Sunday, September 24, 2017

Affordable Care Act Resource Center

Health Care Reform  is here to stay, so it is vital that we advocate for its smart implementation. Already the RCMA has taken action that has resulted in benefits to physicians and patients, such as: Expanding coverage where needed, establishing a high-risk insurance pool, and adopting insurance reforms. At the same time we are lobbying at the federal level to: Eliminate the Medicare Independent Payment Advisory Board, increase Medicaid rates for all physician specialties; and ensure that reimbursement rates are structured to take into account the geographic differences in physician practices costs.  Below is a list of helpful information and tools as you navigate Health Care Reform.

RESOURCES

PRESENTATIONS

Surviving Covered California: Preparing for changes in 2016

Becoming the Practice of the Future Today: 10 Steps to Transform Your Practice and Provide Individualized Care

Surviving Covered California: Preparing for changes in 2015

Covered CA - Insurer Contact List

Covered CA Office Placard  Open Enrollment 2015 Consumer Fact Sheet

Covered CA 2015 Standard Benefit Plan Design

Covered CA Standard Benefits Summary for 2014

Covered California: Know Your Status

Frequently Asked Patient Questions about Covered California

Surviving Covered California: Tip Sheet #4 

Health Insurance Company Network Development Contacts

Plan Names, ID Card, Provider Directory Reference Guide

Qualified Health Plan Networks for Covered California 

What Physicians Need to Know about the Anthem  Exchange Addendum

Surviving the Third Month of Covered California

Surviving the Second Month of Covered California Fact Sheet

Surviving the First Month of Covered California Fact Sheet

Download Covered California Grace Period Fact Sheet

Download CMA's newly updated Health Benefit Exchange Toolkit

Health Benefit Exchange Resources for Physicians

Covered California FAQs for Clinicians & their Staff  2 Page Brochure or 4 Page Brochure

California's Health Benefit Exchange Launches

CMA Health Exchange Resource Center: www.cmanet.org/exchange

Regulations governing California's Health Benefit Exchange

Official Covered California Website: www.coveredca.com

Kaiser Family Foundation's Health Reform Website: www.kff.org/health-reform

Federal Center for Consumer Information & Insurance Oversight (CCIIO) Regulations & Guidance Website: http://www.cms.gov/cciio/resources/regulations-and-guidance/index.html

California Health Benefit Exchange website: www.hbex.ca.gov

Federal Healthcare.gov website: www.healthcare.gov/law/features/choices/exchanges/index.html

CMA On Call Document #7450, “Health Benefits Exchange.This medical-legal document  includes a discussion on network adequacy , administrative burden associated with exchange plans, the grace period issue, concerns that physicians may be contracted with exchange plans without knowing it, what to look for in the mail on exchange plan contracting, and examples of termination provisions in current exchange contracts.  

Essential Health Benefits Fact SheetThis fact sheet was developed to help physicians understand the basic facts around the "essential health benefits" component of federal health care reform and how California's health benefits exchange may be affected. It can be downloaded at http://www.cmanet.org/resource-library/detail?item=essential-health-benefits-package

 

CMA Practice Resources (CPR).  Subscribe or download this monthly publication that includes tips and tools for contracting with health plans in the exchange

California Health Benefits Exchange Fact Sheet.This document provides a summary of the exchange and how it may impact physician practices  

CMA Reform Essentials  Sign up for this regular publication with timely information related to California’s implementation of federal health care reform, including discussions on network adequacy, model contract development, and reporting requirements.

Affordable Care Act (ACA) Update April 2013: More than three years have passed since the Affordable Care Act (ACA) was signed into law, setting in motion some of the most dynamic and volatile years the nation’s health care industry has ever seen.

A Physician's Guide to Covered California, the state's health benefit exchange CMA has developed this toolkit to educate physicians on the exchange and ensure that they are aware of important issues related to exchange plan contracting.

Retaining Independence while Embracing Accountability: Part 1, Part 2, Part 3

ACOs, CO-OPs and other options: A “how-to” manual for physicians navigating a post-health reform world 3rd edition

RCMA-Navigating Today’s Healthcare Marketplace Resource Guide:  Practical Considerations Regarding Physician-Hospital Affiliations and New Business Arrangements

Illustrating Health Reform: How Health Insurance Coverage Will Work: View “Health Reform Hits Main Street” to learn more about the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014.

Watch The Video

April 9, 2014
Navigating Covered CA
Health Plan Contracts

Presenter:
Matthew L. Kinley, Esq.
Pamela Tahim, Esq.


RCMA members may request
a FREE in depth paragraph by
paragraph contract analysis
of the four insurance payors
participating in Covered CA
by contacting Mitzi Young at
myoung@cmanet.org or
(888) 236-0267


Watch The Video
 
March 4, 2014
California's Health Benefit Exchange:
What Physicians Need to Know

Presenter:
Mitzi Young
Physician Advocate

 


 

 

 

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