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    CMA continues advocacy on recent Anthem modifier 25 policy

    June 24, 2019
    CMA along with other state and specialty societies continue to voice concerns with the recent implementation of the Ant...

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    UHC to rollout site of service reviews for arthroscopic and foot surgeries

    June 21, 2019
    Effective September 3, 2019, UnitedHealthcare (UHC) will require prior authorization for certain musculoskeletal surgic...

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    Golden Shore Medical Group assigns assets for liquidation

    June 12, 2019
    Golden Shore closed its doors on January 31, 2019, after Molina Healthcare terminated its contract with the delegated e...

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    Reminder: Anthem fee schedule changes effective July 1

    June 07, 2019
    Physicians are reminded that the changes to the Anthem Blue Cross Prudent Buyer Participating Physician Agreement and f...

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    Reminder: UnitedHealthcare to stop paying consultation services June 1

    May 30, 2019
    As previously reported , UnitedHealthcare’s (UHC) will begin phasing out reimburse consultation services for commercia...

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    CMA continues to challenge Anthem modifier 25 policy

    May 14, 2019
    CMA is very concerned with the adverse impacts of this new policy upon our physician members and has been in continued ...

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    New law requires regulator to review physician complaints of unfair payment patterns

    May 14, 2019
    Effective July 1, 2019, DMHC will be required to annually review complaints filed by providers who believe a plan is en...

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    Some physician groups may be required to obtain a Knox Keene license

    May 13, 2019
    DMHC recently adopted a regulation that requires entities that assume any amount of global risk to either obtain a lice...

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    HHS announces new primary care delivery and payment models

    May 13, 2019
    The HHS recently unveiled five new voluntary Medicare primary care payment models.

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    DHCS releases Prop 56 payments to Medi-Cal managed care plans

    May 09, 2019
    DHCS has received federal approval of its plan to increase Medi-Cal managed care physician payments for the 2018-2019 f...

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    Congressional committee approves Medicare Advantage prior authorization reforms

    May 09, 2019
    These reforms would scale-back Medicare Advantage plan prior authorization and some prescription drug step therapy

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    Coding Corner: The global period – post-op pain management and more

    May 07, 2019
    This month’s tip comes from G. John Verhovshek, the managing editor for AAPC, a training and credentialing association ...

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    Coding Corner: How to report a consult service when your payor doesn’t accept consult codes

    April 02, 2019
    It’s been nearly a decade since Medicare has accepted claims for either outpatient (99241-99245) or inpatient (99251-99...

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    Noridian continues to deactivate providers for not responding to Medicare revalidation notices

    March 29, 2019
    Physicians are reminded that their Medicare billing privileges will be deactivated if they fail to respond to Medicare ...

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    CMA urges Congress to adopt New York surprise coverage law

    March 18, 2019
    A bipartisan group of United States Senators are working to draft legislation to protect patients from unanticipated me...

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    Anthem Blue Cross to deny certain E&M services billed with modifier 25

    March 13, 2019
    Modifier 25 allows separate payment for a significant, separately identifiable E&M service provided on the same day as a...

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    Coding Corner: How to appropriately apply modifiers LT, RT and 50

    March 06, 2019
     Confusion about when to append CPT® modifier 50 Bilateral procedure, versus HCPCS Level II modifiers LT Left side and ...

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    UnitedHealthcare to discontinue payment of consultation services

    March 05, 2019
    UnitedHealthcare (UHC) has announced that it will no longer reimburse consultation services for commercial product li...

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    DHCS will move to new fiscal intermediary on Oct. 1

    February 20, 2019
    The California Medical Association will provide updates as more information becomes available.

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    Survey finds prior authorization hurdles have led to serious adverse events

    February 15, 2019
    More than one-quarter of physicians (28 percent) report the prior authorization process required by health insurers for...

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    AB 72: The independent dispute resolution process and how CMA can help

    February 04, 2019
    CMA has developed a number of resources to help physicians navigate this new law.

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    Coding Corner: Physician/patient meet-and-greet

    January 30, 2019
    Insurers, including government payors such as Medicare and Medicaid, reimburse only those services or procedures that t...

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    DHCS loads 2019 CPT codes and pricing by January 1

    January 24, 2019
    The California Department of Health Care Services (DHCS) has confirmed that the 2019 CPT/HCPCS updates have been load...

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    Medi-Cal provider enrollment moving exclusively to PAVE starting March 5

    January 24, 2019
    The Medi-Cal Provider Enrollment Division will no longer accept paper enrollment forms, effective March 5, 2019.

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    Golden Shore Medical Group to shut down following Molina contract termination

    January 24, 2019
    The plan filed requests in late 2018 with the DMHC to transfer its enrollees to other delegated groups and the request ...

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    CMA recoups $29 million on behalf of physician members

    January 03, 2019
    California physicians have a powerful ally when it comes to dealing with problematic payors—the California Medical Asso...

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    Reminder: Blue Shield/Care1st to complete integration Jan. 1, 2019

    December 12, 2018
    On January 1, 2019, Blue Shield of California will complete the integration of Care1st Health Plan into its operations,...

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