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1. Transition to New Medicare Carrier in California Has Begun
The Centers for Medicare & Medicaid Services (CMS) recently awarded the contract for combined administration and payment of Part A and Part B Medicare claims in California to South Carolina-based Palmetto GBA. Although the contract doesn’t officially take effect until August 4, the transition has already begun with a final implementation date scheduled for September 2. CMA is working closely with Palmetto to ensure a smooth transition.
Palmetto is one of five new Medicare Administrative Contractors (MACs) named by CMS as required by the Medicare Modernization Act of 2003. The MAC contracts, which combine administration of both Part A and Part B claims, are part of an effort to streamline the fee-for-service payment system.
As you know, NHIC has been California’s Medicare carrier for more than a decade, processing claims for physicians, laboratories and other practitioners under Medicare Part B. NHIC will continue processing Medicare claims for California through September 1. Physicians will soon, however, be able to begin submitting electronic claims to Palmetto as part of its “early boarding” transition plan. Although physicians will be able to continue using their current EDI submitter numbers, they will need to complete a new electronic funds transfer (EFT) form. Watch the mail for more information from Palmetto on the early boarding plan.
At CMA’s request, Palmetto will be producing a physician “to do” check-list with deadlines so physicians can easily manage the transition. This checklist will soon be available on the Palmetto website. Physicians are encouraged to sign up for Palmetto’s listserv so they can directly receive all of the latest information on the transition.
CMA is also helping Palmetto develop extensive provider education seminars to help physicians with the transition. The seminars will be help in-person, online, and via telephone. Stay tuned for more information.
Click here for more information.
Contact: Frank Navarro, 888/401-5911 or fnavarro@cmanet.org.
2. Medical Board Diversion Program Shutting Down;
Interim Recommendations Available at CMA Website
The Medical Board of California last year decided it was not capable of effectively running the Physician Diversion Program, which for the past 27 years has been monitoring and providing guidance to physicians with substance abuse problems. The medical board voted unanimously on November 2, 2007, to immediately stop accepting self-referrals and to close the program entirely on June 30, 2008. A coalition of physician organizations is working on a legislatively-mandated, independent comprehensive statewide program to replace the diversion program, but there will be a gap in services.
To help bridge this gap, CMA, the California Society of Addiction Medicine, and the California Psychiatric Association have put together guidelines for hospital medical staffs and well-being committees.
Physicians are also reminded that CMA operates a free confidential hotline for physicians who may have an alcohol or other chemical dependence. This service is completely confidential and will not result in any form of disciplinary action or referral to any disciplinary body.
In Northern California, call 650/756-7787, in Southern California, 213/383-2691.
Click here for more information.
3. Get Your Medical-Legal Questions Answered at CMA ON-CALL;
Free to Members and Newly Updated for 2008
The 2008 CMA ON-CALL documents have been updated and are now available online. ON-CALL is an online library that this year contains over 3,000 pages of medical-legal, regulatory, and reimbursement information. The searchable library contains all the information available in the California Physician’s Legal Handbook, an annual publication of CMA’s Center for Legal Affairs.
ON-CALL documents are available free to members at CMA’s members-only website. Nonmembers can purchase ON-CALL documents for $2 per page in CMA’s online bookstore.
If you haven’t taken advantage of this extraordinary resource, spend a few minutes browsing the ON-CALL index, and see what you’ve been missing.
New and updated ON-CALL documents for 2008 include:
- #0217, Overview of Select Physician Practice Employment Issues
- #0414, Consent for HIV Test
- #1060, Formation and Use of Utilization Profiles
- #1307,rgan and Tissue Donations
- #1620, Physician assistants
Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet.org.
4. Bill to Fund Physician Loan Repayment Program Advances
Fines and penalties paid to the Department of Managed Health Care (DMHC) by health plans that have violated the law would be used to fund the Steven M. Thompson Loan Repayment Program, under a CMA-sponsored bill that passed unanimously out of the Senate Health Committee last week. The program provides up to $105,000 in loan repayment to new physicians who agree to serve in an underserved area for at least three years.
Health plans are required to pay an annual assessment to cover some of the expenses incurred by DMHC for administration of the Knox-Keene Act. Currently, fines and penalties paid to DMHC for violations of the Act go to offset these assessments, essentially rewarding insurers for breaking the law.
Click here for more information on this and other bills of interest to physicians.
Contact: Lisa Folberg, 916/444-5532 or lfolberg@cmanet.org.
5. Bill to Stop Medicare Payment Cuts Introduced in Senate
A bill has been introduced that would stop the 15 percent Medicare payment cuts scheduled to take effect over the next two years, and instead provide physicians with small payment increases. The bill (Senate Bill 2785) would extend the .5 percent update physicians received in January for an additional six months through December 31, and provide a 1.8 percent update in 2009.
Please call California Senators Barbara Boxer and Dianne Feinstein and urge them to cosponsor the “Save Medicare Act of 2008.” Although it is not a long-term fix to the Medicare payment problems, it critically important to protect access to health care for seniors.
This temporary fix would inject some stability into the system for seniors and physicians, who would otherwise be forced to make difficult practice decisions as a result of the pending payment cuts. This bill would also give Congress time to work on a long-term solution to the broken payment system without having to take multiple actions over the next 18 months to stop the pending cuts.
Click here for more information, including contact information for Senators Boxer and Feinstein.
Contact: Elizabeth McNeil, 415/882-3376 or emcneil@cmanet.org.
6. Medi-Cal Prescriptions Must Be Written on
Tamper-Resistant Pads Beginning Tomorrow
New federal security prescription rules that take effect April 1 require most Medi-Cal prescriptions to be written on tamper proof pads.
There are a number of exemptions to this rule. Security prescriptions are not required for:
- Drugs paid for by a managed care entity (except for CalOPTIMA, Santa Barbara Health Initiative, Partnership Health Plans, and Central Coast Alliance for Health)
- Prescriptions provided in nursing homes and some other institutional settings
- Phoned, faxed, or electronically transmitted prescriptions
Of course, all prescriptions for controlled substances, regardless of the payor, must be written on secure tamper-proof pads under California Law.
Recognizing that this new law is very confusing, and that physicians may not be able to easily determine when Medi-Cal fee-for-service is the secondary payor to private insurance, or if a prescribed drug is carved out of managed care, the California Department of Health Services is recommending that prescribers use tamper-proof prescription pads for all Medi-Cal beneficiaries.
CMA remains concerned, however, that the additional hassle and cost involved will force physicians to leave the Medi-Cal program, where access to care is already a problem. CMA continues to seek to reverse the law or at least make it consistent with current state law, which requires security prescriptions only for controlled substances.
Click here for more information.
Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet.org.
7. Don’t Miss Doctor Day in Sacramento; Deadline to RSVP Is April 2
The deadline to RSVP for CMA’s 34th annual Legislative Leadership Day is Wednesday, April 2. Also known as “Doctor Day,” this is a unique event for California physicians and is free of charge to all CMA members.
This year’s conference is Tuesday, April 15, in Sacramento. Attendees will receive a CMA health policy briefing and a short course on “Lobbying 101,” which will train them to become strong physician advocates and prepare them for the legislative meetings later in the day.
Don’t miss the opportunity to meet one-on-one with your elected officials in the State Assembly and Senate to discuss important health policy issues that affect the practice of medicine in California.
And don’t forget your white coats! We’ll be invading the Capitol en masse and we want everyone to know that the doctors have arrived.
Click here for more information.
Contact: Jennifer Williams, 916/444-5532 or jwilliams2@cmanet.org.
8. Early-Bird Deadline for CMA’s Leadership Academy Is April 4
The early-bird deadline for CMA’s 11th annual Health Care Leadership Academy is April 4. Sign up by that date and receive $100 off your registration. Additional discounts are available for young physicians, residents, and medical students. This year’s conference is May 2 – 4 at Disney’s Grand Californian Hotel in Anaheim.
A dynamic multidisciplinary faculty will discuss trends affecting your economic future as a physician. The Academy also will feature a slate of dynamic practice management and leadership skills workshops.
Register online or call 800/795-2262 between the hours of 8:30 am and 4:30 pm.
Contact: Roger Purdy, 916/444-5532 or rpurdy@cmanet.org.
9. Member Benefit of the Week: Up to 15% off Hertz Car Rental
CMA members save up to 15 percent on daily, weekly, weekend, and monthly rentals from Hertz. Call 800/654-2210 or visit the Hertz website to make your reservation.
A members-only code is needed to take advantage of this discount. Visit CMA’s members-only website, or call the member service center at 800/786-4CMA (4262) to get your code.
Click here for more information on your membership benefits.
Contact: CMA’s member service center, 800/786-4CMA or info@cmanet.org.
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