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1. CMA Objects to Onerous Blue Cross Confidentiality Agreement
CMA recently learned that Blue Cross of California is demanding that physicians and their attorneys as part of the contract negotiation process sign a “confidentiality agreement” that not only violates laws protecting the confidentiality of attorney-client communications, but also seems intended to prevent physicians from being fairly represented in managed care contract negotiations. CMA has urged Blue Cross to withdraw this unfair agreement.
“We had hoped that, in the wake of WellPoint’s agreement to settle the national RICO lawsuit, there would be a commitment to working more collaboratively with the physician community in the future,” wrote CMA CEO Joe Dunn in a letter to Blue Cross of California President Brian Sassi. “We urge you to reaffirm that commitment, and to withdraw this unfair and onerous agreement.”
The agreement among other things gives Blue Cross the right to determine “at its sole and absolute discretion” whether or not a physician can use a particular attorney or negotiator. CMA strongly objects to this provision and believes that physicians should have the unfettered ability to retain any experts they want to advise them on important business matters.
Click here for more information.
Contact: CMA’s legal information line, 415/882-5144 or legainfo@cmanet.org.
2. Medical Leadership Council Launches Online Interpreter Database
The Medical Leadership Council on Cultural Proficiency has launched an online database to help physicians and other health care professionals improve language access and provide culturally competent health care.
The free Internet database provides information on interpretation and translation services and educational materials for doctors and patients. Users can search listings by language, by location, or by type of service.
The Medical Leadership Council on Cultural Proficiency is a statewide organization of physician and medical society leaders, health systems representatives, and advocates convened by the California Endowment to improve language access, workforce diversity, and cultural proficiency in health care.
Click here for more information.
3. Deadline to Resubmit Modifier 57 Claims to Aetna Is April 30
Aetna is currently accepting resubmissions of previously denied claims for E&M services provided on the same day as a decision for surgery with dates of service between January 1, 2005, and February 11, 2006.
Aetna in 2005 announced that it would begin reimbursing physicians for E&M services when billed with modifier 57, performed on the same day as a decision for major surgery (global, 90-day procedure). Implementation of this policy change was delayed and Aetna’s claims processing systems finally began recognizing E&M Codes with these modifiers effective February 11, 2006. At that time, Aetna also announced that previously denied claims with dates of service of August 15, 2005, to February 11, 2006, could be resubmitted.
This policy change was recommended by Aetna’s Physicians Advisory Board, which was created as part of Aetna’s RICO lawsuit settlement. A recently resolved RICO settlement compliance dispute has increased the number of claims eligible for retroactive reconsideration. Previously denied claims with dates of service back to January 1, 2005, can be resubmitted. The resubmission deadline is April 30.
Click here for more information.
Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.
4. Applications Deadline for 2007 Steven M. Thompson
Loan Repayment Program Is March 24
Applications are now available for the 2007 Steven M. Thompson Physician Corps Loan Repayment Program. Physicians selected for the program, which was created under a CMA-sponsored law in 2002, will receive medical school loan repayment grants of up to $105,000 in exchange for a three-year service commitment in a medically underserved area of the state.
The program is open to newly licensed physicians who commit to serve a minimum of three years in the approved geographic areas, which include official “health professionals shortage areas” (HPSAs) and federally qualified “health center look-alikes,” community health centers, migrant health centers, and public housing centers. Last year, loan recipients worked in a variety of underserved areas throughout the state, from community clinics in downtown Los Angeles to farmworker health clinics in the Central Valley to rural health facilities in Northern California.
The law requires that most participants be selected from the specialty areas of family practice, internal medicine, pediatrics, and obstetrics/gynecology. Up to 20 percent of the participants may be selected from other specialties.
Applications are due by March 24 and can be downloaded here.
CMA is still seeking a permanent funding source for this very important program. Unfortunately, the Schwarzenegger administration’s proposed 2007-2008 budget does not include new funding for this program.
Please consider supporting this worthy program with a tax-deductible donation. To make a donation, download the donation form on the next page, or contact the Health Professions Education Foundation at 800/773-1669. You will also have the opportunity to support the program with a voluntary donation during the medical license renewal process.
Click here for more information.
Contact: Joseph Greaves, 916/444-5532 or jgreaves@cmanet.org.
5. 5th Annual CMA Foundation Golf Classic, April 14 in Carmel
The CMA Foundation is hosting its fifth annual Golf Classic in conjunction with CMA’s Health Care Leadership Academy, which is April 13-15 in Monterey.
The golf classic will be Saturday, April 14, in nearby Carmel, at the Rancho Cañada Golf Club. The style of play is a scramble, with a best ball format. Play begins with a shotgun start at 1:30 p.m.
Your participation in the golf tournament will help support the foundation’s many programs, including the Alliance Working for Antibiotic Resistance Education, Obesity Prevention Project, Network of Ethnic Physicians Organizations, Advancing Practice Excellence in Diabetes, and the Medical Student Community Leadership Grant Program.
Click here for more information.
Contact: Donna Astrinidis, 916/551-2054 or dastrinidis@cmanet.org.
6. Member Benefit of the Week: Innovative Retirement Income Strategy
CMA has teamed with California Physicians’ Retirement Strategy (CPRS) to offer physicians an innovative retirement income strategy that combines business financing and life insurance.
An important feature in this program is the flexibility to modify or terminate it with little risk if you want to alter your retirement strategy in the future.
Find out more by participating in a short online seminar Saturday, February 24, at 9 a.m., Pacific time.
Register for this event online at http://www.prsplan.com.
Contact: Blaine Ung, vice president of CPRS, at 877/225-7771 or blaine@prsplan.com.
Click here for more information on your membership benefits.
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