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"News You Can Use" — July 25, 2013



<> Executive Director Comment: The MICRA Fight Is On! An initiative has been filed for the November 2014 election that seeks to change the MICRA non-economic damage limit to $1.2 million with a permanent annual cost-of-living adjustment. The State of California has roughly 6 weeks to create the background material and the precise wording of the initiative. Once the State has published "title and summary," and the initiative is qualified, then the collection of signatures commences. We will send out a special NYCU to provide you with all the material you will need to make the case for killing this initiative.

<> Attestation for Medi-Cal Primary Care Rate Increase to Begin in July: Click Here

<> Medi-Cal Primary Care Physician Rate Increase FAQs by CMA: Click Here

<> Executive Director Comment: There are three scope of practice issues that will be dealt with by the Assembly Business and Professions committee, on which sit Assemblymen Brian Maienschein (R) and Brian Jones (R) from San Diego. Please contact them to let them know that allowing nurse practitioners to practice unrestricted medicine without physician supervision is wrong for patients. Click Here to Read Scope Expansion Arguments for and Against

Contact Assemblymen Brian Maienschein:

  • San Diego: 12396 World Trade Drive, Suite #118, San Diego, CA 92128; Telephone: (858) 675-0077; Fax: (858) 675-0688
  • Sacramento: State Capitol, Sacramento, CA 94249; Telephone: (916) 319-2077; Fax: (916) 319-2177
  • Email (via website)

Contact Assemblymen Brian Jones:

  • Santee: 10152 Mission Gorge Rd., Santee, CA 92071; Telephone: (619) 441-2322; Fax: (619) 441-2327
  • Sacramento: State Capitol, Sacramento, CA 94249-0071; Telephone: (916) 319-2071; Fax: (916) 319-2171
  • Email (via website)

<> Covered California Pop Quiz:

  • Question: I am an on-call hospitalist (pathology, radiology, and anesthesia) who sees patients in the hospital on an emergent basis. What happens if I am not contracted with Covered California? How will I be reimbursed?
  • Answer: Click Here


<> Do You Know What You Need to Know About the Coordination Care Initiative, aka, CalMediConnect? If not, click here to register for this July 30 CalMediConnect educational webinar (5pm-6pm). This webinar will NOT be recorded or available for on-demand playback. Click here for information on the coordination care initiative.

<> Legislation That Allows Physicians to Employ PTs Approved by Committee: Click Here

<> Bill to Double J-1 Physician Visas in California From 30 to 60 Passes Key Congressional Committee: CMA's goal has been to double the number of positions to alleviate physician shortages and to improve access to care in California's underserved areas. Click Here

<> CMA's July 23 Legislative Hot List: Click Here


<> Are You Prepared for the September 16 Medicare Part B Transition From Palmetto to Noridian?

  • Are you taking advantage of the "early boarding" opportunity?
  • If you use a vendor to submit claims, do you need to take any action?
  • Are your NPI numbers updated in the National Plan and Provider Enumeration System (NPPES) and consistent with information in the Provider Enrollment, Chain, and Ownership System (PECOS)?
  • Have you signed up to attend a "Meet and Greet" workshop?

Click here for the answers to these questions and more. Click here for CMA's Medicare transition webpage.

<> Noridian "Ask-the-Contractor Teleconference" on August 21: 2:00pm (PST); call-in #: (800) 230-1059. No registration required. Click here for details, including how to submit a question prior to the ACT (accept the "End User Agreement for Providers" and then click on "Schedule of Events")

<> CMA Medicare Transition Resources:


<> House Committee Releases Bipartisan Medicare SGR Reform Bill: On July 18 the House Energy and Commerce Committee released bipartisan legislation that repeals the Medicare SGR. CMA is pleased that Congress is moving forward with a bill to eliminate the SGR and establish a stable payment system. CMA will continue to advocate organized medicine's goals to Congress. Following is a short summary of the House bill:

  • Repeals the SGR.
  • Provides a period of stability for five years with 0.5% annual payment updates.
  • Allows physicians to choose to participate in a fee-for-service program or an alternative payment model.
  • In 2019, for those physicians participating in fee-for-service, it provides up to 1.5% updates for reporting on physician-developed quality measures and for participating in physician-developed clinical projects. Physicians who score poorly will be subject to a net 0.5% cut.
  • Alternatively, physicians may choose to participate in physician-developed alternative payment models. The incentives favor physicians who are willing to take the necessary steps to participate in new models.

The House Ways and Means Committee also plans to release a Medicare SGR reform bill when Congress returns from recess in September.

<> Pharma Sunshine Reporting Starts August 1: Physicians won't see their public reports on the payments and gifts they receive from drug and device manufacturers until September 2014, but companies start collecting data now.


<> HIV Research Survey: Dr. Theodoros Katsivas and colleagues have produced a 7-10 minute, web-based survey directed towards non-HIV specialist physicians and mid-level providers to assess their current HIV knowledge base, HIV testing attitude, and to try to identify barriers to HIV testing. Click Here to Take the Survey

<> SDCMS Survey on Mandated Reporting of Elder Abuse: If you see geriatric patients, please click here to take a (very short) survey.

<> Calling All Psychiatrists: Maintenance of Certification Demystified: On Saturday, August 3, at SDCMS's offices -- 5575 Ruffin Road, Suite 250, San Diego 92123 -- Jonathan Meyer, MD, will explain what you need to do to maintain your board certification(s). 8:30am-11:00am. Free for APA members; $20 for non-members. To register, email Janelle Kistler, Esq., at Janelle.Kistler@SDCMS.org. For more information, call (858) 279-4586.


<> Ask Your Physician Advocate, Marisol Gonzalez:

  • Question: I am an on-call hospitalist (pathology, radiology, and anesthesia) who sees patients in the hospital on an emergent basis. What happens if I am not contracted with Covered California? How will I be reimbursed?
  • Answer: If the services are emergent, the patient can't be charged a higher cost-share than they would have paid in-network. The physician is paid the "best of three" or "greatest of three" from the three amounts, with a subtraction for the patient's cost share: in-network rate; the UCR amount; or the amount Medicare would have paid for the service(s).

Marisol can be reached at (858) 300-2783 or at MGonzalez@SDCMS.org.

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"Sir, I say that justice is truth in action." -- Benjamin Disraeli, British Prime Minister, Parliamentarian, Conservative Statesman, and Literary Figure (1804-1881)

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