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All the latest news from CMA

California’s eRx mandate takes effect Jan. 1

Beginning on January 1, 2022 – less than one month from today – almost all prescriptions written in California must be transmitted electronically. Physicians who have not yet implemented electronic prescribing in their practices should begin the process now.

Anthem Blue Cross underpaying pediatric COVID-19 vaccine claims

Anthem is reimbursing the newly approved COVID-19 vaccine for the 5–11-year-old pediatric population at unreasonably low rates—less than 20% of the CMS rate.

State tobacco tax-funded program awards $39 million to expand California’s health care workforce

PHC last week announced more than $39 million in CalMedForce awards across the state to support medical training and residency programs and help grow the physician workforce. 

Bipartisan legislation introduced to stop Medicare physician payment cuts

Congress is considering bipartisan legislation that will provide critical relief to physicians who are currently scheduled to see their Medicare payment cut by up to 9% next year.

Clearinghouse corrects problem causing rejection of COVID-19 vaccine claims for children

Shortly after federal approval of the COVID-19 vaccine for children age 5-11, the California Medical Association (CMA) began receiving reports that clearinghouse Office Ally was rejecting the claims for 5-11 year olds with a message code stating the CPT codes were invalid.

Have you registered for the Medi-Cal Rx portal yet?

CMA encourages physicians—particularly those who currently prescribe medications for Medi-Cal patients—to register for the secure Medi-Cal Rx Provider Portal as soon as possible and ensure you are prepared for the upcoming transition to avoid any disruptions in patient care.

60-day Provider Relief Fund grace period ends November 30

Providers who fail to meet this reporting deadline will be required to return their PRF payments by December 30, 2021, and will be subject to further enforcement actions such as exclusion from future PRF payments.

Preparing for 2022: Verify your patients’ eligibility, benefits and deductibles

Physicians are urged to verify patients' eligibility and benefits for 2022 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. 

CMS issues third Critical Care E/M Comparative Billing Reports

In late November, CMS will issue a third letter in the Special Edition Comparative Billing Report series on Part B claims for critical care E/M services

CMS to hold physicians harmless from 2023 MIPS penalties amid COVID-19 pandemic

CMS recently announced that it will again this year be granting automatic exceptions from reporting requirements for clinicians and providers participating in Medicare quality reporting programs due to the ongoing disruptions the COVID-19 public health emergency is having on physician practices.