CMS warns of fraudulent DME suppliers The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG). According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies. These marketing schemes by DME suppliers can include: •Unsolicited orders for medical equipment or supplies, often with wording ... January 31, 2014 General Centers for Medicare and Medicaid Services, CMS, Fraud and Abuse, Quality of Care 0 0 Comment Read More »
Senate pro Tem considering MICRA legislation As both sides inch closer to a seemingly inevitable ballot war over California’s Medical Injury Compensation Reform Act (MICRA), a key figure in the legislature may be looking to step in before voters can weigh in on the issue. Earlier this month, Darrell Steinberg, president pro tem of the Senate, said that he was “thinking” about carrying a MICRA-related bill during the 2014 cycle. While Steinberg has previously stated that he wanted to see negotiations take place to avoid a costly ballot war between trial lawyers and physicians, the ... January 27, 2014 General Medical Liability, MICRA, Professional Liability 0 0 Comment Read More »
Professionalism courses for physicians and pharmacists coming in February The Institute for Medical Quality (IMQ) Professionalism Program for Physicians has been scheduled for February 22-23 at the DoubleTree Hotel LAX-El Segundo in Los Angeles. This program addresses both the legal and ethical dimensions of the practice of medicine in California, and introduces participants to a range of resources to address present or future problems. The course consists of a pre-course assessment, a two-day ethics course and a series of longitudinal assessments to track participants’ progress. To ensure interactive learning, each program is limited to 12 participants. IMQ is also offering ... January 27, 2014 General IMG, Institute for Medical Quality, Education and Events 0 0 Comment Read More »
CMA develops simple tool to identify physician participation status in exchange plans On January 1, 2014, Covered California began providing health coverage to more 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted. Even if you did not intentionally contract with any exchange ... January 27, 2014 General Covered California, Health Benefit Exchange, Insurance/Reimbursement, Health Care Reform 0 0 Comment Read More »
CMS to conduct ICD-10 testing in March On October 1, 2014, 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) has announced a limited national testing week for current direct submitters (providers and clearinghouses) from March 3 - 7, 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 ... January 27, 2014 General CMS, ICD-10, Insurance/Reimbursement 0 0 Comment Read More »
Legislative Leadership Conference coming April 22 Mark your 2014 calendars now for the 40th annual California Medical Association (CMA) Legislative Leadership Conference. The conference will take place at the Sheraton Grand Hotel in Sacramento, just three blocks from the State Capitol and across the street from CMA headquarters. This is a unique event for California physicians and is free of charge to all CMA members. Plan to join more than 400 physicians, medical students and CMA Alliance members who will be coming to Sacramento to lobby their legislative leaders as champions for medicine and their patients. Prior ... January 27, 2014 General Legislative Leadership Day, State Legislation, Advocacy 0 0 Comment Read More »
Stepping up to leadership conference in San Diego Looking to escape the cold this winter? Don’t miss earlybird pricing for the Stepping Up to Leadership conference in sunny San Diego—these special rates expire January 31! The Stepping Up to Leadership program offered by the Institute for Medical Quality and the PACE Program at UC San Diego trains medical staff leaders in issues of communication, problem-solving, and improving outcomes for patients and staff. Stepping Up to Leadership offers unique hands-on and interactive learning opportunities, excellent faculty, and course work on effective staff leadership, credentialing and privileging, assessing the ... January 15, 2014 General Events, Leadership 0 0 Comment Read More »
Making sense of Medicare payment changes With the new 2014 fee schedule, the temporary halt to the sustainable growth rate (SGR) cut and an interim .5 percent payment increase, Medicare physicians are understandably confused about what impact these changes will have on their practices. Below is a quick summary of the various Medicare payment changes facing physicians in 2014: 2014 Fee Schedule: While the 2014 Medicare fee schedule contains a 3.7 percent conversion factor increase, the overall fee schedule is budget neutral due to myriad relative value unit (RVU) changes. These changes will impact providers differently ... January 14, 2014 Medicare Medicare, Insurance/Reimbursement 0 0 Comment Read More »
Medical board will collect CURES fees beginning April 1 The Medical Board of California announced it will soon begin collecting an additional $6 per year on physician license applications and renewals to fund the Controlled Substance Utilization Review and Evaluation System (CURES). The fees, authorized by SB 809, provide funding for ongoing maintenance and staffing of CURES. Physicians can expect to see an additional $12 ($6 per year) added to their licensing fees beginning April 1, 2014. CURES is an online database that allows authorized users, including physicians, pharmacists, law enforcement and regulatory boards, to access information about a ... January 14, 2014 General CURES, Medical Board of California, Quality of Care 0 0 Comment Read More »
CMA fights to protect patient privacy in CURES prescription database The California Medical Association (CMA) has filed an amicus brief with the California Court of Appeal in Alwin Lewis, M.D. v. Superior Court of the State of California, asking the court to give meaningful privacy protection to patient data collected in the Controlled Substance and Utilization Review and Evaluation Systems (CURES) database. In this case, a Medical Board of California investigator testified that the board routinely obtains confidential prescribing records from CURES for all patients of physicians subject to medical board investigations, even where the complaint is unrelated to the ... January 14, 2014 General CURES, Legal Advocacy, Privacy, Advocacy, Amicus Briefs 0 0 Comment Read More »
