Sunday, August 19, 2018

OCMA Blog

2014 CalOptima Circle of Care Award: Requesting Nominations

About CalOptima and the Circle of Care Award
 
CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner.

The CalOptima Circle of Care Award recognizes health care professionals, community groups and individuals who demonstrate excellence in the delivery of accessible and high-quality health care services to CalOptima members. The award honors those who go above and beyond in serving their profession, patients or clients. Since the award’s inception in 2000, CalOptima has recognized more than 250 distinguished people or groups whose dedication to our members and community is extraordinary.   
 

Nomination Criteria and Deadline
 
Please join CalOptima in recognizing outstanding health care professionals, community groups and individuals who, in the past 12 months, went above and beyond to serve our members by submitting the attached Nomination Form. Award recipients will be selected based on:
•         The nominee’s service to CalOptima members
•         The nominee’s accomplishments during the past 12 months

Nominators, please note the following criteria:

  • A nominee may only be a Circle of Care Award recipient a total of five times.
  • Only one Nomination Form per nominee is needed.
  • Self-nominations are welcome.
  • Completed Nomination Forms must be submitted by Friday, June 20, 2014.

Click here for the Nomination Form

Mail, deliver, fax or email Nomination Forms to:         

CalOptima Provider Relations Department 
Attention: Maria Wahab
505 City Parkway West, Orange, CA 92868
Email: mwahab@caloptima.org 
Fax: 714-796-6679  

Award recipients will receive an invitation to attend the Circle of Care Awards luncheon on Friday, September 12, 2014.  
 
If you have any questions, please contact Maria Wahab at 714-796-6143. Please allow adequate time before the nomination deadline for CalOptima to respond to any inquiry.


Now Accepting Nominations for the 2015 Physicians of Excellence Awards!

Is your doctor the BEST in Orange County?

Nominate him or her for the 2015 Physicians of Excellence Awards!

OC Register Magazine in conjunction with the Orange County Medical Association (OCMA), will publish its annual list of Orange County Physicians of Excellence in the February 2, 2015 issue of OC Register Magazine, and is currently seeking nominations. The Physicians of Excellence program was designed to honor outstanding physicians practicing in Orange County. The selection criteria that will be used to determine physician excellence were developed by a multi-specialty collaboration of the OCMA. Anyone can nominate a physician to be considered for the Physicians of Excellence program. Physicians need to be nominated only once to be eligible to apply for selection as a Physician of Excellence. Multiple nominations for the same physician are discouraged. Self-nominations will not be accepted. Once nominated, an application packet will be mailed to the nominee with the details of the application process. Membership in the OCMA is not a requirement for selection.

Minimum criteria for Physicians of Excellence include:

  • Hold board certification within specialty of nomination.
  • Maintain a primary practice location in Orange County, California for the last 5 years.
  • Be in good standing with the Medical Board of California
  • Have been in practice within his/her specialty field for the last 5 years consecutively
Nominators are not required to certify that the physician they are nominating meets these criteria.


Nomination forms are located at: 
www.ocma.org/ForPhysicians/Programs/PhysiciansofExcellence.aspx

You may also download the form by simply clicking here.
 
Submit your nomination form to the Orange County Medical Association by July 10, 2014
 
Send to:
OCMA, 17322 Murphy Avenue, Irvine, CA 92614 or 
fax to (949) 398-8120. 
For questions call (949) 398-8100 ext 106 


The Doctors Company Alert: Windows XP Use May Trigger HIPAA Non-Compliance

Alert from The Doctors Company:

Now that Microsoft has stopped supporting the Windows XP operating system, physician practices using Windows XP face threats from viruses, Trojans, and other potential security breaches. All PC workstations and laptops using Windows XP that contain Protected Health Information (PHI) are no longer compliant with HIPAA and the HITECH Act. This includes devices used to access PHI via the Internet. HIPAA Security Rule section 164.308(a)(5)(ii)(B) states that practices must implement “procedures for guarding against, detecting, and reporting malicious software.” This is no longer possible with Windows XP.

If your practice system currently runs on Windows XP, follow these tips immediately to bring your practice into HIPAA compliance:

  • Identify all at-risk workstations and laptops.
  • Analyze the hardware in all at-risk computers to determine if they are capable of running a new operating system, such as Windows 7 or 8.
  • Upgrade all at-risk computers identified as capable of running a new operating system.
  • For computers that cannot be upgraded, either replace the hardware or purchase new computers.
  • Create a transition plan for upgrading or replacing computers.
Internet Explorer 8 is also no longer supported—if your practice is running Windows XP and using Internet Explorer 8, you may be exposed to additional threats.


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

Cooperative of American Physicians, Inc. and Orange County Medical Association Offer 3-part CME Seminar for Physicians

Part One: "Treating Pain in Today's World: Avoiding the New Pitfalls"


LOS ANGELES, CA (April 15, 2014) - The Cooperative of American Physicians, Inc. (CAP) and the Orange County Medical Association (OCMA) are joint sponsors of "Treating Pain in Today's World: Avoiding the New Pitfalls," the first topic in a three-part continuing medical education (CME) series on opioid education.  This topic will be presented on Monday, May 5, 2014 at 6 p.m. at the Orange County Medical Association Conference Center in Irvine, CA.

Chronic pain is a major concern and affects approximately 100 million people in the U.S., according to the Institute of Medicine of the National Academies, and one of the most common reasons for patients to seek medical care.  Physicians are in a key position to balance the benefits and risks of opioid therapy.  They often struggle with the need to assist patients who require management of chronic pain while confronting the risks associated with prescribing opioids.

"CAP's sponsorship of the opioid education series is part of our ongoing commitment to support programs that teach physicians how to reduce their liability risks and improve patient safety, so they can focus on what they do best - providing excellent care," said James L. Weidner, Chief Executive Officer of CAP.

The featured speaker is Standiford Helm II, MD, Medical Director at the The Helm Center for Pain Management and Immediate Past-President of OCMA.

After attending "Treating Pain in Today's World: Avoiding the New Pitfalls," physician participants should be able to:
 

  • Understand the law and new regulations that govern the use of opioids to control pain
  • Understand the multi-discipline methods for controlling pain
  • Describe appropriate assessment, monitoring and documentation strategies to support opioid prescribing
  • Learn how to evaluate the benefits of prescriptive opioids against the potential risks
  • Utilize PDMP/CURES as a tool to discover questionable prescription opioid activity

To register and for more information, please visit: https://treatingpain.eventbrite.com.  OCMA and CAP members may attend this seminar for free.  Registration is required.


Physician Advocate Tip of the Month: Be aware of the off-exchange products that utilize Covered CA plan networks

April Tip:

Be aware of the off-exchange products that utilize Covered CA plan networks.

1. Every plan offered in Covered CA must also be offered outside of Covered CA, using the same network.  If you see these product names on the ID card, it indicates the patient only has access to the Covered CA network. For more information, download "Surviving the Second Month of Covered CA" at www.cmanet.org/ces.

2. To physicians who are currently participating in the Anthem Blue Cross Individual / Covered CA network: Anthem Blue Cross recently notified over 11,000 practices of a contract addendum that will become effective July 1, 2014. For more information, click here.

Receiving practice management guidance from Mitzi Young is a FREE OCMA member benefit!
Contact Mitzi to schedule a one-on-one consultation to discuss your practice management needs: 
 
Mitzi Young
Physician Advocate, CMA Center for Economic Services
888.236.0267
myoung@cmanet.org


Orange County Medical Association Selects Argus Medical Management as Preferred Business Partner

Irvine, Calif. March 24, 2014.   The Orange County Medical Association is pleased to announce another benefit of membership.  The OCMA has designated Argus Medical Management as its Business Partner for physicians seeking practice management services.

 

OCMA members will receive the following benefits:

 

  • Free membership in GroupSource, a Physician Group Purchasing Organization
  • 10% discounts the first year and 5% discounts the second year on Argus' services
  • Physicians who join Argus' Integrated (Independent)Physician Medical Group  model will receive free OCMA membership

Argus Medical Management offers the following physician practice management services:

 

  • Accounting, Regional Manager Oversight
  • Billing, EMR, HIE, Billing & Practice Management Systems
  • Credentialing, Purchasing Discounts, Contracting
  • Integrated physician medical group model which stresses physician independence
  • Marketing
  • PC Support
  • Staff Administration (payroll, benefits, H.R.)   

Argus Medical Management has provided a full spectrum of practice management services to physicians in Orange & Los Angeles Counties since 1995.

 

Contact:  Shing Huang, CFO, 562-299-5210, SHuang@ArgusMSO.com

For GroupSource (GPO/Purchasing Discounts): Peachy Paulino, Director, Marketing Support, 562-299-5252, PPaulino@ArgusMSO.com

 

Please visit the Argus Medical Management website at www.ArgusMSO.com


CalOptima Seeks Candidates to Participate on its Provider Advisory Committee (PAC) 2014-2016

The CalOptima Board of Directors welcomes input and recommendations from the provider community regarding issues concerning CalOptima programs. For this reason, the CalOptima Board encourages providers to become involved through an advisory group known as the Provider Advisory Committee (PAC).

The Provider Advisory Committee advises the CalOptima Board of Directors and staff. The CalOptima PAC is composed of 14 members representing diverse provider constituencies. These include but are not limited to health plans, hospitals, physicians, nurses, allied health professionals, long-term care services and community health centers. The charge of the committee is to:
 
  • Provide advice and recommendations to the CalOptima Board on issues concerning CalOptima programs as directed by the CalOptima Board;
  • Engage in study, research and analysis of issues assigned by the Board or generated by thecommittee;
  • Serve as a liaison between interested parties and the Board;
  • Assist the Board in obtaining public opinion on issues relating to CalOptima programs;
  • Initiate recommendations on issues for study to the CalOptima Board for their approval and consideration; and
  • Facilitate community outreach for CalOptima and the Board.

At this time, CalOptima is seeking candidates to participate on its Provider Advisory Committee (PAC). Service on the PAC is voluntary and with no salary. You need to be available to attend monthly meetings and serve on subcommittees. The following two-year seats are available:
 

  • Long Term Care Services Representative (two seats) 
  • Non-Physician Medical Practitioner Representative 
  • Pharmacy Representative 
  • Physician Representative (two seats)

The committee encourages interested individuals with knowledge and support of Medi-Cal and Medicare to apply. To apply or to nominate an individual for the Provider Advisory Committee, please mail, fax, or email the attached candidate application by Friday, April 11, 2014, along with a biography or resume plus two letters of reference to:

CalOptima
Attn: Maria Wahab
505 City Parkway West
Orange, CA 92868
 
Office: 714-796-6143 
Fax: 714-796-6679 
Email: mwahab@caloptima.org
 
If you have any questions, please call Maria Wahab at 714-796-6143.  


MEDICARE SGR ALERT: Physicians: Call Congress Now!

PROTECT ACCESS TO CARE IN CALIFORNIA


DON'T PATCH IT, REPEAL IT!

MEDICARE SGR REPEAL AND PAYMENT REFORM: HR 4015/S 2000

 

Physicians: Call Congress Now! (800) 833-6354 (Takes 2 Min)

UPDATE MARCH 11, 2014:
House Republican leaders have scheduled a vote for this week on H.R. 4015, with a repeal of the ACA individual mandate as the funding source. (If the mandate is repealed, the government will spend less on premium subsidies and thus, a substantial cost savings will occur.)

This repeal of the ACA is not an acceptable, viable funding option in the U.S. Senate. Knowing that the ACA repeal will not be accepted, House leaders have scheduled a second vote at the end of March to adopt another nine-month patch.

CMA is urging Congress to find bipartisan funding sources. We are opposing another nine-month patch. CMA is calling upon Congress to Fix Medicare Now!

A long-awaited and hard-fought bill to permanently repeal Medicare's fatally flawed sustainable growth rate (SGR) formula finally is before Congress. The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/S. 2000) offers a fiscally prudent opportunity for lawmakers to repeal the SGR formula and put Medicare on the path toward a stable, 21st-century program that can meet the growing health care needs of the nation's seniors.

This is the most progress Congress has made in a decade. We must seize this opportunity and make a final push to get this bill passed NOW. To sustain the bipartisan momentum, your Congressional representatives need to hear from you.

There are many powerful groups that are pushing back, objecting to Congress' plans for funding the physician payment fix. That's where you come in. To overcome the opposition, Congress needs to hear from a large volume of physicians. Every single physician needs to call and email the California Senators and your Member of Congress NOW!

Congress has a significant opportunity to finally repeal the SGR and enact payment reform. Why?

  • The cost to repeal the SGR is at an all-time low of $116 billion - down from $238 billion.
  • Congress has already spent $154 billion over the last decade adopting short-term patches to stop the SGR cuts - more than the total cost to repeal the SGR. It is fiscally irresponsible to adopt another one-year SGR patch. The Wall Street Journal calls the "patches" a sham.
  • There is a bipartisan, bicameral agreement on legislation to establish a new payment system.
  • The deadline is March 31, 2014, when the next 24 percent SGR cut occurs.

But reform won't happen unless Congress hears from thousands of physicians!

Physicians must call Congress to fix Medicare now!
To overcome the partisan funding proposals and the other opposition, Congress needs to hear from a large volume of physicians. Every physician needs to call and email the California Senators and your Member of Congress NOW! Please make as many calls and send as many emails as possible. Every one makes a difference! We are asking physicians to call/email the following individuals:

  • Your local congressional representative (use your local zip code)
  • California Senator Barbara Boxer
  • California Senator Dianne Feinstein
  • House Republican Whip Kevin McCarthy (zip code 93309)
  • House Democratic Leader Nancy Pelosi (zip code 94103)

To contact members of Congress:
Call AMA's Grassroots Hotline, (800) 833-6354, to be connected with your members of Congress in Washington. You will be asked to enter your zip code and select your representative. You are also encouraged to call your representatives in their local district offices (click here to download a current telephone roster).

You may also email your federal legislators via the AMA's "Fix Medicare Now" grassroots website. Utilizing the sample letter provided, it takes no more than two minutes.

Urge Congress to tell their House and Senate leadership to:
1. Protect access to care in California and enact Medicare physician payment reform NOW.
2. The cost to fix the Medicare SGR is at an all-time low and there is bipartisan agreement on the legislation.
3. Use bipartisan funding sources.
4. Oppose another one-year SGR patch.

Ask your patients to help:
AMA has also prepared a flyer that you can use to get your patients involved in the fight to protect Medicare. Distribute the AMA's "Fix Medicare Now" flyer to your patients and ask them to call their representatives, too.

Additional information:


Member Resource: Surviving the Third Month of Covered CA

As of February 15, Covered California reports that more than 828,000 individuals have enrolled in exchange plans, which surpasses its original target. 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 this third tip sheet to help physicians survive the third month of Covered California.

Additionally, CMA has just published a document physicians can provide to their patients to address the most common patient questions. The document is available free for members in CMA's exchange resource center at www.cmanet.org/exchange. If you would like patient materials delivered to your office or patient training for your office staff, please fill out a Covered CA Information Request form and fax or email it back to OCMA. 
 
Still have questions?
Visit CMA's exchange resource center at www.cmanet.org/exchange. There you will find all of CMA's exchange resources, including CMA's comprehensive exchange toolkit, "CMA's Got You Covered: A Physician's Guide to Covered California, the state's health benefit exchange." OCMA members and their staff also have FREE access to your Physician Advocate, Mitzi Young for reimbursement assistance and questions about the exchange. Members can contact Mitzi at (888) 236-0267 or myoung@cmanet.org.


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