Monday, June 18, 2018

I Need News & Information

Resources for Physicians Affected by the IEHP/Vantage Contract Termination

As a follow up to the informational meetings RCMA convened for physicians affected by the IEHP/Vantage contract termination, RCMA has posted the following resources to help physicians understand the options available to continue seeing IEHP patients and the next steps that will need to be taken.


AB 3087 Defeated

Assembly Bill 3087 (Kalra) has been defeated.  This dangerous legislation would have created a commission of unelected political appointees empowered to arbitrarily cap rates for all health care services in all clinics, hospitals and physician practices in California. 

Thousands of physician members contacted their legislators because AB 3087 would have:

  • Decimated California’s health care delivery system.
  • Disrupted care and limited choice for millions of California patients.
  • Caused 175,000 health care workers to lose their jobs.
  • Forced hospitals to close and pushed health care providers into early retirement.
  • Caused a “brain drain” of talented medical students and residents fleeing California for more ideal working conditions.



Medical Assistant Survey

RCMA is collaborating with Moreno Valley College to revise their Medical Assisting program. The goal is to create a program that will not only meet the national accreditation standards but to serve the needs of the physicians/clinics in the Inland Empire. We want our students to be a valuable asset to your office.  

In order to do this, we would greatly appreciate your assistance by completing the Medical Assisting Skills Survey. In doing so, you will ensure that we design a program that will be beneficial to the students and relevant to the needs of your office.  

Thank you for taking the time out of your busy schedule to complete the survey. Your input is greatly appreciated. 

Survey: How would the AB 3087 price fixing proposal affect your practice?


Assemblymember Ash Kalra (D-San Jose) last week announced a radical physician rate setting proposal (AB 3087) that would increase patient out-of-pocket costs, create state-sanctioned rationing of health care for all Californians and force physicians out of state or into early retirement.
The RCMA/CMA are asking physicians to answer a few questions about how AB 3087 will impact their practices. The survey is anonymous and the results will help in our legislative efforts to fight this dangerous and irresponsible legislation.
Take the survey now at: www.surveymonkey.com/r/ab3087.
And, if you are among California's physicians that will be forced into early retirement or out of state if AB 3087 passes, we want to tell your story. Drop CMA a line at communications@cmanet.org.

To Take Action Now Visit: www.actnow.io/PriceFixing

For more information about AB 3087 click here.

Please Donate to RIVPAC Today!

As the election cycles gear up, your RCMA Legislative Committee has been hard at work interviewing candidates for local, state and federal offices. It is imperative that we be effective at representing physician interests. Our success depends upon an integrated approach, consisting of lobbying, continuing grassroots activity and political action through RCMA’s Riverside Political Action Committee (RIVPAC).

RIVPAC is operated by physicians for physicians. By focusing physician resources, we support candidates for local, state and federal office who share our philosophy and vision of the future of health care and medical practice.

Please take a minute and contribute to RIVPAC. You can do so by donating online or by downloading the donation form and faxing it back to us at (951) 686-1692.

Strategies for Increasing Patient Safety with Opioids


Despite overall prescribing rates of opioids being at a ten-year low in 2016, the deaths from opioid overdose are increasing. Furthermore, due to the increased scrutiny by law enforcement and regulatory agencies and the risk of dependency and overdose there are increased liability risks for physicians related to opioid prescribing. NORCAL and it's risk management experts have created a special report to offer recommendations supporting sound pain management principles for mitigating these risks and increasing patient safety with opioids. Click the image below or click here to view the few article and download the report on NORCAL's website

Concerns
  • While overall prescribing rates declined to a ten-year low in 2016, deaths from opioid overdoses are increasing.
Challenges
  • Careful prescribing and monitoring practices are essential to safely manage patients’ pain and increase defensibility in the event of a claim.
Best Practices
  • Sound pain management and prescribing principles to help increase patient safety.


IEHP Begins Payment on Prop 56 Supplemental Payments for Physician Services


IEHP has announced that it will begin issuing the first payments for the Prop 56 supplemental payments to providers on March 16th, 2018, prior to receiving funding from the State.

These supplemental paymenst are for claims paid/encounters received on (or before) December 31st, 2017, related to service dates from July 1, 2017 – September 30th, 2017. Prop 56, which funds healthcare, research, and prevention of tobacco use, includes supplemental payments for physicians who participate in Medi-Cal FFS and Medi-Cal Managed Care. The supplemental payments are based on the submission of specific CPT codes through claims or encounters to your IPA or IEHP if directly contracted.

California voters approved the California Healthcare, Research and Prevention Tobacco Tax Act (also known as Prop 56), which increased the excise tax rate on cigarettes and tobacco products. As a result, Assembly Bill (AB) 120 was passed to appropriate Prop 56 funds for specified DHCS health care expenditures during the 2017-2018 state fiscal year. Therefore, this supplemental payment for physician services is based on the payment requirements set forth by DHCS.

For more information contact IEHP’s Provider Service Representatives at 909-890-2054 with any questions. Click here for an FAQ on this supplemental payment program, including questions concerning CPT codes.

Visit our Medi-Cal Resource Center for more helpful information.

Anthem and AMA Pursue Collaboration To Help Create Positive Change To The Health Care System

Health care affordability is one of the biggest challenges facing patients and doctors today. With a shared goal to help patients have improved access to quality, timely and affordable health care, the American Medical Association (AMA) and Anthem, Inc. (NYSE: ANTM) today announced they will seek to identify and collaborate on solutions that drive a high‐value experience for patients, physicians, other health care professionals and health plans.

As the first step, the AMA and Anthem will work together in 2018 to pursue opportunities for collaboration in the following areas:
  • Enhance consumer and patient health care literacy
  • Develop/enhance and implement value‐based payment models for primary and specialty care physicians
  • Improve access to timely, actionable data to enhance patient care
  • Streamline and/or eliminate low‐value prior‐authorization requirements

Continue for full statement.


To learn more about how Anthem and the American Medical Association are working together to make changes in the health care system click here.

CMA publishes guide for physicians affected by EHS contract terminations

The California Department of Managed Health Care (DMHC) issued a cease-and-desist order on December 26, 2017, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order comes after SynerMed—a company closely affiliated with EHS—was accused of blocking patient access to specialists to hold down costs.

EHS has 600,000 patients statewide—90 percent of whom are Medi-Cal managed care patients. As required by the DMHC, health plans affected by this order were required to submit a transition plan by January 3, 2018 and have begun the transfer all EHS patients to different health care providers due to be completed by February 5, 2018.

The California Medical Association (CMA) has published a guide intended to help physicians understand the impact these recent changes may have on their practices and where patients are being moved so they can determine whether to explore contract relationships with other entities.

The guide is free to our members along with other helpful resources in the CMA Resource Library.

Significant new California laws of interest to physicians for 2018

The California Legislature had an active year, passing many new laws affecting health care. RCMA/CMA have provided a summary of these changes spanning a number of topics including health care coverage, drug prescribing & dispensing, and public health. Stay up-to-date by downloading the PDF here.


Tags

2013 2014 Ebola Outbreak 2014 Election 2016 ACA AIDS Annual Report Appointments Assembly Business and Professions Committee Awards Ballot Initiatives Boxer Budget Burnout CA Ballot Initiatives CAFP California CMA CMA Annual Report Comments Congress Construction Controlled Substance Discontent Dolores EHR Election Election 2014 Exchange Governance Grace Period H.R.2. Health Exchange Health Laws Healthcare Laws HIE HIT HIV Hizon HOD House House of Delegates ICD-10 IEHP Languages Lee Legislation Mahdi Meaningful Use Medical Medi-Cal Medicare MICRA Mode of Practice No on 46 NoOn46 Opioids Outstanding Contribution Patients Paul Green Practice Management Prop 46 Prop 56 Proposition 46 Public Health Alert Rajaratnam Rating RCMA Repeal Risk Management Riverside Community Hospital Riverside County Schedualing Senate SGR Stage 2 Survey Termination Trial Lawyers Uppal Vaccines White Wilson Creek Winery 2014 2014 Election 2014 laws 2015-2017 2016 2016 Election 2018 46 AB 3087 AB 880 ABX2-15 ACA Advocacy Affordable Care Act AHCA AMA Anthem Blue Cross Assembly Assembly Bill Attestation Awards Blue Shield of California Burnout CA CA Senate Cal INDEX California California Laws California Legislation California Society of Plastic Surgeons Californian Physicians Cameron Kaiser CCI CDC CEO Clearinghouses CMA CMS Coalition for Patient Access and Quality Care Committee Congress Coroner Council on Graduate Medical Education Covered CA Covered Califonria Covered California CPT modifer CSPS CURES Cuts Deadlines deductible Delegates Delivery Models DHCS donate Drugs Dual Elligibles Ebola EHR eligibility Employment Law End-Of-Life Energy and Commerce Committee Republicans enrollment Exchange FAQ Federal Federal Legislation Feinstein Funding Future Gary Honts Grace Period Health Care Reform Health Reform Healthcare Rates Healthcare Reform Hernandez HIPAA ICD-10 IEHIE IEHP Imagine Plastic Surgery Increase Installation insurance JFK Memorial Hospital Kaiser Permanente Laws Legislation Legislative Alert Loma Linda long term disability LTSS MA Mahdi Managed Care Meaningful Use Measles Medicaid Medi-Cal Medical Board Medicare member benefit MICRA Molina National Prescription Drug Take-Back Day Nomination Nominations Nondiscrimination Posting NORCAL Noridian Obamacare Insurance October 22 On-Call opioid opioid abuse Outstanding Palmetto GBA Patient Patient Care Payment Models PHA Physician Aid-in-Dying Physician Burnout Physician Recruitment Plastic Surgery POLST Practice Management practice managment Practice Mangement President Priorities privacy Professional Liability Prop 46 Prop 56 Proposition 46 Public Health Public Health Alert RCH RCMA RCMA Member Red Tape Reputation Retreat Risk Management Riverside County RIVPAC SB 491 SB 492 SB 493 SB 62 Scope of Practice Sequestration SGR State Capitol Stress Survey Telemedicine Tenet Thakur Law Firm Transforming Your Practice UC Riverside Vantage Virtual We Care for California Workers' Comp
Home   |   Physicians   |   Resources   |   Benefits   |   Events   |   About   |   Patients   |   Join
Copyright (c) 2018 Riverside County Medical Association