Weekly Roundup: In Case You Missed It | |
CDC Recommends Novavax for Adolescents Following FDA EUA
After being authorized for adults last month, Novavax is now authorized as a two-dose series for ages 12-17. The CDC stated that Novavax’s COVID-19 vaccine is an important tool in the pandemic and provides a more familiar type of COVID-19 vaccine technology for adolescents. Having multiple types of vaccines offers more options and flexibility for the public, jurisdictions, and vaccine providers.
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Prior Authorization Reinstatement for New Start Medications
Beginning September 16, prior authorization (PA) requirements will be reinstated for 11 drug classes for new start medications for beneficiaries 22 years and older. DHCS published a Prior Authorization Reinstatement Reference Guide which lays out the requirements, how to submit a PA, and other useful resources for submitting PAs.
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PRF Reporting Period 3 Closes September 30
Providers who received one or more payments exceeding $10,000 in the aggregate from January 1 - June 30, 2021 are required to submit a Provider Relief Fund (PRF) Reporting Period 3 report no later than September 30 at 8:59 pm. Access the PRF Reporting Portal and submit your information as early as possible.
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Governor Unveils State Strategy to Support Youth Mental Health
Late last week in Fresno, Governor Newsom discussed California’s Master Plan for Kids’ Mental Health of which a key component is the $4.7 billion Children and Youth Behavioral Health Initiative (CYBHI). CYBHI seeks to improve access to behavioral health services for all youth and children in California, regardless of payer. DHCS will build and drive adoption of the Behavioral Health Virtual Services Platform to support the delivery of behavioral health services from treatment to recovery; provide an e-Consult platform for pediatric and primary care providers to connect with BH providers; and make it easier to access BH services in California’s schools. Click here for more information.
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Legislature Passes AB 1636 to Protect Patients
California Legislature unanimously passed CMA-sponsored bill AB 1636 that will ensure physicians who have committed sexual misconduct are prohibited from the ability to petition the medical board for reinstatement. In December 2021, the LA Times reported that the Medical Board of California reinstated 10 of 17 California physicians who previously had their licenses revoked for sexual misconduct. AB 1636 will protect patients and the integrity of the medical profession by ensuring that physicians who commit sexual misconduct are appropriately disciplined. The bill now sits on the governor’s desk awaiting signature.
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Continuing Medi-Cal Coverage for Young Adults
When the COVID-19 PHE ends, many individuals included in the young adult expansion will age, or would have already aged, out of coverage when they turn 26—which for some, may be months before their state-funded full-scope Medi-Cal coverage will begin again under the 26-49 expansion taking effect on January 1, 2024. DHCS will resolve that by continuing to provide them with state-funded full-scope Medi-Cal coverage before the expansion occurs. Read more in the Medi-Cal COVID-19 PHE Emergency Operational Unwinding Plan.
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Share Your Experience with Unconscious Bias for CMA’s Health Equity Summit
The Health Equity Summit, taking place October 14, aims to bring together stakeholders from across sectors to create dialogue, derive recommendations for policy makers and other key stakeholders to drive the field forward, and understand identified, data-driven best practices to mitigate unconscious bias and set a standard to reduce unconscious bias within health care. In preparation for this event, CMA is looking to speak with clinicians willing to share their experiences with unconscious bias. To express your interest, please fill out this form. Find more details here.
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Transforming Medi-Cal Managed Care Plans
DHCS issued a news release announcing its intent to award contracts to three managed care plans (MCPs) to deliver Medi-Cal services to Californians across the state, beginning in 2024. This first-ever statewide competitive procurement for commercial MCPs will transform and redefine how care is delivered to millions of Californians. In the Bay Area, Anthem Blue Cross will be awarded contracts to deliver Medi-Cal services in San Francisco and Santa Clara counties. DHCS is also entering a direct contract with Kaiser Permanente in 32 counties, subject to federal approval.
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Biden Administration Makes Largest Ever Investment in Navigators Ahead of Open Enrollment Period
HHS is investing $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP) and make health coverage more equitable and accessible to everyone. These awards will enable Navigator organizations to retain staff and add to the more than 1,500 existing Navigators who were trained to help consumers find affordable, comprehensive health coverage in nearly every HealthCare.gov state and county during the 2022 open enrollment period.
This announcement marks the single largest Navigator funding award provided to date and serves as a continuation of historic levels of funding.
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The No Surprises Act, Transparency, and You
Tuesday, August 30 | 9:00 am
Hosted by America’s Health Insurance Plans (AHIP)
New government mandates pose significant challenges to healthcare organizations. In fact, according to a Change Healthcare survey conducted in 2021, more than 70% of healthcare leaders believe implementing the price comparison tools required by these mandates will be particularly difficult.
This webinar will include an overview and updates to the No Surprises Act, an overview of the Transparency in Coverage Act, and solutions for helping comply with mandates.
Register here.
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Leadership Reading and Discussion Group
Wednesday, September 7 | 6:00 to 7:30 pm
FREE | CME Available | Online
Physicians are free to join any meeting of the Leadership Reading and Discussion Group; reading the book is not required. Doctor Hilary Worthen, course director of the Physician Leadership Program, facilitates the discussion group that is held on Zoom. The book selection for September 7 is “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back” by Elisabeth Rosenthal, MD. This book describes how the flawed system of health insurance and delivery has failed patients in the US, and proposes solutions for far-reaching reform.
Register here.
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Monkeypox Management: A Patient-Centered Approach
Friday, September 9 | 12:00 to 1:00 pm
Hosted by the Pacific AIDS Education & Training Center
Join speakers from San Francisco Department of Public Health and Lifelong Medical Care for this virtual webinar addressing the local epidemiology and clinical manifestations of monkeypox, approaches to evaluating and discussing monkeypox with patients, and barriers to health-seeking behaviors using patient-centered techniques. Access the flyer and distribute it with your networks.
Register here.
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Ballots & Brews
Mare Island Brewing Co., Vallejo | Friday, Sept. 9 | 6:30 to 9:00 pm
Free for members | $50/person for non-members
Bring the family to Mare Island Brewing Co.'s "Whaleboat Room" to enjoy good food and good company. Sip some suds and learn about the biggest health care issues on the November ballot or eat some free food and play games outside (e.g. cornhole, giant Jenga, foosball, or bring your own from home!) with waterfront views. Micah Scheindlin, CMA Associate Vice President of Political Operations, will present on how 2022 ballot measures could impact you and your patients.
Register here.
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Therapeutics Webinar Series for Providers
Monday, September 12 | 12:00 to 1:00 pm
Hosted by CDPH
This bi-weekly webinar series features CDPH subject matter experts who will provide updates, resources, and answers to providers’ questions. The webinar series will continue through at least the end of the year.
Register for the whole series here.
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Virtual Grand Rounds: COVID-19 Updates and Cardiac Manifestations of Long COVID
Tuesday, September 13 | 12:00 to 1:00 pm
Hosted by CMA | FREE
After a massive summer surge of COVID-19, with many Americans having had COVID-19 more than once, we are still grappling to understand the epidemiology, causes and manifestations of long COVID. After an update on the current status of COVID-19 and other emerging infectious diseases including monkeypox (MPX) from Erica Pan, M.D., MPH, we will be hosting Donald Grandis, M.D., a UC San Francisco cardiologist who will discuss the cardiac manifestations of long COVID.
Register here.
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Bay Area Physician Wellness Collaborative
Tuesday, September 13 | 6:00 to 8:00 pm
FREE | CME Available | Online
The Bay Area Physician Wellness Collaborative aims to bring together medical group leaders, chief wellness officers, wellness committee chairs, and others who have been charged with “fixing the physician burnout problem” from across the East Bay. Participants will:
- Receive a highly structured road map to make substantive changes over a three-year period that can fundamentally change the practice environment in your organization
- Learn from wellness experts who will provide curated information and implementation tools that they can bring back to their organizations
- Become part of an online community to share information and experiences
- Create a network of peers to support each other in this work
The guest speaker for the September 13 session is Gaurava Agarwal, MD, CWO at Northwestern Medicine and a leader in CWO development nationwide. This collaborative is by invitation only; please click here to indicate your interest in joining the collaborative.
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Climate and Health Advocacy Bootcamp
Thursdays, September 29-October 27 | 12:00 to 1:30 pm
Hosted by the Medical Society Consortium on Climate and Health
Health professionals are the most trusted voices in society and our collective voices are needed to prepare communities to effectively respond to the climate crisis. Through this 5-week bootcamp, you will grow your network by joining colleagues around the country to learn strategies to effectively channel your voice and action as a health professional to address the “greatest health threat” of the 21st Century.
Register here.
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Understanding the Climate Health Crisis and How California Physicians Can Make an Impact
Friday, October 21 | 2:00 to 4:00 pm
Hybrid: Virtual and In-person at L.A. Live
This free event will be an engaging two-part panel discussion that will explore the health impacts of climate change in California and the opportunities for California's physicians to advance policy-level climate solutions with enormous public health co-benefits. Sponsored by Climate Health Now and the California Foundation on the Environment and the Economy (CFEE) in coordination with CMA.
Register here.
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