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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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    Anthem Blue Cross correcting ultrasound recoupment issue

    December 11, 2018
    The California Medical Association has learned that Anthem Blue Cross is correcting a system error that has resulted in...

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    Time to verify your patients’ eligibility and benefits for 2019

    December 11, 2018
    With the new year soon upon us, physicians are urged to be diligent in verifying patients' eligibility and benefits to ...

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    Coding Corner: Separate reporting of pre-, intra- and post-procedure work

    October 30, 2018
    “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billing. Thi...

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    Some Medi-Cal managed care plans slow to distribute Prop 56 funds

    October 17, 2018
    In May, the California Department of Health Care Services (DHCS) distributed the Proposition 56 supplemental funds for ...

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    CMS proposes site-neutral payments for some physician services

    September 28, 2018
    The Centers for Medicare and Medicaid Services (CMS) has proposed eliminating the Medicare site of service payment diff...

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    CMA pushes back on CMS’ proposed Medicare payment changes

    September 28, 2018
    The California Medical Association (CMA) recently submitted comprehensive comments to the Centers for Medicare and Medi...

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    Coding Corner: CPT reporting for preventive medicine services

    September 24, 2018
    CPR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billin...

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    DHCS receives approval on Medi-Cal supplemental tobacco tax payments for FY 2018-2019

    September 20, 2018
    The California Department of Health Care Services (DHCS) recently received federal approval on its plan to increase Med...

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    Have you received your supplemental Medi-Cal managed care payments?

    September 20, 2018
    Plans were required to issue supplemental payments to qualifying physicians within 90 days. The 90-day window ended Aug...

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    Coding Corner: ICD-10 unveils new diagnostic codes to report human trafficking

    September 11, 2018
    CPR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billin...

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    Health Net addresses problems with explanation of payment

    September 11, 2018
    On August 21, 2018, Health Net notified providers that some paper explanation of payment (EOPs), commonly known as expl...

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    L.A. Care issues recoupment letters for services dating back to 2012

    September 11, 2018
    CMA has learned that L.A. Care Health Plan, the publicly operated Medi-Cal health plan serving more than 2 million Los ...

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    Health Net Federal Services continues to address TRICARE transition issues

    September 10, 2018
    As previously reported, Health Net Federal Services (HNFS) has experienced implementation issues since taking over as t...

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    Deadline to request a MIPS targeted review is October 1

    September 04, 2018
    If you participated in the Medicare Merit-Based Incentive Payment System (MIPS) in 2017, your MIPS final score and perf...

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    CMA and AMA oppose CMS proposal to collapse E/M codes

    September 04, 2018
    More than 150 health care organizations, including CMA and AMA, sent a joint letter to CMS, opposing the agency’s propo...

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    UnitedHealthcare Community Plan to exit Sacramento Medi-Cal market on November 1

    August 10, 2018
    The UHC Community Plan has issued notice that it will no longer provide services to approximately 4,400 Medi-Cal member...

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    SB 1156 takes California back to the bad old days

    August 05, 2018
    Not long ago, health insurance companies limited access to insurance and quality health care for millions of California...

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    Coding Corner: NCCI Policy Manual updates: Part 2

    August 03, 2018
    CPR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billin...

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    United Healthcare Smart Edits go live August 16

    August 03, 2018
    UnitedHealthcare (UHC) will implement its Smart Edits program for professional claims for all of its commercial, Medica...

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