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1. Physicians, Beware of Misleading Medem Invoices
A number of physicians have reported to CMA that they have received unsolicited invoices from Medem, charging them $195 for “Practice Web Site and iHealth Services.” Physicians should be aware that these invoices are offers of service, not actual bills. While the services being offered are legitimate, you do not need to pay the “invoice” unless you actually want to sign up for Medem’s services.
CMA has expressed its concern to AMA, a part owner of Medem, about these misleading solicitations. AMA has assured CMA that it is working with Medem to stop this untoward marketing practice. In the meantime, physicians should inform their office staff of this issue.
Click here for more information. Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.
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2. Medicare Claims with Surrogate UPIN OTH000
Will Be Rejected After April 1
Effective April 1, Medicare carriers will no longer accept “surrogate” physician identification numbers. Currently, providers and suppliers are allowed to bill Medicare using OTH000, a generic Unique Physician Identification Number (UPIN), when the ordering or referring physician’s UPIN is unknown or unavailable.
Surrogate UPINs were originally intended for use when a physician has requested but not yet received a UPIN. In practice, however, many physicians’ billing systems use OTH000 as a default, even when a valid UPIN is available.
To stop this unsafe billing practice, claims submitted with surrogate UPIN OTH000 after April 1 will be returned as unprocessable. Physicians should hold claims until a UPIN is obtained. Returned claims can be resubmitted within one year.
Click here for more information. Contact: CMA’s reimbursement help line, 888/401-5911. BACK TO TOP
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3. Medi-Cal Covers Hepatitis Combo Vaccine for High-Risk Patients
Medi-Cal will now reimburse physicians for hepatitis A/B combo vaccine administered to high-risk patients age 19 or older. High-risk patients are:
- Those who receive injections of blood or other blood factor products, either for medical treatment or through occupational exposure
- Individuals with chronic liver disease or who have had a liver transplant
- Users of illegal drugs (injectable and noninjectable)
- Men having sex with other men
- Individuals who have come in contact with blood, body fluids, feces, sewage, or live hepatitis A or B virus
- People who work in high-risk environments, such as day care centers, hemodialysis units, drug and alcohol treatment centers, correctional facilities, and places where emergency medical assistance is rendered
Physicians can bill Medi-Cal for hepatitis A/B combo vaccine administered to high-risk adults on or after December 1, 2005 (CPT-4 code 90636).
Click here for more information. Contact: Robin Flagg, 415/882-5110 or rflagg@cmanet.org.
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4. The Humana Settlement Claim Deadline Is TOMORROW
Physicians have until tomorrow, Friday, February 17, to file a claim for their share of the $40 million Humana settlement. Claim forms and filing instructions, including the list of all Humana affiliates, are available in CMA’s RICO Resource Center.
Click here for more information. Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org. BACK TO TOP
5. CMA Opposes Physician Involvement in Capital Punishment
CMA today issued a statement reiterating the association’s long-standing opposition to physician involvement in capital punishment. The statement follows a recent federal court ruling suggesting that physician participation is one way to minimize excessive pain during executions in California. CMA has for decades sought to end physician participation in capital punishment, including seeking legislation banning such actions by physicians and other health care professionals.
U.S. District Judge Jeremy Fogel Tuesday ordered state officials to change the way they administer the fatal dose, or face a delay in death row inmate Michael Morales’s execution, which is scheduled for February 21. Fogel said in a 15-page ruling that San Quentin State Prison officials may either administer fatal levels of sedatives exclusively or have an anesthesiologist present to ensure that Morales is unconscious before they deliver the standard mix of sedatives, paralytic agents, and heart-stopping chemicals.
CMA believes that a physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not participate in legally authorized executions. Regardless of its method of delivery, capital punishment is not a medical task, it does not require medical skills and the use of a physician’s medical skills for this nonmedical task is inappropriate and a breach of one of the medical profession’s most important ethical boundaries. CMA believes that physician participation in capital punishment threatens the public’s trust of physicians. This trust is central to the physician-patient relationship.
If they want to go ahead without appealing the ruling, state corrections officials must decide whether to accept Fogel’s proposal of using sedatives, or select an anesthesiologist. Neither the state attorney general nor Morales’ attorneys would say whether they plan to appeal the ruling. California began executing prisoners by injection in 1996 after a federal appeals court ruled that San Quentin’s gas chamber violated the U.S. Constitution’s ban on cruel and unusual punishment.
AMA has also declared physician participation in executions to be unethical. Physician participation includes, but is not limited to, prescribing or administering medications as part of the execution procedure, attending or observing an execution as a physician, as well as monitoring vital signs on site or remotely, or rendering technical advice regarding execution.
Click here for more information. Contact: CMA Media Relations, 916/444-5532 or pwarren@cmanet.org. BACK TO TOP
6. Watch the Mail for Information on CMA’s Health Savings Account Program
Members will soon receive in the mail information about CMA’s newest member benefit: the CMA Health Savings Account program. An HSA is a tax-exempt account used to pay current health care expenses and save money for future expenses. CMA’s HSA program is open to physicians, their families, and their office staff.
To open an HSA, you must be covered by a qualified high-deductible health plan (HDHP). Since HDHPs generally cost less than traditional health plans, the money you save on monthly premiums can be deposited to your tax-exempt HSA.
The mailer you will receive contains an overview of the HSA program, information on the qualified HDHPs available from Marsh (a CMA affinity partner), and a form you can fill out to request a quote or more information.
Click here for more information.
Contact: CMA HSA Customer Service (provided by Marsh), 800/842-3761.
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7. There's Still Time to Register for IMQ's Conference on Medical Staff
and Hospital Collaboration, Feb. 23-24 in Monterey
There are still a limited number of spaces available for the Institute for Medical Quality’s (IMQ) second annual conference on medical staff and hospital collaboration, February 23-24 at the Hyatt Regency in Monterey. Last year’s
conference, which focused on pay-for-performance initiatives, was attended
by a dynamic group of medical staff leaders and administrators from hospitals throughout California.
This year’s conference, “Data Collection and Quality of Care Issues,” brings together hospitals and medical staffs to improve their effectiveness in delivering care.
This program covers:
- Government, payor, and accreditor data-collection requirements
- How data collection is tied to charting and reimbursement
- The implementation and impact of electronic health records
- Linking hospital and physician practice data, and new error reporting laws
- Whether appropriate and accurate data is being collected
- How the medical staff can get “buy-in” from colleagues
- External forces currently affecting hospitals
- How to run an effective meeting and handle disruptive physicians
- Thorny issues facing medical staff leaders, such as medical staff
bylaws and peer review
Click here for more information.
Contact: Leslie Anne Iacopi, 415/882-5167 or liacopi@imq.org. BACK TO TOP
8. New Mailing Address for CMA’s San Francisco Office
CMA’s San Francisco office has a new mailing address. Please make a note of it: California Medical Association, 221 Main Street, Suite 580, San Francisco, CA 94105.
Click here for more information. BACK TO TOP
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