Monday, December 18, 2017

OCMA Blog

Act now to avoid a 4% Medicare penalty in 2019

Act now to avoid a 4 percent Medicare penalty in 2019 (Spoiler alert: It’s easy!)

This is the first year physicians need to report on quality measures under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS). Eligible professionals who fail to report in 2017 face a 4 percent payment penalty in 2019. But did you know that physicians only need to report on one quality measure for one patient during 2017 in order to avoid a payment penalty in 2019?

During the 2017 transition year, CMS will allow physicians to select one of three “pick your pace” participation options. Participating at any level in 2017 will ensure that you will not be hit with the 4 percent pay cut in 2019.

The most lenient participation option—reporting on one measure for one patient—allows physicians to avoid a penalty by "testing" the program to ensure that their systems are working and that they are prepared for broader implementation in 2018 and beyond.

The American Medical Association (AMA) has published a video, “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” with step-by-step instructions on how to report so physicians can avoid a negative 4 percent payment adjustment in 2019.

The California Medical Association (CMA) has also published a MACRA resource page at www.cmanet.org/macra to help physicians understand the new payment reforms and what they can do now to start preparing for the transition. Also available in the CMA MACRA resource center is an overview of MACRA, and a comprehensive list of tools, resources and information from CMA, the American Medical Association and CMS.


California Physicians Oppose Graham-Cassidy Repeal Bill

The U.S. Senate is currently considering the Graham-Cassidy block grant bill, which would repeal the Affordable Care Act’s (ACA) insurance mandate, underfund health insurance subsidies and make drastic cuts to the Medicaid program. Under the bill, traditional Medicaid funding would be capped. Medicaid expansion and ACA subsidies for low- and middle-income families would be subject to an underfunded block grant and phased out in 2027. This bill would be disproportionately harmful to states like California, which embraced Medicaid expansion and increased coverage under the ACA. 

In response, the California Medical Association (CMA), representing over 43,000 physicians in all specialties and modes of practice, called on the California Congressional Delegation to oppose this bill. Congress should work with health care professionals to craft legislation that increases patient access to health care and maintains coverage for the more than 15 million Californians insured through Medi-Cal and Covered California.
  

“This bill would significantly reduce Medicaid funding, which provides health coverage for more than 13 million Californians,” said CMA President Ruth Haskins, M.D. “A vote for this legislation is a vote to deteriorate public health in California – especially in areas like the Central Valley, where approximately half of the population relies on Medicaid for health care.”  Patients without coverage seek more expensive care in overcrowded emergency rooms, passing costs on to states, counties, health care providers and taxpayers. These problems would be exacerbated by the reduction of subsidies currently provided to poor and middle class families. The Graham-Cassidy bill also allows states to do away with pre-existing condition protections and other essential health benefits that keep Americans healthy.  

“Congress should engage with physicians and other medical experts on the front lines caring for patients to develop legislation that improves patient access to physicians, protects coverage for our most vulnerable populations and addresses affordability,” said Dr. Haskins.


Honoring the Work of the Waste Not OC Coalition

Today, in the House of Representatives, Congressman Lou Correa honored the work of the Waste Not OC Coalition.  His full speech can be read by clicking here


NEPO to host Building Healthy Communities Summit Oct. 19-20

The Network of Ethnic Physician Organization (NEPO) Building Healthy Communities Summit is taking place immediately before the California Medical Association (CMA) House of Delegates on October 19-20, at the Disneyland Hotel in Anaheim. This year’s conference theme – “Striving for Health Equity in the Era of Change" – will focus on emerging health policy issues and solutions as we strive to achieve health equity and reduce health disparities.

The summit agenda will include a thought-provoking array of plenary sessions and workshops. Attendees will hear from nationally acclaimed thought leaders, learn about emerging health care policy issues and share best practices on how to reduce health disparities.

“Building healthier communities is a key component of what community physicians are all about,” said NEPO Chair Margaret Juarez, M.D. “The NEPO Summit helps physicians and health care providers connect to work with organizations across the state to make California healthier for all.”

This annual symposium has drawn an increasing crowd of motivated physicians, interested in advancing their expertise in health policy as an adjunct to their practice of medicine. Featuring keynote addresses by Robert K. Ross, M.D., President and CEO of the California Endowment, and Senator Ricardo Lara (D-Bell Gardens), the NEPO Summit will provide you with opportunities to network with policymakers, health care advocates and thought leaders, alongside breakout sessions on topics as diverse as the impact of immigration laws on health care, physician mental health, and addressing maternal morbidity and mortality.

Register by September 15 to take advantage of the early-bird rate of $199. Participants can earn up to 12 AMA PRA Category 1 Credits™ of continuing medical education.

For more information or to register, click here


Have You Received A Termination Notice from Blue Cross Recently?

The California Medical Association (CMA) has heard from several physicians who have received unexpected termination notices from Anthem Blue Cross. The notices, which specify no cause for termination, appear directed only to physicians who refer to out-of-network ambulatory surgical centers. If you have recently received a similar termination notice from Anthem Blue Cross, CMA wants to hear from you. Please contact CMA's Reimbursement Helpline at (888) 401-5911 or economicservices@cmanet.org

 


O.C. Health Care Agency Advisory: Recall of Tuna Potentially Contaminated with Hepatitis A

A recall has been issued of frozen tuna potentially contaminated with hepatitis A which was sourced from Sustainable Seafood Company, Vietnam, and Santa Cruz Seafood Inc., Philippines. This voluntary recall was issued as part of an ongoing Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) investigation. The complete recall advisory can be found at: https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm561199.htm.

The Health Care Agency's Advisory can be found by clicking here.

 

 


Serve on CMA's Standing Councils and Subcommittees

The California Medical Association’s (CMA) Board of Trustees is seeking applications or nominations for members interested and willing to serve on CMA's Standing Councils and Subcommittees for 2017-18. Appointments begin and expire at the conclusion of the House of Delegates, and current members eligible for reappointment must submit a new application for the 2017-18 term.
 
The Committee on Nominations will also contact each Council/Subcommittee Chair for evaluation of their respective committee members, and Component Medical Societies may also inquire about a member’s performance.
 
Please distribute this solicitation to any and all interested parties.

  • Term Length/Duration: One (1) year
  • Time Commitment: Up to four (4) meetings per year with one (1) potentially in-person. Council meets as needed.
  • Requirements: Member of the CMA in good standing.
  • Staff Contact: Michelle Chapanian, (916) 551-2054, mchapanian@cmanet.org

DEADLINE: June 13, 2017.
Please submit to nominations@cmanet.org with a completed application form (PDF or Word), brief CV (less than five pages) and statement of interest.

Attachments:

  • Nominations Form/Application: PDF and Word
  • Councils and Subcommittees Information Packet:
    • Solicitation Letter
    • Councils and Subcommittee Membership Roster
    • List of Councils and Subcommittees and Council/Subcommittee Charges
    • CMA Bylaws Provisions Governing Councils/Subcommittees
    • CMA's Conflict of Interest Policy


Tell regulators how new out-of-network billing and payment law will affect your practice

On July 1, 2017, a new law (AB 72) will take effect that will change the billing practices of non-participating physicians providing non-emergent care at in-network facilities including hospitals, ambulatory surgery centers and laboratories. The law, signed in 2016, was designed to reduce unexpected medical bills when patients go to an in-network facility but receive care from an out-of-network doctor.
  

To ensure health plans and insurers do not game the system to pay artificially low reimbursement rates to physicians, we need all physicians to take action by contacting the health plan/insurance regulators to express the importance and potentially negative impacts of this law if not implemented correctly.

A sample letter is provided on the CMA website.
 
NOTE: For this effort, phone calls will not be as effective.  We are asking that you submit your statement via email or mail so that there is a tangible record of your comments.  

Description
AB 72, passed by the California Legislature and signed into law this year, would require an “interim payment” to physicians and place limitations on the ability of physicians who do not contract with a patient’s health plan or insurer to collect their full billed charges for non-emergency services performed at a contracting health facility.

 


#UpliftOC with Simple Acts of Kindness

County of Orange, CA Health Officer Dr. Eric Handler describes how practicing simple acts of kindness is actually good for YOUR mental health and well-being, in addition to the folks around you -- and how to implement the practice into the family and school settings. Share your simple acts of kindness with us on social media with the hashtag #UpliftOC!

https://www.youtube.com/watch?v=SVimYOug8v8

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