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"News You Can Use" <> March 12, 2014



Executive Director Request: Victory on SGR (and the long-standing GPCI inequity) is within reach, but our five congresspeople and our two senators NEED TO HEAR FROM YOU — and YOUR PHONE CALLS ARE COUNTED!

Why? Our carefully crafted bipartisan compromise is unraveling under partisan pressure. We must FORCEFULLY let Congress know that another nine-month kick-the-can-down-the road non-solution is unacceptable to you, your practice, and your patients. And if we don’t close the deal on SGR, the meticulously crafted GPCI fix goes right down the tubes with it …

1) Please Contact All Three of Your Federal Legislators:

  • Your U.S. House Representative from San Diego
  • California Senator Barbara Boxer
  • California Senator Dianne Feinstein

2) By Calling AMA's Grassroots Hotline at (888) 434-6200

  • In under 90 seconds, you will be connected to your choice of our two senators or your congressperson (call all three!), and they even give you a short summary of the talking points.

3) And Tell Them Each to:

  • Protect access to care in California and enact Medicare physician payment reform NOW!
  • Seize this unique opportunity! The cost to fix the Medicare SGR is at an all-time low and there is bipartisan agreement on the legislation.
  • Oppose another SGR patch.
  • Cosponsor HR 4015 / S 2000 today.

Additional SGR Resources:

Save the Date: San Diego-wide Physician Networking Opportunity & Mixer on April 3Click Here for Details

Practice Management Reminders:

  • March 14: Anthem Blue Cross Eligibility, Benefits, and Claim Status Inquiry Functions Move to Availity: Click Here
  • March 31: Deadline for 2013 Meaningful Use Attestation in Medicare EHR Incentive Program: Click Here
  • March 31: Application Deadline for 2013 Medi-Cal EHR Incentive Program: Click Here
  • April 1: Practices Required to Use New CMS 1500 Claim Form: Click Here

Executive Director Comment on Covered California: Got implementation problems with Covered California — either for you, your practice, or your patients? SDCMS members may email Marisol Gonzalez at MGonzalez@SDCMS.org or me at Gehring@SDCMS.org for help.


Two More Measles Cases Confirmed in San Diego: Click Here

All Physicians: Please take a survey on the “Knowledge, Practice, and Attitudes of Non-HIV Specialists With Regard to HIV and HIV Screening in the San Diego-Tijuana Border Region.” Click here for further details and to take this confidential, de-identified survey. The survey will identify areas where further training and intervention can help increase the identification and engagement in care of HIV-infected individuals.


If You Want to Participate in CMS’s Voluntary Medicare ICD-10 End-End Testing: Click Here

National Doctors’ Day Is Sunday, March 30: “A day to celebrate the contribution of physicians who serve our country by caring for its’ citizens.” Click Here


Appeals Court Rules Health Plans May Be Responsible for Payment When They Irresponsibly Delegate Risk — a Big Win for CMA: Click here to read the court’s ruling. Click here for details.

CMA Announces Its Sponsored Bill Package for 2014:

  • All Products Clauses Bill to Allow Physicians to Opt in to Each Network or Product
  • Bill to Add Sugar-sweetened Beverage Safety Warnings
  • Bill to Restore the 10% Medi-Cal Cut
  • Bill to Fund Primary Care Residency Programs
  • Bill to Recruit and Retain Physicians in the Central Valley
  • Allied Health Professional Supervision Numerical Limits Bill
  • Telephone and Electronic Patient Management Services Bill
  • Bill to Adopt the HITECH Act as the Standard for Healthcare Data Breaches

MBC to Suspend Licenses of Physicians With Delinquent Taxes: Click Here

Court Rules in Favor of Physician Whistleblower: Click Here


Traumatic Brain Injury Program: The Impact on Our Athletes and Veterans: Tuesday, March 18, 11:30am–2:00pm. Presented by the SDCMS Foundation for the Retired Physicians Society. Join us to hear William Perry, PhD, David Bazzo, MD, and Alan Shahtaji, DO, discuss complex treatment modalities and the long-term effects of TBI. Email Liz.Brave@SDCMS.org to RSVP. $15, which includes lunch.

SDCMS CURES Sign-up: More than 50 San Diego physicians signed up to access the CURES system! Click here for information on how you can register for CURES.

Save the Date: Physician Networking Opportunity & Mixer on April 3: Come mingle, socialize, and network with your fellow San Diego County physicians on Thursday, April 3, 2014, 5–8pm, at the Handlery Hotel, 950 Hotel Circle North, San Diego, CA 92108. All San Diego County physicians are welcome and encouraged to attend. Complimentary hors d’oeuvres and drinks will be served, and all attendees will be entered to win several exciting raffle prizes! Click here to RSVP or email your name and telephone number to Jen Ohmstede at JOhmstede@SDCMS.org. Call Jen with any questions at (858) 300-2781.

Save the Date: 17th Annual Western Health Care Leadership Academy on April 11–13: This year the Academy is thrilled to welcome keynote speaker Hillary Rodham Clinton, former secretary of state and former U.S. senator from New York. The conference will examine the most significant challenges facing healthcare today and present proven models and innovative approaches to transform your organization’s care delivery and business practices, with topics including leadership development, ACA implementation, and practice management. $100 discount if registration received on or before March 14. Visit www.westernleadershipacademy.com for more details.

Save the Date: SDCMS’s 2014 White Coat Gala Will Be Held on Saturday, June 14, 2014: At the Hyatt La Jolla at Aventine from 6:00pm to 11:00pm. J. Steven Poceta, MD, will be installed as SDCMS’s president for 2014-15, and Robert E. Peters, MD, PhD, SDCMS’s current president, will be recognized. Contact Jen with any questions at (858) 300-2781 or at JOhmstede@SDCMS.org.


Ask Your SDCMS Physician Advocate, Marisol Gonzalez: 

Member Question: For Covered California patients, how can I avoid patient confusion and frustration related to my participation status at the time of service?

Answer: With all of the new exchange plans added to the mix, it is no longer satisfactory to simply accept "I have Blue Shield" as an indication of whether the patient can be seen in network. It is important when scheduling to determine if the physician is indeed in the patient's network. The first step is to ensure front office staff has a clear understanding of the physician’s participation status as displayed on the plan websites. Second, upon scheduling, request that the patient fax or email a copy of the front and back of their ID card to the practice. This will allow the practice to clearly identify whether they are in the patient’s network and also to verify patient eligibility before the visit and communicate with the patient before the visit. Taking these steps could help avoid out-of-network costs for and frustration from patients when they are faced with a larger than expected bill.

Note: Q&A taken directly from CMA’s “Surviving the Third Month of Covered California.” To obtain a copy of this tip sheet, please email Marisol Gonzalez, the SDCMS Physician Advocate at MGonzalez@SDCMS.org.

Click Here to Read the March 2014 Issue of San Diego Physician Magazine: If you would like to be notified via email when future issues of San Diego Physician are ready to be read online, email Editor@SDCMS.org and include your complete name.

SDMCS’s Discounted Disability Insurance Premium May Be Raised: If you submit prior to April 1, you can lock in the older/cheaper rates. Contact Brian Gerwe at SDCMS at (858) 300-2782 or at Brian.Gerwe@SDCMS.org for additional information. Click here to request an illustration.

Microsoft to End Windows XP SP3 and Office 2003 Support on April 8, 2014: 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


San Diego County Enrollment in Covered CA 148% Above Projections: 63,845 individuals have been enrolled in a Covered CA plan as of January 31. If your practice would like information on how to address patient questions, or to receive literature for your office waiting rooms, contact Barbara.Mandel@SDCMS.org. The SDCMS Foundation provides provider education to assist physician practices address patient education and practice concerns.

Covered California Takes SHOP Website Offline Until Fall: Click Here

Covered California Resources for SDCMS-CMA Members:

SDCMS and SDCMS Foundation Seminars and Webinars for Physicians and Office Staff:

  • Friday, March 14: “How to S.H.O.P. (Small Business Options Program) for Health Insurance for Your Practice” • Webinar for Physicians & Staff • 12:00pm–12:30pm • Click Here to RSVP
  • Thursday, March 27: “Get in the Know: How Your Uninsured Patients Can Get Insured” • Seminar (at SDCMS) for Physicians & Staff • 5:30pm–7:30pm (Dinner Provided) • Email Victor at Victor.Bloomberg@SDCMS.org for Further Details and to RSVP

“It is better to rise from life as from a banquet, neither thirsty nor drunken.” Aristotle (384 BCE – 322 BCE)

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