Initiative Update: YES ON Proposition 35 to Protect Our Health Care INITIATIVE UPDATE:YES ON Proposition 35 to Protect Our Health Care August 2, 2024 San Diego County Medical Society proudly supports Yes on Prop 35 — a November ballot measure that will address our most urgent health care priorities by securing ongoing revenue and dedicating these funds to protect and expand access to care at primary care and specialty care physicians, community health clinics, hospitals, emergency rooms, family planning and mental health providers. Why Proposition 35 Matters California’s health care system is in crisis. Hospitals are closing. Emergency rooms are overcrowded. More than 40 ... August 2, 2024 CMA, Medi-Cal, SDCMS Membership YESON35 0 0 Comment Read More »
"Yes on 56" Campaign Supplies San Diego County physicians are invited to show their support for the “Yes on 56” campaign by requesting campaign materials from SDCMS and then stopping by or offices (5575 Ruffin Road, Suite 250) to pick them up when your campaign packet is ready. Email Jennipher Ohmstede at SDCMS — JOhmstede@SDCMS.org — and let her know how many of the following supplies you’d like; she’ll let you know when your packet is ready to be picked up (note: some supplies like posters can be downloaded by clicking here): ... September 20, 2016 Medi-Cal, Public Health Tobacco Tax, Yes on 56 0 0 Comment Read More »
Ensure You Receive Maximum Incentive Funds Champions for Health can assist primary care and specialty care physicians with new reporting to ensure you receive maximum incentive funds. Those physicians registered for Medi-Cal (30% of practice) are eligible to receive FREE technical assistance, with very low-cost technical assistance available for Medicare providers. SDCMS members qualify for a 40% discount. For further information, email Barbara.Mandel@SDCMS.org or call (858) 300-2779. May 26, 2016 Medi-Cal Incentive Funds, Quality Reporting 0 0 Comment Read More »
DHCS Begins Recouping Retroactive Medi-Cal Radiology Cuts May 11, 2016 In 2010, the California state budget included cuts to Medi-Cal radiology rates, stipulating that the maximum reimbursement rates for radiology services could not exceed 80 percent of the Medicare rate for the same or similar services. The Department of Health Care Services (DHCS) did not, however, implement the rate reduction until July 20, 2015, with retroactive cuts going back to October 2012. To recoup the retroactive cuts, DHCS recently announced that it would be offsetting overpayments against amounts due. Physicians affected by this retroactive recoupment were notified by ... May 11, 2016 Medi-Cal DHCS, Medi-Cal, Radiology 0 0 Comment Read More »
CMA Responds to Unveiling of Governor Brown’s Proposed 2016–17 State Budget January 7, 2016 Steve Larson, MD, president of the California Medical Association (CMA), representing over 41,000 physicians statewide, issued the following statement in response to the unveiling of Governor Brown’s proposed 2016–17 state budget released this morning: “We are pleased to see the governor is committed to working with the Legislature and health plans to find a solution to the MCO tax. Without that, a gaping hole would exist in the state’s Medicaid (Medi-Cal) fund that would have devastating impacts on patients across the state. “Ensuring that Medi-Cal is better funded is ... January 7, 2016 CMA, Medi-Cal Medi-Cal, State Budget, Tobacco Tax 0 0 Comment Read More »
CMA Capitol Insight With Anthony York: July 7, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Signatures and Special Sessions A controversial measure was signed into law last week by Gov. Jerry Brown — Senate Bill 277 (Pan), which eliminates the personal belief exemption from mandatory vaccinations for all public school children. The real question now is what comes next. Brown’s signature sets off a 90-day clock for opponents of the bill to qualify a referendum. If the requisite signatures are gathered, the measure would not go ... July 7, 2015 Medi-Cal, Vaccinations End of Life Option Act, Medi-Cal, SB 128, SB 277 0 0 Comment Read More »
CMS’ Open Payments Posts Full Year of 2014 Financial Data Financial Transactions Between Doctors and Medical Manufacturers Total $6.49 Billion — June 30, 2015 By the Centers for Medicare & Medicaid Services The Centers for Medicare & Medicaid Services (CMS) today published 2014 Open Payments data about transfers of value by drug and medical device makers to healthcare providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals, totaling $6.49 billion. Acting CMS Administrator Andy Slavitt said, “Consumer access to information is a key component of delivery system reform and making the ... June 30, 2015 CMS, Medi-Cal, Medicare, Sunshine Act Open Payments, Sunshine Act 0 0 Comment Read More »
DHCS Continues Fixes to Computer Systems for ACA Primary Care Rate Increases DHCS Continues Fixes to Computer Systems for ACA Primary Care Rate Increases By the California Medical Association As of April 11, 2014, the Department of Health Care Services (DHCS) updated its computer systems to process individual fee-for-service (FFS) claims at the new higher rates under the Affordable Care Act (ACA) primary care provider rate increase. With that update DHCS also released local code crosswalks for evaluation and management (E/M) and vaccine administration codes. There were, however, a few remaining exceptions for some specialized claims that were being paid at the lower ... August 4, 2014 ACA, Medi-Cal Medi-Cal Primary Care 0 0 Comment Read More »
Implementation of AB 97 Medi-Cal Provider Payment Reductions The Department of Health Care Services (DHCS) has announced the implementation plan for the provider payment reductions required pursuant to Assembly Bill 97 (Chapter 3, Statutes of 2011). AB 97 requires DHCS to implement 10% provider payment reductions to most categories of services in Medi-Cal fee-for-service (FFS) as well as actuarially equivalent reductions in Medi-Cal managed care. DHCS received federal approval for the reductions, effective June 1, 2011, but has been prevented from implementing many of these reductions due to a court injunction in the Managed Pharmacy Care, et al ... July 28, 2014 Medi-Cal AB 97, Medi-Cal Cuts 0 0 Comment Read More »
Physician Experiences With Access Issues in the Medi-Cal System The California Medical Association (CMA) is partnering with several organizations throughout the state to collect providers' stories that demonstrate Medi-Cal network inadequacy and hindered access to continuous, quality care for Medi-Cal beneficiaries. Collecting as many stories as possible is essential for mobilizing effective advocacy efforts around access and payment reform with Medi-Cal managed care health plans and the Department of Health Care Services (DHCS). More than a million new beneficiaries have enrolled in Medi-Cal since January 1, 2014, yet impending cuts threaten to make Medi-Cal the lowest-paying Medicaid program in ... May 28, 2014 Medi-Cal Medi-Cal 0 0 Comment Read More »