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Medicare transition is three weeks away

September 16, 2013, is the cutover date for transition of the Medicare Part B fee-for-service contractor from Palmetto GBA to Noridian. Although every effort has been made to minimize the burden to practices and to ensure that physicians continue to receive their Medicare payments in a timely fashion after the transition, physician practices will have to make some changes in their processes. Practices are encouraged to review the resources available to you to ensure you are aware of and prepared for the transition. Physician practices that submit their claims electronically, ...

MICRA: Haven't we all seen this before?

For nearly four decades California trial attorneys have been trying to rewrite the Medical Injury Compensation Reform Act (MICRA). By now, you’ve likely heard the main narrative spun by the trial lawyer-backed Consumer Watchdog and other MICRA opponents – 38 years is too long for a law such as MICRA to exist without being updated in some fashion. Oddly enough, Consumer Watchdog and others are quick to leave out the fact that the only time MICRA was successfully altered, trial lawyers agreed to back off in exchange for a bigger piece ...

MICRA Update: Crunch time in the Capitol

A little more than three weeks remain in the 2013 legislative session, which means both sides in the growing fight over California’s Medical Injury Compensation Reform Act (MICRA) are working hard to woo members of the state Assembly and Senate over to their side of the issue. In the days following the Legislature’s return from its summer recess, the California Medical Association (CMA) and other members of the Californians Allied for Patient Protection began blanketing legislative offices with letters of support for the historic patient and provider protections built into ...

Is your license renewing in September or October? Renew early to avoid delays with new online licensing system

The Medical Board of California is asking physicians that need to renew their medical licenses during September and October to do so early due to a planned disruption. According to the medical board, the Department of Consumer Affairs will transition to a new online licensing and enforcement system in mid-September 2013 and during this transition there could be disruptions in cashiering and other services. The disruption will affect both online and mail renewals. To avoid any possible lapse in licensure due to processing delays, physicians whose licenses are set to ...

Are you ready for the next HIPAA compliance deadline?

The Department of Health and Human Services (HHS) released new regulations in January 2013 that made important changes to the privacy and security requirements under the Health Insurance Portability and Accountability Act (HIPAA). These new regulations, known as the HIPAA Omnibus Rule, implement many of the provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Covered entities have until September 23 to comply with these changes. Physician offices will, at minimum, need to review and update their business associate agreements, office privacy and security policies and ...

Federal regulations bring delays to ACA milestones

Deadlines and milestones relating to the Affordable Care Act (ACA) are beginning to slide, as the federal government gets a better picture of how capable it will be of implementing the massive changes called for in the law. In July, the federal government announced that the penalty on employers for not providing employees health insurance would be delayed until 2015, while also scaling back income verification requirements that would have been used to determine subsidy levels for individuals purchasing coverage through the new insurance marketplaces. The income verification announcement, which came ...

CMA, CMA Foundation partner for exchange's provider education grant program

The California Medical Association (CMA) and the CMA Foundation have submitted a joint application to Covered California, the state’s health benefit exchange, for a portion of the $3 million set to be awarded as part of its provider education grant program. The program is expected to award grants to between three and six statewide organizations that will be responsible for educating health care providers about Covered California and how the exchange will operate come January 2014. CMA's application was submitted jointly with the Latino Physicians of California and the American ...

Plan departures leave questions for California policy holders

While much attention has been given to the successful signing of health plans participating in Covered California’s new online insurance marketplace, it’s worth noting that some major players in the state’s current insurance market are refusing to play ball. In June, both United Healthcare and Aetna announced that they would not be participating in California’s individual market following the end of 2013. In announcing their departures, both companies noted that only a small portion of their overall business was conducted in California, and given the coming changes promised through the ...

DHCS to implement 10 percent Medi-Cal cuts in January 2014

The Department of Health Care Services (DHCS) today announced that it would begin to implement the 10 percent Medi-Cal physician payment rate reduction on October 1, 2013, for Medi-Cal managed care and on January 9, 2014, for fee for service. DHCS also announced that it would be retroactively implementing the cuts for FFS providers to June 1, 2011, when the law authorizing the cuts went into effect. DHCS said it will recoup a percentage of provider payments to recover overpaid funds during the retroactive period. These retroactive payment recoveries will ...

State delays duals pilot project until April 1

The California Department of Health Care Services (DHCS) announced today that it would delay by three months implementation of the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than April 2014. The project was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state's ...