Blog entries

Medi-Cal Payments and the State Budget

Lynn Young — Thu, 02 Sep 2010 18:31:39 +0100

There has been some media attention over the last few days paid to the fact that some Medi-Cal providers are not getting paid due to the late State Budget. I thought it would be helpful to summarize the issue, and what it means for physicians. Hopefully this will help you answer physician questions when they arise.

Every year, the State creates a $2 billion fund ($1 billion State + $1 billion Federal) called the Medi-Cal Provider Interim Payment Fund (MPIPF). This funRead More...

Legislature Passes Bill Implementing Ban on Rescissions

Lynn Young — Thu, 02 Sep 2010 18:29:08 +0100

AB 2470 allows patients to appeal to state regulators if insurers cancel coverage for them after they get seriously ill
Sacramento – Legislation providing patients a vital safeguard to ensure the federal ban on rescissions is followed passed the Assembly today on a bipartisan vote and was sent to the governor’s desk.

AB 2470, authored by Assemblyman Hector De La Torre, D-South Gate, and sponsored by CMA, means plans cannot act as judge and jury wheneRead More...

Medicare Fee Schedule - Palmetto GBA Update

Lynn Young — Tue, 29 Jun 2010 18:30:36 +0100

Palmetto GBA has received the revised fee schedule from CMS with the 2.2% increase for services from June 1 through November 30, 2010. They are testing their system with the new fee schedule, and should have everything pricing correctly by this Thursday, July 1.

Palmetto has provided CMA with the following additional information on the previously held June claims:

· Claims with June dates of service received on June 1 and June 2 Read More...

Childhood Immunization Saves Lives and Money

Lynn Young — Thu, 03 Jun 2010 14:53:35 +0100

Elvis made history by leading the campaign for vaccination. The image of Elvis being vaccinated was made into ads and billboards. The rate of polio plummeted.

Now, more than 50 years later, we find ourselves with other epidemics that could be curtailed by vaccinations. The fear of immunizations is based on misinformation. Evidence from stRead More...

About Pertussis (Whooping Cough) What Is It?

Lynn Young — Thu, 03 Jun 2010 14:50:25 +0100

A very contagious disease caused by a type of bacteria called Bordetella pertussis. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States.

Vaccines: Very effective but not 100 percent effective. If pertussis is circulating in the community, there is still a chance that a fully vaccinated person can catch it.

Symptoms: The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild coRead More...

SGR Petition

Lynn Young — Mon, 12 Apr 2010 05:00:00 +0100

Physicians, Patients Launch Medicare Petition Drive A 21 percent cut in Medicare physician reimbursement took effect April 1, and now physicians and their patients and families are fighting back.

Get involved.

Each year for the past decade, physicians have faced steep payment cuts that make it harder and harder for them to care for their Medicare patients. Congress knows about the problem. It knows the faulty formula Medicare uses to pay doctors does not work, but it has not fRead More...

SGR Cuts

Lynn Young — Wed, 03 Mar 2010 06:00:00 +0100

Congress Stops SGR Cuts through March 31; CMA Fighting for Permanent Repeal

Responding to strong pressure from CMA, AMA, and seniors, the US Senate last night passed HR 4691, legislation stopping the 21% cut to Medicare payment rates to physicians through March 31. The House had already passed the bill. President Obama is expected to sign the legislation shortly. Because Medicare contractors were instructed to hold claims for 10 days, physicians are not expected to face any cuts in MeRead More...

Medicare Formula Needs Fixing

Lynn Young — Mon, 25 Jan 2010 06:00:00 +0100

California seniors need Congress to act on Medicare cuts formula: Choice of physicians at risk
California residents face several issues with choice of physicians and access to care: 9.0% of the state's residents live in a designated primary care shortage area; 13.3% report that they could not see a doctor in the last 12 months due to cost; there are 274 emergency department visits per 1,000 population in the state; and 31% of the state's Medicare beneficiaries age 65 and ovRead More...