"News You Can Use" <> May 13, 2014 May 13, 2014 Cal MediConnect, Covered California, Medi-Cal, Medicare, Member Social, MICRA Cal MediConnect, Covered California, Medi-Cal, MERS, MICRA, Pertussis 0 CONTENTS Seminar on Financial and Legal Life Skills SDCMS’s 2014 White Coat Gala on Saturday, June 14, 2014 East County Physician Networking Opportunity & Mixer on July 10 SEIU California Has Joined the Broad-based Coalition to Defeat the Trial Lawyer-backed Anti-MICRA Ballot Measure Got “Access-to-Care” Horror Stories From Covered California or Medi-Cal? Two Middle East Respiratory Syndrome (MERS) Cases in the U.S. Pertussis Cases Increase in San Diego County Meaningful Use Expanded Exemptions and Expanded Assistance — Apply by July 1! Duals Demonstration (Cal MediConnect) Passive Enrollment Has Begun Cal MediConnect Resources for SDCMS Members CMA Patient Access Bills Clear the Legislature's First Committee CMA Defeats Bill That Would Have Eliminated In-office Exception to Self-referral Law Anthem Blue Cross Asks Physicians to Complete “Member Health Assessments” Physicians Warned of Identity Theft Tax Scam Physicians Who Wish to Opt out of Blue Cross Exchange Network Must Do So by June 30 Windows XP Use May Trigger HIPAA Non-compliance Dr. Horacio Rodiles Appointed to the United States-México Border Health Commission “Trauma Across the Lifespan” CME/CEU Event SDCMS Physicians, Family, and Friends Are Invited to Attend a Sunday, July 13 Production of "Ether Dome" Ask Your SDCMS Physician Advocate In Case You Missed SDCMS’s May 8 “Hiring, Discipline, and Termination” Seminar Two More Examples of Tangible Member Benefits CMA Practice Resources for May 2014 Follow SDCMS’ Twitter Feed and Get a Treasure Trove of Healthcare News Delivered Daily to Your Smartphone Is Your Office Manager / Practice Administrator Using SDCMS’ Online Forum? Physician Confusion Over Covered California Plans Has Negatively Impacted Patient Care Covered California Resources for SDCMS-CMA Members ABOVE THE FOLD Seminar on Financial and Legal Life Skills: Covering financial, legal, real estate, taxes and accounting, time vs. money, insurance, picking your advisors. May 31, 8:00am–12:00pm. For SDCMS members only. Email me at Gehring@SDCMS.org for information or to RSVP. SDCMS’s 2014 White Coat Gala on Saturday, June 14, 2014: At the Hyatt La Jolla at Aventine from 6:00pm to 11:00pm. Email JOhmstede@SDCMS.org. East County Physician Networking Opportunity & Mixer on July 10, 5:00pm–8:00pm: Complimentary hors d’oeuvres and drinks will be served! Near Grossmont Hospital. To RSVP, email your name and telephone number to Jen at JOhmstede@SDCMS.org or click here to RSVP online. Questions? Call Jen at (858) 300-2781. The Service Employees International Union (SEIU) California Has Joined the Broad-based Coalition — includes California Chamber of Commerce, Planned Parenthood, Community Clinics, and many, many more — to Defeat the Trial Lawyer-backed Anti-MICRA Ballot Measure: Click Here Got “Access-to-Care” Horror Stories From Covered California or Medi-Cal? Contact me at (619) 206-8282 or at Gehring@SDCMS.org. MEDICAL Two Middle East Respiratory Syndrome (MERS) Cases in the U.S. (neither in California): Click here for details from the CDC. Click here for MERS FAQs. Pertussis Cases Increase in San Diego County: Click Here FEDERAL Meaningful Use Expanded Exemptions and Expanded Assistance — Apply by July 1! Click Here STATE Duals Demonstration (Cal MediConnect) Passive Enrollment Has Begun: Click Here Cal MediConnect Resources for SDCMS Members: Click here to watch SDCMS's May 1 seminar titled “Cal Mediconnect: What You Need To Know” [contact SDCMS for login assistance at (858) 565-8888 or at Membership@SDCMS.org]. Contact your physician advocate, Marisol Gonzalez, for a letter geared towards patients who are with the “contracting physician” or the “non-contracting physician,” or if you have any further questions about the Cal MediConnect program: MGonzalez@SDCMS.org or at (858) 300-2783. CMA Patient Access Bills Clear the Legislature's First Committee: AB 2400 would ban so-called all-payor clauses, which require physicians to take every product if they sign up for one insurance product from a given health plan. Passage of AB 2400 would significantly improve physician negotiations with health plans and access to care. AB 1805 would prospectively eliminate the 10% Medi-Cal cut. AB 1759 would extend through 2015 and indefinitely thereafter the reimbursement increase for certain Medi-Cal primary care providers, currently mandated by the ACA, but set to expire on December 31, 2014. AB 2458 would allocate $25 million in general fund dollars for one year and another $2.8 million every year for three years from the California Health Data and Planning Fund, to establish 300 new residency spots in California. CMA Defeats Bill That Would Have Eliminated In-office Exception to Self-referral Law, stopping what would have been a major blow to the integrated care model. Click Here Anthem Blue Cross Asks Physicians to Complete “Member Health Assessments”: Click Here Physicians Warned of Identity Theft Tax Scam: Click Here Physicians Who Wish to Opt out of Blue Cross Exchange Network Must Do So by June 30, 2014: Click Here Windows XP Use May Trigger HIPAA Non-compliance: Click Here LOCAL Dr. Horacio Rodiles, SDCMS-CMA Member Since 1973, Appointed to the United States-México Border Health Commission: Click Here “Trauma Across the Lifespan” CME/CEU Event: Jointly Sponsored by the American Psychiatric Association and the San Diego Psychiatric Society on June 7–8 at the Hyatt Regency La Jolla at Aventine: Click Here SDCMS Physicians (Including Retired Physicians), Family, and Friends Are Invited to Attend a Sunday, July 13 Production of "Ether Dome" at the La Jolla Playhouse: Included is a mixer at 5:30pm at the new Jame's Place, where light appetizers of sliders, fish tacos, and sushi will be served, as well as one drink ticket toward a glass of wine or beer. The play will began at 7:00pm following the mixer. $45 per person. Click here and enter the promo code SDCMSF to order tickets, but do so by May 31! BENEFITS / PRACTICE MANAGEMENT Ask Your SDCMS Physician Advocate, Marisol Gonzalez: Member Question: My Medi-Medi patient was passively enrolled into a Cal MediConnect plan for both their Medicare and Medi-Cal services. This patient would like to go back to fee-for-service Medicare so that I can remain their physician. How does my patient make this change? Answer: Patients can go back to their regular Medicare, but they still must choose a Medi-Cal health plan. This change can be made any month by contacting Health Care Options at (844) 580-7272. For more information about the Cal MediConnect program, SDCMS members can view a May 1 recording of an SDCMS Cal MediConnect seminar, which addresses many of the physician issues with the program, and provides a thorough overview of how the program works. SDCMS members may also contact your SDCMS physician advocate, Marisol Gonzalez, at MGonzalez@SDCMS.org or at (858) 300-2783 with any questions. In Case You Missed SDCMS’s May 8 “Hiring, Discipline, and Termination” Seminar: Click Here (Members Can Email Membership@SDCMS.org for Login Assistance) Executive Director Comment: Two More Examples of Tangible Member Benefits: SDCMS Members-only Covered California Contract Analyses: We have, for members only, a line-by-line analysis of Covered California agreements for Blue Shield, Health Net, Molina, and Anthem Blue Cross. SDCMS Members-only Report of Average Office and Medical Staff Salaries SDCMS members who are interested in either of the above, or nonmembers who took the staff salary survey, can contact Marisol Gonzalez, your physician advocate, at (858) 300-2783 or at MGonzalez@SDCMS.org. CMA Practice Resources for May 2014: What Physicians Need to Know About the Anthem Exchange Addendum Anthem Mistakenly Lists Almost 1,000 Physicians As Participating in Individual / Exchange Network Looking Forward on Covered California: Growing Data Demands Anthem Accidentally Overpays Some Physicians DHCS Systems Now Making Enhanced Primary Care Payments at Individual Claim Level DWC Updates Workers’ Compensation Fee Schedules DWC Offers Free Webinar on Workers’ Comp Billing Dispute Process The Coding Corner: What Do We Do Now? ICD-10 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 COVERED CALIFORNIA CMA Survey Results: Physician Confusion Over Covered California Plans Has Negatively Impacted Patient Care: Click Here Covered California Resources for SDCMS-CMA Members: Email Membership@SDCMS.org to access a matrix to help answer questions like “Am I contracted to see Covered California patients?” “Which health plans are participating in Covered California?” “How do I check my participation status with these plans?” In-office Education for Staff Provided by the SDCMS Foundation: Email Victor.Bloomberg@SDCMS.org CMA's "Surviving the Third Month of Covered California" Tip Sheet CMA's Frequently Asked Patient Questions About Covered California CMA's Health Insurance Exchange Resources Webpage for Physicians CMA's "Understanding the Grace Period for Subsidized Exchange Enrollees" Covered California Consumer Materials for Your Office Waiting Room: Call (858) 300-2789 “Our acts make or mar us, we are the children of our own deeds.” — Victor Hugo, French Poet, Novelist, and Dramatist (1802–1885) Comments are closed.