly said it will hear King v. Burwell—a case that questions whether premium subsidies can be provided under the Affordable Care Act (ACA) to individuals purchasing health insurance coverage on exchanges run by the federal government. The lawsuit has the potential to affect 36 states that use the federal health care exchange, but would not change the subsidies in states like California that run their own exchanges. The decision to hear the case comes just one week before the second exchange open enrollment ...