Thursday, January 17, 2019

Social Media Tips for Medical Practices: A How-To Guide

The benefits of using social media in a medical practice are becoming increasingly recognized, which makes the pressure to get involved even greater. As medical practices become more and more sophisticated at using social media for knowledge sharing, marketing, and other forms of communication, those who fail to participate will fall behind. These social media tips for medical practices can help you get started.


RCMA/CMA's Advocacy Secures $1 Billion+ for Medi-Cal Providers

In 2016, and with a $1 million investment, the California Medical Association (CMA) led a coalition to take on Big Tobacco to improve access to care through Medi-Cal.

California voters overwhelmingly approved Prop 56, which added a $2 tax on tobacco products and stipulated that funds should increase access by improving provider payments. California's 2018-2019 state budget continues to provide over $1 billion annually to improve provider payments so more Medi-Cal patients can access care when they need it most. Other key investments include graduate medical education (GME) funding increases and school loan repayments.

What Does This Mean For Riverside County Doctors?
This supplemental funding affects both fee-for-service Medi-Cal as well as Medi-Cal Managed Care. Click Here to view a comparison of Prop 56 payments by year as well as how these new reimbursements compare to current Medicare Rates in Riverside County.

RCMA has been informed that Inland Empire Health Plan (IEHP) will be paying FY 2018/2019 at the enhanced rates, including the additional E&M codes, starting July 1, 2018. However, given the lag in encounter data and timing of payments, the first enhanced payments physicians will see this Fall will be 2017/2018 timeframe payments.  The first quarter payment for 2018/2019 will not be until early 2019.  

Look for further communication from IEHP in the next few weeks. Payments will be made directly to IEHP providers based on encounter submissions reflecting the E&M codes shown in the Rate Comparison Chart

For Further Information Please Contact:
Riverside County Medical Assoication
(800) 472-6204

or

Inland Empire Health Plan (IEHP)
(909) 890-2054
 


Opioid Advocacy Update

From the beginning of the opioid epidemic, the California Medical Association (CMA) has been one of the most engaged and determined stakeholders working to strike a balance between patient access to necessary medicine and preventing and addressing abuse.

 

CMA has been a leader in advocating for increased funding, access and availability of preventive services, opioid-use disorder treatment programs and non-opioid therapies, including mental health services and medication-assisted treatment (MAT). We have successfully worked to stop legislation that interferes with the practice of medicine and creates barriers to care, such as government-mandated dosage and duration limits.

 

Over the last few years, the changing landscape surrounding prescribing opioids has been dizzying as payors, legislators, pharmacies and medical boards seek ways to be proactive in addressing the opioid epidemic – sometimes ignoring the actual realities of medical practice and creating barriers to good care. And as you’re aware, California physicians have been engaged in the debate since the beginning, on behalf of our patients and profession.

 

CMA released a white paper, “Opioid Analgesics in California: Relieving Pain, Preventing Misuse, Finding Balance” in 2013. Developed through CMA’s Council on Science and Public Health, it has been the cornerstone of our work to educate physician colleagues, guide the medical board and policymakers, and help health care stakeholders navigate the evolving science related to opioids. At its core is the premise that care must be evidence-based and reflect the individual needs of the patient – ultimately, allowing physicians to make proper care decisions.

 

CMA’s emphasis on these principles has remained constant, including advocacy on opioid-related activities in 2018, which include:

 

Controlled Substance Utilization Review and Evaluation System (CURES): CMA has been working with the state for years to ensure adequate educational and technical support for physicians who will have to check CURES as part of their prescribing workflow, starting on October 2, 2018. CMA has advocated for sustained user outreach and educational efforts by the state that provide clarity of this new law, as well as prioritize the clinician perspective on an ongoing basis following implementation. We will continue to engage as the new requirement to consult CURES is implemented and work with stakeholders to ensure CURES has adequate support.

 

Ensuring Fair Enforcement: The Medical Board of California is examining deaths associated with the use of prescription opioids and is reviewing whether the care and treatment provided by physicians to those individuals met the standard of care. As part of a “routine” review, the board sent letters to physicians who were identified as prescribing opioids in a manner that, after physician review, merited further investigation, and requested that those physicians submit additional information including a summary of the care provided, the patient’s medical records, and any additional materials that would be pertinent to the board’s investigation.

 

CMA has raised concerns about the board’s process and will continue to work with the board to address physician concerns, monitor the board's process to determine whether disciplinary actions are based on the appropriate standard of care, and if the process used to identify physicians subject to these inquiries needs additional transparency or modification. Physicians who are under review may contact CMA (800-786-4262, CMAdocs.org) for information about the disciplinary process and their legal rights.

 

Access to Medication-Assisted Treatment and Overdose Reversal Medications: To help reduce the rates of overdose and stigma associated with opioid-use disorder, CMA sponsored AB 2384 (Arambula), which would have removed barriers to coverage of MAT services and naloxone to ensure that people who face addiction have better access to treatment. Governor Jerry Brown vetoed AB 2384, claiming a need for utilization controls and barriers to patient access of life-saving treatments. In response, CMA issued a statement expressing disappointment and concern, while reiterating our intention to work with the next governor to make this issue a priority in 2019.

 

The federal opioid bill continues to push treatment in the right direction by providing grants to improve access to MAT and codifying the ability for physicians to prescribe MAT for up to 275 patients, which is critical since the current caps are far too limiting and leave many patients on waiting lists for years.

 

Individual Patient Care: At the federal level, CMA successfully fought back against legislation that would have required one-size-fits-all medicine by mandating prescription drug dosage and duration limits.

 

California legislators also sought to statutorily limit dosages and durations of opioid pain relievers through AB 2741 (Burke) and AB 1998 (Rodriguez), using arbitrary and minimal amounts. Both bills were defeated earlier this year.

 

Federal Funding and the Congressional Opioid Crisis Response: Earlier this year, Congress approved $10 billion in new funding for states to address opioid-related education, prevention, treatment and law enforcement issues. The House and Senate reached an agreement on the “Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act,” and they will send it to President Donald Trump soon. It is a comprehensive package of more than 300 bills that, among other things, provides grants to states to address prevention and treatment, as well as stop the flow of illicit drugs, such as fentanyl. It also expands the number of Institute for Mental Diseases inpatient Medi-Cal beds available for opioid substance abuse disorder treatment and enhances Medi-Cal patient access to non-opioid options. Medicare coverage for treatment has been expanded, with new Medicare payment and delivery demonstration projects approved for comprehensive management of opioid-use disorder.

 

Unfortunately, the bill package also includes a mandate for physicians to e-prescribe controlled substances for Medicare patients after January 1, 2021. However, it includes many exceptions, and it directs the Centers for Medicare and Medicaid Services to implement additional exceptions. In a major win, the Drug Enforcement Administration (DEA) has been mandated to update its antiquated and burdensome process for e-prescribing. While more than 90 percent of physicians e-prescribe, only 21 percent e-prescribe controlled substances, largely due to the DEA’s burdensome requirements. The state mandate takes effect in 2022.

 

Physician Education on Safe Prescribing and Treatment: Governor Brown recently signed AB 2487 (McCarty), which originally mandated all California physicians to take an eight-hour course required to qualify for a federal waiver to the Drug and Addiction Treatment Act of 2000 in order to allow physicians to prescribe MAT drugs, like buprenorphine, outside of an opioid treatment center.

 

After CMA-led negotiations with the author, the bill was amended to allow physicians who seek to prescribe MAT to fulfill their annual continuing education requirement by completing the DATA-Waivered Physician course along with four additional credit hours on treating substance use disorders. Successful advocacy prevented additional and mandatory continuing education.

 

The road has been long and hard-fought, and California’s comprehensive approach has focused on safe prescribing, naloxone distribution, public education campaigns, local opioid safety coalitions and increasing access to treatment, including MAT.

 

This approach has produced promising results. From 2013-2017, California experienced over a 24 percent decrease in opioid prescriptions, and is only one of five states with a multi-year decrease in prescription opioid overdoses. California is now tied for the lowest per capita opioid prescription rate in the country, while opioid prescribing has decreased for the fifth year in a row.

 

More work remains, as the drugs responsible for these overdose deaths are changing and have been spurred by illicit fentanyl. CMA will continue to work with policymakers, elected officials and health care stakeholders to ensure your voice – and your patients’ voices – are heard.

 

ADDITIONAL RESOURCES:

 

White Papers:

 

Webinars:

 


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.


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. 

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.

On the Horizon: New Employment and Labor Laws Affecting California Employers in 2018


By Thakur Law Firm, APC.

With the New Year upon us, we brace for the perennial tidal wave of California employment law changes of statutory tweaks, regulatory guidelines, and myriad new judicial decisions that will impact our clients.  We must make sure to advise our employer clients of any changes to daily operations and policies, as well as stay abreast of the ever-changing rights of employees in the workplace. The variety of new laws and rules can easily overwhelm employers and, if they are not in compliance, even the most well-advised employers might be ambushed by penalties for policies and practices that might well have been permissible just last year. Several new pieces of legislation deal specifically with the job applications and employers’ hiring processes and restrict what information employers can consider in making hiring decisions and what questions they may ask job applicants. As a result, employers must stay vigilant of changes in the law and constantly revise their hiring documents and processes, as well as training procedures for new and existing staff. Most employers want clear, cut-and-dry advice, so they may easily maintain their compliance. To that end, below is a summary of key new laws that the California legislature has enacted, which take effect on January 1, 2018, along with the best practices to be ready and ensure compliance.

Download Summary Of New Laws

Thakur Law Firm 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 and is offering RCMA members complimentary consultations up to 30 minutes, 10% off hourly rates for pre-litigation, litigation and hourly matters along with flat fees for various contracts, agreements and handbooks. Download Flyer To access this benefit, please contact Pamla Thakur, esq. at pamela@thakurlawfirm.com or (714) 853-9919.

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