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CMA Practice Resources

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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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    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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    Reminder: Physicians encouraged to review changes to Anthem fee schedule

    May 08, 2019
    Anthem will be increasing payment for the more commonly billed Evaluation and Management (E/M) services.

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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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    Webinar: How Physicians Can Appeal AB 72’s Interim Rate and How CMA Can Help

    April 18, 2019
    The webinar will review the out-of-network billing and payment law, including when the law applies, appropriate billing...

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    Anthem clarifies recent E&M services billed with modifier 25 policy

    April 10, 2019
    Per the new policy, Anthem will deny an E&M service with a modifier 25 billed on the day of a related procedure when th...

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    Anthem announces fee schedule and contract changes effective July 1

    April 10, 2019
    According to a notice issued to approximately half of its PPO network, the plan will be increasing payment for the more...

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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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    CMA encourages physicians to speak to patients about end-of-life wishes

    April 01, 2019
    April 9, 2019, marks the beginning of Health Care Decisions Week, which culminates on April 16 with National Health Car...

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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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    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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    Security prescription law fix heads to governor’s desk for signature

    March 04, 2019
    Implementation of the new state law that requires security prescription forms to have a uniquely serialized number law ...

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    CMS launches Beyond the Policy podcast

    February 27, 2019
    The first episode—and Management Coding discusses the rationale for 2019 Physician Fee Schedule policy changes affectin...

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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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    DWC announces free online access to MTUS treatment guidelines

    February 05, 2019
    The MTUS guidelines are based on the principles of evidence-based medicine and treatment guidelines developed by the Am...

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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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    Anthem issues new ID numbers for some patients

    January 30, 2019
    New ID cards containing the new ID number were mailed to all affected members in late December.

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    Bill introduced to fix security prescription law

    January 25, 2019
    Flawed implementation of a new state law that requires all security prescription forms to have a uniquely serialized ...

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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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    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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