February 3, 2023

Medicare Changes: 2023 and Beyond



Cheryl Bradley, Associate Director of the CMA Center for Economic Services, joins us to review the policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective for Calendar Year 2023 and beyond. This on demand webinar will provide you with the resources to help you maneuver regulatory and procedural challenges that impact your practice. Watch now. CME is available.

Applications Open for Loan Repayment Program



You can now submit your application for the CalHealthCares Loan Repayment Program. CalHealthCares provides loan repayment physicians who provide care to Medi-Cal patients. Eligible physicians can apply for an award of up to $300,000 in exchange for a five-year service obligation. The application deadline is March 3.

Evusheld Not Authorized for Use



Recently, the FDA revised the EUA for Evusheld (tixagevimab co-packaged with cilgavimab) and Evusheld is not currently authorized for use in the U.S. until further notice by the Agency. Data show Evusheld is unlikely to be active against certain SARS-CoV-2 variants. This action to limit the use of Evusheld prevents exposing patients to possible side effects of Evusheld such as allergic reactions, which can be potentially serious, at a time when fewer than 10% of circulating variants in the U.S. causing infection are susceptible to the product. 

Section 126 Application for Additional GME Slots Now Open



CMS announced the distribution of the first 200 GME slots, out of the additional 1,000 slots, that were created as part of the Consolidated Appropriations Act, 2021 (CAA). The slots will be effective July 1, 2023. The application cycle for the 200 FY 2024 slots is currently open and will remain open until March 31, 2023. In order to be eligible for these additional FTE resident cap slots, a hospital must qualify in at least one of the following four categories:   

• Hospitals in rural areas (or treated as being located in a rural area under the law)  
• Hospitals training a number of residents in excess of their GME cap  
• Hospitals in states with new medical schools or branch campuses  
• Hospitals that serve areas designated as health professional shortage areas (HPSAs) 

Medicare Physician Fee Schedule Updated

When Congress passed its year-end omnibus legislation in the final days of 2022, it included a 2% Medicare physician payment cut for 2023. As a result, the Centers for Medicare and Medicare Services (CMS) updated the 2023 conversion factor to $33.8872 for 2023. Noridian has now updated its 2023 Medicare Physician Fee Schedule to reflect this change and has started releasing 2023 claims for payment. 

Medi-Cal Rx Transition: Phase II Begins



Phase II of the DHCS Medi-Cal Rx transition began last Friday, January 20. In Phase II—which will be implemented in two waves—Medi-Cal Rx prescribers will again be required to submit prior authorizations (PAs) for the remaining drug classes. 

• Phase II Wave 1 (January 20, 2023): New start prescriptions in 39 drug classes 
• Phase II Wave 2 (February 24, 2023): New start prescriptions in the remaining 21 drug classes. 

New start prescriptions for pediatric patients 21 years of age and under continue to be excluded to prevent additional administrative obligations for providers of specialty pediatric services who have been significantly impacted by the transition to Medi-Cal Rx. 

Quality Payment Program Exceptions: MIPS EUC Deadline Extended



CMS has extended the deadline to file a 2022 MIPS Extreme and Uncontrollable Circumstances (EUC) hardship extension until March 3, 2023. The original deadline was Jan 3, 2023. If physicians feel they have been impacted by the COVID-19 pandemic in 2022 they may file a MIPS hardship exemption with CMS to avoid a 2024 MIPS penalty. 

Risks to Patients Exposed to Xylazine in Illicit Drugs

Medi-Cal posted a reminder for physicians to continue to administer naloxone for opioid overdoses and consider xylazine exposure if patients are not responding to naloxone or when there are signs or symptoms of xylazine exposure (e.g., severe, necrotic skin ulcerations). Health care professionals should provide appropriate supportive measures to patients who do not respond to naloxone.

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Updates on the Legal Landscape in Post-Roe America and the Impact of the Dobbs Decision 

Wednesday, February 8 | Noon 

Free | Hosted by UC Health 

The University of California Health Systemwide Grand Grounds will review the current legal landscape, as well as considerations for health care providers and medical staff as they attempt to navigate this rapidly evolving post-Roe legal landscape. An overview of restrictive state laws' impact on medical education and women's health will also be provided. 

Register here. 

New NP Classifications – What Physicians Need to Know 

Thursday, February 23 | 12:15 to 1:15 pm 

Hosted by CMA 

Assembly Bill 890 (Wood), signed into law in September 2020, created two new classifications of nurse practitioners (NPs) - 103 and 104 NPs - who can perform certain functions without standardized procedures and protocols in California. The regulations implementing the bill became effective as of January 1, 2023. These regulations set the minimum standards for the law’s "transition to practice" requirements for NPs seeking to apply for licensure under these classifications. NPs can elect, but are not required, to transition to these new classifications. This webinar will provide an overview of the law and regulations, explain under what circumstances 103 and 104 NPs can practice and where, and show how this may impact physicians and patients. 

Register here. 

Guided Nature Hike

Saturday March 25, 2023 | 10:00 a.m. - 1:00 p.m.

Join us for a hike on Saturday, March 25, at 10 a.m. and see sweeping views of Solano County and beyond. Open to all physicians and their families at no cost, the hike will be easy to moderate in difficulty, 4-6 miles total and led by Solano Land Trust docents. The hike will take place near Rockville Rd. and Suisun Valley Rd. Free for NSMS members + 3 Guests.

Register here.

NSMS Movie Night featuring The Super Mario Bros. Movie

Friday, April 7

Century Napa Valley & XD

Bring the family along for a private screening of The Super Mario Bros. Movie. Arrive before showtime to play a Super Mario Bros. quiz and win prizes! This event is free for members +3 guests. Tickets will be reserved on a first-come first-served basis. A waiting list will be generated once all tickets are claimed.

Reserve your spot.

The 2023 NSMS Awards Gala & Casino Night

Friday, May 19 | 6:00 to 9:30 pm

Eagle Vines Golf Club, American Canyon

Join over a hundred physicians, health care leaders and special guests for an evening of entertainment as we celebrate the following individuals:

• Haroon Mojaddidi, M.D. - Physician of the Year (Solano)
• Colleen Townsend, M.D. - Physician of the Year (Napa)
• Karen Relucio, M.D. - Professor Emeritus
• Eugene Eisenberg, M.D. - Lifetime Achievement



Stay after the awards ceremony to try your hand at blackjack, poker, craps and more. Gamble with complimentary chips, then turn them into raffle tickets for a shot at great prizes. Past raffle prizes have included hot air balloon rides, SF Giants and Golden State Warriors memorabilia, wine train dinners, golf rounds, and more. This event is free for NSMS members +1 guest.

Register here.

Health IT: Powering Value-Based Care 

Monday, May 22 | 9:00 am to 4:00 pm 

Sacramento, CA | Free for CMA members 

Save the date for CMA’s first annual healt IT conference. The conference will bring together thought leaders from across California and the nation to explore the intersection of technology and payment reform. CMA expects a diverse set of attendees that will include physicians, medical groups and IPAs, health plans, health information organizations (HIOs) and others who will take the learnings from this conference to change how care is delivered in this state. 

Register here.