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Early bird deadline for the 2014 NEPO Leadership Summit is July 31

The California Medical Association Foundation and the Network of Ethnic Physician Organizations (NEPO) invite you to attend the 2014 NEPO Leadership Summit, September 19-21 at the new Riverside Conference Center. Register by the July 31 early bird deadline and save $150. The NEPO Summit is an opportunity for physicians, public health professionals and community leaders who work with underserved communities to learn about emerging health care policy issues, share best practices on how to reduce health disparities and increase access to health care services for the populations they serve. The ...

California among six states that pay the least for Medicaid beneficiaries, says GAO report

According to a report released this week by the U.S. Government Accountability Office (GAO), California is one of six states that spends less than $6,000 per Medicaid (Medi-Cal in California) enrollee per year. The other states include Illinois Alabama, Arkansas, Mississippi and Tennessee. In contrast the report found that eight states, including New York, spend at least $10,500 per beneficiary. The report also found that Medi-Cal fee-for-service pays on average 61 percent of what private insurers in the state pay for the same evaluation and management services, with Medi-Cal ...

CMA files brief with CA Supreme Court in case that could undermine MICRA's longstanding definition of professional negligence

The California Medical Association (CMA), together with other amici, has filed a brief with the California Supreme Court, urging reversal of an appellate court opinion that thwarts the long-standing definition of "professional negligence" in California's Medical Injury Compensation Reform Act (MICRA). The ruling, if allowed to stand as precedent for future cases, could be misused to undermine the goals of MICRA and adversely affect the entirety of the health care system and safety net in California. In this case, Flores vs. Presbyterian Intercommunity Hospital, a hospital inpatient sued for injuries ...

Employment Practices Liability Insurance (EPLI)

Many members think they have coverage for wrongful termination, harassment, discrimination claims by employees or patients (third party). However, most policies exclude coverage for these types of actions or only provide limited coverage (a contribution to defense costs). The San Bernardino County Medical Society sponsored Employment Practices Liability program includes a unique blend of risk management services and insurance specifically designed to assist physician groups in addressing these important employment issues. Among the features of the program are: Special First-Time Buyers program A Helpline ...

Blue Shield data breach affects California doctors

The Department of Managed Health Care (DMHC) has notified physicians of a data breach that disclosed the social security numbers as well as names, business addresses, telephone numbers, medical groups and practice areas of over 18,000 physicians who contract with Blue Shield of California. DMHC discovered that Blue Shield of California had inadvertently included physician social security numbers in public rosters provided to DMHC. These rosters are generally public documents and subject to disclosure under the Public Record Act (PRA). As a result, DMHC produced the rosters, including the social ...

Physicians can review Sunshine Act data starting today

The Centers for Medicare and Medicaid Services (CMS) announced that starting today physicians can complete part 2 of the registration process to review and dispute disclosures under the Physician Payments Sunshine Act. Physicians have 45 days to review and dispute their data (plus an additional 15 days to resolve disputes). The review and dispute process ends August 27, 2014. The information will be published publicly on September 30, 2014. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including ...

California Democratic Party to remain neutral on Prop. 46

Backers of Proposition 46, the MICRA lawsuit measure, were dealt another severe blow this weekend when, despite their intense lobbying, the Executive Board of the California Democratic Party rejected their efforts to gain an endorsement, instead voting to remain neutral. Over the course of the three-day meeting, Democratic Party leaders and activists who reviewed Prop. 46 found that, if the initiative were to pass, health care costs would go up, access to care would go down, community clinics would be harmed and personal privacy will be put at risk. Understanding its ...

CMS proposes to end Sunshine Act CME exclusion

The Centers for Medicare & Medicaid Services (CMS) has decided to eliminate the continuing medical education (CME) exclusion for the Physician Payments Sunshine Act. The news was included in the 2015 Medicare Physician Fee Schedule proposed rule. The Sunshine Act stems from a provision of the Patient Protection and Affordable Care Act. Under the Sunshine Act, 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. Any payments, ownership interests and other “transfers of ...

CMA, AMA and others urge CMS to delay new rules authorizing multi-hospital systems to establish system-wide medical staffs

The California Medical Association (CMA), the American Medical Association and dozens of other state and specialty medical associations have asked the Centers for Medicare & Medicaid Services (CMS) to delay for one year new Medicare rules that would allow multi-hospital systems to establish system-wide medical staffs. CMA commented extensively on this and prior iterations of this rulemaking expressing serious concerns about the proposed amendments to the CoPs and their impact on medical staff self-governance. CMA believes that medical staff self-governance is a vital part of a carefully crafted system designed ...

Change in mailing address for Medi-Cal TAR submissions

Effective for dates of service on or after July 1, 2014, all paper treatment authorization requests (TAR) currently being mailed to the Los Angeles Field Office and the Northern and Southern Pharmacy Sections should be mailed to the following address: West Sacramento TAR Processing Center 820 Stillwater Road West Sacramento, CA 95605-1630 Updated provider manual sections will be published in a future Medi-Cal Update.