November 2018
Your monthly news & updates
Last Day to Change Your Medicare Participation Status is December 31st

Once again, it’s time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31, 2018, to make changes for the 2019 participation year.
As always, physicians have three choices regarding Medicare: Be a participating provider; be a non-participating provider; or opt out of Medicare entirely. Details on each of the three participation options are as follows:
  • A participating physician must accept Medicare-allowed charges as payment in full for all Medicare patients.
  • A non-participating provider can make assignment decisions on a case-by-case basis and bill patients for more than the Medicare allowance for unassigned claims. Non-participating physician fees are 95 percent of participating physician fees. If you choose not to accept assignment, you can charge the patient 9.25 percent more than the amounts allowed in the participating physician fee schedule (which equates to 15 percent of the non-participating fees). 
  • Physicians who opt out of Medicare are bound only by their private contracts with their patients. Medicare's limiting charges do not apply to these contracts, but Medicare does specify that these contracts contain certain terms. When a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract. As a result of the Medicare Access and CHIP Reauthorization Action of 2015 (MACRA), validated opt-out affidavits signed on or after June 16, 2015, will automatically renew two years after the effective date.
Physicians who want to change their participation status for 2019 must send a letter to  Noridian , California’s Medicare contractor, postmarked by December 31, 2018.
The California Medical Association (CMA) also has information on physicians' Medicare participation options in CMA’s health law library document #7209, " Medicare Participation (and Nonparticipation) Options ." Health law library documents are free to members at  www.cmadocs.org/health-law-library . Nonmembers can purchase documents for $2 per page.
Physicians can also visit CMA’s MACRA resource center at  www.cmadocs.org/macra  to better understand the payment reforms, how they may impact physician practices and access resources to help with the transition. The center is a one-stop-shop with tools, checklists and information from CMA, the Centers for Medicare and Medicaid Services, the American Medical Association and national specialty society clinical data registries.
Contact: Cheryl Bradley, (213) 226-0338 or  cbradley@cmadocs.org .

Urologist and Transplant Surgeon Named CMA President-Elect

Urologist and kidney transplant surgeon Peter N. Bretan, Jr., M.D., was elected by the California Medical Association (CMA) House of Delegates as the association’s new president elect. He will take office at the close of this year’s meeting and will serve as on the CMA Executive Committee as president-elect for one year. Dr. Breton will be installed as president following next year’s House of Delegates. He will be the first Filipino-American physician to serve as CMA president.
Dr. Bretan practices in Marin, Sonoma and Santa Cruz Counties. He has served as a CMA Trustee and delegate, and is a three-time county medical society president. He is the current President of the California Urological Association and serves as an adjunct clinical professor at Touro University, where he has taught classes in health care policy for the past 15 years.
Dr. Bretan is the founder and CEO of Life Plant International, a charitable organization that promotes disaster preparedness, organ donation and early disease screening worldwide. He has also provided care around the world on medical missions.
"My greatest motivation is in service to give back to society for my good fortune. I grew up as a child farm laborer, and I know what it is to be without adequate health care,” said Dr. Bretan. 
Dr. Bretan earned his Bachelor of Science degree in physiology from University of California, Berkeley and his medical degree from the University of California, San Francisco, where he completed residencies in general surgery and urology, as well as a fellowship in radiology. He also completed a fellowship at The Cleveland Clinic Foundation in transplantation and renovascular surgery.
The full 2018-2019 CMA Executive Committee includes:


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Upcoming Events

November 6 - Primary Election

November 7 - CMA Webinar - Prop 56

November 12 - KCMS Business Office Closed in observance of Veteran's Day

November 22-23 - KCMS Business Office Closed in observance of Thanksgiving
Service Spotlight
KCMS 2018 Outstanding Physician Award

Congratulations to Chang Na, MD, this year's recipient of the KCMS 2018 Outstanding Physician Award. We are pleased to honor her for her contributions to KCMS, the community, and her patients.

Happy Birthday

Gabriela Angulo-Zevallos, MD
Raymond Chan, DO
Raymond Chaney, MD
Donald Cornforth, MD
Joseph Davidson, MD
Tony Deeths, MD
Dyrel Faulstick, MD
Virginius Gontero, MD
Benjamin Ha, MD
Claudia Jonah, MD
Jorieth Jurich, DO
Frank Lang, Jr., MD
Kristopher Lyon, MD, FACEP
Richard O'Reilly, MD
Chan Park, MD
Pamela Staiger, MD
Kevin Stiles, MD
Nicholas Valos, MD
Steven Wang, MD


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