NYCU September 16, 2025 September 16, 2025 CAHAN Alerts, Champions for Health, CMA, COVID-19 Vaccinations, MAHA, Medicare, Member Social, Public Health, SD County Health , SDCMS, Transgender Healthcare, Trump Administration, Vaccines 0 TUESDAY, SEPTEMBER 16, 2025 PHYSICIANS: Beware of scammers posing as Drug Enforcement Administration representatives! Our office has been contacted by a local physician who reported receiving a phone call from a scammer representing themselves as being from the DEA. This was a major issue five years ago but seems to be returning as a threat. The DEA has posted a warning for physicians, medical personnel and the public to be on the lookout and proceed cautiously with those claiming to be representing the DEA. The DEA warning can be found HERE. SAN DIEGO COUNTY’S PUBLIC HEALTH OFFICER ISSUES STATEMENT ON VACCINES AND NEW WEST COAST HEALTH ALLIANCE Sayone Thihalolipavan, MD, MPH, the Public Health Officer for the County of San Diego has asked us to share his recent statement on vaccines: “The San Diego County Public Health Services (PHS) department is in alignment with the California Department of Public Health (CDPH). PHS is in frequent contact with CDPH and closely monitoring updates to vaccine recommendations as part of the new West Coast Health Alliance. Please visit the County website on Vaccine Recommendations for ongoing updates. “The well–known practices to protect yourself and others from COVID–19 are still effective, including covering your coughs and sneezes, washing your hands often, wearing a mask, and staying home and away from others when sick with any respiratory virus. “We encourage people talk to their healthcare provider if they have questions about the COVID vaccine. People can find a vaccine near them by contacting their doctor or healthcare provider, local pharmacy or by visiting myturn.ca.gov. Insurance reimbursement and coverage for COVID–19 vaccines are still pending. Please check with your insurance company on coverage.” SENATOR AND PHYSICIAN AKILAH WEBER PIERSON OFFERS INFORMATIVE WEBINAR ON SICKLE CELL DISEASE TONIGHT FROM 5:30–7:30PM In observance of Sickle Cell Awareness month, the office of Senator Akilah Weber Pierson is offering an informative webinar this evening from 5:30 to 7:00pm on sickle cell disease, examining its impact and current challenges. A distinguished group of speakers includes Dr. Jenny Kim, Medical Director for the Comprehensive Sickle Cell Center at Rady’s Children’s Hospital & Hematology/Oncology Clinical Professor for the Dept. of Pediatrics at UCSD; Dr. Srila Gopal, Medical Director, UC San Diego Adult Sickle Cell Program, Dr. Osbourne Blake and Dr. Resa Calvano from Kaiser Permanente’s West Los Angeles Sickle Cell Medical Care Program along with London Knight, fashion model and celebrity advocate. Mary Brown, President and CEO of the San Diego Sickle Cell Disease Foundation will serve as moderator. Registration is necessary to receive the link for the webinar. You can RSVP HERE for this important event. URGENT | CMA URGES PHYSICIANS TO IMMEDIATELY SPEAK OUT AGAINST CIGNA’S UNLAWFUL DOWNCODING POLICY California Medical Association (CMA) is urging physicians and medical groups to reach out to Cigna and share their concerns about the insurer’s new ‘Evaluation and Management Coding Accuracy’ reimbursement policy, scheduled to take effect on October 1, 2025. The policy would allow Cigna to automatically downcode higher–level Evaluation and Management (E/M) services whenever it determines the encounter criteria on a claim does not support the level billed. Physicians who dispute these downcoding decisions would be forced to file an appeal and submit supporting medical records via fax, creating substantial costs for both physicians and the plan itself. CMA has cautioned Cigna that this policy appears to violate state law, creates unnecessary administrative burdens, and fails to align with nationally recognized standards. “Rather than improving accuracy, this policy functions as a barrier to appropriate reimbursement and adds wasteful administrative costs to both practices and Cigna,” CMA said in a letter to the insurer. CMA believes that more constructive approaches — such as targeted provider education and outreach to outliers — would better achieve coding accuracy while preserving physician time for patient care. They have formally called on Cigna to rescind the policy and will continue to advocate aggressively to protect physicians from unlawful downcoding practices. The American Medical Association recently sent a letter to Cigna to express their strong concerns with the policy as well. CALL TO ACTION! CMA is urging physicians and medical groups to also make their concerns known directly to Cigna. Please contact Cigna Customer Service at (800) 88–CIGNA [(800) 882–4462] or via the provider portal and request that the company rescind the R49 downcoding policy. When contacting Cigna, emphasize the following key points: The policy lacks transparency and fails to disclose claims adjudication criteria. It conflicts with AMA and CMS E/M coding guidelines. It risks violating California’s claims payment and disclosure laws. It will increase administrative burdens and costs for both practices and the insurer. SDCMS TO HOST AN IMPORTANT FUNDRAISER ON OCTOBER 8TH FOR DR. SION ROY FOR STATE SENATE I wanted to share some exciting news with you. Earlier this year former CMA Board Member and practicing cardiologist Sion Roy announced he is running to replace Ben Allen in the California State Senate. We have seen the impact that physicians such as Drs. Richard Pan and Akilah Weber Pierson have had in the legislature. Sion will be the additional voice we need as two of the three physicians currently in the legislature will be leaving. Dr. Roy has long been an advocate for physicians and their patients, having his voice in the State Senate is among CMA’s top priorities. Now more than ever we see how important it is to have physicians in public office helping shape the policy developed. You can learn more about Dr. Roy at DrSionRoyforSenate.com. SDCMS will be hosting a fundraiser for Dr. Roy Wednesday, October 8th. I hope you, your colleagues and friends will be able to join us. This is a campaign where we will need every physician that is able to make a personal contribution, helping amplify the support CALPAC makes for his campaign. You can RSVP to attend directly to the campaign through Dylan Ford at djford09@gmail.com. FALL INTO FUN! OUR FALL ‘PHYSICIAN SOCIAL & MIXER’ IS OCTOBER 10TH AT UCSD IDA & CECIL GREEN FACULTY CLUB You don’t want to miss our Fall Mixer on October 10th, from 5:30–8:00pm at the UC San Diego Ida & Cecil Green Faculty Club. It’s the pumpkin spice of social medical gatherings. There is already a large number of RSVPs but we want to celebrate the lack of seasonal change in San Diego with you too! Come mingle, socialize and network with your fellow San Diego County physicians — SDCMS members and non–members are welcome and encouraged to attend. Complimentary light appetizers and hosted wine and craft beer will be provided. This event is open EXCLUSIVELY to physicians and their guests and space is limited, so reservations are required. You can REGISTER HERE. Contact Jen Ohmstede with any questions about the event at JOhmstede@SDCMS.org. As always, let me know if you have any questions! Paul Hegyi, CEO WHAT TO KNOW … CAHAN ALERT Health Advisory: New World Screwworm Outbreak in Mexico and Central America CLICK HERE California’s Legislature Passes 2 Prior Authorization Reform Bills CLICK HERE Under Pressure, Rady’s Children's Hospital Strikes Shaky Middle Ground on Trans Care CLICK HERE 8% of Americans Lacked Health Insurance Last Year CLICK HERE Health Care Costs are Soaring. Blame Insurers, Drug Companies — and Your Employer CLICK HERE Appeals Court Allows Trump Administration to Block Medicaid Funds for Planned Parenthood CLICK HERE States Counter RFK Jr.’s Vaccine Moves, but Many People Could Be Left Without Access CLICK HERE MAHA Strategy for Children Has Over 120 Initiatives, Few Specific Actions CLICK HERE Under Trump, FDA Seeks to Abandon Expert Reviews of New Drugs CLICK HERE WHAT TO DO … SEP 18, 2025: 12:15-1:15pm, FREE Webinar for Members and Non–Members, sponsored by CMA and The Doctors Company, ‘Managing Adverse Events in the Office Practice’. Managing adverse patient safety events and unexpected health care outcomes in a medical office setting can be challenging due to the uniqueness of the situation, or lack of standard processes, resources, or trained staff. Learn about the most frequent types of claims and risk issues arising in outpatient care. This session provides a framework for responding to an adverse patient safety event or unexpected health care outcome in an office practice, including transparent communication and disclosure to the patient and their family, documentation of the event, and creating a culture of safety to learn from these unexpected events CLICK HERE SEP 23, 2025: 12:15-1:15pm, FREE Webinar for Members and Non–Members, sponsored by CMA, ‘Medicare Revalidations and Reporting Changes — Staying Compliant & Informed’. Kelsey Slettebak and Julie Schroeder of Noridian Healthcare Solutions will provide a comprehensive overview of the Medicare provider enrollment revalidation process. Gain a clear understanding of enrollment compliance, the revalidation process, reporting changes to an enrollment record and best practices for compliance and continuity CLICK HERE SEP 25, 2025: 12:15-1:15pm, FREE Webinar for Members and Non–Members, sponsored by CMA, ‘Safeguarding Medicare Enrollment — Preventing Deactivation, EFT Errors & Ownership Reporting Problems’. Medicare enrollment can be jeopardized by internal vulnerabilities often unnoticed until billing disruptions occur. Specifically in two critical risk areas, deactivation reasons and electronic funds transfer (EFT) documentation mismatches. Dan Schmitt and Julie Schroeder of Noridian Healthcare Solutions explore strategies for distributing access, maintaining continuity and preparing for transitions. Plus how discrepancies between practice names, IRS documentation and NPPES records can delay or block EFTs, even when updated documents like the 147C letter are submitted. Learn how to strengthen internal processes, align documentation and ensure uninterrupted operations with real–world examples and actionable guidance CLICK HERE OCT 10, 2025: 5:30–8:00pm, UC San Diego Ida & Cecil Green Faculty Club, 9500 Gilman Dr, La Jolla, ‘SDCMS Physician Social & Mixer’. Please note this event is open exclusively to physicians and their guests and space is limited so rsvps are required. SDCMS members and non–members are welcome and encouraged to attend. Complimentary light appetizers and hosted wine and craft beer will be provided CLICK HERE OCT 25, 2025: 8am, Tecolote Shores South Mission Bay, sponsored by Head for the Cure Foundation, ‘2nd Annual Head for the Cure 5K Run/Walk San Diego’. To raise awareness and funds for brain tumor research. Join or contribute to the effort by visiting the Team Dave! UCSD page created in honor of the late Dr. David Bazzo, former SDCMS President. Please support this worthwhile cause in Dr. Bazzo’s memory. For full details about the event CLICK HERE NOV 14, 2025: 12-1pm, FREE Webinar for Members, Non–Members, NPs, and PAs, sponsored by CMA and CDPH, ‘Virtual Grand Rounds: Emerging Public Health Issues’. Presenters include Erica Pan, MD, MPH, CA State Public Health Officer & Director of CDPH, and Kimberly Newell Green, MD, CMA Trustee & UC San Francisco Associate Clinical Professor. More information to come. CME credit available CLICK HERE NOV 18, 2025: 6-7pm, FREE Webinar for Members and Non–Members, sponsored by TDC and SDCMS, ‘Understanding the Anatomy of a Lawsuit’. This webinar outlines and discusses the course that a medical malpractice lawsuit takes when filed against a physician in California. Walk through the physician’s receipt of a Notice of Intent to Sue and explore the litigation process, looking at what elements a Plaintiff must prove in order to prevail and how a defense would be built for the Defendant physician. We’ll also provide several proactive steps physicians can take in their own practice to be prepared if ever involved in a suit. CME credit available CLICK HERE NOV 21, 2025: 12-4:30pm, Del Mar Racing, Jimmy Durante Blvd, Del Mar, CA. Join Champions for Health at the Del Mar Thoroughbred Club for ‘A Day at the Races’. Enjoy an exclusive afternoon of exciting horse racing, delicious food and refreshing drinks while supporting vital healthcare programs for San Diego’s underserved communities CLICK HERE WHAT TO READ, LISTEN & WATCH … Podcast ‘What the Health?’ Countdown to Government Shutdown LISTEN HERE Alzheimer’s Project Clinical Roundtable Free On–Demand CME Webinar Series on Dementia WATCH HERE Champions for Health & TDC’s Free On–Demand CME Webinar Series ‘Innovations and Smart Approaches in Safe Prescibing’ to Help Fulfill DEA Training Requirements (Modules 1–5) WATCH HERE SDCMS Video Archive: View our FREE digital catalog of videos & webinars WATCH HERE SDCMS Webinar: Are You Aware and Prepared for New California Laws? WATCH HERE SDCMS Webinar: Managing the Noncompliant and Nonadherent Patient WATCH HERE SDCMS Webinar: Physician Financial Wellness (Part 1) WATCH HERE SDCMS Webinar: Physician Financial Wellness (Part 2) WATCH HERE SDCMS Webinar: Will Your Documentation Defend You? 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