DHCS identifies glitch in UCR web app for CHDP primary care rate increase payments The California Department of Health Care Services (DHCS) has identified an error in its web application that was designed to allow physicians the ability to enter their usual and customary rates (UCR) for Child Health and Disability Prevention Program Services (CHDP) claims. Physicians who already entered their UCR data prior to November 26, 2014, will need to return to the portal and reenter their information. The web app was developed to address a problem with the Affordable Care Act primary care rate increase unique to CHDP providers. Before the rate increases ... December 9, 2014 Managed Care, Medi-Cal Medi-Cal, Pediatrics, Affordable Care Act, Department of Health Care Services 0 0 Comment Read More »
CMA passes five tobacco-related resolutions The California Medical Association (CMA) has been a tireless advocate for stronger restrictions on the tobacco industry for decades. This weekend, the CMA House of Delegates (HOD) continued that tradition, adopting five antismoking resolutions. The resolutions address increasing the legal age for tobacco sales, the use of electronic cigarettes and a tobacco-free military. Resolution 104-14 asks CMA to support the removal of the tobacco control pre-emption from the California Penal Code so that local governments would have the ability to increase the legal age of tobacco sales to 21. Resolutions 101-14, ... December 9, 2014 General Public Health, Tobacco, House of Delegates 0 0 Comment Read More »
CMA president sets sights on tort reform, burdensome regulations and membership growth The new president of the California Medical Association (CMA), Luther Cobb, M.D., spoke to the 500-member House of Delegates (HOD) in San Diego on Saturday saying that CMA must use the political capital it has ‘banked’ by recently defeating the trial lawyers’ Proposition 46 to further reshape the future of medical liability. “Now that the trial attorneys have so amply demonstrated the wrong way to do it, CMA can chart a course for meaningful and durable reform, that is fair to those truly injured by medical mishaps, while protecting the ... December 9, 2014 General House of Delegates, CMA Governance 0 0 Comment Read More »
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 ... November 17, 2014 General AMA, House of Delegates, American Medical Association 0 0 Comment Read More »
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 ... November 17, 2014 Medi-Cal, Medicare CMS, ICD-10, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
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 ... November 17, 2014 Managed Care Affordable Care Act, Health Insurance Exchange, ACA, Covered California 0 0 Comment Read More »
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" ... November 17, 2014 General CALPAC 0 0 Comment Read More »
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 ... November 17, 2014 Medi-Cal, Medicare , Fee Schedule, Medicare, Centers for Medicare and Medicaid Services, CMS 0 0 Comment Read More »
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 ... November 14, 2014 General Affordable Care Act, ACA 0 0 Comment Read More »
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 ... November 14, 2014 Medicare Medicare, Billing/Coding 0 0 Comment Read More »
