U.S. District Court blocks Anthem-Cigna merger A federal judge has blocked the $48 billion mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). The ruling favored the U.S. Department of Justice (DOJ) and 11 states, including California, who argued that the Anthem-Cigna merger would limit price competition and lower the quality of care that Americans receive. “The California Medical Association (CMA) has opposed the Anthem-Cigna mega-merger since day one because it would hurt patients and increase health care costs,” said CMA President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract ... March 2, 2017 Managed Care Anthem Blue Cross, Cigna 0 0 Comment Read More »
Large insurers drop barriers to prescribing medications for opioid use disorder Three of the nation's largest insurers—Aetna, Cigna, and Anthem Blue Cross—have in recent months announced that they will no longer require physicians to seek prior approval before prescribing medication to treat opioid use disorder. These policy changes come as more than 2.2 million people meet the diagnostic criteria for an opioid use disorder. Treatment of opioid use disorder with opioid maintenance therapies has been shown to be cost-effective, safe and successful when used appropriately. Increasing access to treatment is crucial to addressing opioid misuse and overdose, and the California Medical Association ... March 2, 2017 General Aetna, Anthem Blue Cross, Cigna, Opioids, Preauthorization 0 0 Comment Read More »
ACIP publishes new vaccination schedules for children, adolescents and adults On February 1, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) published updated immunization schedules for children, adolescents and adults. The 2017 child and adolescent immunization schedule includes several updates including influenza, human papillomavirus (HPV), hepatitis B, Haemophilus influenzae type B (Hib), pneumococcal, meningococcal and diphtheria and tetanus toxoids and acellular pertussis vaccines (DTap). Changes to the 2017 adult immunization schedule include new or revised recommendations for influenza, human papillomavirus, hepatitis B, and meningococcal vaccines. The new schedule was published online, in the Annals of ... March 2, 2017 General Public Health, Vaccination, Immunization 0 0 Comment Read More »
2017 Medicare EHR payment adjustment reconsideration forms due February 28 Eligible physicians who have been identified as being subject to Medicare electronic health record (EHR) payment penalties in 2017 (based on the 2015 reporting period), and believe that determination to be in error, have until February 28, 2017, to submit a reconsideration form to the Centers for Medicare and Medicaid Services (CMS). The reconsideration form can be downloaded from the CMS website. For reconsideration instructions, click here. If you have questions about the reconsideration process, please email pareconsideration@provider-resources.com. For more information on payment adjustments and hardship applications, or for information ... February 23, 2017 Medicare CMS, EHR, Electronic Health Record, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMA shares tools and resources on diabetes prevention The California Medical Association (CMA) has developed a resource page to share tools and resources on diabetes prevention and to help providers connect their patients with diabetes prevention programs recognized by the Centers for Disease Control and Prevention (CDC). CMA’s resource page shares information on the AMA’s Prevent Diabetes STAT toolkit, which providers and care teams can use to identify patients with prediabetes and refer eligible patients to evidence-based diabetes prevention programs approved by the CDC’s National Diabetes Prevention Program. CMA will continue to update this page, highlighting existing programs ... February 23, 2017 General Diabetes, Public Health 0 0 Comment Read More »
Self-assessment: How burnt out are YOU? The American Medical Association's "Preventing Physician Burnout" module has a quick 10-question survey to help physicians determine their workplace stress levels and how they measure up against other physicians. After completing the survey, you will see your results compared to others in your region and in your specialty. The survey is part of AMA's STEPS Forward™ collection, which includes 43 free interactive educational modules aimed at helping physicians redesign their medical practices to minimize stress and reignite professional fulfillment in their work. Continuing medical education credit can be earned from ... February 13, 2017 General Physician Burnout 0 0 Comment Read More »
Are you exempt from ICD-10 PQRS penalties in 2016? On October 1, 2016, new ICD-10 code sets went into effect that will impact the ability of the Centers for Medicare and Medicaid Services (CMS) to process data reported on certain quality measures for the fourth quarter of 2016. Because of this, CMS announced that it will waive 2017 or 2018 Physician Quality Reporting System (PQRS) payment adjustments, if applicable, for any physician or group practice that fails to satisfactorily report for 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for ... February 13, 2017 General CMS, Centers for Medicare and Medicaid Services, ICD-10, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
CMS erroneously warns some physicians of 2017 meaningful use penalties Providers who attested to meaningful use with the Medi-Cal Electronic Health Record (EHR) Incentive Program for program year 2015 are exempt from Medicare payment adjustments in 2017. Because the California Department of Health Services pushed back the deadline to submit meaningful use applications for the 2015 program year to December 13, 2016, the agency was not able to send information to the Centers for Medicare and Medicaid Services (CMS) regarding 2015 Medi-Cal meaningful use attestations until late in December 2016. For this reason, some Medi-Cal providers are now erroneously ... February 13, 2017 Medi-Cal, Medicare Department of Health Care Services, EHR, Meaningful Use, Medi-Cal, Medicare, CMS 0 0 Comment Read More »
Leading health care groups deeply concerned that Governor's budget proposal may decimate access to care In his 2017-18 budget proposal, Governor Jerry Brown eliminates $33.4 million in health care workforce funding that would begin addressing the primary care workforce crisis that is gripping California’s underserved communities. This is the first year of a three-year $100 million investment. The budget investment came at the urging of a broad coalition of statewide healthcare organizations including the California Academy of Family Physicians (CAFP), CaliforniaHealth+ Advocates, and the California Medical Association (CMA), who recognized that access to care challenges must be systemically and comprehensively addressed. “While our organizations recognize ... February 13, 2017 General California State Budget, Medi-Cal, State Legislative Advocacy 0 0 Comment Read More »
Survey shows a correlation between ethnicity, gender and burnout in nation's physicians The 2017 Medscape Lifestyle Report has found a correlation between ethnicity, gender and burnout among the nation’s physicians. The survey of more than 14,000 physicians from over 30 specialties found an association between ethnicity and burnout. Asian Indian physicians reported the lowest level of burnout at 46 percent, with Chinese physicians reporting the highest level at 56 percent. Fifty-two percent of Caucasian physicians and 51 percent of Hispanic/Latino physicians reported burnout, with black physicians slightly less burned out at 48 percent. There was also a higher percentage of female physicians reporting ... February 13, 2017 General Physician Well-Being, Physician Wellness, Physician Burnout 0 0 Comment Read More »
