CMA Practice Resources (CPR) is a free monthly e-bulletin from the California Medical Association’s practice management experts that focuses on critical payor and health care industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting related issues along with information on the latest practice management news.
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In this issue:
- United Healthcare to exit Covered California at the end of 2016
- United Healthcare adopting protocol for submission of clinical data
- Reminder: CMS meaningful use hardship exception deadline is July 1
- DHCS begins recouping retroactive Medi-Cal radiology cuts
- Physicians advised to check enrollment status of pregnant patients insured by Covered California
- Noridian begins deactivation of providers who failed to revalidate
- The End of Life Option Act takes effect on June 9: What physicians and patients need to know
- CMA publishes tip sheet on Medicare quality reporting programs
- Maintaining your Medicare opt-out status
- New online Medi-Cal provider enrollment portal to launch soon
- DHCS issues new beneficiary card design
- The Coding Corner: Annual updates resume for ICD-10; Changes coming Oct. 1
- CMA advocacy at work
- Payor updates
- Save the date
- Problems getting paid?
- Health plan provider newsletters
United Healthcare (UHC) has signaled that it will be exiting California’s health benefit exchange, Covered California, at the end of 2016. While UHC had indicated in its June 2016 Network Bulletin that it would likely be withdrawing from most Affordable Care Act exchange plans nationally, the departure from Covered California is unexpected, as the payor was expected to grow its participation in California for 2017.
UHC first entered the Covered California marketplace in 2016 with approval to offer exchange coverage in five regions of California where fewer than three exchange health plans were already being offered for 2016, including:
- Region 1: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne and Yuba counties
- Region 9: Santa Cruz, San Benito and Monterey counties
- Region 11: Fresno, Kings and Madera counties
- Region 12: San Luis Obispo, Santa Barbara and Ventura counties
- Region 13: Imperial, Inyo and Mono counties
The number of enrollees impacted by UHC's withdrawal from the exchange market in California is estimated to be approximately 1,200.
Physicians with questions or concerns should contact UHC Provider Services at (877) 842-3210.
Effective July 1, United Healthcare (UHC) will expand its Clinical Data Submission Protocol to include Medicaid and commercial benefit plans. UHC's Clinical Data Submission Protocol, introduced in 2015, originally targeted only Medicare benefit plans and required physicians to submit all laboratory test results for UHC Medicare patients. The immediate impact on California physicians was negligible, as the UHC Medicare patient population resides only in the Medicare Advantage product, where reporting was required only at the medical group level.
While UHC lauds the sharing of clinical patient data as an opportunity to support quality and cost effective patient care, the California Medical Association has expressed concerns about the administrative burden and impact on physician practices.
For more information about the protocol and requirements for submitting data to United Healthcare, physicians should refer to the updated Clinical Data Submission Protocol Frequently Asked Questions and Methods of Clinical Data Exchange.
In support of this initiative, UHC has volunteered to assist practices establish the transmission method that works best with the current capabilities of the practice. For more information or to speak to the UHC clinical data team, contact the UHC Provider Call Center at (877) 842-3210 or your local Network Account Manager or Provider Advocate.
Physicians should be aware that July 1, 2016, is the extended deadline for physicians to file hardship exception applications from the electronic health record incentive program meaningful use requirements.
New rules released last year state that eligible professionals must attest that they met the requirements for Modified Stage 2 Meaningful Use for a reporting period of at least 90 consecutive days during calendar year 2015. However, the Centers for Medicare and Medicaid Services (CMS) did not publish the updated stage 2 regulations until October 16, 2015. As a result, physicians were not informed of the revised program requirements until fewer than the 90 required days remaining in the calendar year.
In mid-December 2015, Congress adopted a last-minute bill that gave CMS the authority to grant a blanket exception for all eligible physicians who applied for an exception from the 2015 meaningful use penalties.
CMS also released new “streamlined” hardship exception application forms “that reduce the amount of information that eligible professionals must submit to apply for an exception,” the agency said. The new application forms and instructions on filing a hardship exemption are on the CMS website.
To help physician members navigate the hardship exemptions process, the California Medical Association (CMA) has published “Meaningful Use Hardship Exception Frequently Asked Questions.” This document answers questions about the blanket exemption, including who should apply, deadlines and more.
This free members-only resource is available in CMA's online resource library.
In 2010, the California state budget included cuts to Medi-Cal radiology rates, stipulating that the maximum reimbursement rates for radiology services could not exceed 80 percent of the Medicare rate for the same or similar services. The Department of Health Care Services (DHCS) did not, however, implement the rate reduction until July 20, 2015, with retroactive cuts going back to October 2012.
To recoup the retroactive cuts, DHCS recently announced that it would be offsetting overpayments against amounts due. Physicians affected by this retroactive recoupment were notified by DHCS in late March.
The California Medical Association raised concerns with DHCS about the financial burden that such a large recoupment would place on practices. As a result, DHCS agreed to cap the overpayment withholding at 20 percent of the physician's reimbursements until the total amount of retroactive overpayments are reached. Standard practice for DHCS is to withhold 100 percent of physician reimbursements until the total amount is repaid.
Just last week, affected physicians began receiving "zero pay" notices with patient level detail of all their claims impacted by the retroactive radiology cuts. These notices understandably have caused some alarm among physician practices.
These notices do NOT mean that physicians' Medi-Cal reimbursements will be withheld until the retroactive overpayments are recouped. These notices simply provide an accounting of all the affected claims and the total that will be recouped. The actual recoupment will begin with the following week's checkwrite, and will be capped at 20 percent of each check until the total amount due has been recouped. Your adjusted payment, after the 20 percent recoupment, can be found on line 11 of the "individual financial summary."
In cases of financial hardship, DHCS is willing to consider extended payment options. Physicians interested in discussing this option are encouraged to contact Medi-Cal at (800) 541-5555. There are three prompts. The first one will require language selection. At the second prompt, select 1 for provider and then select option 5 for other general billing inquiries.
In April, news broke that nearly 2,000 pregnant women with Covered California health plans were automatically – and without their knowledge or consent – transferred from their exchange plan to Medi-Cal, even though they were supposed to have the option to stay with Covered California.
The problem, attributed by Covered California partly to a computer glitch, can be traced to a recent policy change. Usually, consumers are placed in either Covered California or Medi-Cal based on their income, with no choice in the matter.
But the rules are different for some pregnant women whose household income falls between 138 percent and 213 percent of the federal poverty level, or roughly $22,100 to $34,100 for a family of two.
Under the October policy change, women who are pregnant at the time they apply for health coverage and fall into this income bracket will automatically be placed into Medi-Cal. Previously, they had a choice between Medi-Cal and Covered California.
Women in the affected income range who already have Covered California plans before they become pregnant are now supposed to be given the choice to remain in their subsidized exchange plans—which have out-of-pocket costs such as co-pays and deductibles—or move to Medi-Cal, which is free.
The Covered California computer glitch, however, is moving these women into Medi-Cal automatically, without giving them the option to stay with their current plans. Covered California has promised to fix the problem, but the fix is not expected to go live until September.
The California Medical Association called representatives of Covered California for clarification and was advised that providers should check the eligibility of their pregnant patients to determine if the patient is still enrolled in a Covered California plan or if they have been migrated to Med-Cal.
If the patient has been migrated, physicians should ask the patient if she intends to keep Medi-Cal or if she wants to be reinstated with Covered California. Patients who would like to be reinstated should call the Covered California “Pregnancy Escalation Line” at (800) 675-2607.
This issue reinforces the importance of verifying eligibility each time the patient is seen to ensure the physician can be paid for services rendered. If the patient opts to switch back to Covered California and pays her premiums retroactively back to the cancellation date, the claims will be paid by the patient’s Covered California plan. However, if the patient opts to keep her Medi-Cal coverage and the physician is not a Medi-Cal participating provider, the physician will not be paid and cannot bill the patient. If a provider knows a patient has Medi-Cal coverage, regardless of whether the provider participates in the Medi-Cal program or not, California law prohibits them from seeking payment from the patient.
Covered California has taken several steps to help reduce the number of women who are switched without their consent. The agency sent multiple written notices to the approximately 2,000 women that it identified as having been impacted by the glitch. The agency has updated its main website to give consumers more information about reporting a change related to pregnancy.
It is also important to note that the exchange does not require members to report a pregnancy. Covered California patients only need to report a pregnancy if they are interested in other coverage options for pregnant women such as Medi-Cal or the Medi-Cal Access Program.
The due date for physicians to revalidate their Medicare enrollment information has passed for the most recent cycle of physician revalidation required by the Centers for Medicare and Medicaid Services (CMS). Physicians who received a revalidation notice from Noridian, CMS’ Medicare contractor for California, and who did not turn in a completed application to CMS prior to the May 31 deadline, will have their Medicare billing privileges deactivated.
If you are deactivated for failure to respond to a revalidation notice, you must submit a reactivation application. The date of receipt of the reactivation application will be the new effective date for Medicare billing privileges. No payments will be made for the period of deactivation.
If a revalidation application is received but incomplete, Noridian will contact you for the missing information. If the missing information is not received within 30 days of the request, Noridian will deactivate your billing privileges.
If your revalidation application is approved, the provider will be revalidated and no further action is needed.
If you do not know if you received a notice, you can look up your revalidation date through the CMS look-up tool. Those due for revalidation in the near future will display a revalidation due date. All other providers/suppliers will see "TBD" in the due date field.
For more information on the revalidation process, see MLN Matters #SE1605.
If you have questions about the revalidation process, click here or contact Noridian by calling (855) 609-9960.
On June 9, 2016, California will become the fifth state in the nation to allow physicians to prescribe terminally ill patients medication to end their lives. California's new "End of Life Option Act" permits terminally ill adult patients with the capacity to make medical decisions to be prescribed an aid-in-dying medication if certain conditions are met. Recognizing the complexity of this new law, the California Medical Association (CMA) has published legal guidance in a question-and-answer format intended to help physicians and patients understand and navigate the law's requirements. The 15-page document addresses straightforward questions and identifies issues that are not yet resolved.
“As physicians, there are a lot of questions about requirements under the new law, required documentation and forms, requests for the drug, consulting physicians and so on,” said CMA President Steven E. Larson, M.D., MPH. “There certainly will be areas that evolve as we look to best practices in areas like which drugs to prescribe, but this is a resource to help us all navigate the new landscape.”
This resource – On-Call document #3459, "The California End of Life Option Act” – is free through CMA’s online health law library at www.cmanet.org/cma-on-call.
CMA also hosted a webinar, "The California End of Life Option Act: An Overview," on Wednesday, June 1. The webinar is now available on demand in CMA's online resource library. The webinar reviews the requirements of the act, who qualifies to participate, what is required if a physician opts out, and what the documentation and reporting obligations are. This webinar also discusses the importance of palliative and hospice care services as well as advance care planning, tools and resources. The webinar is free to all interested parties, regardless of their membership status.
CMA removed longstanding opposition to physician aid-in-dying last May and took a neutral position on the End of Life Option Act (ABX2 15).
CMA encourages Californians to think and talk with loved ones about their wishes for end-of-life medical care before a serious illness or injury occurs. CMA has developed a number of guidelines, forms and other resources to assist providers, patients, and loved ones with making important end-of-life decisions. CMA's end-of-life resources can be found on CMA's website at www.cmanet.org/endoflife.
Contact: CMA legal information line, (800) 786-4262 or email@example.com.
There is still one more performance year under the current Medicare quality reporting programs – the Physician Quality Reporting System (PQRS) and Meaningful Use/Electronic Health Record Incentive Program. These programs will sunset in the 2017 reporting year as the new Merit-Based Incentive Payment System (MIPS) program, under the Medicare Access and CHIP Reauthorization Act of 2016 (MACRA), is implemented.
To assist physicians, the California Medical Association (CMA) has published a tip sheet that includes a summary of the current quality programs, critical deadlines ahead for this final reporting year and helpful links to checklists that help practices successfully report. The resource can be found in the CMA resource library and on the CMA Centers for Economic Services (CES) webpage at www.cmanet.org/ces.
Physicians who intend to opt-out or who have previously opted-out of Medicare should be aware of changes to the Medicare opt-out period as a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Validated opt-out affidavits signed on or after June 16, 2015, will automatically renew every two years. Previously, physicians who opted out of the program would have to renew their affidavit every two years to maintain their opt-out status. Under the new rules, affidavits will renew every two years unless the physician cancels in writing with at least 30 days notice prior to the start of the next two year opt out period. Cancellation notices must be sent to all Medicare contractors with which they filed their original affidavits.
Opt-out affidavits signed prior to June 16, 2015, will expire two years after the effective date. If you have an opt-out affidavit signed prior to June 16, 2015, and you wish to extend your opt-out period, you must submit an opt-out renewal affidavit to Noridian Medicare no later than 30 days after the current opt-out expiration date. Subsequent renewals will happen automatically every two years per the new rules.
More information about opting out and maintaining opt-out status is available here.
The California Department of Health Care Services (DHCS) recently announced that its new Medi-Cal provider enrollment system is expected to go live this summer. The new system, called the Provider Application and Validation for Enrollment (PAVE), will transform provider enrollment from a manual paper-based process to a web-based portal that providers can use to complete and submit their applications and verifications and to report changes.
The new system should significantly improve the provider enrollment experience by minimizing errors in the application process and significantly reducing the time required to process provider enrollments.
PAVE will also permit online payment of fees, if applicable; allow providers to check application status online; and use electronic signatures for all provider types. PAVE will include checklists of required attachments that will let the provider know that a complete application has been prepared and will ensure that the provider has provided responses to all required questions before the application can be submitted. PAVE will allow providers to attach required supporting documentation electronically and verify that attachments are complete prior to submission.
Initially, PAVE will only be available for providers that currently enroll to serve fee-for-service beneficiaries directly through the DHCS Provider Enrollment Division. However, DHCS plans to expand access to Medi-Cal providers who enroll through other divisions and departments until all Medi-Cal enrollment activities are directed through the PAVE system.
PAVE will also allow providers to quickly revalidate their information in accordance with the Affordable Care Act.
The portal will also be accessible on mobile devices. PAVE will eventually replace the paper application process, although paper applications will still be accepted for some undetermined transition period.
The California Medical Association (CMA) has been involved in stakeholder meetings and beta testing of the new system over the past two years. Recent demos of the system seem very promising, with a much more intuitive interface and streamlined process.
DHCS is currently fine-tuning the system before its summer release. Additional details and instructions will be released closer to the launch date.
For more information, click here.
To commemorate Medi-Cal’s 50th anniversary, the Department of Health Care Services (DHCS) has introduced a new design for the Benefits Identification Card (BIC) for Medi-Cal beneficiaries. This new design, featuring the California poppy, will be provided to newly eligible recipients and recipients requiring replacement cards. There are no plans to provide the new card to the entire Medi-Cal population.
Physicians are advised that both the old and the new card (to see both designs, click here) should be accepted by providers. Physicians are reminded, however, that they should continue to verify eligibility before every visit, as possession of a Medi-Cal BIC does not guarantee eligibility. For more information on verifying benefits, see the "Eligibility: Recipient Identification" section of the Part 1 provider manual.
The date to switch production to the new card for the remainder of the Medi-Cal population has not yet been determined.
CPR’s “Coding Corner” focuses on coding, compliance and documentation issues relating specifically to physician billing. This month’s tip comes from Barbara Aubry; Renee Dustman, executive editor at AAPC; and G. John Verhovshek, the managing editor for AAPC, a training and credentialing association for the business side of health care.
ICD-10 has received minimal updates since 2012. Changes effective October 1, 2016, mark the return of regular, annual updates for the diagnosis code set.
To date, there are 1,900 proposed revisions to the ICD-10-CM code set, for use beginning October 1. Of that number, there are 313 deletions and 351 revised codes. The codes are posted on the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics website.
Some nonspecific codes are deleted and replaced by more specific designations. For instance:
- Delete: N830 Follicular cyst of ovary
- Add: N8300 Follicular cyst of ovary, unspecified side
- Add: N8301 Follicular cyst of right ovary
- Add: N8302 Follicular cyst of left ovary
A code for Zika virus (A92.5) has been added, and there are 299 revisions and improvements to the diabetes mellitus codes.
Among the many proposed updates in the Tabular List, a large chunk occurs in categories H54 Blindness and low vision and O00 Ectopic pregnancy.
The American Congress of Obstetricians and Gynecologists’ (ACOG) request for new codes to capture multiple gestational pregnancies with co-existing ectopic and intrauterine pregnancies has been approved for the October 2016 addenda. According to ACOG, new codes are necessary to recognize the increased incidence of ectopic pregnancy occurrence with the use of assisted reproductive technologies. At the meeting in March, ACOG requested to amend their proposal to include laterality. “Laterality is important to track since patients who have had ectopic pregnancies in the past are more likely to have subsequent ectopic pregnancies,” ACOG said.
Prepare for new codes
Probably the most important step clinicians can take to prepare for ICD-10 updates is to document, with precision, the patient’s diagnoses. Providers and coders must be vigilant to avoid using “unspecified” codes, unless there is no other option. In addition, be sure to review the Local Coverage Determination (LCD) and National Coverage Determination (NCD) medical necessity policies for coding changes. CMS and its Medicare administrative contractors will be responsible for updating their policies in advance of the effective date of October 1. If you use a vendor, whether for billing or coding, check to be sure your vendor can guarantee their product will be ready with the latest codes by October 1.
Presently, there are 75,625 ICD-10-PCS (procedure) codes for fiscal year 2017. Of that number, 3,651 are new and 487 are revised. The list of proposed new and revised codes for ICD-10-PCS is available on the CMS.gov website.
Of the new codes, 3,549 (97 percent) are in the cardiovascular system section. The changes relate to unique device values, the addition of bifurcation as a qualifier, congenital cardiac procedures and placement of an intravascular neurostimulator. Revised code titles now specify the number of vessels rather than the number of coronary artery sites, and also specify the descending thoracic aorta.
Additional new codes include expansion of body part detail in the removal and revision of lower joints, and add unicondylar knee replacement.
The current list is not final. The work group meets again in July, which may result in more code changes. The CDC and CMS decided to release the proposed list early to help providers and vendors prepare for the update. The final rule containing all finalized codes to be implemented October 1 will be released August 1, 2016.
“I want to thank you for the time and assistance that CMA’s Center for Economic Services provided to our practice. Without the assistance of CMA, I would have been lost trying to find the right ear to address our issues. CMA is an invaluable resource and I advocate for membership with all physicians.”
Director, California Contracting
Representing CMA members Drs. Thomas Fogel (1986), Jay Meisel (1999) and Victor Schweitzer (1989)
MEDICARE: Noridian has published a schedule of upcoming educational events on its website including web-based workshops, in-person seminars and Ask the Contractor Teleconferences. Providers are encouraged to visit the Education and Outreach tab on the Noridian website to view a listing and description of upcoming events.
UNITED HEALTHCARE: United Healthcare (UHC) has advised that beginning with September 1, 2016, dates of service, reimbursement of CPT code 99050 for after hours and weekend care will only be paid to participating primary care providers including family practice, general practice, internal medicine, OB/GYN and pediatrics. Reimbursement will no longer be allowed for CPT code 99050 for non-participating providers or participating specialists as of September 1, 2016. The updated UHC After Hours and Weekend Care Policy reflecting this change will be published on September 1, 2016, at UnitedHealthcareOnline.com under Tools & Resources > Policies, Protocols and Guides.
WORKERS' COMPENSATION: The Division of Workers’ Compensation (DWC) has added a search tool on the DWC website to help find Independent Medical Review (IMR) determinations quickly and efficiently. The new tool allows IMR determinations to be located by case number, date of injury, specialty of reviewer, and/or category of treatment request. More information about the DWC IMR process can be found on the DWC website.
The California Medical Association offers our members free programs to educate physicians and staff on a range of practice management issues. Space is limited, so register soon.
Upcoming CMA webinars
Most webinars are held over the lunch hour, from 12:15 to 1:15 p.m. and are free for CMA members and their staff. See the event calendar for additional details and to register.
6/8: How to Increase Workers' Compensation Revenue: Workers' compensation payors can substantially reduce your revenue in two ways: by systematically downcoding evaluation and management codes and by paying the wrong reimbursement due per California’s Official Medical Fee Schedule. To combat downcoding and incorrect reimbursements, this webinar explains how to easily appeal these reduced payments. This webinar will also provide the correct reimbursements for popular CPT codes and break down the new mandated appeal process into easy step-by-step instructions. If you treat injured workers, this webinar will make it easy to know whether your payments are correct and how to appeal downcoded and incorrect payments.
6/15: MACRA and the Quality Payment Program: An Update on the Recent Proposed Rule: This webinar will cover the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the next steps in health system transformation including the Transforming Clinical Practice Initiative (TCPI). We’ll also discuss key elements of the Merit Based Incentive Payment System (MIPS) pathways versus the key elements of the Alternative Payment Models (APMs) pathway. This webinar will also review timelines and how to give feedback.
6/22: DMHC IMR and Other Complaint Processes: Tips and Best Practices for Physicians: The California Department of Managed Health Care (DMHC), the regulatory agency that oversees 122 health plans, will provide an overview of the department, with a focus on the DMHC Help Center. The webinar will also cover the DMHC Independent Medical Review (IMR) and complaint processes, discussing the importance of the IMR and complaint processes in the policy, legislative and regulatory arenas and providing information on how to submit the IMR/complaint form to the DMHC Help Center. It will also provide tips and best practices for assisting patients with access to care or billing issues, including denials of care, and will include an overview of the provider complaint unit.
6/29: California Healthcare Performance Initiative (CHPI) Physician Quality Rating Program: Navigating the Review and Corrections Process: Last year, through commercial and Medicare claims data, CHPI issued clinical quality ratings for 15,000 California physicians. CHPI is gearing up to publish its second cycle of physician quality scores later this year; physicians will soon begin receiving notices advising of their quality scores along with information on how to access the review and corrections portal to confirm or correct their data. This webinar will provide an overview of the CHPI quality rating project, along with step-by-step instructions on how physicians can review their data for accuracy before the quality scores are published.
Upcoming CMA seminars
CMA experts travel to local county medical societies throughout the state, holding live seminars for members and their staff on a variety of issues.
6/8: Solano County Medical Society/Napa County Medical Society: Contract Renegotiation: How to Get Past No with a Payor
Contact: CMA’s member help center, (800) 786-4262 or firstname.lastname@example.org.
The California Medical Association’s Center for Economic Services provides direct reimbursement assistance to CMA physician members and their office staff.
Reimbursement Help Line (888/401-5911)
- One-on-one educational and reimbursement assistance to physician members and their staff
- Tools and resources to empower physician practices
- Seminars and toolkits for physicians and their staff
- Staffed by practice management experts with a combined experience of over 125 years in medical practice operations
Need help? Contact CMA’s reimbursement experts at (888) 401-5911 or email@example.com.
To make sure that you are aware of important news from your contracting health plans, we encourage you to regularly read plans' provider newsletters and bulletins. Follow the links below to access the current issues.
AETNA: www.aetna.com. Click on "Health Care Professionals" in the main menu, then on "News for Providers" in the left sidebar.
CIGNA: www.cigna.com. Click on "Health Professionals" under "Customer Care" in the main menu. Then, scroll down and click on "Newsletters."
ANTHEM BLUE CROSS: www.anthem.com/ca. Click on "Providers" in the main menu, then on "Professional Network Update" under "Spotlight."
BLUE SHIELD: www.blueshieldca.com. Click on "I'm a Provider," then on "Announcements" under "News and Features."
HEALTH NET: www.healthnet.com. Click on "I'm a Provider" and then "California." Enter username and password, and then click "Online News."
MEDI-CAL: www.medi-cal.ca.gov. Click on "Publications" in the main menu, then on "Provider Bulletins."
MEDICARE/NORIDIAN: https://med.noridianmedicare.com/web/jeb/fees-news. Noridian publishes individual articles through the Latest Updates section in the left sidebar. The articles are condensed approximately every six-to-eight weeks into a Bulletin.
UNITED HEALTHCARE: www.unitedhealthcareonline.com. Click on "Tools & Resources" in the main menu, then on "Network Bulletin."
CMA RESOURCE: Find up-to-date profiles on each of the major payors in California.
If you have questions related to any of the articles in this issue, please contact CMA's reimbursement help line, (888) 401-5911 or firstname.lastname@example.org. Questions about membership, including technical website issues, should be directed to CMA's member help center, (800) 786-4CMA or email@example.com.
Let us know which topics you would like to see addressed in future issues. Contact CMA's Center for Economic Services at (916) 551-2061 or firstname.lastname@example.org.