This Weekly’s Hot Topics

  • 3 days left to submit an informal review request for several CMS performance reporting programs. CMS News
  • ACCC webinar this Thursday, entitled “CMS Final CY2018” Affiliate Association News
  • Contracting information resources MOASC News

 

A Capital Public Radio analysis of data from the California Department of Managed Health Care found that the number of contested denials handled by the department has nearly tripled over the past five years — from roughly 1,500 in 2012 to more than 4,200 in 2016. The department said the increase is because of a jump in the number of insured Californians during that time; the state’s uninsured rate has steadily declined since the Affordable Care Act roll-out in 2014. For more information click here and go to California News.

Upcoming Noridian/JEMAC webinars include:
Modifier 59, NCCI, and MUE Webinar (November 29); Preventive and Screening Services Webinar (December 6); Modifier 59, NCCI, and MUE Webinar (December 13); Understanding National and Local Coverage Determinations Webinar (December 13); Telehealth Services Webinar (December 14). For more information click here and go to Noridian News.

DHCS has detailed the requirements of Medi-Cal plans to provide palliative care services to their beneficiaries in accordance with SB1004 (2014). DHCS will implement the Medi-Cal palliative care program through managed care and fee-for-service providers beginning January 1, 2018. For more information click here and go to DHCS/Medi-Cal News.

MOASC Members are in the thick of contract negotiations with local IPAs and health plans. Do you know enough about your practice to negotiate the rate that’s right for you?. For more information click here and go to MOASC News.

Friday, December 1 at 5pm PT, is also the deadline for you to access and review your 2016 PQRS feedback report and 2016 Annual QRUR,  to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. For more information click here and go to CMS News.

To view the complete California Oncology Weekly Newsletter, click on the date below.

November 28, 2017