e-News is our electronic publication emailed as needed to keep physicians' practices up to date with time sensitive information.

e-News

January 9, 2020

CMS Proposed Rule Significantly Reduces the Federal Medicaid (Medi-Cal) Commitment to States, Providers and Patients For decades, through both Republican and Democratic Administrations, the Centers for Medicare and Medicaid Services (CMS) has allowed states to apply hospital fees, Medicaid managed care plan taxes, intergovernmental transfers, state special funds, and other local sources of funding to the non-federal share of Medicaid financing to draw down federal matching funds. States use these tools largely to address provider shortages and increase provider participation in vastly underfunded state Medicaid programs. In November 2019, CMS issued a complex proposed rule that will dramatically limit the ways that states may finance the non-federal share of Medicaid in the future. The rule will significantly reduce Medicaid funding in many states, as at least 34 states are employing these mechanisms to ensure their state Medicaid programs are adequately funded. The rule has far-reaching implications that would be devastating to many state budgets. More...

MEDICARE CHANGES: 2020 AND BEYOND Thursday, January 23, 2020 Location: Bella Luna Bistro & Bar 350 W. Main Street, Merced, CA Registration and Lunch: 11:30am Presentation: 12:00pm-2:00pm Registration is due by January 15, 2020 For more information or to Register for the event please see the flyer at the link below. MEDICARE CHANGES: 2020 AND BEYOND

AB 290 (Wood) – Health care service plans and health insurance: third-party payments AB 290 a bill that CMA and MMCMS staunchly opposed, yet still passed in 2019 has been shot down in the courts. U.S. District Judge David Carter said th at  AB 290  could h ave devastating consequences like potentially life-threatening disruptions in treatment and displacement from transplant waiting lists. MMCMS was a supporter of the coalition that opposed this bill and wrote a couple of different letters opposing it (see below). Following is a summary of the bill: AB 290 (Wood) – Health care service plans and health insurance: third-party payments CMA Position: Oppose Requires a health care service plan or health insurer to accept payments from specified third-party entities without a financial interest and requires financially interested entities, as defined, making a third-party premium payment to provide assistance in the manner specified and to disclose to the plan or insurer the name of the enrollees or insureds on whose behalf a third-party premium payment will be made. Requires health plans and insurers to provide regulators with information regarding premium payments by financially interested entities and reimbursement to providers and sets forth standards governing reimbursement of financially interested providers. Establishes a reimbursement rate for financially interested providers that provide services to enrollees or insureds on whose behalf premium payments are made by financially interested entities and establishes a dispute resolution process to determine if the reimbursement amounts are appropriate. Read the article from the San Francisco Chronicle here . Read the MMCMS letter to Assembly Member Jim Wood here . Read the MMCMS letter to Senator Anna Caballero here .

Medicare transitioned to MBI Jan. 1 Physicians are  reminded  that the transition period to the new Medicare Beneficiary Identification (MBI) numbers ended on December 31, 2019. Beginning January 1, 2020, providers must use only the new MBI number for Medicare transactions regardless of the date of service with few exceptions. More...

Anthem requires National Drug Code for outpatient claims effective January 1, 2020 Effective January 1, 2020, Anthem Blue Cross has imposed a new billing  requirement  on providers for all drug related claims, except those administered in an inpatient facility setting. More...

WEBINAR: The ABCs of AB 5: Classifying Health Care Workers in California's Gig Economy-Jan. 30 This presentation is an overview of the recent changes to California law governing the independent contractor vs. employee distinction. The webinar will provide physicians, who serve as employers, employees and independent contractors, with a basic understanding of how California classifies various health care workers, what businesses and workers can do to protect their rights, risks of misclassification and what's next for AB 5. Participants will hear about AB 5 itself, the  Dynamex  and  Borello  tests for employment, recent legal challenges to AB 5 and the consequences for misclassifying health care workers . More...

Learn more about MMCMS at our website! www.m mc m s.o rg