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In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the individual and small group health insurance markets and is now providing health insurance to much of the nation's uninsured. Under the ACA, two-thirds of California's uninsured may be eligible to purchase private insurance through a health insurance exchange purchasing pool. In California, that exchange is called Covered California.
Below are resources developed by CMA to help educate physicians on the exchange and ensure that they are aware of important issues related to exchange plan contracting.
Click here for the most recent news related to the Affordable Care Act and California's implementation of its health benefits exchange. You can also subscribe to receive daily email updates when new information is published matching this keyword.
CMA Educational Resources
- Surviving Covered California: Preparing for changes in 2017: It is critical that physician practices understand their participation status, which products are being offered and what changes to expect in 2016. This document contains tips to survive Covered California in 2016.
- Covered California: Know Your Participation Status: This document provides detailed instruction on how to check your participation status with the various exchange plans.
- Qualified Health Plan Networks for Covered California. To help both physicians and patients decipher the new exchange product networks, this document summarizes the top four plans’ networks and related products.
- Covered California: Understanding the Grace Period for Subsidized Exchange Enrollees. This document answers frequently asked questions about the Covered California grace period.
- Surviving Covered California Tip Sheets. These documents contain tips on what to expect from and how to survive Covered California.
- CMA's Got You Covered: A physician's guide to Covered California, the state's health benefit exchange. This guide provides a comprehensive overview of the Affordable Care Act and the exchange, key issues to watch as the exchange develops and things to consider when deciding whether to contract with an exchange plan.
- Covered California: FAQs for Clinicians and their Staff
- California Health Benefits Exchange Fact Sheet. This document provides a summary of the exchange and how it may impact physician practices.
- Essential Health Benefits Fact Sheet. This fact sheet will help physicians understand the basic facts around the "essential health benefits" component of federal health care reform.
- Health Benefits Exchange. This document includes a discussion on network adequacy, potential administrative burdens associated with exchange plans, the grace period issue, concerns that physicians unknowingly may be contracted with exchange plans, what to look for in the mail on exchange plan contracting and examples of termination provisions in current exchange contracts.
- Frequently Asked Patient Questions about Covered California. This document provides answers to the most common patient questions.
- Frequently Asked Patient Questions about Covered California: Spanish. This document provides answers to the most common patient questions in Spanish
- Covered California Patient Information Request Form. CMA can provide you with educational materials to distribute to patients who ask for information about Covered California. We can also provide in-person educational sessions for your medical office team and provide educational materials specifically for physicians and their practice staff. If you are interested in receiving resources for your office, please complete and return this form.
CMA Webinars and Seminars
- On-Demand Webinars: Previously recorded webinars are free for member physicians and their office staff and are $99 for nonmembers.
- Surviving Covered California: What Physicians Need to Know (Originally presented on April 23, 2014).
- California's Health Benefit Exchange: Updates on Key Developments Within the Exchange (Originally presented on December 11, 2013).
- California's Health Benefit Exchange: The positives and perils of contracting (Originally presented on October 30, 2013).
- California's Health Benefit Exchange: How it will impact your practice and change commercial insurance (Originally presented on April 24, 2013).
- Click here to view all exchange-related webinars available for on-demand viewing.
- Live Educational Seminars:
- CMA staff is available to provide live on-site informational sessions on the exchange and what physicians and their staff can do to prepare for contracting with exchange plans. If you are interested in attending a seminar in your area, please contact your local county medical society.
CMA produces a number of publications to keep members up to date on the latest health care news and information affecting the practice of medicine in California. You can subscribe to any of these newsletters at www.cmanet.org/newsletters.
- CMA Practice Resources. CMA Practice Resources (CPR) is a free monthly newsletter from CMA's practice management experts that focuses on critical payor and health care industry issues, including contracting with health plans in the exchange, and how these issues directly impact the business of a physician practice.
- CMA Newswire. CMA publishes a biweekly e-newsletter, CMA Newswire, to keep its members up-to-date on critical issues affecting the practice of medicine in California.
- California Health Benefit Exchange website
- Federal Healthcare.gov website
- Kaiser Family Foundation's health reform website
- Federal Center for Consumer Information & Insurance Oversight regulations and guidance website