Is your Medicare practice information up-to-date? The February issue of CMA Practice Resources (CPR) contained an article discussing the importance of maintaining up-to-date practice demographic information with contracted managed care payors (see “Ensure your practice information is up-to-date with contracted payors”). This advice applies equally to government payors, such as Medicare, that you are enrolled in. Medicare administrative contractors (MAC), such as Noridian in California, obtain practice contact information from a practice’s Medicare enrollment application, from either the Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or through a paper application. The MAC may contact ... March 17, 2015 Medicare Practice Resources, Medicare 0 0 Comment Read More »
DWC implements annual changes to workers' compensation physician fee schedule The California Division of Workers’ Compensation (DWC) has implemented its annual adjustments to the California workers’ compensation resource-based relative value scale (RBRVS) fee schedule effective for dates of service on or after March 1, 2015. Under the RBRVS Physician Fee Schedule regulations, located under “Physician services” on DWC’s Official Medical Fee Schedule (OMFS) webpage, the calculations to determine maximum allowable amounts for each code incorporate a number of factors, including the assigned relative value units for each code along with the yearly adjusted conversion factor determined by DWC. DWC ... March 17, 2015 General RBRVS, Resource Based Relative Value System, Workers' Compensation 0 0 Comment Read More »
DHCS identifies another glitch in issuing primary care rate increase for CHDP claims The California Department of Health Care Services (DHCS) has experienced various difficulties issuing the Affordable Care Act primary care rate increase funds on Child Health and Disability Prevention (CHDP) Program claims. Before the rate increases were implemented, some practices had been instructed by DHCS to bill CHDP claims at their Medi-Cal rates. This caused concern – based on DHCS’s pricing logic of paying the lesser of Medicare’s rate or the billed charges – that some practices would not qualify for the retroactive increases once the systems were updated to ... March 17, 2015 Medi-Cal, Medicare CHDP, Child Health and Disabilityh Prevention Program, Affordable Care Act, DHCS 0 0 Comment Read More »
Raising the smoking age to 21 could reduce tobacco use among next generation A report released today by the Institute of Medicine (IOM) said that raising the smoking age to 21 could reduce smoking by as much as 12 percent in the next generation. In addition, smoking-related deaths could be cut by nearly 10 percent. Tobacco use remains the leading cause of preventable death in this country. The U.S. Surgeon General estimates that 5.6 million youth alive today will lose their lives prematurely if we don’t do more to reduce current smoking rates. Roughly 90 percent of daily smokers first tried a cigarette before ... March 17, 2015 General Smoking Age, Tobacco, Institute of Medicine, Smoking 0 0 Comment Read More »
United Healthcare introduces Group Medicare Advantage PPO product Effective June 1, 2015, United Healthcare (UHC) will be introducing its Group Medicare Advantage PPO product in several southern California counties. The California Medical Association (CMA) has learned that contract amendments were mailed on February 24 to over 10,000 currently contracted UHC physician practices in Imperial, Orange, Los Angeles, Riverside, San Bernardino and San Diego counties that the payor intends on including in its provider network for this new product. The insurer states that the new product, offered exclusively to employer/union group retirees, will offer greater access to a national ... March 17, 2015 Medicare Contract Amendment, Payor Contracting, United Healthcare 0 0 Comment Read More »
Growing aging population will result in a shortage of 90,000 doctors by 2025 The U.S. could face a shortage of as many as 90,000 physicians because of a growing elderly population, according to a report published last week by the Association of American Medical Colleges (AAMC). The report also predicts that the greatest physician shortfall will be in the demand for surgeons who treat diseases in the elderly. The report says the growth in the insured population due to the Affordable Care Act will have little impact on the need for more physicians – just two percent of the projected growth in demand, ... March 17, 2015 General Physician Workforce, Residents and Fellows, Aging 0 0 Comment Read More »
We Care for California coalition introduces legislation to increase Medi-Cal rates to Medicare levels Senate Health Committee Chair Ed Hernandez and Assembly Health Committee Chair Rob Bonta joined health care providers, medical students, patients and advocates on the steps of the Capitol on Wednesday to introduce AB 366 and SB 243, legislation that would not only restore a 10 percent cut to Medi-Cal reimbursement rates, but would also place reimbursement on par with Medicare, increasing payments rates for inpatient hospital services and most outpatient services. The proposals would also require the Department of Health Care Services to pay Medi-Cal managed care plans at ... March 9, 2015 Medi-Cal, Medicare Medic-Cal Cuts, We Care for California, Legislative Advocacy, Medi-Cal 0 0 Comment Read More »
Physician groups urge CMS to create contingency plans for ICD-10 transition The California Medical Association (CMA), American Medical Association (AMA), and 98 other state and specialty societies urged the Centers for Medicare and Medicaid Services (CMS) to put contingency plans in place for the October transition from ICD-9 to ICD-10 to avoid possible failures that could result in significant disruptions for physicians and Medicare patients. Now that CMS and the chairmen of the three Congressional health committees have announced they will not support a further delay in the implementation of ICD-10, organized medicine has turned its attention to CMS to ... March 9, 2015 Medi-Cal, Medicare CMS, ICD-10, ICD-9, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS extends PQRS reporting deadline for some reporting methods The Centers for Medicare and Medicaid Services (CMS) has extended the submission deadlines for two Physician Quality Reporting System (PQRS) reporting methods from February 28 to March 20 at 8 p.m., EST. The two affected reporting methods are: Direct electronic health record (EHR) submission or submission via a vendor using certified EHR technology Qualified clinical data registry (using the QRDA III format) reporting for PQRS and the clinical quality measure component of meaningful use for the EHR Incentive Program Submission timeframes for other PQRS reporting ... March 9, 2015 Medi-Cal, Medicare EHR, Physician Quality Reporting System, PQRS, CMS, Meaningful Use 0 0 Comment Read More »
Brown appoints Napa public health officer to head CDPH Gov. Jerry Brown has appointed Karen Smith, M.D., a Napa County public health officer and deputy director of Napa County Health and Human Services for more than 10 years, to be head of the California Department of Public Health (CDPH). She will replace Ronald Chapman, M.D., who announced in December that he would resign as the department’s director. Dr. Smith earned her medical degree from Stanford University School of Medicine and master’s of public health degree from Johns Hopkins School of Hygiene and Public Health. She held positions at the ... March 9, 2015 General Public Health, Department of Public Health 0 0 Comment Read More »
