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"News You Can Use" <> December 18



Executive Director Comment: There are two parallel tracks to address the upcoming 24% cut in Medicare rates from the (un)Sustainable (non) Growth Rate (SGR) Medicare cost-of-living formula (today postponed from January 1 to April 1). NEITHER track obviates the 2% cut stipulated by sequestration — no, the Ryan/Murray deal did not correct that!

  • Track #1 — A Permanent SGR Fix: House and Senate committees have passed bills, but they won’t be considered until after the new year. Click here to see a summary.
  • Track #2 — A 3-month Patch to Allow Time for Track #1 to Succeed: Congress has adopted a 0.5% update to Medicare payments for three months and postponed the 24% cut till April 1, following a bipartisan vote of 64 to 36 in the U.S. Senate Wednesday afternoon. The president is expected to sign the legislation Friday. It is the first positive update since 2010.

California Finally Pays Primary Care Physicians (who have attested to eligibility) the Affordable Care Act-mandated 2013 Medi-Cal Bump to Medicare: Click Here for Further Details

Executive Director Note: The increased payments are NOT automatic! To qualify for the increased payments, providers must first attest to their eligibility. See the link above for details.

Trying to Figure out Life After Residency? Clueless on lawyers and accountants and insurance and investing and job interviews and etc …? Then Attend SDCMS’ free “Preparing to Launch” Workshop on Saturday, February 1: Click here for details. Contact Jen to register at (858) 300-2781 or at JOhmstede@SDCMS.org.

Webinar on Covered California and What to Tell Your Patients Regarding Health Insurance Coverage: Thursday, December 19, 12:00pm to 1:00pm, for physicians and their office staff. Click Here to Register

Practice Managers / Office Managers: Please Take the 2013 SDCMS Medical Office Salary Survey! Takes 5 minutes, it’s anonymous, and anyone who completes the survey will receive a copy of the results. Click Here to Take the Survey Now


CMA Summary of New 2014 Healthcare Laws: Click Here for Details

Democrats’ Budget Framework Includes the Restoration of 10% Medi-Cal Cuts: Plan doesn’t specify how much money it would restore to the program, saying it would be a “phase in” of higher provider rates. Click Here for Further Details

Executive Director Comment: CMA held the governor’s proposed 10% Medi-Cal cuts at bay for almost 5 years, but the Supreme Court finally allowed Secretary Sibelius to waive rules for California. When the 10% cut (with retroactive clawback) kicks in (absent action by the California Legislature), and California's physicians see a large influx of newly insured Medi-Cal patients with the Affordable Care Act, Medi-Cal access issues will be significantly exacerbated — after all, how much lower can Medi-Cal rates get than 49th in the nation?

CMA Medi-Cal Survival Guide Takes the Guesswork out of Understanding Numerous Program Changes: Click Here for Further Details

Low Income Health Plan Transition Begins January 1: As part of a multi-faceted Medi-Cal expansion, the California Department of Health Care Services (DHCS) will be transitioning roughly 600,000 enrollees with incomes at or below 133% of the federal poverty level from the Low Income Health Program (LIHP) to Medi-Cal managed care effective January 1, 2014. Physicians should be aware that in order to be reimbursed for non-emergent services provided to patients who transition to a Medi-Cal managed care plan, they must be contracted with the plan for the Medi-Cal product. Physicians who treat LIHP patients should watch “General Provider Training for the LIHP Transition,” which focuses on provider-specific guidance regarding changes to existing processes. For more information on the LIHP transition, see the DHCS’s LIHP transition webpage. Click Here for Further Details

New Workers’ Compensation RBRVS Physician Fee Schedule Effective January 1, 2014: Members Can Click Here for Further Details


Would You Like Covered California Consumer Materials for Your Office Waiting Room? Call (858) 300-2789

Covered California Deadline Extended, Resources Added: In order to have coverage go into effect on January 1, 2014, patients must now complete their enrollment by December 23, 2013. Physicians interested in purchasing health insurance for employees through SHOP can use the new self-service website for coverage effective January 1, 2014. For more information, visit http://www.coveredca.com, or for in-office presentations for you and your staff, email Victor.Bloomberg@SDCMS.org.

Webinar on Covered California and What to Tell Your Patients Regarding Health Insurance Coverage: Thursday, December 19, 12:00pm to 1:00pm, for physicians and their office staff. Click Here to Register

CMA Updates Exchange Toolkit to Reflect Key Developments: Click Here for Details


CMS Delays Stage 3 Reporting Requirements for Meaningful Use Until 2017: Click Here for Details

Voluntary Submission of the New CMS 1500 Claim Form Begins in January: Practices are encouraged to contact their software vendors on their readiness to ensure the practice has time to work through any issues before the mandated date of use in April. Click Here for Further Details

CMS Publishes 2014 Medicare Fee Schedule: Most provisions take effect January 1, 2014, although a few issues are open for public comment by January 27, 2014. Click here for further information, including key points.


Ask Your SDCMS Physician Advocate, Marisol Gonzalez: 

Member Question: Next week, I have an appointment with a patient who is deaf. The mother of the patient is requesting a sign language interpreter. With my other established deaf patients, I communicate with them in writing, and they are OK with this method of communication. Is it OK if I use this method instead of an ASL interpreter?

Answer: It depends. According to CMA’s ON-CALL document, "Sign Language Interpreters," in many situations a physician may be able to effectively communicate with a patient through the use of a notepad. The effectiveness of a notepad as a communicative tool will depend on: (1) whether or not the physician and patient have a longstanding relationship and good rapport; (2) the nature of the services the patient is receiving, e.g., a routine annual exam or a potentially serious invasive procedure; (3) whether the patient has received similar services in the past and has already received detailed information from the physician about the proposed procedure; and (4) the patient’s ability to read and respond effectively in writing. If the patient still insists on having an ASL interpreter, you will need to provide one at the time of the appointment.

Contact Marisol: SDCMS member physicians are invited to contact Marisol with their practice management questions at (858) 300-2783 or at MGonzalez@SDCMS.org.

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“Happy are all free peoples, too strong to be dispossessed. But blessed are those among nations who dare to be strong for the rest!” — Elizabeth Barrett Browning, English Poet (1806–1861)

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