Important Information on the Anthem Exchange Addendum As you may have seen in CMA's April 7 Alert, Anthem Blue Cross sent an addendum to over 11,000 practices who are participating in their individual / exchange network. The addendum makes changes to a prior addendum sent out in 2012. CMA has concerns with a few provisions, outlined in the Alert article. While CMA's article identifies issues with three provisions in the addendum, of significant concern is the language in section 12, which removes a participating physician’s ability to opt out of the individual / exchange product without affecting ... April 9, 2014 Health Plans Anthem 0 0 Comment Read More »
What Physicians Need to Know About the Anthem Exchange Addendum By the California Medical Association (CMA): April 8, 2014 Anthem Blue Cross recently notified over 11,000 practices who are currently participating in its individual / exchange network of a contract addendum that will become effective July 1, 2014. The amendment only applies to physicians who are currently participating in the Anthem Blue Cross individual / exchange network. According to the notice, which was mailed on March 31, the addendum contains new regulatory requirements. While many provisions are requirements of Covered California, the California Medical Association (CMA) has concerns with certain provisions ... April 9, 2014 Health Plans Anthem 0 0 Comment Read More »
Coordinated Care Initiative (Duals Project) Update By the California Medical Association Background The 2012 budget authorized the Coordinated Care Initiative (CCI), which would allow persons eligible for both Medicare and Medi-Cal (dual eligibles) to receive medical, behavioral, long-term supports and services (LTSS), and home- and community-based services coordinated through a single health plan in eight counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara). CCI contains two main components: 1) Cal MediConnect-transitioning individuals who are eligible for both Medi-Cal and Medicare (duals) away from fee for service and into managed care; ... April 9, 2014 Cal MediConnect Cal MediConnect, Coordinated Care Initiative, Dual Eligibles 0 0 Comment Read More »
SDCMS Medical Student Members Travel to Sacramento Students Who Attended: Amy Alagh, Mir Amaan Ali, Jeremy Chang, Andrew Fithian, Spencer Fuller, Shannon Green, Matthew Haynie, Yuki Iizuka, Yash Khandwala, Thomas Kwong, Fred Liu, Ming Liu, Tiffany Loh, Vidya Mahadavi, Vishnu Manoranjan, Nicholas Mascarenhas, Leselle Norville, David Nykin, Ellyse Rengstorf, Kellie Satterfield, Eileen Shi, Rehan Syed, Devesh Vashishtha, Arvin Wali, Jeffrey Wyss, Sherry Zhang The First Group of Medical Students Went up on March 24, Along With Dr. Robert Hertzka and Dr. Sherry Franklin: The Second Group of Medical Students Went up on March 25, Along With Dr. Robert Hertzka and Dr. Sherry Franklin: Meeting With Senator Joel Anderson: Meeting With Assemblymember Toni Atkins: Meeting With Senator Marty Block: Meeting With Senator Ben Hueso: Meeting With Assemblymember Brian Jones: Meeting With Assemblymember Brian Maienschein: Meeting With Assemblymember Dr. Richard Pan: Meeting With Assemblymember Marie Waldron: Meeting With Assemblymember ... April 7, 2014 SDCMS Membership Legislators, Medical Students 0 0 Comment Read More »
Senate Votes to Stop the 24% Medicare SGR Payment Cut Tonight (Monday) the Senate voted 64–35 to adopt HR 4302, the 17th patch to stop the 24% Medicare SGR payment cut for one year until April 2015. The cut was scheduled to take effect tomorrow. The House approved the same bill last week. It will now move to the president’s desk where we expect a signature. Despite Congress’s failure to achieve long-term reform, there is a silver lining for California physicians. HR 4302 includes the following: Stops the Medicare SGR 24% payment cut for one year ... March 31, 2014 SGR SGR 0 0 Comment Read More »
MICRA Signatures Submitted, Physicians Must Rally to Oppose Trial Lawyers on All Fronts On Monday, March 24, Consumer Watchdog, a front group for the Consumer Attorneys of California, submitted roughly 830,000 signatures to qualify a measure for the November ballot that would scrap key provisions California’s Medical Injury Compensation Reform Act (MICRA). This deceptive measure will raise healthcare costs for all Californians by lifting MICRA’s cap on non-economic damages, thus increasing lawsuits against healthcare providers and decreasing access to care for patients across the state. California’s physician community must join together and oppose this dangerous measure. This same trial lawyer group is also ... March 25, 2014 MICRA MICRA 0 0 Comment Read More »
Members: Get Your Photo Taken for Free SDCMS is working with RCL Portrait Design to photograph our member physicians for our directory and website. Photographs will be taken at the locations and dates listed below (subject to change, please confirm appointment beforehand). There is no cost for you to participate. Additional portraits will be made available to those physicians wishing to purchase them; however, there is no obligation to do so. To schedule your appointment, call RCL Portrait Design at 1 (800) 951-8712 — you can make an appointment for any location. For professional quality and best presentation, ... March 25, 2014 Member Benefits Physician Photos 0 0 Comment Read More »
Healthcare Changes Are Coming for Dually Eligible Medi-Cal and Medicare Patients! Effective April 1, 2014, the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS) will be rolling out Cal MediConnect, a new program to coordinate care for some of San Diego’s most vulnerable patients. Cal MediConnect, a three-year demonstration project for patients dually eligible for Medicare and Medi-Cal, is part of the California Coordinated Care Initiative (CCI). This demonstration project will give participating health plans responsibility to coordinate Medi-Cal, Medicare, and long-term services and supports previously offered by the State and through the County ... March 25, 2014 Cal MediConnect Cal MediConnect, Dual Eligibles 0 0 Comment Read More »
Medicare EPs Must Attest by March 31, at 11:59pm ET to Receive 2013 Incentive Reminder: Medicare Eligible Professionals (EPs) Must Attest by March 31, 2014, at 11:59 pm ET to Receive 2013 Incentive! From the Centers for Medicare & Medicaid Services Due to the large volume of providers attesting, please submit your data as soon as possible and during non-peak hours to avoid system delays. If you are an eligible professional, the last day you can register and attest to demonstrating meaningful use for the 2013 Medicare EHR Incentive Program is March 31, 2014. You must successfully attest by 11:59pm Eastern Daylight Time on March ... March 25, 2014 Meaningful Use, Medicare Meaningful Use, Medicare 0 0 Comment Read More »
Got Drugs? The National Prescription Drug Take Back Day — Saturday, April 26, 10:00am–2:00pm — aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications. Click below to access various PDF flyers for your office: All San Diego County Locations: English • Spanish • Tagalog Central San Diego County Locations Northern San Diego County Locations Eastern San Diego County Locations ... March 25, 2014 Prescription Drug Abuse Prescription Drug Abuse, Prescription Drugs 0 0 Comment Read More »