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Don't Miss out on Increased Medi-Cal Payments!

September 27, 2013 The California Department of Health Care Services (DHCS) will soon be implementing rate increases for primary care physicians who treat Medicaid patients, as authorized under the Affordable Care Act. In order to see the bump in pay, providers must first attest to their eligibility. According to DHCS, less than half of eligible providers have completed the brief self-attestation process as of September 24. Although the regulations implementing the pay raise were released by the Centers for Medicare & Medicaid Services (CMS) in November 2012, DHCS is still awaiting ...

SDCMS Board of Directors (BOD) / Delegation Meeting Tuesday, October 1

SDCMS BOD Members and House of Delegates (HOD) / District 1 Delegates and Alternates: Just a reminder that we have a combined BOD / Delegation meeting that will take place on Tuesday, October 1 — the meeting will start promptly at 6:00pm.  As we will be reviewing all of the resolutions for this year’s HOD, we anticipate this meeting will run long (until at least 9:00pm or later). Please plan your schedule accordingly. The resolutions are accessible below: Reference Committee A Resolutions Reference Committee ...

5th Annual SDCMS "Outstanding Medical Office Manager" Contest

Nominate Your Office Manager Today — Nominations Submission Deadline: November 1, 2013! SDCMS wants to recognize San Diego County’s most outstanding medical office manager / practice administrator, i.e., someone who goes above and beyond his or her job description, who anticipates problems before they arise, who works efficiently with the practice’s time and resources, and who strikes the right balance between exercising control and boosting morale when supervising staff. SDCMS member physicians can nominate their office managers by explaining in writing (up to 600 words) why their office manager is the best in San Diego ...

MICRA Update: Victory in the Capitol, but the Fight Goes On

California’s legislative session officially wrapped up last week, and because of aggressive advocacy by the California Medical Association (CMA) and action taken by thousands of California physicians, a bill to scuttle the state’s Medical Injury Compensation Reform Act (MICRA) was never introduced. Despite weeks of pandering to members of the Legislature, California’s trial lawyers, along with their front group Consumer Watchdog, were unable to find enough legislators to vote for their greedy and misguided effort at lifting MICRA’s historic protections for their own financial gain. A majority of the Legislature ...

Continuing Nationwide Shortage of Tuberculin Skin Testing Antigen

September 17, 2013 This CAHAN updates the August 28, 2013, alert on the nationwide tuberculin skin testing (TST) antigen shortage and notifies local providers regarding changes in routine tuberculosis (TB) screening at County of San Diego Health and Human Services Agency (HHSA) Public Health Centers (PHCs). The ongoing national shortage in TST antigens has caused reduced supplies throughout the community. In order to assure resources are available for groups at increased risk for TB, HHSA PHCs will no longer provide routine TB testing for individuals with health insurance. Routine testing includes ...

CMA Legislative Update as of September 6

By the California Medical Association (CMA) Scope Bills: SB 491 — Nurse Practitioners: CMA had a great victory with the desired outcome of having SB 491 held on suspense. Essentially, the bill failed in committee and is done for the year. Unlike the Senate, the Assembly Appropriations Committee estimated significant costs associated with SB 491. We expect that the author will re-introduce a scope bill next year. We are also being very vigilant about ensuring that there is no attempt to do a “gut and amend” at the end ...

CMA Comments on the Medicare 2014 Fee Schedule

Click Here to Access the Below Letter in PDF Click Here to Access the Multi-state Letter to CMS Click Here to Access an Excel Spreadsheet on the Impact of the Proposed CY 2014 GPCI Cost Share Weights on Locality GAFs September 6, 2013 Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert H. Humphrey Building, Room 445-G 200 Independence Avenue, SW Washington, DC 20201 Re: Payment Policies under the Physician Fee Schedule Proposed Rule for CY 2014 78 Fed. Reg. 43,281 (July 19, 2013); CMS-1600-P; RIN 0938-AR56 Dear Administrator Tavenner: The California Medical Association (CMA) ...

Medicare Transition to Noridian on MONDAY!

We are just days away from the September 16 cutover date from Palmetto to the new Medicare Part B fee-for-service contractor, Noridian. Although efforts have been made to minimize the burden to practices and to ensure that physicians continue to receive their Medicare payments in a timely fashion after the transition, there are a number of things physicians should be aware of, including: Last Day to Submit to Palmetto: September 11, 2013, is the last day providers may submit electronic claims to Palmetto (2:00pm cutoff time), and the last day ...

Incarcerated Beneficiary Recoveries From Providers

In June and July 2013, the Centers for Medicare & Medicaid Services (CMS) initiated recoveries from providers and suppliers based on data that indicated a beneficiary was incarcerated on the date of service. Medicare identified previously paid claims that contained a date of service partially or fully overlapping a period when a beneficiary was apparently incarcerated based on information CMS receives from the Social Security Administration (SSA). As a result, a large number of overpayments were identified and overpayment (demand) letters sent. CMS has since learned ...

HIPAA Omnibus Rule Compliance FAQs

On January 25, 2013, the U.S. Department of Health and Human Services published new regulations that made significant changes to the privacy and security requirements under the Health Insurance Portability and Accountability Act (HIPAA). These new regulations, known as the HIPAA Omnibus Final Rule, implement many of the key provisions of the Health Information Technology for Economic and Clinical Health Act (HITECH) Act of 2009. Covered entities and their business associates have until September 23, 2013, to comply with the new rule. CMA's "HIPAA Omnibus Rule Compliance FAQs" answers most ...