- What regulations limit your ability to serve your patients? Tell CMA now!
- California grapples with ‘severe’ doctor shortage, study shows
- DMHC finds significant errors in most health plans’ annual timely access reports
- Physicians targeted by identity theft tax scam
- Bills introduced to stop IPAB
- Dr. Abraham Verghese to speak at Western Health Care Leadership Academy
- CMS awards $100 million to help small practices succeed
- CDPH publishes new Zika resources for physicians
- DHCS extends reporting deadline for 2016 Medi-Cal meaningful use
- Meaningful use reporting deadline pushed back two weeks to March 13
- Free CME: CMA hosts webinar on cannabis in medicine
Important Dates & Deadlines
- 3/13/17: PQRS EHR reporting deadline
- 3/13/17: 2016 Medicare meaningful use attestation deadline
- 3/13/17: Deadline to submit Q2 testimony
- 3/15/17: Webinar: Cannabis in Medicine: A Review of Policy and Scientific Evidence
- 3/17/17: CMA Council on Legislation
- 3/29/17: CMA Legislative Advocacy Day Webinar Training
- 4/18/17: CMA's 43rd Annual Legislative Advocacy Day
- 5/5-7/17: Western Health Care Leadership Academy
Nuriel Moghavem is a fourth-year medical student at Stanford University. He will find out March 17 if he's able to stay in California for his residency or if he'll have to move out-of-state. He publishes a weekly health policy newsletter, "Informed Consent."
Future #CMAdocs: Nuriel Moghavem
We’re not the same doctors of yesterday. In the 1970s, if you were a smart college student interested in making boatloads of money and enjoying high social standing, you went into medicine. Today, high-achieving college students look at the increased hours, ludicrous student debt, systematic burnout and reduced salaries of physicians and explore tech, consulting or finance instead." Read More
Featured member benefit:
Laboratory Quality: California Medical Association (CMA) members save 15 percent on COLA’s Laboratory Accreditation Program and its educational products and services. CMA members also receive free online support and a complimentary basic quality lab course, and may be eligible for a discount on AAFP and ACP proficiency testing programs. Read More
(Photo courtesy of Andy Marso/Kansas News Service)
Quotable: Dr. Saeedeh Salmanzadeh became a U.S. citizen at a naturalization ceremony in October 2015. When the presiding official asked if any of the new citizens wanted to speak, she was one of the first to raise her hand. By then Salmanzadeh had spent 15 years in America, after leaving her home in Iran where she was a doctor. Read More
Physicians in the News
- Doctors Caught In Middle As Travel Ban Intersects With Rural Recruitment
KCUR - 2/27/17
- California’s cuts to medical education will harm patients
San Jose Mercury News - 2/23/17
- Geriatricians Can Help Aging Patients Navigate Multiple Ailments
Kaiser Health News - 2/23/17
- With role models, can minority students change medicine’s racial imbalance?
Stat - 2/23/17
- Providers that help patients manage chronic conditions face fewer readmission penalties, study finds
Healthcare Finance - 2/21/17
1. Congressional push for ACA 'repeal and replace' ramping up
Physician leaders and staff from the California Medical Association (CMA) were in Washington, D.C., three times last month aggressively advocating our priorities for health care reform. Bottom line? CMA is fighting to ensure that no Californian loses health insurance coverage.
The CMA leadership delegation was joined by Brad Anderson, M.D., (Bakersfield); Tom Daglish, M.D., (Visalia); and Steve Beargeon, executive director of the Tulare County Medical Society – all from key Republican leadership districts. Two California medical students also joined the CMA contingent – Karthik Sarma of UCLA and Sarah Smith of UC Irvine.
Despite enormous hurdles and disagreement within the House and Senate Republican caucuses, House Republican leaders are pushing to pass the Affordable Care Act (ACA) “repeal and replace” plan on the floor of the U.S. House of Representatives before the April recess. They plan to pass the legislation through the budget reconciliation process, which only allows provisions that have a financial impact. However, reconciliation only requires a 51-majority vote – rather than the usual 60 votes required in the Senate.
While negotiations continue on the plan’s specifics, the legislation follows the outline of House Speaker Paul Ryan’s “The Better Way” plan. The current proposal provides the following:
- Repeals the ACA, but wouldn’t take effect until 2020 to provide a transition to the replacement plan.
- Repeals the ACA individual mandate and its penalties, low-income subsidies and the taxes that funded the ACA, such as the medical device tax, the health plan Cadillac tax on high-end health benefits and the tax on high-income earners.
- Repeals the essential health benefits package, which includes preventive and maternity care, but allows states to set those requirements. (CMA supported the essential health benefits package, particularly for preventive services.)
- Drafters of the plan say they intend to maintain coverage for individuals with pre-existing conditions and children on their parent’s policies until age 26. (CMA strongly supports maintaining coverage for patients with pre-existing conditions.)
- Insurers would be allowed to sell insurance across state lines (and not meet individual state laws). (This would obliterate California’s large body of law protecting patients and physicians, including CMA-sponsored laws, such as the requirement that insurers pay claims within 45 days.)
- Relaxes the ACA’s community rating rules and would allow insurers to charge older individuals five times as much as younger individuals. (CMA supported the ACA’s community rating.)
- Allow individuals to purchase insurance in the private marketplace. Advanceable/refundable tax credits would be provided to help individuals afford coverage. The amount of the credit would be based on age, rather than income. The tax credits would begin at $2,000 for 20- and 30-year-olds and graduate up to $500 per decade to $4,000 for 60- to 64-year-olds. (CMA is concerned that under this plan insurance may not be affordable for low- to moderate-income people.)
- As an alternative to the individual mandate penalties, it institutes penalties for anyone who seeks to sign up for insurance if they have not maintained “continuous coverage.” It would penalize individuals who let their coverage lapse for more than one year with a 30 percent increase in premiums for one year. (CMA is concerned that this could preclude some individuals from affording insurance. We’re waiting for the Congressional Budget Office analysis of the impact.)
- Loosens restrictions on health savings accounts (HSAs) paired with high-deductible health plans, and expands the use of HSAs to pay for over-the-counter medications. (CMA supports HSAs.)
- Provides $100 billion for the next 10 years for “state innovation” grants. These funds can be used in a variety of ways to establish state high-risk pools or reinsurance programs, provide assistance with out-of-pocket expenses, or provide dental and vision benefits. (CMA agrees that reinsurance funding is important.)
- Grandfathers the Medicaid expansion for those states that expanded Medicaid coverage for adults up to 138 percent of the federal poverty level. However, if such adults go off Medicaid and reenroll, the state would no longer receive the enhanced 90 percent federal match. If the state wishes to cover new adult Medicaid enrollees, the state would only receive a 50 percent federal match. Hospitals in states that didn’t expand Medicaid would see the ACA disproportionate share hospital payment cuts restored. (CMA is fighting to maintain the Medicaid expansion, and we’re concerned about the low physician reimbursement rates and the resulting lack of access to physicians. CMA is pushing a proposal that would provide an increased federal match for physicians who provide care to Medi-Cal patients in counties where more than 35 percent of the population are enrolled in Medi-Cal. The National Governor’s Association just released a new proposal that would allow all states to expand Medicaid in the future with the enhanced match as long as other flexibilities were provided to allow states to require Medicaid beneficiaries to work, among other things.)
- Eliminates the Medicaid entitlement for children, pregnant women, the disabled and elderly. Establishes a per capita cap funding system that provides each state an allotment per Medicaid beneficiary based on 2016 funding levels. An annual medical inflator would be established to keep funding current with rising costs. It’s unclear whether there would be an across-the-board cut to Medicaid before the per capita cap program starts – previous drafts showed a 25 percent cut. (CMA has concerns with eliminating the Medicaid guarantee for our most vulnerable patients. CMA also has policy opposing per capita caps, but we are working to improve the proposal. We are opposing the across-the-board cut and urging a large medical inflation adjustment. We are also asking that prescription drugs be excluded from the cap, as those rapidly rising costs could consume the entire budget. Again, CMA is advocating for increased funding for physician Medicaid payment rates to increase access to care in underserved regions. And finally, CMA is asking Congress to urge California Governor Jerry Brown to restore the Proposition 56 tobacco tax funds intended to increase Medi-Cal physician payment rates to improve access for patients.)
- The major funding source of the legislation is a proposal to cap the tax exclusion for individuals with employer-sponsored insurance. It caps the tax break at 90 percent of current premiums, which is opposed by both organized labor and the U.S. Chamber of Commerce.
- Defunds Planned Parenthood for one year. (CMA opposes the defunding of Planned Parenthood.)
As currently drafted, this plan won’t pass the U.S. House or the Senate. The House Freedom Caucus (formerly the Tea Party Caucus) has said it will accept nothing less than the full repeal legislation the House passed last year. And, at least three Republican Senators have said they would oppose the current proposal because the tax credits are akin to a new entitlement program.
On the other end of the Republican spectrum, at least four Senators have expressed opposition to eliminating the Medicaid expansion. The Republican members from Medicaid expansion states and the Republican Governors are heavily weighing in on the Medicaid provisions.
The Central Valley has some of the highest concentrations of Medicaid and Covered California patients in the nation. These communities are concerned about the loss of coverage and Medicaid funding for their residents. Despite these disagreements, the leadership is working to pass bills out of the relevant committees in the next few weeks and to the House floor by the April recess.
The CMA delegation also met with leaders of the Centers for Medicare and Medicaid Services to urge them to continue to reduce regulatory burdens under the quality, cost and electronic health record (EHR) reporting programs established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Specifically, CMA urged the following:
- Hold EHR vendors more accountable for compliance and interoperability.
- Eliminate unrealistic Meaningful Use Stage 3 measures that were maintained under MACRA.
- Provide additional exemptions and accommodations for small and rural practices and exempt physicians within five years of retirement from penalties.
- Make scoring adjustments for Medicare-Medicaid dual eligible patients, so physicians are not disincentivized from treating such complex, costly and vulnerable patients.
- Allow large physician groups that provide care across many counties to receive geographic payments based on the site of service to more accurately cover local costs to provide care.
- Promote primary care medical home models across California.
- Improve access to physicians
- Protect state and federal Medicaid funding
- Ensure Californians do not lose coverage
- Provide affordable coverage, particularly for low- and moderate-income families
- Eliminate administrative and regulatory burdens in the Medicaid and Medicare programs
- Provide a choice of insurers, HSAs and physicians
- Maintain reforms on the insurance industry – coverage for pre-existing conditions, 85 percent medical loss ratio and no annual/lifetime limits on benefits
- Stabilize the individual insurance market
- Provide access to affordable prescription drugs
Members who feel passionately about CMA’s health reform priorities should email firstname.lastname@example.org. Our communications department can help publish op-eds in your local newspapers and secure media interviews in your market. It’s critically important that policymakers hear from physicians through earned media and in-person meetings.
2. What regulations limit your ability to serve your patients? Tell CMA now!
President Donald Trump has issued an Executive Order requiring agencies to eliminate two regulations for every one they issue. The Administration has also created task forces “charged with calling out those rules that eliminate jobs or inhibit job creation; that are outdated, unnecessary or ineffective; or that impose costs in excess of benefits.”
More from Bloomberg:
“Within 90 days, they must provide a report to agency heads, identifying specific regulations that are ripe for repeal, replacement or modification. They are charged with calling out those rules that eliminate jobs or inhibit job creation; that are outdated, unnecessary or ineffective; or that impose costs in excess of benefits. The task forces are specifically directed to seek input from those affected by regulations, including small businesses; consumers; nongovernmental organizations; trade associations; and state, local and tribal governments.”
Physicians are no strangers to burdensome regulations, and we know not all regulations are created equal. Some regulations protect public health, while others are outdated or hurt doctors’ ability to expand their medical practice to serve more patients, especially those from low-income and underserved communities.
Let’s focus on the latter – what regulations would you like to see eliminated because they limit your ability to serve your patients?
Send your thoughts to email@example.com – we’ll include the best comments in an updated article in the next CMA Newswire.
California doesn't have enough doctors to handle its primary health care demands and the problem is getting worse, according to a recent article in the San Francisco Business Times about a new study by UCSF Healthforce Center.
The study, published last month, found that California doesn’t have enough primary care physicians in most regions of the state. According to the study, the shortage is becoming more acute because of an aging physician workforce, a growing patient population and expanded coverage through the Affordable Care Act.
According to the study, only two regions of California (the Greater Bay Area and Sacramento) have ratios of primary care physicians per population above the minimum ratio recommended by the Council on Graduate Medical Education (60 primary care physicians per 100,000 people).
The study also found that two regions (the Inland Empire and San Joaquin Valley) have ratios of primary care physicians to population that are below the minimum required by California law for managed care plans (50 primary care physicians per 100,000 people).
Some estimates show that California will need an additional 8,243 primary care physicians by 2030 – a 32 percent increase.
In an effort to increase California's primary care physician workforce, the state legislature passed a budget in 2016 that included historic support for and expansion of primary care graduate medical education (GME)—committing to invest $100 million over three years to support primary care residency programs in medically underserved areas.
Unfortunately, Governor Jerry Brown’s proposed 2017 budget takes a huge step backward, eliminating $33.4 million of that health care workforce funding and redirecting $50 million in Prop. 56 funding that was intended to go to GME programs. The California Medical Association (CMA) believes these budget cuts are irresponsible and make a bad situation worse.
A robust and well-trained primary care workforce is essential to meeting the health care demands of all Californians. Inadequate funding for residency programs exacerbates access problems—every year hundreds of graduating medical students don't find a residency slot in California to continue their training, forcing talented, young doctors who want to stay and practice in California to other states and communities.
CMA will be working through the budget negotiation process to restore this critical funding. We are also urging physicians, residents and medical students to ask their legislators to oppose Governor Brown’s budget proposal to eliminate physician workforce funding.
For more information on the budget as it relates to health care, including GME funding talking points, see CMA's budget summary.
Click here to read the UCSF study.
Ninety percent of health plans' 2015 timely access compliance reports submitted to the California Department of Managed Health Care (DMHC) contained one or more significant data inaccuracies, making it virtually impossible for the agency to measure health plan compliance.
California's timely access regulations require plans to maintain provider networks sufficient to ensure that consumers can get appointments within defined timeframes. To ensure that these appointment timeframes are met on a consistent basis, each health plan must monitor its own network, measure appointment availability and submit compliance reports to DMHC every year.
According to DMHC, 36 of 40 health insurers reviewed could face fines for failing to submit accurate data or comply with state rules.
DMHC said that while some data errors can be attributed to a lack of attention to detail or a failure to accurately perform basic mathematical calculations, several of the issues involve failure by health plans to follow the mandatory DMHC methodology, as required by law.
“Other significant data errors appear to have been caused by work performed by a single vendor hired by numerous health plans to gather data and prepare compliance reports. Twenty-two health plans that used this vendor submitted deficient compliance reports, several of which included information concerning thousands of primary care physicians and specialists who were not under contract with the health plan and who did not participate in the plan’s network.”
DMHC found the errors submitted by the vendor so egregious that it banned the plans from using the vendor and will require plans to use a DMHC-approved vendor moving forward.
Some of the faulty data health plans submitted included using the names of physicians that were not a part of the plan at all. For example, Aetna Health of California, Inc., greatly overinflated its reported specialist network by submitting the names of 30,000 cardiologists, dermatologists and allergists — three times higher than the number of specialists reported by any other health plan for those three provider types.
Fourteen plans also made simple mathematic calculation errors, requiring DMHC to spend significant time and resources to audit and correct data. “Errors of this type strongly suggest that health plans did not allocate the resources necessary to ensure appropriate report review and submission of accurate data, data for which they are required to attest accuracy under penalty of perjury," the report said.
According to DMHC, the serious and significant failure by California’s health plan industry to ensure gathering and submission of accurate timely access compliance data has forced the agency to take steps to protect California consumers and ensure access to care as required under the law.
“California’s health plan industry must immediately secure all resources necessary to gather data in accordance with the mandatory DMHC methodology and accurately report compliance in all future reports. Plans that do not comply will be subject to enforcement action,” the report said.
In an effort to gain better compliance with agency requirements, DMHC held an all-stakeholder meeting last month to discuss steps that must be taken by health plans to ensure that the 2016 compliance data—due to be submitted in March 2017—is validated and accurate.
Only four health plans submitted information without identifiable errors. Two were full-service health plans, Community Health Group and Inland Empire Health Plan. The two others specialize in behavioral health: Human Affairs International of California and Managed Health Network.
The California Medical Association (CMA) has received reports from physicians that fraudulent federal income tax returns have been filed using physician names, addresses and social security numbers. In many cases the fraudulent tax return includes the name of an unknown person listed as the physician's spouse. Sometimes, this other name is a prior patient of the physician.
Affected physicians are likely to learn of the scam by receiving a 5071C letter from the IRS alerting them of possible fraud. Physicians may also have received a rejection notification when attempting to electronically file their taxes. This occurs because a return has already been filed using that social security number.
If you learn that your identity has been compromised in this way, act quickly and consider the following steps.
IRS – Contact the IRS through its identity theft website, or by phone at (800) 830-5084, to let officials know you have been a victim of this scam. If you have been unable to electronically file your return this year, you should still file a paper return and attach an IRS 14039 Identity Theft Affidavit to describe what happened.
Also attach copies of any notices related to this issue that you received from the IRS, like the 5071C letter. Be sure to also notify your tax preparer. Verify with the IRS and your tax preparer where to mail your paper tax return, based on the type of return you are filing and your geographic area.
If you have not received a notice from the IRS but believe your personal information may have been used fraudulently or are concerned about whether you may have been victimized, call the IRS Identity Protection Specialized Unit at (800) 908-4490. Additional information is available on the IRS website.
Office of the California Attorney General – Physicians affected should register the identity theft with the California Attorney General. Not only is the Attorney General's website a great resource for identity theft victims, but more information about the victims of this tax scam makes it more likely that an investigation could determine the source of the scam.
FTC – File a complaint with the Federal Trade Commission (FTC). This not only helps the FTC identify patterns of abuse, but the printed version becomes your "identity theft affidavit." That affidavit, along with a police report, constitutes your identity theft report, which you will need for the IRS. The FTC also recommends several other immediate steps to take and provides relevant helpful information on its website.
Police Report – Consider filing a report with the local police in the jurisdiction where you reside. Bring with you all documentation available, including the state and federal complaints you filed. This will likely be necessary if there is financial account fraud as a result of the identity theft. However, if the only fraud is tax fraud, the police report is likely unnecessary unless specifically requested by the IRS.
Social Security Administration – Call the Social Security Administration's fraud hotline at (800) 269-0271 to report fraudulent use of your Social Security Number. To find out if your number is being used for fraudulent employment, you can also request your Personal Earning and Benefits Estimate Statement from the Social Security Administration website or by phone at (800) 772-1213. Make sure to check the report for accuracy.
Financial Accounts – Physicians should also consider taking steps to protect their various financial accounts, such as running a credit report or placing a credit freeze on any existing credit cards. The FTC, Attorney General and DOJ websites referenced above provide several suggestions on how to protect your financial interests in the event of identity theft.
Additional Information – The U.S. Department of Justice website has additional information about identity theft and fraud.
CMA will continue to monitor this fraudulent tax scheme and keep physicians up to date. If you have been a victim, and may have information to help us determine the scope of the situation, please contact the CMA Center for Legal Affairs at (800) 786-4262.
California Congressman and physician Raul Ruiz, M.D., (D-Palm Springs) and Senate Finance Committee Ranking Member Ron Wyden (D-OR) recently introduced bills that that would prevent the Medicare Independent Payment Advisory Board (IPAB) from moving forward.
IPAB was to be a 15-member federal agency with the task of achieving specified savings in Medicare without affecting coverage or quality. It was established by the Affordable Care Act and up until now has not been implemented. The board was charged with making recommendations to reduce per capita spending growth in Medicare if spending growth exceeds a specified target.
The California Medical Association (CMA) has long advocated for the board’s elimination. CMA is concerned that strict budgetary targets and other limitations imposed on the panel would ultimately threaten the ability of the nation’s seniors and disabled to obtain health care because the cuts directed by IPAB would disproportionally fall on physicians and negatively impact access to care.
“Given the Trump administration’s short but disturbing record of irresponsible and cruel executive actions, it would be a huge mistake to leave in place the authority to push through harmful cuts to Medicare with minimal input from Congress,” Wyden said.
Senator John Cornyn (R-TX) and Representative Phil Roe, M.D., (R-TN) have introduced similar bills. CMA applauds the actions of these representatives, particularly our own physician Congressman, Dr. Ruiz, to eliminate the IPAB once and for all.
With a dramatic shake-up happening in Washington, D.C., the Western Health Care Leadership Academy is the right place and time for physician leaders who want to stay on top of policy and political changes to shape the future of health care. Register today and join us in San Diego for the West Coast's premier health care leadership conference!
Featuring Abraham Verghese, M.D.
We are pleased to announce our featured speaker Abraham Verghese, M.D., MACP, physician, professor at Stanford School of Medicine and best-selling author of "Cutting for Stone." Modern medicine is in danger of losing a powerful tool: human touch. Dr. Verghese will talk about our strange new era of health care, where patients are merely data points, and calls for a return to the old-fashioned physical exam, the bedside chat and the power of informed observation.
Additional speakers include:
CNN commentator Paul Begala: Begala is part of the political team that has won both an Emmy Award and a Peabody Award. In the 2012 campaign, he was a senior adviser for the pro-Obama Super PAC, making Begala one of the few people to play a critical role in electing two different presidents.
Science correspondent Ira Flatow: Award-winning science correspondent and TV journalist, Flatow is the host of "Science Friday," heard weekly on PRI and podcast on iTunes, iOS, Android, etc. He anchors the show each Friday, bringing radio and internet listeners worldwide a lively, informative discussion on science, technology, health, space and the environment.
Radio talk show host Hugh Hewitt: Hewitt is the host of "The Hugh Hewitt Show" on the Salem Radio Network, heard nationally every weekday morning. Hewitt is also an NBC News analyst, a professor of law at Chapman University Fowler School of Law in Orange County, CA, and a partner with the Los Angeles law firm of Larson O’Brien LLP.
More speakers will be announced, along with the full agenda, at westernleadershipacademy.com. Register now! (This activity has been approved for AMA PRA Category 1 Credit™.)
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Adjacent to the San Diego Convention Center and steps from the Gaslamp Quarter, this San Diego hotel in downtown is at the center of many popular attractions including Balboa Park, the San Diego Zoo, Seaport Village, SeaWorld® San Diego and LEGOLAND® California.
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The Centers for Medicare & Medicaid Services (CMS) has awarded $20 million to 11 organizations for the first year of a five-year project to provide on-the-ground training and education about the Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), for clinicians in individual or small group practices. CMS intends to invest up to an additional $80 million over the remaining four years.
Health Services Advisory Group was awarded the contract to help small practices in Arizona, California, Hawaii, New Mexico and the U.S. Virgin Islands prepare for and participate in the new Quality Payment Program, established by MACRA.
This local, experienced, community-based organization will provide hands-on training to help to small practices (15 clinicians or fewer), especially those that practice in rural and under-resourced areas. The training and education resources should be available immediately and will be provided at no cost to eligible clinicians and practices.
According to CMS, clinicians will receive help choosing and reporting on quality measures, as well as guidance with all aspects of the program, including supporting change management and strategic planning, and assessing and optimizing health information technology.
The California Medical Association and the American Medical Association fought to include language in the Medicare reform law to provide this direct assistance to small and rural practices to help them comply with MACRA’s Merit-Based Incentive Payment System and transition to new payment models. As part of that outreach effort, CMS also launched a new helpline for clinicians seeking assistance with the Quality Payment Program. The helpline can be reached by calling (866) 288-8292 from 8 a.m. to 8 p.m. EST, or emailing firstname.lastname@example.org.
The California Department of Public Health (CDPH) has published new and revised Zika virus resources for physicians on its website.
The evolving Zika virus outbreak and science have presented challenges for providers who are asked to educate, counsel, screen, monitor and manage patients with Zika virus exposure. “We hope these resources will aid health care providers in meeting the needs of California’s families,” the agency said.
These materials can be accessed through the CDPH Zika webpage.
The new resources include: 1) CDPH Zika Screening Algorithm; 2) CDPH Zika Virus Information for Healthcare Providers; 3) Zika Virus Exposure Patient Self-Assessment, English and Spanish; 4) Evaluation and Follow-Up Procedures for Suspected Congenital Zika Virus Infection – Fetus, Newborn and Infant; 5) Risk-based Testing for Local Zika Virus Transmission; and 6) Patient Educational Materials.
In addition to these California-specific materials, CDPH is also highlighting a Centers for Disease Control and Prevention (CDC) program called Zika Care Connect (ZCC), a new resource being developed by the agency in collaboration with March of Dimes. ZCC establishes a network (searchable online) of specialized health care providers who can care for patients and families affected by the Zika virus.
“ZCC will help California families find specialty health care services, and health care providers can also use ZCC as a resource for coordinating care for patients affected by Zika who need access to other specialists."
Total of 505 Zika infections identified in California
According to CDPH, there have been a total of 505 Zika infections identified in California, with six new infections reported in the week of February 24, 2017. Not one of these infections was locally acquired. Cumulatively, there have been six infections due to sexual transmissions, with the number of infections in pregnant women totaling 88. There have been four infants born with birth defects caused by the Zika virus.
The California Department of Health Care Services (DHCS) has announced that it will extend the deadline for Medi-Cal meaningful use reporting for the 2016 program year. The deadline has been pushed back one month to May 2, 2017. After that date, DHCS will only accept 2017 attestations.
The Medicaid Electronic Health Record (EHR) Incentive Program provides funding to Medicaid (Medi-Cal in California) providers and hospitals to adopt, implement, upgrade and make meaningful use of certified EHR technology. Eligible providers should be aware that 2016 is the last year that eligible providers can sign up for the program. Providers who have not received at least one incentive payment by the end of the 2016 reporting year won’t be able to receive any EHR incentive program payments in the future.
DHCS's announcement comes a week after the Centers for Medicare and Medicaid Services also extended its 2016 reporting deadline for Medicare meaningful use.
A few other reporting changes were also announced for 2017. DHCS will only accept meaningful use reporting for Stage 2 this year and all clinicians can report Stage 2 no matter how many times they have submitted Stage 2 attestations in the past.
Providers will also have the option to report Stage 3 meaningful use beginning October 24, 2017. Providers who have previously attested to meaningful use will be required to use a full year reporting period for clinical quality measures in 2017. Providers who have never attested to meaningful will be able to able to use 90-day reporting periods.
Click here for more information about Medi-Cal meaningful use reporting.
The Centers for Medicare & Medicaid Services (CMS) on Monday announced that physicians would have two additional weeks to register and attest to meaningful use for 2016 and avoid the 2018 penalty. Physicians now have until Monday, March 13, to attest for the 2016 reporting year. Two weeks ago, hospitals also received a similar reprieve.
Physicians should note that CMS is only extending the attestation period, not the reporting period, so physicians must have concluded their reporting by December 31, 2016.
Although the Medicare meaningful use program is being phased out this year, physicians are still required to report meaningful use measures for 2016 to avoid a 3 percent Medicare penalty in 2018. According to CMS, approximately 171,000 physicians are expected to be penalized this year because they didn't attest to meaningful use for 2015.
Medicare meaningful use reporting will end in 2017, with eligible clinicians who do not participate in the new advanced alternative payment models transitioning to Medicare's new Merit-Based Incentive Payment System (MIPS).
To attest, providers should submit their data through the CMS registration and attestation system. Physicians may select an EHR reporting period of any continuous 90 days from January 1, 2016, through December 31, 2016.
CMA recommends that physicians attest during off-peak hours, such as evenings and weekends, to speed up the attestation process. Physicians are also urged to take time now to ensure that their Medicare enrollment information is up-to-date before entering their 2016 attestation data. Review the CMS Registration and Attestation Resources Page for other tips to success.
Please note the deadline referenced above only applies to the Medicare EHR program, not the Medicaid (Medi-Cal in California) program. For more details on the Medi-Cal program and deadlines, see http://medi-cal.ehr.ca.gov.
On November 8, 2016, California voters approved state ballot initiative Proposition 64, “The Control, Regulate and Tax Adult Use of Marijuana Act” (AUMA), which legalized the use of recreational marijuana for those 21 years of age and older.
To inform physicians about the new state requirements under AUMA and present the most current clinical information pertaining to the potential medical uses of cannabis as well as its medico-legal policy context, the California Medical Association (CMA) is offering a free one-hour webinar to members ($99 for non-members). The program will offer 1 unit of continuing medical education (CME) credit*.
The webinar will explicitly focus on whether or not evidence exists, and how strong any evidence is, for the use of cannabis to treat symptoms of a handful of diseases, with a particular focus on chronic and neuropathic pain.
Samantha Pellón, MPH, is an associate director in CMA’s Center for Health Policy. She covers public health policy issues and staffs CMA’s Council on Science and Public Health, a committee composed of physicians and medical students charged to study and make recommendations concerning public health and clinical issues.
Michael Lubrano, M.D., MPH, is a postgraduate anesthesia resident in the UC San Francisco Medical Center’s Department of Anesthesia and Perioperative Care. He recently served two terms as chair of CMA’s Resident and Fellow Section (RFS) and is a currently both a member of the RFS Delegation to the CMA House of Delegates and a member of CMA’s Council on Science and Public Health. Dr. Lubrano has an interest in the public health consequences of cannabis legalization, as well as its potential use for chronic pain management.
Participants should register at least one hour before the webinar. If you do not register an hour before the webinar start time, we cannot guarantee your attendance.
To register, click here.
Contact: CMA Member Help Center (800) 786-4262 or email@example.com.
*The California Medical Association/Institute for Medical Quality (CMA/IMQ) is accredited by the Accreditation Council on Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The California Medical Association/Institute for Medical Quality (CMA/IMQ) designates this live internet activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
On-demand webinars are not available for CEU or CME credits.
Laboratory Quality: CMA members save 15 percent on COLA’s Laboratory Accreditation Program and its educational products and services. CMA members also receive free online support and a complimentary basic quality lab course, and may be eligible for a discount on AAFP and ACP proficiency testing programs.
COLA was the first approved private, non-profit accreditor for complying with the State of California’s laws and regulations for quality in clinical laboratories. COLA customized its national program to address the unique requirements of this state, including the licensing requirements for persons performing, supervising or directing a laboratory testing in California.
On May 9, 2016, the California Department of Public Health published on its Laboratory Field Services website a notice regarding the general requirements for renewing your state-issued clinical laboratory license if enrolled in COLA to meet state and federal CLIA regulations. The notice explains how to apply for a Certificate of Deemed Status as a new laboratory operation or at your next annual renewal. The Certificate of Deemed Status will now function as your official state license.
If you are already enrolled in COLA or plan to switch to COLA at the time of your renewal, you should apply for a ‘"Certificate of Deemed Status." Simply provide Laboratory Field Services (LFS) with a copy of your CLIA certificate and a completed state license application. Indicate on the application or renewal application that you are choosing accreditation with COLA. COLA will provide you with a verification of enrollment letter and a unique identifier (COLA ID number) that you can send to LFS along with your license application or renewal form. In lieu of the state survey, COLA will perform your routine survey to ensure you meet both the federal CLIA requirements and the unique requirements of the State of California.
If you have any questions about how to renew your state license as a COLA-accredited laboratory or if you wish to enroll in COLA to meet state law, please call COLA’s toll-free number at (800) 981-9883.
For more information on the current CMA member benefit offerings from COLA, visit www.cmanet.org/groupdiscounts.