Medicare Transition Update: Noridian adds additional Meet and Greet Workshops At the request of the California Medical Association (CMA) and other organizations in California, Noridian has added seven additional Meet and Greet Workshops throughout the state. Transition of the Medicare Administrative Contract from Palmetto GBA to Noridian is scheduled for September 16, 2013 (Part B). Following is the list of locations in California: July 9-11 ... July 9, 2013 Medicare Medicare, Noridian 0 0 Comment Read More »
Extra! Extra! Read all about it! New Medicare transition webpage available As the California Medical Association (CMA) has previously reported, administration of the Medicare contract will change to Noridian Healthcare Solutions effective September 16, 2013 (Part B). In response to this important change, CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access the most recent updates and important information regarding the transition in one easy-to-access to location. July 9, 2013 Medicare Noridian, Medicare 0 0 Comment Read More »
Attestation for Medi-Cal primary care rate increase to begin in July The Centers for Medicare & Medicaid Services (CMS) released regulations in early November 2012 implementing rate increases for primary care physicians who treat Medicaid patients. The goal of the increase is to recruit more physicians to treat low-income patients who will be newly eligible for health coverage under the Affordable Care Act (ACA). Under the ACA, primary care physicians will see their reimbursement rates raised to Medicare levels in 2013 and 2014. According to CMS, states must also incorporate the increased payment rates into their contracts with managed care ... July 9, 2013 Medi-Cal ACA, Affordable Care Act, Centers for Medicare & Medicaid Services, CMS, Medi-Cal 0 0 Comment Read More »
Next phase of Healthy Families to Medi-Cal transition scheduled for August 1 Phase 3 of the Healthy Families transition from fee-for-service to Medi-Cal managed care is scheduled for August 1, 2013. This phase will impact approximately 107,000 children who have a Healthy Families plan that does not offer Medi-Cal managed care or subcontract with a Medi-Cal managed care plan, thus requiring them to transition to a new plan. This is the first phase of the Healthy Families transition where patients may be required to change physicians. Enrollment will include consideration of the child’s primary care providers. Affected counties are: ... July 9, 2013 Managed Care, Medi-Cal Managed Care, Medi-Cal, Healthy Families 0 0 Comment Read More »
Update your NPI information before the Medicare transition to Noridian According to a new report by the U.S. Department of Health & Human Services Office of the Inspector General, 58 percent of the databases used to determine provider identities and help to prevent the occurrence of fraud are inaccurate or incomplete. The National Plan and Provider Enumeration System (NPPES), which houses National Provider Identifier (NPI) numbers, is not always consistent with information in the Provider Enrollment, Chain and Ownership System (PECOS). The national revalidation effort by the Centers for Medicare & Medicaid Services (CMS) is a big step in improving ... July 9, 2013 Medicare Medicare, NPI, Noridian 0 0 Comment Read More »
AMA's new "administrative burden index" ranks cost of doing business with commercial insurers The American Medical Association (AMA) recently unveiled its new Administrative Burden Index (ABI), which ranks commercial health insurers according to the level of unnecessary cost they contribute to the billing and payment of medical claims. The ABI reflects the overhead cost needed to bill and collect payment from each major payer and was introduced as part of AMA's annual National Health Insurer Report Card. AMA found that administrative tasks associated with avoidable errors, inefficiency and waste in the medical claims process resulted in an average ABI cost per claim of ... July 8, 2013 General Billing and Coding, AMA, Insurance/Reimbursement, Practice Management 0 0 Comment Read More »
Budget deal jump starts special session bills Almost six months have passed since Gov. Jerry Brown opened a special session on health care reform in California, and members of the state Legislature are now beginning to tie up the final loose ends. Of the three sets of bills put forward under the special session’s parameters, all but one appeared to be stalled indefinitely until members of the Legislature reached a budget deal. These bills, which outlined California’s plans to expand the Medi-Cal program and establish a so-called "bridge plan" between Medi-Cal and exchange plans, were sprung from ... July 8, 2013 Medi-Cal Health Insurance Exchange, Affordable Care Act, Health Care Reform, Medi-Cal 0 0 Comment Read More »
Physicians are encouraged to check Covered California's provider database in July As previously reported, there remain some uncertainties around the process of physician contracting with exchange plans. Beginning sometime in July, the exchange should alleviate much of the uncertainty as to who is and is not considered to be an exchange provider. This is because Covered California will be unveiling a centralized online provider database for the first time in July. Using this database, exchange patients will be able to see which providers are included in the respective exchange plans’ networks. This centralized database will also be utilized by the exchange’s eligibility ... July 8, 2013 Managed Care Health Care Reform, Health Insurance Exchange, Affordable Care Act, Covered California 0 0 Comment Read More »
Highlights from AMA's 2013 House of Delegates The California delegation to the American Medical Association’s (AMA) House of Delegates presented a number of important resolutions at the AMA annual meeting in Chicago. The following are summaries of some of the California resolutions that the AMA House of Delegates adopted as policy. 1. Health Risks of Sitting (Res. 413): The delegates adopted a resolution that asks AMA to recognize that there are potential risks of prolonged sitting and encourage efforts by employers, employees and others to make available alternatives such as standing work stations and isometric balls, and ... June 27, 2013 General AMA, American Medical Association, House of Delegates 0 0 Comment Read More »
Scope of practice bills to be heard on July 2, urge your legislator to OPPOSE these bills The California Medical Association (CMA) is urging physicians to contact legislators and ask for NO votes on SB 491, SB 492 and SB 493. These three bills will expand scope of practice of nonphysician practitioners and remove necessary physician supervision, ultimate harming patients and decreasing quality of care. These bills may be heard in the Assembly Business, Professions and Consumer Protection Committee as early as July 2. Senate Bill 491 (Hernandez) would allow nurse practitioners to open practices without any oversight from a trained medical doctor and prescribe dangerous, addictive ... June 27, 2013 General Advocacy, Scope of Practice 0 0 Comment Read More »
