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CMA files complaint about Anthem’s unlawful denial of claims for emergency services

October 14, 2013
Area(s) of Interest: Health Information Technology Payor Issues and Reimbursement 


Voting with an overwhelming majority, the California Medical Association (CMA) House of Delegates has said that insurers should be required to reimburse physicians for telephonic and electronic patient management. The resolution (Res. 407-13) asks CMA to sponsor legislation to that effect when politically and economically feasible.


The resolution received nearly universal support during testimony, with many speakers noting that patients are increasingly relying upon telephone calls and emails for consultations that previously were conducted during in-office appointments. Under the language adopted by the House, payment for these consultations would be similar to office visits that are similar in complexity or time required from the treating physicians.


The issue of payment for telephonic or electronic patient management has come before the House in the past, with CMA previously having adopted policy to support the practice, but this latest resolution explicitly asks the association to sponsor legislation to mandate the practice in California.

 

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