Sunday, December 17, 2017

OCMA Blog

CURES On-Demand Webinar

July 1, 2016 is the deadline for mandatory CURES registration for all physicians with an active medical license and a Drug Enforcement Agency certificate. In order to help prepare physicians, CMA hosted a webinar on the CURES 2.0 registration process, which was presented by the Department of Justice. The webinar is now available on-demand in the CMA Resource Library and is free for both members and non-members. Please click here to view the CURES 2.0 webinar


Covered California Provider Education News: Know Your Participation Status

Covered California: Know Your Participation Status

In late April 2014, the California Medical Association (CMA) surveyed physicians about their contracting experience with Covered California plans. Eighty percent of respondents reported that they had been confused about their participation status in a Covered California plan and that they believed such confusion had negatively impacted patient care.

Unfortunately, checking your practice's participation status is not as straightforward as it might seem. Plagued with inaccuracies, Covered California took down its cross-plan provider directory earlier this year. Add to that the fact that some exchange plans have used vague contract terms and amendments that rope physicians into participating in their exchange networks, often without their express consent or knowledge, and you'll see that "do you take my insurance" is not always an easy question to answer. 

CMA has developed a toolkit to assist physicians with checking their participation status within Covered California. Click here to download the Know Your Status toolkit.

Meet your Covered CA Provider Educator, Karli Nevarez

Karli is available to provide and distribute multilingual patient education materials for your practice or medical group, as well as appear in person to facilitate a brief presentation or answer questions for your staff. These presentations are for physicians and their staff to gain a better understanding of Covered California and the products offered through the exchange. Karli's services are available to both members and non-members of OCMA.

If you would like Karli to come to your practice or medical group to deliver materials and/or present to your staff, you may contact her at: (310) 818-6998 or knevarez@thecmafoundation.org.  
 
You can also fill out the Covered CA Information Request Form and fax or email the form back to the OCMA. 


MICRA lawsuit measure assigned proposition number

Via the California Medical Association-

The unprecedentedly broad and diverse coalition working to defeat the trial lawyers’ MICRA lawsuit measure is now officially the “No On 46” campaign, following the assignment of proposition numbers to qualified ballot measures by the Secretary of State’s Office on Monday.

If approved by voters, Proposition 46 would increase health costs, reduce access to care and threaten patient privacy, all to make it easier and more profitable for lawyers to sue doctors and hospitals. In addition to increasing the overall number of medical lawsuits and the cost of health care across the board, Proposition 46 contains a number of unrelated provisions designed to mislead and deceive voters – including a little-discussed mandate relying on a massive expansion of a government-run prescription drug database, which third-party analysts say cannot be implemented as written and will leave personal medical information vulnerable to privacy breach.

For these reasons, health providers, education groups, labor unions, business organizations, working men and women, and community clinics have all announced their opposition to Proposition 46.

On Monday, two additional groups – the State Building and Construction Trades Council of California (SBCTC) and the California NAACP – joined the “No On 46” campaign, pointing out the devastating effects it would have on California.

“This initiative will cost state and local governments hundreds of millions dollars and raise health costs for everyone,” said Robbie Hunter, President of the SBCTC. “That hurts job creation and will negatively impact California’s future.”

According to California’s independent Legislative Analyst, the proposed measure could increase state and local government health costs by “hundreds of millions of dollars annually.”

“This measure is terribly flawed and will reduce access to quality health care for underserved communities,” said Alice Huffman, President of the California NAACP. “At a time when we’re working hard to cover as many Californians as possible under the ACA, Proposition 46 takes us in the wrong direction. Proposition 46 will disproportionately hurt minority communities. It’s bad medicine for California.”

These two organizations join the growing list of California public entities and private organizations that have announced their formal opposition. For a complete list, please visit the campaign website, www.noon46.com.


Another Trial-Lawyer Backed Health Care Initiative

MICRA isn’t the only ballot issue facing California doctors this year – a health care rate regulation initiative threatening provider reimbursements is also on the November ballot. The same trial lawyer-backed group pushing to change MICRA is sponsoring a separate rate regulation ballot measure that would give the Insurance Commissioner new powers to approve or reject insurance rates, benefit levels, co-pays and deductibles, which would impact payments to providers and limit patient access to care. 

The Orange County Medical Association (OCMA) joins the California Medical Association (CMA) in opposition to this initiative. We are encouraging our members to join the official campaign opposed as individual physicians. 

The measure
  • Gives the elected State Insurance Commissioner new powers to set insurance rates at levels which don’t meet the cost of providing care, resulting in lower reimbursements to providers and ultimately reduced access to care for patients.  
  • Gives one politician the power to approve or reject benefits, interfering with care decisions that are better made between doctors, healthcare providers and patients. 
Not surprisingly, the proponents drafted the measure without any input from physicians, patients, hospitals, or other health care providers – even though it will create a massive new layer of health care regulation in California.

Of course, the real motive of the proponents is found buried in its language – a provision which opens up a new mechanism that allows the proponents and their trial lawyer backers to file lawsuits in rate proceedings, bleeding off invaluable health care dollars to line their own pockets.

We know defeating the MICRA initiative is a top priority. But we urge you to join us in also fighting this measure as it will have a significant impact on provider reimbursements and patient access to care.

Please join OCMA and a broad coalition of doctors, hospitals and health care providers in opposing this measure. 

If you would like to join the campaign’s media training webinar on May 8, please contact Kyle Griffith via email at kgriffith@bcfpublicaffairs.com

CMA Resource: Surviving the Second Month of Covered California

As of January 15, Covered California reports that more than 625,000 individuals have enrolled in exchange plans. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect.

To help answer some of the more common questions, the California Medical Association (CMA) offers a second tip sheet as a members-only benefit to help physicians survive the second month of Covered California. To access the full Covered CA tip sheet, click here or visit  http://www.cmanet.org/resource-library/detail/?item=surviving-the-second-month-of-covered.


OCMA hosts Leaders Toolkit: A two-day course for physicians seeking leadership roles in organized medicine


Leadership, except for the amazing few, is a learned art.

The Leader's Toolkit is a Socratic seminar (via a didactic "lecture") that covers the key elements of leadership in a very concise manner. While there will be some theory, we will highlight actionable behavior, tools, and concepts that you will (or should) use every day. This two-day course is available to CMA/OCMA members only.

What Will Be Covered:

  • Strategy: Knowing when to change, change management, strategic planning, strategic execution
  • Leading Your Team: Non-delegatable responsibilities of the leader, setting boundaries - management philosophy, making decisions
  • Building Your Team: Hiring (and firing)
  • Managing Your Time: Setting priorities, managing your time
  • Managing Your Meetings: Running a Meeting, parliamentary procedure
  • Managing Your Organization's Money: assessing your financials from the CEO's perspective and knowing the correct questions to ask
  • CMA/CMS Structure: Understanding and leveraging this critical relationship from a physician leader's perspective
  • Managing Your Message: Communicating by email, communicating one-to-one, having difficult conversations, negotiating, communications with your customer (aka marketing)

Meeting Dates & Times: 
Leader's Toolkit will begin promptly at 8:00 am on Saturday, March 22, 2013 and includes a mandatory dinner that evening. We will convene again at 8:00am on Sunday, March 23rd. We will conclude at 12 noon.
 
Presenter:
Tom Gehring, CEO, Executive Director of the San Diego Medical Society, has taught this immensely popular seminar for the past 5 years. 
 
Location:
OCMA Conference Center
17322 Murphy Ave.
Irvine, CA 92614

Registration Information
 
RSVP: Fax the form to 916.551.2563 or contact Jennifer Moller, CMS Services at 916.551.2541 or jennifer@cmsservices.org.
Space is limited so RSVP today!
 
Cost: This program is FREE to our members and offered as a member benefit. We do require that all participants purchase a set of 13 leadership and reference books which are discussed during the seminar and provide the attendee valuable resources for further study and reference. This collection of books may be purchased directly from Amazon (list will be provided) and most are available as e-Books, hard-bound and/or as paperbacks and cost between $150 - $200 for the set.
 
Class size is limited to 16 attendees and reservations are taken on a first-come, first-served basis. Meals over the two days will be provided by CMA including dinner on Saturday night. Travel and lodging costs are the responsibility of the attendee.  
 
Attire: No ties, no suits, no fancy attire - jeans are just fine. California casual, please.

"My participation in the Leader's Toolkit seminar was useful in so many ways - some unexpected. I have been more effective at communicating within my family, at my workplace and among the leadership at my hospital. I recommend this course to all physicians who want to advocate for patients or for other doctors, who hold any leadership role in their practice, hospital, community or medical group, or who have any aspirations for such a role." 
- Ruth Haskins, M.D.


CMA Develops Simple Tool to Identify Physician Participation Status in Exchange Plans

January 23, 2014

On January 1, 2014, Covered California began providing health coverage to more than 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so that they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted.

Even if you did not intentionally contract with any exchange plans, the California Medical Association (CMA) urges physicians to check their participation status. It is very possible that physicians may have been unknowingly opted into an exchange plan network due to the way that major insurance plans have structured their provider agreements.

If you've attempted to look up your exchange plan participation status on the Covered California website, you know that it's not a straightforward process. Because it is critical that physicians know what plans they are contracted with, CMA has created a quick and easy tool to look up your exchange plan participation status in just a few clicks.

The tool, available to members only, requires simply your first and last name and middle initial and it will tell you which plans list you as a contracting physician (as of September 2013, the most recent data released by Covered California). To access the tool, visit http://www.cmanet.org/exchange-lookup.

Please note: You will be required to login with a member account. If you have not already activated your web account, visit http://www.cmanet.org/activate. If you need assistance activating your account, contact CMA's member service center at (800) 786-4262 or memberservice@cmanet.org.

For more information on Covered California, visit CMA’s exchange resource center at www.cmanet.org/exchange. Physician members and their staff also have free access to CMA’s practice management experts at (888) 401-5911 or economicservices@cmanet.org.


CMA launches Covered California Provider Education Program

The California Medical Association (CMA) and the CMA Foundation have been awarded a $1.5 million grant from Covered California, the state's new health benefit exchange. The grant application was submitted in partnership with the Latino Physicians of California, the American Academy of Pediatrics and a number of CMA's component medical societies.
 
The grant is being used to establish the CMA's "California Health Benefit Exchange Outreach and Education Program." The goal is to help medical professionals across the state and their health care teams to educate their patients about the new coverage options available through Covered California and the financial assistance available to help pay for them. The program will focus more intensive outreach to physicians working in communities with a large number of consumers eligible for Covered California.
 
Physicians are powerful and effective messengers to deliver information to patients. We will be working to educate not only physicians, but also the office and health care teams that support physician practices. We will work with registered nurses, medical assistants, nurse practitioners, physician assistants, office managers and other physician practice staff in the targeted geographic areas that have the highest number of newly eligible exchange enrollees. All staff working in a practice or clinic will have an opportunity to learn more about Covered California insurance plans to fully utilize their skills and potential in educating patients about exchange eligibility and enrollment.

Regional Outreach

The California Health Benefit Exchange Outreach and Education Program will have four regional Provider Educators, with one assigned to each of the following regions: 1) Fresno, Kern, Tulare and Kings Counties; 2) San Diego, Riverside and San Bernardino Counties; 3) Los Angeles and Orange Counties; and 4) San Joaquin, Santa Clara, Alameda and Contra Costa Counties. For those practices in regions not listed, CMA Foundation staff will provide outreach and education. 

Educational Strategy

The educational strategy will be a multifaceted approach that factors in the different physician practice environments and incorporates multiple strategies to communicate with the physicians and their health care teams. The approach will incorporate group learning sessions, focus groups, educational print medium and one-on-one "touches" supported by newsletters, webinars and e-communication.
 
We will develop learning communities of grantees, sub-grantees and other interested partners to share challenges and best practices and to help us use resources as effectively as possible.
 
Our strategy will also include the following: 

  • Identify the gaps in physician knowledge about the exchange and design educational messaging to address those gaps.
  • Create a master list of existing regularly held meetings of the association members and partners so that we can utilize the already built network and standing meeting schedule
  • Establish lesson plans to ensure consistency in presentations.
  • Identify physician champions to be trained to educate their peers and other health care professionals and staff.
  • Establish a Physician/Health Care Worker Subcommittee to provide message testing, guidance and input on presentations and one-on-one education.
  • Make resources available through the physician practice to patients, helping them understand Covered California.
  • Develop a physician toolkit comprised of essential outreach materials for physician champions and their health care teams to give to patients.
  • Work with hospitals and health plans to book training and education sessions in hospital grand rounds, regularly scheduled patient-support focused meetings and medical staff meetings.

Resources

For the full Covered California Grant Newsletter, click here.

For a list of Health Benefit Exchange resources available to physicians, click here.

All resources are available on the CMA website at  http://www.cmanet.org/issues-and-advocacy/cmas-top-issues/aca/.

OCMA members may contact Physician Advocate Mitzi Young with questions about Covered California and the Health Benefits Exchange at (888) 236-0267 or myoung@cmanet.org

OCMA Internist and Addiction Specialist Receives Gary Nye, MD Award

Max A. Schneider, M.D., an Orange County internist and addiction specialist, was given the Dr. Gary Nye Award at the 2013 at the California Medical Association (CMA) House of Delegates held this weekend in Anaheim. The award is given annually to a CMA member physician who has made significant contributions toward improving physician health and wellness.

Dr. Schneider for over 40 years has helped educate medical students, residents and physicians on addiction as a disease and the specific risks it poses for physicians. 

He was instrumental in establishing addiction medicine as part of the medical school curriculum at University of California, Irvine School of Medicine.

Dr. Schneider helped establish the concept of physician well-being committees and has served on the well-being committees for the Orange County Medical Association, St. Joseph’s Hospital, Children’s Hospital of Orange County and Chapman Hospital.

A fellow and past president of the American Society of Addiction Medicine, he also is past chairman of the Board of Directors of the National Council on Alcoholism and Drug Dependence and has served as a consultant to the Drug and Alcohol Advisory Committee of the U.S. Food and Drug Administration.

Dr. Schneider graduated from the University of Buffalo, School of Medicine in 1949. He practiced internal medicine in his native Buffalo for 11 years until 1964 and since 1964 has practiced in Orange County.

Resources to Assist Physicians with the Medicare Contractor Transition

Goal:   Provide members with information and resources to prepare their practices for the transition of Medicare contractors from Palmetto to Noridian on September 16 (Part B).

 

Current CMA Resources

 

1. CMA’s Medicare Transition webpage – CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access updates and important information regarding the transition in one easy-to-access to location. All resources related to the Medicare transition will be accessible through this site.

2. CMA’s Medicare Transition Guide: What physicians need to knowThis guide, which members can download free from the CMA website, includes an FAQ that includes information on the transition dates, what will remain the same with the transition and what will change, Noridian’s online provider portal, what practices can do to prepare for the transition, and links to additional resources and way to stay apprised of new information on the transition.

3. CMA Practice Resources (CPR)CMA Practice Resources is a free monthly newsletter from CMA’s practice management experts that focuses on critical payor and health care industry issues, including the Medicare transition, and how these issues directly impact the business of a physician practice. To sign up, visit the CMA website or contact CMA Member Services at (800) 786-4262.

4. CMA webinarAt the request of CMA, Noridian has agreed to conduct a webinar for CMA members on August 7 from 12:15-1:30pm.  The other webinars Noridian is offering is open to all provider types in California, Nevada, Hawaii, and the U.S. territories of American Samoa, Guam and the Northern Mariana Islands. However, the August 7 webinar will be limited to CMA members and will give attendees an opportunity to ask their specific questions. This webinar will be held at the OCMA Conference Center during a "Lunch & Learn." 
During the gathering, we will participate in the "live" CMA Medicare Transition webinar and then discuss any questions. To register for the Lunch & Learn, click here.


For those who miss the live webinar, it will be available on-demand via the CMA website.

 

5. Content alert updates - The CMA website allows registered users to create custom content alerts on the top­ics that are of interest to you. Once signed up, you will be notified any time there is new content posted in one of your interested areas, including Medicare issues. To sign up, users should visit their account dashboard on the CMA website and click on “my alerts,” then select “Insurance Reimbursement -> Medicare.”

 

CMA Resource in Development

 

  • Practice preparation checklist indicating all of the steps practices should take to prepare for the transition to Noridian. This document will be added to the Medicare Transition Guide.

 

MEC Engagement

 

The Priority Assistance Committee recommends that MEC proactively educate members about the resource available from CMA to help navigate contracting with the exchange.


  • Promote CMA Medicare transition website
  • Promote CMA’s Medicare transition guide
  • Promote Aug 7 Medicare transition webinar (promo from CMSS coming)
  • Include articles and announcements in CMS publications and communications
  • Alert CMA’s Michele Kelly 213/226-0338 mkelly@cmanet.org of any issues related to the transition. 

Additional Resources


  • Noridian’s transition website: The Noridian transition website includes information on what’s new/changing and what will remain the same during and after the transition.
  • Paul O’Donnell, Noridian (701) 277-2401.  NOTE: MEC are welcome to contact Mr. O’Donnell directly; however, it is important to keep CMA/Michele Kelly in the loop so that she is aware of issues as they arise.

 

Additional Medicare-related Resources

 

1.      Medicare Enrollment Guide for Physicians - This document guides  physicians through the enrollment process and assists enrolled physicians who are making changes or who must revalidate their enrollment.

2.      Getting Started with the Medicare Physician Quality Reporting System (PQRS) – this guide assists physicians with understanding and complying with PQRS.

3.      Medicare Electronic Prescribing Overview: Payment Incentives and Payment Reductions – Overview of electronic prescribing (eRX) program, including incentive payments for physicians who e-prescribe and payment penalties for physicians who do not.

4.      Medicare Part B Important Changes: What they mean to your practice

5.     Medicare Audit Guide for Physicians – Guide for preparing and responding to a Medicare audit.

6.      Various Medicare webinars available on demand at www.cmanet.org/events

7.      Numerous Medicare-related CMA On-Call documents can be downloaded at www.cmanet.org


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