This Weekly’s Hot Topics
- Final deadline to enroll in a 2018 Marketplace plan is December 15. (National News)
- 12/31/17 deadline to participate, or not, in Medicare for 2018. (CMS News)
- Advocacy Alert! Contact your Senators & Representatives! (National News)
- Blue Shield is automatically reprocessing the affected claims (California News)
Earlier this year, the California Medical Association (CMA) began receiving calls from physician offices concerned that Blue Shield of California was not correctly paying claims under the state’s new out-of-network billing and payment law (AB 72). AB 72 requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities, and places limitations on the ability of physicians in such circumstances to collect their full billed charges. For more information click here and go to California News.
The California Department of Managed Health Care (DMHC) took enforcement action including a $5 million fine—against Anthem Blue Cross for a systemic failure to resolve consumer grievances in a timely manner. For more information click here and go to DMHC News.
MARK YOUR CALENDAR, for MOASC’s Spotlight On® Hematology, Saturday, January 27, 2018 in Huntington Beach. MOASC’s Spotlight On series presentation brings highlights of the 2017 ASH annual meeting. MOASC awarded educational grants to 3 UCI Fellows who attended the ASH Annual in Atlanta, GA on December 9 – 12, 2017. They & UCI faculty will present their discoveries through interactive discussions on ASH highlights. For more information click here and go to MOASC News.
Stop the Medicare Sequester Cut! Call your member of Congress today. With the passage of the tax bill, Congress has done the unthinkable – triggering a cut to Medicare payments (referred to in Washington as a “sequester” cut). Call Congress and let them know the Medicare sequester must be stopped. This will have a dangerous impact on cancer care in the United States, reducing access and increasing costs for patients. For more information click here and go to National News.
The Centers for Medicare and Medicaid Services (CMS) recently published the final Medicare Physician Fee Schedule for 2018. Overall, there are many positive changes in the final rule, including the reduction of penalties under the flawed Value Modifier (VM) program, the expansion of coverage for telehealth services, the delay in implementation of the Appropriate Use Criteria (AUC) for imaging, and the reduction of documentation requirements for Medicare Shared Savings Program accountable care organizations. For more information click here and go to CMS News.
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