CMA files a petition with the Supreme Court to block the 10 percent physician reimbursement cut The California Medical Association (CMA) filed a petition today asking the United States Supreme Court to review the Ninth Circuit Court of Appeals ruling that cleared the way for the State of California to implement a 10 percent cut to Medi-Cal provider reimbursement rates. Federal law requires that Medi-Cal patients have the same access to physicians and other health care providers as the general insured public. Despite this law, a three judge panel of the Ninth Circuit ruled that the state could move forward with the rate cuts, passed by ... September 20, 2013 Medi-Cal Advocacy, Medi-Cal, Medi-Cal Cuts, United States Supreme Court, Access to Care, Medi-Cal Lawsuit 0 0 Comment Read More »
Reminder: Changes to Anthem Blue Cross reimbursement policies and claims software become effective November 1 In late July, Anthem Blue Cross sent physicians a notice advising of upcoming changes to the insurer’s reimbursement policies and claims editing software called ClaimsXten. The changes will go into effect on November 1, 2013. Because of these changes, physicians may notice a difference in how certain codes and code pairs are adjudicated. Along with the notice, Anthem provided a comprehensive grid outlining all new, revised and existing reimbursement policies and claims editing rules as well as copies of Anthem’s reimbursement policies. Changes include: denial of 3D rendering CPT codes 76376 ... September 20, 2013 General Anthem Blue Cross, Managed Care, Insurance/Reimbursement 0 0 Comment Read More »
PQRS administrative claims-based reporting deadline is October 15 Physicians who do not successfully participate in the Physician Quality Reporting System (PQRS) this year will be subject to PQRS payment penalties starting in 2015. PQRS is a Centers for Medicare and Medicaid Services (CMS) quality reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals. Physicians who do not report on at least one individual measure in 2013 or elect to participate in the administrative claims reporting option will receive a 1.5 percent payment penalty in 2015. The penalty ... September 20, 2013 General Medicare, Physicians Quality Reporting System, PQRS, Centers for Medicare and Medicaid Services, Insurance/Reimbursement 0 0 Comment Read More »
CMS launches new online ICD-10 implementation guide The Centers for Medicare & Medicaid Services (CMS) recently launched an online ICD-10 implementation guide to help practices of all sizes successfully make the switch to the new ICD-10 coding system, which is used to report medical diagnoses and inpatient procedures. Physicians and payors must begin using the new code sets by October 1, 2014. ICD-10 (The International Classification of Disease tenth revision) is a system of coding created in 1992 as the successor to the previous ICD-9 system. ICD-10 will include new procedures and diagnoses, which the U.S. Department ... September 20, 2013 General CMS, ICD-10, Practice Management 0 0 Comment Read More »
MICRA Update: Victory in the Capitol but the fight goes on California’s legislative session officially wrapped up last week, and because of aggressive advocacy by the California Medical Association (CMA) and action taken by thousands of California physicians, a bill to scuttle the state’s Medical Injury Compensation Reform Act (MICRA) was never introduced. Despite weeks of pandering to members of the Legislature, California’s trial lawyers, along with their front group Consumer Watchdog, were unable to find enough legislators to vote for their greedy and misguided effort at lifting MICRA’s historic protections for their own financial gain. A majority of the Legislature ... September 20, 2013 General Advocacy, Malpractice Insurance, MICRA, Professional Liability 0 0 Comment Read More »
Press - Package of bills to increase number of physicians in rural, underserved areas signed by Governor Brown Sacramento – Two bills that would put more physicians in rural and underserved parts of California were signed by Governor Jerry Brown. SB 21 and AB 1288 were both sponsored by the California Medical Association (CMA). The 2013-14 state budget included a $15 million annual appropriation to fully fund the University of California Riverside School of Medicine (UCR SOM). The Inland Empire, including Riverside and San Bernardino Counties, is experiencing the lowest supply of physicians per capital than any other region of the state. Allocating a continuous funding source for ... September 11, 2013 General Advocacy 0 0 Comment Read More »
Legislature passes CURES bill The California Assembly has unanimously passed a bill (SB 809) that will provide $9 million annually to upgrade and maintain the Controlled Substances and Utilization Review and Evaluation System (CURES). CURES is an online database that allows authorized users, including physicians, pharmacists, law enforcement and regulatory boards, to access information about a patient’s controlled substance prescription history. The bill now heads to the governor’s desk. The California Medical Association (CMA) changed its position on the bill from neutral to support after negotiating significant amendments to the bill that will make ... September 11, 2013 General Advocacy, CURES, Drug Prescribing, Prescription Drug Monitoring Program (PDMP), Public Health 0 0 Comment Read More »
Governor signs CMA-sponsored bill to expedite physician licensure for practice in underserved areas Governor Jerry Brown has signed a bill (AB 1288) sponsored by the California Medical Association (CMA) that requires priority review status be given to the license applications of physicians who can demonstrate that they intend to practice in a medically-underserved area or serve a medically-underserved population. With California facing an uneven disbursement of physicians, increasing the physician pipeline to those areas to ensure delivery of safe, quality medical care will be crucial to the health of those communities. “We need more physicians in rural and underserved areas of California,” said Paul ... September 11, 2013 General Licensure, Medical Board of California, Underserved Communities, Professional Development and Licensure 0 0 Comment Read More »
Trial attorneys re-file anti-MICRA ballot initiative On August 30, the trial attorneys re-filed their proposed anti-MICRA ballot initiative with the Attorney General’s Office, a political maneuver that will buy them more time as they attempt to navigate around the organized opposition to the proposal. The revised initiative was filed only hours before the start of the long Labor Day weekend, an obvious attempt at keeping their proposal off the public’s radar as best they could. Despite the revisions, the central focus of this proposed initiative remains to be to more than quadruple California's current $250,000 cap ... September 10, 2013 General Medical Malpractice, MICRA, Professional Liability 0 0 Comment Read More »
CMA opposes bill that lowers standard of proof for physician discipline California legislators are currently considering a bill, SB 670 (Steinberg), that would increase the likelihood that limitations will be erroneously placed on a physician’s ability to practice. SB 670 allows the Medical Board of California to use a significantly lower standard of proof – "probable cause" instead of the more reliable "clear and convincing evidence" – to determine if a physician's prescribing of controlled substance is a danger to patients and the public. This reduces the level of evidence needed to justify placing a serious limitation on the physician’s ... September 10, 2013 General Drug Prescribing, Medical Board of California, Advocacy, Professional Development and Licensure 0 0 Comment Read More »
