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Since the transition of TRICARE managed care services from United Health Military & Veterans (UMVS) to Health Net Federal Services (HNFS) on January 1, 2018, physicians have reported significant delays in the processing of authorizations and referral requests, which is affecting patient care. To address the delays, the Defense Health …

The deadline to submit 2017 data for Medicare’s Merit-based Incentive Payment System (MIPS) has been extended to Tuesday, April 3, 2018, at 5 p.m. Pacific time. (Note: For groups that missed the March 16 deadline to submit data via the CMS Web Interface, it’s not too late to submit your data through …

The Centers for Medicare and Medicaid Services (CMS) will begin mailing new identification cards to California Medicare beneficiaries between April and June 2018, as required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The new cards will contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number …

On December 26, 2017, the California Department of Managed Health Care (DMHC) issued a cease-and-desist order, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order came after SynerMed—a company closely affiliated with EHS—was accused of blocking patient access to specialists to hold …

The Tax Cuts and Jobs Act signed into law in December of 2017 represents the largest reform of our tax system in thirty years. In addition to changing the general tax rates, the new law limits how tax losses can be used, specifies which industries will qualify for the new …

Countdown to the Saving Private Practice Consortium With just over 30 days to go before the Saving Private Practice Consortium, I would like to encourage all of you to join LACMA and your colleagues on Saturday, March 3rd at the LA Hotel Downtown for what will be an empowering day …

In November, the Centers for Medicare and Medicaid Services (CMS) released regulatory guidance for clinicians participating in the Merit-Based Incentive Payment System (MIPS) who had been adversely impacted by recent natural disasters. This week, CMS updated its list of California counties that will be given automatic MIPS exceptions under the “Extreme and …

The California Legislature had an active year, passing many new laws affecting health care—with a strong focus on health care coverage, drug prescribing, public health and workers’ compensation issues. The California Medical Association has published a summary of the most significant new health laws of interest to physicians. For more …

With the new year soon upon us, physicians are urged to be diligent in verifying patients’ eligibility and benefits to ensure they will be paid for services rendered. The beginning of a new year also means that both calendar year deductibles and visit frequency limitations reset. And, with open enrollment, …

The California Medical Association (CMA) has received numerous calls from physicians whose prescriptions are being turned away by pharmacies for being non-compliant with state law. Specifically, the forms in question do not have checkboxes to indicate refills. California law requires 14 elements that must appear on California security prescription forms, including …