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"News You Can Use" — June 18, 2013



<> Voting for Physicians of Exceptional Excellence, aka, "Top Doctors," Ends at 11:59pm This Friday, June 21!

  • Board-certified SDCMS Members: Click here to vote. If you cannot find your password, click here to retrieve it.
  • Board-certified Nonmembers: Click here to register to vote. If you have any problems e-voting, please contact James Beaubeaux at James.Beaubeaux@SDCMS.org or at (858) 300-2788.

<> "Financial and Legal Literacy for Doctors" Workshop, Saturday, June 22: 8:00am-12:00pm, at SDCMS's offices on Ruffin Road. Click here for details. Members, email me at Gehring@SDCMS.org if you want to come.

<> Practical Media Training, Saturday, July 13, 8:30am-11:30am: Our crack team of mentors will give you opportunities to practice your newspaper, radio, standup TV interview, and TV panel media skills. A great way for physicians to practice in a safe environment, or, as Churchill said, "Better to sweat in peace than bleed in war." Please let me know at Gehring@SDCMS.org if you plan on attending or need further information.

<> Three Scope of Practice Bills to Be Heard after July 2: Contact Assemblymen Brian Jones and Brian Maienschein and urge them to oppose these three bills that will expand scope of practice of nonphysician practitioners and remove necessary physician supervision. Click here for details and information on how to take further action!


<> Executive Director Comment: Surely you jest ... expand Medi-Cal while simultaneously reducing nearly worst-in-the-nation Medi-Cal rates???? Who exactly does Sacramento think will see all those new Medi-Cal patients? Please read this tale from Kafka below; it's longer than usual for NYCU, but want you to get the full flavor.

<> Despite Surplus, State Budget Slashes Medi-Cal Rates: The California Legislature passed a $234-billion budget on Friday that will cut Medi-Cal payments to physicians and other providers by 10%. The cuts were originally passed as part of the 2011-12 budget, but were held up in court as CMA and other plaintiffs filed suit to stop the draconian cuts.

In January of this year, a three-judge panel of the 9th Circuit court ruled that the state could move forward with the rate cuts, despite an earlier district court ruling that found that the cuts would irreparably harm the millions of patients who rely on Medi-Cal for healthcare. CMA and the other plaintiffs in the case had requested a rehearing from the full Ninth Circuit Court of Appeals, which was denied. 

Although the state is in a much better financial situation than it was in 2011 when the cuts were first passed, the 2013-14 budget includes roughly $1 billion in Medi-Cal provider rate cuts annually. 

On Saturday, the California Legislature passed legislation (AB X1-1) that would expand Medi-Cal to more than 1.4 million state residents under the Affordable Care Act. The irony of slashing rates while promising coverage to more than a million new patients has not gone unnoticed. If the state moves forward with the cuts, particularly at a time when millions of new patients will be eligible for the program, access to care will be decimated in our state, undermining the success of federal health reform.

The budget does restore dental and mental health benefits under the Medi-Cal program.

The final agreement includes $206 million to improve mental health services, including $142 million in one-time general fund money; $51 million in non-general fund money in the coming fiscal year and about $150 million the following fiscal year to boost grants for CalWORKS, California's welfare-to-work program; and $16.9 million in general fund money in the coming fiscal year and $77 million the following fiscal year to help partially restore Denti-Cal benefits for adults. Denti-Cal is the Medi-Cal dental program.

Even before the cuts, California's Medi-Cal provider payment rates are some of lowest in the nation. Low reimbursement rates have driven many of California's providers from the program. As a result, 56% of Medi-Cal patients report difficulty finding a doctor. If these cuts are not stopped, Medi-Cal will become nothing more than a broken promise of access to care.

"What good does it do our communities if they have healthcare coverage, but cannot get in to see a doctor?" said Senator Ricardo Lara, author of SB 640, one of two CMA-sponsored bills (along with AB 900, authored by Assemblyman Luis Alejo) that will stop the Medi-Cal cuts. "If we want healthy communities we need to provide access to quality and preventative care."

CMA has joined an unprecedented coalition of physicians, dentists, healthcare workers, and hospitals that will continue working to stop the cuts. The coalition, called "We Care for California," includes the largest statewide organizations representing physicians, dentists, hospitals and healthcare workers, as well as health plans, first responders, caregivers, and other health providers.

CMA and the We Care for California coalition will aggressively push for a solution to the provider cut before the end of session. 

<> If You Haven't Already Done So, Please Take SDCMS' 2-Question Medi-Cal Survey: If (and only if) you take Medi-Cal, please CLICK HERE to take our two-question, multiple choice survey so that we can get some data to our legislators. Thank you!


<> Multistate Hepatitis A Outbreak Associated With Frozen Berry Blend Update — More San Diego Cases:

  • Click here for information on the latest numbers.
  • Click here for a link to the County website for updated resources in English and Spanish on hepatitis A and the outbreak.
  • Click here a new link to revised CDPH guidance on post-exposure prophylaxis, and more.

<> Health Alerts From CDC:


<> California Supreme Court Rules in Peer Review El-Attar v. Hollywood Presbyterian Medical Center Case: Click Here

<> UC Riverside Medical School: The conference legislative committee adopted action to appropriate $15 million to UCR. Their action seemed to have included the money, but, instead of appropriating additional funds, it was taken out of the existing UC appropriation.


<> TRICARE Extends Specialty Authorization and Referral Waiver Through July 2: The U.S. Department of Defense (DoD) has extended the specialty care authorization and referral request waiver for TRICARE covered services through July 2, 2013. Click Here

<> Meaningful Use Payment Adjustments Are Coming Soon: Beginning January 1, 2015, Medicare physicians who have not successfully attested to meaningful use of an EHR system may incur payment penalties, as mandated by the HITECH Act. These payment adjustments are 1-2% of total Medicare charges in 2015, to 2% in 2016, and 3-5% in 2017 and beyond. Medicaid rates will not be adjusted for failure to achieve meaningful use. Click Here

<> Submit Quality Measures for Potential Inclusion in CMS' PQRS Program by July 1: CMS is accepting quality measure suggestions through July 1 for potential inclusion in the proposed set of quality measures for the Physician Quality Reporting System (PQRS) program for future years. Click Here


<> Sign up to Attend Our July 20 "Taming Microsoft Outlook" Workshop: This three-and-a-half hour SDCMS members-only workshop is a must-attend for those busy physicians looking to make Microsoft Outlook their servant and not their master. Email me at Gehring@SDCMS.org.

<> Coordinating Physician Health Activities in California: A Workshop for Physician Health Committees: Saturday, July 13, 2013, 9:00am to 12 noon, at the UCSD Hillcrest Campus, Multipurpose Facility, 402 Dickinson Street, 4th Floor Conference Room, Ste. 450, San Diego 92103. Attendance is limited. There is no fee, but advance reservation is required. For further information and to register, click here. For information about California Public Protection and Physician Health (CPPPH), click here.


<> CMA Practice Resources (June 2013 Issue):

  • New TRICARE Contract Might Create Gap in Medical Malpractice Coverage: Click Here
  • Federal Medi-Cal Audits to Begin in June: Click Here
  • Medi-Cal to Delay Payments for up to Three Weeks in June: Click Here
  • Covered California Unveils Plans for New Online Health Insurance Marketplace: Click Here
  • CMA Member Survey Confirms Significant Problems With TRICARE Transition: Click Here
  • Noridian Transition Update: Click Here
  • Three Weeks Left to Avoid the 2% E-prescribing Penalty in 2014: Click Here
  • Anthem Blue Cross Annual Medicare Advantage Chart Review Underway: Click Here
  • United Healthcare to Require Prior Authorization for Outpatient Radiology and Cardiology Services: Click Here
  • Did You Know? Blue Cross Offers Interpreter Services, Including Sign Language Interpreters: Click Here
  • Begin Reporting PQRS to Avoid Future Payment Adjustments: Click Here
  • The Coding Corner: Avoid Common Place-of-service Coding Errors: Click Here

<> Follow SDCMS' Twitter Feed and Get a Treasure Trove of Healthcare News Delivered Daily to Your Smartphone: Click Here

<> Is Your Office Manager / Practice Administrator Using SDCMS' Online Forum? Click Here to Join

"It has been my experience that folks who have no vices have very few virtues." -- Abraham Lincoln (1809-1865)


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