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CMA Practice Resources

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    Coding Corner: Medicare now allows modifier 59 on CCI column 1 or column 2 code

    August 15, 2019
    This is a change from the previous rule requiring placement of those modifiers on the column 2 code.

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    Anthem to begin pre-payment modifier audit process

    August 15, 2019
    The pre-payment modifier review will focus on claims billed with modifiers 25, 59, 57, LT/RT

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    UnitedHealthcare to allow update of approved prior authorizations

    August 14, 2019
    UHC will now allow physicians to update or modify an existing, approved prior authorization after the date of service. ...

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    CMA to host webinar on Medicare changes for 2020

    August 14, 2019
    The California Medical Association is hosting a webinar with California’s Medicare contractor, Noridian Healthcare So...

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    Fake DEA extortion scam resurfaces in California

    August 08, 2019
    Scam artists posing as U.S. Drug Enforcement Administration (DEA) agents are calling California physicians and consumer...

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    Anthem Blue Cross to reduce timely filing requirement to 90 days

    August 05, 2019
    All claims submitted on or after October 1, 2019, will be subject to the new 90 day filing requirement.

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    CMS publishes 2017 performance data on Physician Compare website

    August 05, 2019
    CMS recently published 2017 performance information from the Medicare QPP on the “Physician Compare” website.  

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    Symphony Provider Directory streamlines provider information reporting

    July 31, 2019
    The Symphony Provider Directory streamlines the way plans and providers exchange and reconcile provider information.

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    Coding Corner: July 2019 HCPCS code updates for drugs and biologicals

    July 16, 2019
    On July 1, 2019, several new HCPCS codes became available for reporting drugs and other agents.

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    How to make the most of your appeals

    July 12, 2019
    Under California’s unfair payment practices law, payors are required to establish a fast, fair and cost-effective dispu...

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    Final MIPS scores for 2020 Medicare payments now available

    July 08, 2019
    The payment adjustment you will receive in 2020 is based on this final score.

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    DHCS instructs plans on 2018/19 supplemental Prop 56 managed care payments

    July 01, 2019
    On June 13, 2019, the California Department of Health Care Services issued instructions for Medi-Cal managed care plan ...

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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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    DHCS Webinar: What Physicians Need to Know About the Value-Based Payment Incentives

    June 07, 2019
    The program is funded with $180 million in Proposition 56 funds, estimated at $360 million in total funds annually with...

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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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    CMS releases latest episode of “Beyond the Policy” podcast

    June 05, 2019
    Episode 3 of this podcast highlights the “ CMS Innovation Center: Where we are, How Models are Developed and the Next S...

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    California Medical Association supports Timely Access to Care Act

    June 05, 2019
    New legislation would reduce health care bureaucracy and delays for patients.

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    TRICARE West providers targeted in phishing scam

    May 31, 2019
    Health Net Federal Services recently notified providers about an email phishing scam targeting TRICARE West Region prov...

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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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    FAQ: Can I charge patients for copies of their medical records?

    May 24, 2019
    California law allows physicians to charge patients 25 cents per page for copying their medical records or 50 cents per...

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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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    TRICARE mental health transitions to Health Net Federal Services

    May 09, 2019
    Effective May 13, 2019, Health Net Federal Services (HNFS) will assume management duties for the TRICARE West mental ...

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    Updated FAQ available for DHCS fiscal intermediary transfer

    May 09, 2019
    The contract with the current fiscal intermediary will continue to run parallel with DXC until September 30, 2019.

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