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“News You Can Use” <> September 18, 2013



Executive Director Comment: Are You Ready for the Following Medicare, HIPAA, and ICD-10 Changes??? See Below!

Medicare Intermediary Transition From Palmetto to Noridian: Click Here

September 23 HIPAA Compliance Deadline: SDCMS members click here for a fabulous webinar. Click here for details. Click here to access CMA’s “HIPAA Omnibus Rule Compliance FAQs.”

10 Questions Physicians Need to Be Asking About the October 1, 2014, ICD-9 to ICD-10 Transition:

SDCMS Foundation Heroes de la Salud on September 26: Wendy Buchi, MD, Rosemari M. Johnson, MD, and Imaging Healthcare Specialists will be honored by the SDCMS Foundation as 2013 Health Heroes at the Foundation’s Heroes de la Salud event on Thursday, September 26 at 6:00pm at The Abbey in Bankers Hill. The Ultimate Stones, a rock cover band, will headline. Tickets — including dinner and a signature “Start Me Up” beverage — are just $100. RSVP at www.SDCMSF.org/heroes or call (858) 300-2789.

Money and Legal Skills for Early Career Physicians: Saturday, September 21, 2013, 8:30am–12:00pm. Click Here

CMA 3 for 3 in Killing Inappropriate Scope of Practice Expansions: All three scope expansions by allied health professionals that would have placed patients at risk were killed or significantly modified by CMA. Click Here


CDC Urges Pertussis Vaccine During Every Pregnancy: Click Here

Continuing Nationwide Shortage of Tuberculin Skin Testing (TST) Antigen (Sept. 17 Update): Click Here


Governor Signs CMA-sponsored Bill to Expedite Physician Licensure for Practice in Underserved Areas: Click Here

Urge Gov. Brown to Sign a CMA-sponsored Bill to Improve Access in Underserved Communities: SB 191, which will extend funding for the Maddy EMS Fund, is on the governor's desk. Click Here

Trial Lawyers Re-file Anti-MICRA Ballot Initiative, a political maneuver that will buy them more time as they attempt to navigate around the organized opposition to the proposal. Click Here

Blue Shield Notifies Physicians of New Requirement Regarding Crossover Claims: Effective October 13, 2013, doctors must wait 30 calendar days following receipt of a Medicare remittance advice before submitting a secondary claim to Blue Shield for Blue Plan or Federal Employee Program members. Click Here

State Delays Duals Pilot Project Until April 1, 2014: The California DHCS announced that it would delay by three months implementation of the state’s “pilot project” to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than April 2014. Click Here

DHCS Webinars on What Physicians Need to Know About the Coordinated Care Initiative:

  • October 8, 1:00pm–2:00pm: Click Here
  • November 18, 1:00pm–2:00pm: Click Here
  • December 10, 1:00pm–2:00pm: Click Here

Anthem Blue Cross Announces Changes to Reimbursement Policies and Claims Software Effective November 1, 2013: You may notice a difference in how certain codes and code pairs are adjusted by Anthem. Click Here


CMA Comments on CMS’s 2014 Medicare Physician Fee Schedule Proposed Rule: Of particular concern to CMA and California’s physicians is the $46 million Medicare payment reduction in California as a result of shifting nonphysician clinical personnel wages, such as NP and PA wages, from the physician practice expense geographic practice cost index (GPCI) to the physician work GPCI. NPs and PAs are not defined as physicians by Medicare, and, therefore, it is CMA’s opinion that CMS lacks the authority to include nonphysician wages in the physician work calculation. Moreover, the change significantly reduces reimbursement in high-cost regions of California and the rest of the country. CMA strongly urges CMS to withdraw this proposal. Click here for CMA’s detailed comments on this issue and others.

Incarcerated Beneficiary Recoveries From Providers: In June and July 2013, CMS initiated recoveries from providers and suppliers based on data that indicated a beneficiary was incarcerated on the date of service. CMS has since learned that the information related to these periods of incarceration was, in some cases, incomplete for CMS purposes. CMA and others have sent a joint letter asking CMS to halt their recovery efforts until the data has been corrected. We will continue to provide you with updates as they becomes available. Click Here


September 2013 CMA Practice Resources: CMA Practice Resources (CPR) is a free monthly e-bulletin from the CMA’s practice management experts that focuses on critical payor and healthcare industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting related issues along with information on the latest practice management news.

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


Nominate Your Office Manager for SDCMS' 5th Annual "Outstanding Medical Office Manager" Contest Today! SDCMS member physicians can nominate their office manager by explaining in writing (up to 600 words) why their office manager is the best in San Diego County. Send nominations (and questions) to Kyle Lewis at SDCMS at KLewis@SDCMS.org. Nominations deadline is November 1, 2013.

“There are risks and costs to a program of action. But they are far less than the long-range risks and costs of comfortable inaction.”
— John F. Kennedy

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