Below is content from the CMA Practice Resources (CPR) newsletter, which keeps you up-to-date on critical payor and health care industry changes.
November 19, 2024
In California, both DMHC and CDI offer an independent medical review (IMR) process that allows patients to appeal healt...
On January 1, 2025, TriWest Healthcare Alliance will begin providing managed care services to TRICARE beneficiaries in ...
November 13, 2024
If you plan to change your Medicare participation status for 2025, you must do by December 31. Unless Congress interven...
November 08, 2024
Medi-Cal will be reprocessing previously denied claims for Flucelvax with dates of service back to August 1...
November 04, 2024
Medi-Cal Rx will reinstate claim edits and prior authorization requirements for patients 21 years of age and younger on...
DHCS is looking for physicians to participate in online focus groups to identify opportunities to strengthen communicat...
October 11, 2024
Effective Dec. 9, 2024, submitters who submit certain batch transactions on behalf of Medi-Cal providers will be requir...
October 09, 2024
DHCS recently announced that it will be deactivating Medi-Cal Rx override code “55555” effective October 18, 2024. This...
October 08, 2024
On Tuesday, October 15, CMA President Tanya W. Spirtos, M.D., and CMA CEO Dustin Corcoran are hosting a special webinar...
October 02, 2024
In August 2024, CMA was notified by a physician practice that Blue Shield of California was mistakenly denying claims f...
September 24, 2024
CMS is accepting 2023 MIPS exception applications through Oct. 11 due to the Change Healthcare cyberattack. However, 20...
Aetna is experiencing problems with electronic eligibility verification transactions for Aetna Passport to Healthcare P...
September 12, 2024
UnitedHealthcare recently announced the CPT codes that are eligible for its new Gold Card Program, which launches on Oc...
August 16, 2024
Physicians who have not received incentive payments for participating in an Advanced APM for the 2024 payment year shou...
August 06, 2024
AMA has assigned provisional CPT code for vaccines to protect patients against the H5N8 strain of avian influenza (bird...
CMS recently released the proposed 2025 Medicare Physician Fee Schedule, which includes a 2.8% physician payment cut. C...
Prop 35 has launched a new online Action Center to activate supporters.
July 29, 2024
Manifest Medex is hosting a free webinar on August 22 for practices that want to learn more about California's Data Exc...
July 19, 2024
As a direct result of California Medical Association (CMA) advocacy, Aetna has excluded California from a recent update...
July 16, 2024
CMA is urging Aetna to immediately rescind a recent update to its Claim and Code Review Program for emergency services ...
July 12, 2024
Beginning August 1, 2024, all California dispensers of controlled substances will be required to report dispensations t...
July 11, 2024
Practices that have still not received retroactive payments for COVID-19 services as required under SB 510 should submi...
July 09, 2024
Physicians who have not received incentive payments for participating in an Advanced Alternative Payment Model for the ...
The ballot measure sponsored by CMA and the Protect Our Health Care Coalition has been assigned a proposition number fo...
July 03, 2024
On January 1, 2024, the first phase of Medi-Cal provider rate increases took effect as a result of the 2023-24 budget...
July 01, 2024
CMS has opened the Final Score Preview period for MIPS. Clinicians and authorized representatives of practices, virtual...
June 24, 2024
CDC issued a health advisory warning about potential disrupted access to care for individuals taking prescription stimu...
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