Thursday, August 16, 2018

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RCMA's Free Saving Private Practice Consortium 8/18/2018 Murrieta

All physicians and their practice administrators are invited to get the help they need to survive and thrive in the ever-changing world of healthcare. Free 15 minute personal one-on-one consultations will be scheduled with RCMA/CMA subject matter experts and industry experts serving the local physician community. This is a great opportunity for physicians to get their questions answered, problems solved, and explore resources that can help doctors continue caring for their patients irregardless of their mode of practice.

SPECIAL GUEST SPEAKER: Janus Norman, Senior Vice President, CMA Centers for Government Relations & Political Operations

Download Flyer                              RSVP Online

AREAS OF CONSULTATION INCLUDE:

  • All Practice & Personal Insurance
  • Billing & Collections
  • EHR & HIE Implementation
  • Estate Planning & Asset Protection
  • Information Technology
  • Legal Support
  • Malpractice Risk Management
  • Medi-Cal & Medicare
  • Office Staffing
  •  
  • Professional Liability Insurance
  • Payor Contracting
  • Payor Advocacy
  • Payor Reimbursement Support
  • Physician Employment Contracting
  • Physician Recruitment
  • Practice Management
  • Practice Cost Reduction
  • Strategic Planning
  •  

    MEET THE EXPERTS

    California Medical Association Center for Economic Services
    Areas of Consultation: Practice Management, Medicare, Medi-Cal, Payor Contracting, Denied Claims
    CMA’s Center for Economic Services (CES) is staffed with practice management experts with over 125 years in medical practice operations experience. With the combined strength of all the departments of the CMA, CES is able to empower physician practices by providing resources and guidance to improve the success of the practice. Assistance ranges from coaching and education to direct intervention with payors or regulators.
    CMA CES experts onsite at Saving Private Practice include:
      Cheryl Bradley, Associate Director - Medicare
      Kris Mark, Associate Director - Medi-Cal & Contracting
      Mitzi Young, Physician Advocate - Practice Management & Denied Claims

    Inland Empire Health Information Organization (IEHIO)
    Areas of Consultation: HIE Connections, EHR Implementation, EHR Workflow & Documentation
    IEHIO is a non-profit grass-roots organization providing linkage between healthcare stakeholders in the Inland Empire and Manifest MedEX, California’s HIE. IEHIO goals are to coordinate data sharing services not only for treatment at the point of care, but also for care management and population health analytics specific to participant needs and programs; while promoting a community-wide data-sharing model that improves healthcare for all residents of the Inland Empire.
    IEHIO experts onsite at Saving Private Practice include: Stacy Proctor, IEHIO, Program Director & Cardelia Reid, RN, MSN, MBA, IEHIO Clinical Informatics Director.

    Intalare
    Areas of Consultation: Reducing Practice Costs, Purchasing
    Intalare is a Group Purchasing Organization (GPO) with more 35,000 physicians offices and clinics as clients nationwide who trust Intalare to provide the products and services they need most at the best possible price! By aggregating purchasing volume as a group practices can leverage superior pricing and save money on everything a physician practice buys.
    Intalare experts onsite at Saving Private Practice include: Jennifer Brons, Intalare, Account Manager

    MediQuest Staffing
    Areas of Consultation: Office Staffing (Hiring, Interviewing, Salary Surveys, Retention Strategies, Difficult Employees, etc.)
    MediQuest Staffing matches high-quality healthcare professionals with fully screened, talented medical support staff such as front and back office MAs, billers, coders, medical collections, and practice managers to name just a few.
    MediQuest experts onsite at Saving Private Practice include: Rachael McGarvey, MediQuest, Regional Service & Delivery Manager

    Mercer Health & Benefits Insurance Services, LLC
    Areas of Consultation: Practice Insurance & Personal Insurances
    RCMA’s endorsed Business Partner Mercer provides information to make informed decisions with your needs in mind. Available programs include: Workers’ Compensation, Individual and Small-Group Health insurance, Cyber Liability, Life, Disability, Business Owners Policies, Long-Term Care and more.
    Mercer experts onsite at Saving Private Practice include: Liz Fogle, Mercer, Relationship Manager

    NetServe Systems, Inc.
    Areas of Consultation: IT, Cloud Services, HIPAA, Network/Security Risk Assessments, Technical Consultations
    NetServe Systems is a comprehensive one-stop IT solution for medical offices handling ALL your IT needs.
    NetServe Systems experts onsite at Saving Private Practice include: Abdi Ahmed, NetServe Systems, CEO

    NORCAL Group
    Areas of Consultation:
    Medical Professional Liability Insurance, Risk Management
    As RCMA’s endorsed partner, NORCAL Group has over 32,000 insureds including physicians, medical groups, clinics, hospitals and healthcare facilities. NORCAL continually strives to remain true to their history and values, and to maintain their singular focus on protecting their policyholders’ careers and professional reputations while supporting the delivery of safe, quality patient care.
    NORCAL Group experts onsite at Saving Private Practice include:
    Bradford S. Dunkin, MHA, NORCAL Group, Sr. Risk Management Specialist & Belinda Ramon, NORCAL Group, Regional Business Development Representative

    RCMA Physician Workforce Development
    Areas of Consultation:
    Physician & Mid-Level Provider Recruitment and Resources

    RCMA is committed to addressing the physician shortage in Inland Southern California and RCMA’s Physician Recruitment Development Director is available to meet with you and provide additional help and resources to help you hire an associate.
    RCMA experts onsite at Saving Private Practice include:
    Sonya Jackson, RCMA, Physician Workforce Development Director

    Thakur Law Firm, APC
    Areas of Consultation:
    Healthcare Law, Employment Law, Business &Corporate Law, Real Estate Law, Estate Planning & Asset Protection
    Thakur Law Firm is a full service law firm with expertise in Health Care Law, Business & Employment Law, Estate Planning, Real Estate, Tax Law and Litigation. Thakur Law Firm, APC is a full service law firm with expertise in Health Care Law, Business & Employment Law, Estate Planning, Real Estate, Tax Law and Litigation.
    Thakur Law Firm experts onsite at Saving Private Practice include: Pamela Thakur, Esq., Jas Sondh, Esq. & Ash Dudheker, Esq.

    Universal Financial Systems
    Areas of Consultation:
    Medical Billing & Collections
    Universal Financial Systems (UFS) is a Southern California based financial services company specializing in medical billing & collections, consumer & commercial collections, litigation & judgment collections, accounting services and general business consulting.
    UFS experts onsite at Saving Private Practice include: George Christidis, UFS, COO

    Zymeda Provider Solutions
    Areas of Consultation:
    Practice Management, Strategic Planning, Payor Contracting, Billing Zymeda Provider Solutions is a full service practice management partner offering services in strategic planning, operational process improvement, billing, medical practice staffing and training, benefit administration and managed care operations.
    Zymeda experts onsite at Saving Private Practice include: Helene Beilman-Werner, Zymeda, CEO & Pam Geukens, Zymeda, Director of Operations

    Are You Ready to Check CURES?

    Effective October 2, 2018, physicians must consult California’s prescription drug monitoring database (the Controlled Substance Utilization Review and Evaluation System, or CURES) – prior to prescribing Schedule II, III or IV controlled substances. All individuals practicing in California who possess both a state regulatory board license authorized to prescribe, dispense, furnish or order controlled substances and a Drug Enforcement Administration Controlled Substance Registration Certificate must be registered to use CURES.

    Because of the critical importance of adequate technical support for physicians who will have to rely on CURES as a part of their prescribing workflow, the California Medical Association (CMA) negotiated into the final legislation a requirement that the mandate could not take effect until the California Department of Justice (DOJ) certified that the database was ready for statewide use and that the department had adequate staff to handle the related technical and administrative workload.
      

    On April 2, 2018—two years after the law was enacted—DOJ finally certified that CURES was ready for statewide use. The certification began a six-month transition period, with the duty-to-consult taking full effect on October 2, 2018.

    What Physicians Need to Know
    Under the new mandate, physicians must consult the database prior to prescribing controlled substances to a patient for the first time, and at least once every four months thereafter if that substance remains part of the patient’s treatment. Physicians must consult CURES no earlier than 24 hours or the previous business day prior to the prescribing, ordering, administering or furnishing of a controlled substance to the patient.

    The law provides, however, that the requirement to consult CURES would not apply if doing so would result in the patient’s inability to obtain a prescription in a timely manner and adversely impact the patient’s conditions, so long as the quantity of the controlled substance does not exceed a five-day supply.

    Physicians are also not held to this duty to consult when prescribing controlled substances to patients who are:

    • Admitted to a facility for use while on the premises;
    • In the emergency department of a general acute care hospital, so long as the quantity of the controlled substance does not exceed a seven-day supply;
    • As part of a surgical procedure in a clinic, outpatient setting, health facility or dental office, so long as the quantity of the controlled substance does not exceed a five-day supply; or
    • Receiving hospice care.

    In addition, there are exceptions to the duty to consult when access to CURES is not reasonably possible, CURES is not operational or the database cannot be accessed because of technological limitations that are beyond the control of the physician.

    CMA Fights for CURES Protections
    CMA worked closely with the bill's author and other stakeholders to reach mutually agreeable language, which was reflected in the final version of the bill (SB 482, Lara). Among the negotiated amendments are liability protections related to the duty to consult the database and changes to ensure that health care providers can meet the requirements under state and federal law to provide patients with their own medical information without penalty. The bill also clarifies that health care providers sharing the information within the parameters of HIPAA and the Confidential Medical Information Act, including adding the CURES report to the patient’s medical record, are not out of compliance with the CURES statute.

    Save the Date: CURES webinar with DOJ on 8/22
    CMA will be cohosting a live CURES webinar with DOJ on August 22, 2018. The webinar will be free to all interested parties. Registration will open soon at cmanet.org/events.

    For More Information
    For more information, see CMA On-Call document #3212, “California’s Prescription Drug Monitoring Program: The Controlled Substance Utilization Review and Evaluation System (CURES).” On-Call documents are free to members in CMA's online resource library at www.cmadocs.org. Nonmembers can purchase documents for $2 per page.

    Additional Resources:
    CURES website: oag.ca.gov/cures
    CURES FAQ: oag.ca.gov/cures/faqs
    Medical Board CURES webpage: mbc.ca.gov/cures
    • CMA CURES webpage: cmadocs.org/cures
    • CMA Safe Prescribing webpage: cmadocs.org/safe-prescribing

    CMA will continue to provide educational resources and work with DOJ to ensure a smooth implementation of the new requirement. Physicians who experience problems with the CURES database should contact the DOJ CURES Help Desk at (916) 227-3843 or cures@doj.ca.gov



    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.

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