Verifying your patients' eligibility and benefits in 2015 may save your practice thousands of dollars With the new year soon upon us, physicians are urged to be diligent in verifying patients' eligibility and benefits to ensure that you will be paid for services rendered. The beginning of a new year means calendar year deductibles and visit frequency limitations start over. With open enrollment there may also be changes to patients’ benefit plans, or they may even be insured through a new payor. The new year also brings a host of other challenges that could affect your ability to be paid: Medicare patients ... January 6, 2015 General Practice Management, Insurance/Reimbursement 0 0 Comment Read More »
CMS to hold Medicare claims for first two weeks of January Last week the Centers for Medicare and Medicaid Services (CMS) announced it would hold claims for services paid under the 2015 Medicare physician fee schedule due to technical errors discovered after the new fee schedule was published. Medicare Administrative Contractors (MACs) will hold claims containing 2015 services for the first 14 calendar days of January 2015 (Thursday January 1 through Wednesday January 14) to allow time for CMS to correct the errors. The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are ... January 6, 2015 Medicare Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMA Capitol Insight: Jan. 5, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature .-------------------------------------------------------------------------------- Hot Button Health Care As lawmakers return to Sacramento this week, much is still to be decided about the future of health care reform. State legislators will deal with a number of hot-button issues in the first half of 2015, many of which will have dramatic impacts on California’s health care policy and potentially the future success of the Affordable Care Act. It all begins on Monday when Gov. Jerry Brown ... January 6, 2015 General CMA Capitol Insight, Health Care Reform, Advocacy, Anthony York 0 0 Comment Read More »
2015 antibiotic awareness toolkit now available; download the new mobile app The Alliance Working for Antibiotic Resistance Education (AWARE) is a long-term project of the California Medical Association (CMA) Foundation, funded by the Centers for Disease Control and Prevention (CDC) through the California Department of Public Health (CDPH). Working with participating health plan partners, the CMA Foundation is able to identify high prescribers of antibiotics and provide targeted education. The 2015 AWARE Provider Toolkit was recently mailed to roughly 30,000 physician high prescribers. Since its inception, AWARE’s goals have aimed to: Increase appropriate prescribing of antibiotics; ... January 6, 2015 General , AWARE, Antiobiotic Resistance 0 0 Comment Read More »
U.S. Supreme Court to hear ACA subsidy case on March 4 The U.S. Supreme Court has scheduled oral arguments for March 4, 2015, in 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. If the subsidies are struck down, some 5.4 million Americans who signed up for ... January 6, 2015 General Affordable Care Act, Health Insurance Exchange, ACA, U.S. Supreme Court 0 0 Comment Read More »
California ACEP publishes safe prescribing handout for patients The California Medical Association has joined with the California Chapter of the American College of Emergency Physicians to promote a statewide safe prescribing program for patients seen in emergency departments or urgent care facilities. The hope is that this program – motivated by the desire to reduce prescription drug abuse and drug diversion – will lead to better patient care, safer prescribing and fewer unmet expectations. A key portion of this program is a handout that explains safe prescribing to patients, available in both English and Spanish: Also provided ... January 6, 2015 General Drug prescribing, Public Health, American College of Emergency Physicians 0 0 Comment Read More »
CMA creates new resource summarizing Medicare incentive and penalty programs Over the past few years, Congress has created a number of programs that call for payment incentives and reductions (referred to as “adjustments” by the Centers for Medicare and Medicaid Services) that impact physicians and their practices. At their inception, most of these programs offered an incentive to participate. However, most of the programs are entering their penalty phases, with complex and potentially conflicting requirements and implementation processes. To help physicians understand how these programs will affect their practices, the California Medical Association (CMA) has created a new resource, “Medicare ... December 18, 2014 Medicare Medicare, Incentive Programs 0 0 Comment Read More »
Congress passes a number of health care provisions in the current budget Congress narrowly passed a $1.1 trillion federal budget that will fund most of the federal government through September 2015. Below is a summary of key health care provisions in the bill. Within the bill, Congress expressed concern that there had not been adequate opportunity for public comment on bundling of surgical codes in the final rule of the Medicare Physician Fee Schedule. The budget bill says that the appropriate methodology has not been tested to ensure that patient care and patient access are not negatively impacted ... December 16, 2014 General, Medicare Advocacy, Federal Legislation, Medicare, Prescription Drugs, CDC, Ebola, Recovery Audit Contractor 0 0 Comment Read More »
CMA elects new chair and vice chair of its board of trustees On Sunday, December 7, 2014, the California Medical Association (CMA) Board of Trustees elected David H. Aizuss, M.D., as the new chair and Robert E. Wailes, M.D., as vice chair. Dr. Aizuss is a board certified ophthalmologist practicing in Los Angeles. Through the David H. Aizuss, M.D., Medical Corporation, and the Ophthalmology Associates of the Valley Medical Surgical Group, a partnership of medical corporations, Dr. Aizuss focuses exclusively on direct patient care. He also serves as an assistant clinical professor of Ophthalmology at the UCLA Geffen School of Medicine. Dr. Aizuss ... December 16, 2014 CMA House of Delegates, Physician Leadership, Board of Trustees 0 0 Comment Read More »
Lame duck session of Congress adjourns, leaving SGR reform until 2015 In the final hours of the lame duck session, Congress passed a $1.01 trillion spending bill that will keep most of the federal government funded through next September, but it failed to pass a fix for the Medicare sustainable growth rate (SGR). Congress will leave it to be addressed before the April 1 deadline next year, when physicians will be faced with a 21 percent payment cut. Unfortunately, Congress will begin anew with many new members who have not been a part of the bipartisan, bicameral SGR Repeal and Medicare ... December 16, 2014 Medicare SGR, Sustainable Growth Rate, Medicare, U.S. Congress 0 0 Comment Read More »
