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On YOUR Toes; News YOU Can Use
ON YOUR TOES
GOVERNOR SIGNS CPMA BILL TO ADDRESS PODIATRIC X-RAY TECHNICIAN SHORTAGE
California Governor Gavin Newsom has signed Assembly Bill 1704, sponsored by the California Podiatric Medical Association (CPMA) and authored by Assemblymember Phillip Chen, to address the chronic shortage of podiatric x-ray technicians.
AB 1704 will help alleviate the existing barriers to education and to accommodate the specialized podiatric setting by providing a simplified pathway (which is more accessible, flexible, and cost-effective) that will enable podiatric medical assistants to take the state-limited permit exam, so they may assist podiatrists in taking in-office x-rays.
“CPMA thanks Governor Newsom for signing AB 1704, which will help to ensure that podiatric physicians will be able to provide necessary care to their patients in a timely manner, which can often make all the difference in the world,” said CPMA President Holly Spohn-Gross, DPM.
CPMA Working for YOU!
CIGNA HITS PAUSE TO REEVALUATE BURDENSOME MODIFIER 25 POLICY IN THE FACE OF FIERCE CPMA ADVOCACY
Cigna has delayed the August 13, 2022, implementation of its recently announced policy to require the submission of medical records with all Evaluation and Management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed.
CPMA had serious concerns with Cigna’s policy change as it would result in significant, unnecessary administrative burden and compliance cost to physician practices, would delay patient care, and would create duplicate requests thus wasting health care dollars. The policy also lacks clarity on the product types impacted, is inconsistent with industry standards and CMS guidance, and appears to violate California law.
CPMA, the California Medical Association (CMA), and other stakeholders reached out to Cigna regarding these serious concerns and urged the payor to rescind the policy. Due to this advocacy, Cigna has delayed implementation and the policy is under additional review.
CPMA believes a more collaborative approach to identify alternative policies and methods for cost containment— including provider education on proper coding practices that do not bluntly penalize physicians using the modifier appropriately—will prove more effective and less costly in the long term. The Association will continue to work with Cigna to address our concerns and will provide updates as more information becomes available.
CPMA Working for YOU!
REPORTING FOR PROVIDER RELIEF FUND PAYMENTS RECEIVED IN PERIOD 4 BEGINS JANUARY 1, 2023
Reporting for period 4 ― for Provider Relief Funds (PRF) payments exceeding $10,000 received July 1-Dec. 31, 2021 ― will open January 1, 2023. Recipients of period-4 payments must use their funds on eligible pandemic-related expenses by December 31, 2022.
Allowable Expenses Under the Provider Relief Fund, allowable expenses are those used to prevent, prepare for and respond to the coronavirus and may include healthcare related expenses or general and administrative-related expenses. All recipients of PRF payments are subject to auditing.
Examples of eligible expenses common for practices include: • N95s, surgical masks, temperature-monitoring devices, and other infection-control supplies • Ventilators, improved filtration systems, and other infection-control equipment • Mortgage or rent on practice office • Employee health insurance, hiring bonuses, recruitment and retention payments to expand or maintain patient care capacity, and other fringe benefits. Providers should read the HRSA’s explanation of allowable expenses for additional guidance, https://www.hrsa.gov/ provider-relief/reporting-auditing HHS will look very closely at how funds are used, so it is important to be precise in reporting. Funds must have been used for healthcare-related expenses before they can be applied to lost revenue.
Providers should maintain records related to their reporting for a minimum of five years.
Reporting requirements HRSA has a “How to Report” webpage with instructions broken into three main steps: registering to use the portal, reading the reporting requirements notice, and completing and submitting the report at https://www.hrsa.gov/ provider-relief/reporting-auditing
When registering to use the portal, providers will want to have certain information on hand, such as their tax ID or employer identification number and PRF payment information. Providers who submitted a PRF report during a prior reporting period do not need to re-register.
The reporting requirements notice provides details on how to report on the use of the funds and lists the required reporting data categories.
Most COVID-19 relief programs have stringent requirements that funds from multiple sources not be used to cover the same expenses. The best way to avoid having expenses disallowed in a follow-up audit is to maintain good records of which expenses were covered by specific programs, whether EIDL, Paycheck Protection Program or HHS’s Provider Relief Fund.
Again, the portal for providers to begin reporting the use of those funds begins January 1, 2023, if the payments exceeded $10,000. Providers will report the use of their period-4 funds through the U.S. Health Resources & Services Administration’s PRF reporting portal at https://www.hrsa.gov/ provider-relief/reporting-auditing
(Source: CDA 6/8/2022)
2023 MINIMUM WAGE HIKE BRINGS CHANGES FOR CALIFORNIA EMPLOYERS
California doesn’t have just one minimum wage—it has many.
California has several minimum wage laws that can often be confusing and overwhelming for businesses. In California, the minimum wage is determined by a law that links it to the cost of living. Additionally, many cities and counties across the state have legislated their own minimum wage laws that are even higher than federal or state minimum wage.
Current California Minimum Wage
The minimum wage in California for 2022 for employers with 25 or fewer employees is $14 an hour. Employers with 26 or more employees pay $15 per hour. The minimum wage in California was set to increase yearly until it reached $15/hour in 2022. However, on July 27, 2022, a new minimum wage of $15.50 was set to go into effect on January 1, 2023, due to the high inflation rate in the past year. This is for all sizes of employers!
Local regulations add yet another layer of complexity to California’s labor laws. If you operate in more than one location, you could be subject to multiple different minimum wage levels in a single day. Employers should check the city websites where their practices are located.
How should small business owners prepare for minimum wage increases?
While minimum wage increases may pose a challenge for small businesses, there are ways to stay ahead of the curve. Small business owners can avoid being caught off guard by keeping up to date on changes to the minimum wage and adjusting prices and compensation as necessary.
If a minimum wage increase is on the horizon, it’s important to look at your budget and financial records, such as operational costs, in preparation for the change.
(Paycor 10/18/2022)
NEW CALIFORNIA LAW CREATES E-PRESCRIBING EXEMPTION FOR PRESCRIBERS MEETING SPECIFIC CRITERIA
Under a law that takes effect in 2023, California prescribers can request an exemption from the current requirement to electronically prescribe all medications if they register with the California State Board of Pharmacy and state that they meet one or more specified criteria. Although the law takes effect January 1, 2023, the Board of Pharmacy is responsible for creating the prescriber registration and currently does not expect to have it ready by the first of the year. The new law also authorizes a pharmacy to decline to dispense an electronic prescription submitted via software that fails to meet any specified criteria.
Healthcare practitioners in California who issue 100 or fewer prescriptions in a calendar year could receive an exemption from the state’s existing law requiring practitioners to electronically prescribe all medications.
BUT the exemption is not automatic. Authored by Assemblymember Jim Wood (D-Santa Rosa), and signed into law by Governor Gavin Newsom in late September, AB 852 requires that prescribers meet designated criteria and take specified action at a date to be determined after the law takes effect in January 2023.
The exemption will be available to prescribers who register with the California State Board of Pharmacy and state that they meet one or more of the following: • They issue 100 or fewer prescriptions per calendar year. • Their practice is in the area of an emergency disaster declared by a federal, state, or local government. • They are unable to issue electronic data transmission prescriptions due to circumstances beyond their control.
Prescriber registration with the Board of Pharmacy will be enabled in 2023.
Again, while the law takes effect January 1, the Board of Pharmacy does not expect to have it ready by the first of the year. CPMA is in contact with the board to help make the registration process goes as smoothly as possible and will keep members updated about its availability. The board has confirmed the registration will be online and annual, with email reminders sent to registered prescribers.
Prescribers who wish to be exempted from the electronic prescribing requirement should carefully evaluate and forecast their prescribing numbers to confidently determine whether they will fall below the threshold of 100 or fewer prescriptions per calendar year. Prescribers should do this before they register with the Board of Pharmacy. Until successful registration with the board, and for all prescribers who issue more than 100 prescriptions annually, electronic prescribing for all medications remains the law.
A few other exemptions for the existing e-prescribing requirements already exist, such as due to a temporary service interruption or technological failure.
E-prescriptions submitted via non-compliant software can be declined
The new law also authorizes a pharmacy, pharmacist, or other authorized practitioners to decline to dispense or furnish an electronic prescription submitted via software that fails to meet any one of the specified criteria, including compliance with the federal Health Insurance Portability and Accountability Act of 1996.
While CPMA does not endorse any particular electronic prescribing system, there are a few recommendations for doctors in the market for an e-prescribing platform. First and foremost, if the practice does any prescribing of controlled substances, the system MUST have the ability to do EPCS and query the CURES database. Not all commercially available systems can do both, so practices should ask prospective vendors before investing in a system. And, get it in writing. CPMA suggests that members checkout SureScripts site https://surescripts.com/network-connections/eprescribingprescriber-software. It is the largest electronic prescribing network in the country. Vendors on their certified product list will give doctors and patients the largest number of pharmacies from which to choose.
Another site to checkout is the software review/rating site Capterra, which also offers live chat with software experts https://www.capterra.com/eprescribing-software/
Please note that the listing of Capterra and SureScripts is for informational purposes only and does not denote CPMA endorsement of the sites or products listed on these sites.
HHS EXTENDS COVID PUBLIC HEALTH EMERGENCY TO JANUARY 2023
The Biden Administration extended the COVID-19 public health emergency for an additional 90 days. As the U.S. braces for a spike in cases this winter, the public health emergency (PHE) will continue through at least January 11, 2023.
When a decision is made to terminate the declaration or let it expire, HHS has said the agency will provide 60 days notice prior to termination.
During the COVID-19 pandemic, through California Podiatric Medical Association (CPMA) and other stakeholders’ advocacy, both public and private health plans expanded their coverage and reimbursement for services provided via telehealth. As long as the nation continues to be in a public health emergency, these policies remain in effect.
Congress also recently extended the current COVID-19 pandemic telehealth waivers for five months beyond the end of the public health emergency.
NEW ICD-10 CODE SET EFFECTIVE OCTOBER 1, 2022
Providers must use the “2023 ICD-10-CM” code set for services provided on or after October 1. There are changes to the new code set that impact podiatric medicine and surgery. There are ICD-10 code changes pertinent to social determinants of health, diabetes, alcohol use, noncompliance, and use of immunosuppressive drugs.
New ICD-10-CM Code Set Takes Effect October 1:
• Z79.85 Long-term (current) use of injectable non-insulin antidiabetic drugs • Z59.82 Transportation insecurity • Z59.86 Financial insecurity • Z79.620 Long-term (current) use of immunosuppressive biologic • Z91.190 Patient’s noncompliance with other medical treatments and regimen due to financial hardship
New ICD-10-CM Codes can be found at https://www.cms.gov/medicare/icd-10/2023-icd-10-cm
APMA will host a webinar covering podiatry-relevant coding changes on December 14. Register now at https://tinyurl. com/4jr5vw5n
(Source: APMA 10/17/2022)
PHYSICIANS ARE NOW REQUIRED TO UPDATE PRACTICE DEMOGRAPHIC INFO EVERY 90 DAYS
Since 2016, California health plans and insurers have been required to comply with uniform standards and provide timely updates for their provider directories, as required by SB 137. As part of the requirements, plans/insurers must regularly contact contracting providers to advise them of the information the payor has about them in the directory.
While under state law the interval for these communications had been either every 180 days or annually, depending on the size of the practice, a new federal law took effect in January 2022 that now requires health plans/insurers to verify the accuracy of their contracting providers’ demographic information every 90 days. Providers should have received notification from payors.
Providers who fail to comply with the verification requests risk payment delays and removal from the provider directory. Health plans or insurers may also terminate a contract with a provider for a pattern or repeated failure to update the required information.
In addition to reviewing/updating you practice information at least every 90 days, practices should also note that if the practice is moving, adding or losing providers, changing the practice name and/or TIN, closing a practice or changing specialties, it’s important to inform payors with at least 90 days advance notice to prevent payment issues.
Under SB 137, health plans/insurers operating in California are also required to offer an electronic method to allow providers to verify or submit changes to their directory information.
Major California Insurance Payer sites to check/ change provider demographics:
Anthem Blue Cross https://tinyurl.com/2p8fzeww
United Healthcare https://tinyurl.com/3zmey759 Aetna https://tinyurl.com/45bn6zwu
Cigna https://tinyurl.com/59wpyjpa
Blue Shield https://tinyurl.com/3zmey759
Kaiser – South https://tinyurl.com/bdhkrcsn
Kaiser – North https://tinyurl.com/bdhkrcsn
(Source: CMA 7/5/2022)
DMEPOS ENROLLMENT CONTRACTORS CHANGE
REMINDER; November 6 is the final day the National Supplier Clearinghouse (NSC) will process Medicare enrollment applications for DMEPOS suppliers. Starting November 7, two new contractors will process Medicare enrollment applications for DMEPOS suppliers:
• Novitas Solutions (NPEAST DMEPOS):
Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands • Palmetto GBA (NPE WEST): Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands
For more information, take advantage of APMA’s DME
Resources for members at apma. org/dme.
(Source: APMA 10/17/2022)
CALIFORNIA PAID FAMILY LEAVE GRANTS AVAILABLE TO ELIGIBLE BUSINESSES
Eligible small businesses in California may now apply for grants up to $2,000 per employee utilizing California’s Paid Family Leave program (PFL).
These grants, funded by the California Employment Training Panel and California Labor and Workforce Development Agency, are geared toward helping small businesses offset the increased costs that may arise when an employee is out on leave, such as cross-training existing staff, and hiring and training new and/or temporary employees.
California’s PFL program provides eligible employees with up to eight weeks of wage replacement benefits when the employee is off work for certain qualifying reasons, such as to bond with a new child or to care for a seriously ill family member.
$2,000 and $1,000 Grants are Available
Grants are available in the following amounts:
• Businesses with 51–100 employees may receive up to $1,000 per employee utilizing
Paid Family Leave. • Businesses with one to 50 employees may receive up to $2,000 per employee utilizing Paid Family
Leave.
To qualify, businesses must:
• Employ between one and 100 employees; • Be registered to do business in the State of
California; • Be in an active status with the office of the California Secretary of State; and • Have an active California Employer Account
Number under which employees are listed for payroll
For more information or to apply for a grant, visit CaliforniaPFL.com, including their Frequently Asked Questions. After reviewing the eligibility requirements and collecting the necessary information to apply, it will take businesses approximately 10 to 15 minutes to fill out the online application.
The grant period is June 1, 2022, to May 31, 2024, or until funds run out.
(Source: Calchamber 8/23/2022)
LIDOCAINE SHORTAGE INFORMATION AND RESOURCES
CPMA is aware of the ongoing shortages of lidocaine and the significant impact these shortages have on members’ practices. While the causes of the shortage and potential solutions are complex and multifactorial, CPMA/APMA has compiled the following resources for those members facing lidocaine shortages.
These resources provide information on the drug supply chain and shortage issues. The last listed link,
ASHP Shortage List, is a searchable database. This database provides anticipated release dates for products. Note that the release date is when the product is available to distributors. Where your practice falls within the distributor’s allocation process will determine when you receive the product.
In terms of immediate options, CPMA/
APMA suggests the following: • Establish relationships with multiple distributors
• Consider alternate local anesthetics when medically appropriate
• Look to non-traditional sources such as dental suppliers
• Draw up only the required amount of local anesthesia needed rather than filling the entire syringe when the syringe holds more than what is necessary for the procedure
CPMA will continue monitoring this concern and investigating solutions with policymakers and other impacted stakeholders.
Additional Resources
• FDA Drug Shortages Information Web Page https://tinyurl.com/sxk3kk4u
• FDA Drug Shortages Database https://www.accessdata.fda.gov/scripts/drugshortages/
• ASHP Current Drug Shortages List https://www.ashp.org/drug-shortages/current-shortages ?loginreturnUrl=SSOCheckOnly
PAY SCALE MUST BE INCLUDED IN JOB POSTINGS BY CALIFORNIA EMPLOYERS WITH 15 OR MORE EMPLOYEES
Beginning January 1, 2023, California employers with 15 or more employees will be required to (1) disclose a position’s pay scale in any job posting or advertisement and (2) provide the pay scale to any third party used by the employer to announce, post, publish or otherwise advertise a job. The third party, in turn, will be required to include the pay scale in the job posting. Also under the new law, employers with 15 or more employees are required to provide to an employee, upon the employee’s request, the pay scale for the position in which the employee is currently employed.
Pay scale for positions must be included in all job postings
California employers of all sizes are already required under a state law that took effect in 2019 to provide a position’s pay scale to any applicant applying for that position upon the applicant’s “reasonable request.” As defined by existing law and SB 1162, pay scale means the salary or hourly wage range that the employer reasonably expects to pay for the position.
That requirement will continue, but the requirements of SB 1162 are intended to further ensure that employers do not rely on an applicant’s salary history information when determining whether to offer employment to an applicant or what salary to offer.
Effective January 1, 2023, SB 1162 will require employers with 15 or more employees to:
Disclose a position’s pay scale in any job posting or advertisement.
Provide the pay scale to any third party used by the employer to announce, post, publish, or otherwise advertise a job. The third party, in turn, will be required to include the pay scale in the job posting.
Companies based outside of California and hiring for positions or work to be done in California will be required to disclose pay scales in job postings in compliance with the new law.
The law increases wage transparency for currently employed
Also under the new law, employers with 15 or more employees are required to provide to an employee, upon the employee’s request, the pay scale for the position in which the employee is currently employed. Maintenance of job title, and wage rate history required
Employers of all sizes will be required to maintain job title and wage rate history records for all their employees for the duration of the employment plus three years after the end of the employment.
The Labor Commissioner is authorized to inspect the employer’s records, and the specified time frame allows the Labor Commissioner to determine if a pattern of wage discrepancy exists.
Employers can be ordered to pay a civil penalty between $100 and $10,000 per violation.
An individual can file a written complaint with the Labor Commissioner alleging an employer has violated the pay-scale disclosure requirements within one year of learning about the violation.
The Labor Commissioner is required under the law to “promptly investigate” such complaints and, if a violation is found, can order the employer to pay a civil penalty of between $100 and $10,000 per violation with the exception of a first-time violation if the employer demonstrates that all job postings for open positions have been updated to include the required pay scales.
Individuals themselves can also bring a civil action against the employer for appropriate relief.
(Source: CDA 11/1/2022)
EMPLOYEE FINAL PAYCHECK: FAQS AND ANSWERS
CPMA has received several inquiries from members regarding employees’ final checks. The following is from the California Chamber of Commerce on the issue:
When an employee quits without any notice at all, you have 72 hours to cut a final paycheck and have it ready for them to pick up. If an employee gives less than 72 hours’ notice, you have 72 hours from the time notice is given to have the check ready. The 72 hours runs regardless of business hours. It generally is the responsibility of the employee to return to pick up their check or request that it be mailed.
Some of the most common questions about final paychecks in this situation are:
Where should the check be for the employee to pick up? A final paycheck must be available for them to pick up “at the office of the employer within the county in which the work was performed,” according to California Labor Code Section 202.
So, for example, an employee who works at a Northern California branch of your company could not be required to travel to your Southern California branch where your payroll is done to pick up a final paycheck. You would need to make sure it was available for the employee to pick up at the Northern California branch by the 72-hour deadline.
What if my payroll is done out of state, and I can’t get a check in time? Unfortunately, there is no exception to the 72-hour rule based on where your payroll is done, so if the check is late, you would be subject to waiting time penalties of a day’s wages for every day it is late up to 30 calendar days.
What if an employee doesn’t come to pick up their final paycheck? Often an employee will not return to pick up a check, in which case an employer might wonder if they need to eventually mail it to the employee.
California law is clear that the final paycheck should be mailed to an employee who quits only if the employee specifically requests that it be mailed and also designates a mailing address.
If the employee does not come in to pick up their final paycheck and never requests that it be mailed, should I mail it anyway just to be sure they get their wages?
No. If you drop it in the mail and then the employee comes in to pick up the check before it arrives at the employee’s home, you will be liable for penalties for late wages for every day the employee then has to wait for the check to arrive.
In addition, if you don’t have a current address on file, the check may go to the wrong address and cause even further penalties to accrue.
If an employee requests that I mail the check, does it have to arrive at the employee’s home within 72 hours?
No. The date of the mailing is considered the date of payment for purposes of the requirement to provide payment within 72 hours of the notice of quitting. So as long as the check is mailed on time, there is no legal violation even though it may take several days in the mail to reach the employee’s home.
First-class mail is considered sufficient for mailing, although some employers may choose to use a form of delivery that provides proof of receipt.
What if an employee is working remotely from their home in another county? The law on final paychecks simply says the check must be available at the office of the employer within the county in which the work was performed — and does not address remote workers.
If an employee is working from home in a different county than the one where the employer is located, it’s unclear where the final check would need to be. However, an employer could ask the employee if they would simply like the check mailed to avoid any issues.
What if the employee has given more than 72 hours’ notice, or if we have terminated them or laid them off?
Note that the above mailing rules do not apply when an employee quits with more than 72 hours’ notice, in which case the wages are due on the last day of work. These rules also do not apply when an employee is terminated or laid off, in which case the wages are due at the time and place of termination or layoff.
(Ellen Savage, J.D., HR Adviser, CalChamber 10/11/2022)
BEREAVEMENT LEAVE PROTECTED BY CALIFORNIA LAW BEGINNING JANUARY 2023
California employers with five or more employees will be required beginning Jan. 1 to provide up to five days of protected bereavement leave to employees for the death of a family member, including a domestic partner or extended family member. A second law that takes effect Jan. 1 adds “designated person” to the list of persons an employee is allowed to take unpaid and paid off time to care for, respectively, under the California Family Rights Act and Paid Sick Leave laws.
Amendments to the California Family Rights Act and Healthy Workplaces, Healthy Families Act, expand employees’ leave rights and take effect January 1, 2023.
The changes, brought by two pieces of legislation signed into law in September by Gov. Gavin Newsom, require covered employers to provide protected bereavement leave, and they add “designated person” to the list of persons an employee is allowed to take time off to care for under both CFRA and Paid Sick Leave laws.
Up to five days of bereavement leave protected
Many California employers already provide some form of bereavement leave to employees as a benefit, and some California cities and counties enforce local bereavement laws, but bereavement leave will be defined and protected for all covered employees across the state beginning in January.
Employers with five or more employees will be required by Assembly Bill 1949, which amends the California Family Rights Act, to provide up to five days of bereavement leave to employees for the death of a family member, including a domestic partner or extended family member.
Employees are eligible for the leave if they have been employed for at least 30 days before their leave begins. Employers cannot lawfully refuse to grant a request for bereavement leave by any eligible employee.
Bereavement leave may be unpaid as specified
Specifically, under the new law: • “Family member” means a spouse, child, parent, sibling, grandparent, grandchild, domestic partner, or parent-in-law. • Employees are not required to take bereavement leave on consecutive days. • The leave is considered unpaid unless the employer already has a paid bereavement leave policy in place.
• Employees must complete their leave within three months of the family member’s death. • Employees can elect to use accrued vacation, sick time, or other paid time for the leave but are not required to do so. • Employers can request documentation of the death of the family member, such as a death certificate or published obituary. • Employers must maintain the confidentiality of any employee who requests the leave. Practices may want to create a bereavement policy or should update their existing policy before the law takes effect and communicate the change to employees. • CFRA and Paid Sick Leave can be used to care for
‘designated person’ California employers with five or more employees are already required under CFRA to provide up to 12 weeks of unpaid protected leave to employees who request it to care for a child, parent, parent-in-law, grandparent, grandchild, sibling, spouse or domestic partner with a serious health condition.
Existing state law also requires employers of every size to provide eligible employees working in California a set amount of paid sick leave to all eligible employees for qualified reasons for themselves or a “family member.”
Starting January 1, under Assembly Bill 1041, employees can also take protected CFRA leave and Paid Sick Leave to care for a designated person.
DESIGNATED PERSON DEFINED DIFFERENTLY FOR CFRA, PAID SICK LEAVE
For the purpose of CFRA leave, the law defines designated person as “any individual related by blood or whose association with the employee is the equivalent of a family relationship,” whereas designated person is completely undefined under the Healthy Workplaces, Healthy Families Act for the purpose of Paid Sick Leave.
Because the law does not explicitly define “designated person” practices should avoid defining designated person in their Paid Sick Leave policy. Unless the law further defines designated person, employers should allow the employee to define their designated person when they request their Paid Sick Leave or consult with their legal counsel.
Specifically, the law:
Allows the employee to identify the designated person at the time they request CFRA leave or the Paid Sick Leave days.
Authorizes the employer to limit an employee to one designated person per 12-month period.
The law does not change the amount of allowable leave or other terms of CFRA.
THE LAST DAY TO CHANGE YOUR MEDICARE PARTICIPATION STATUS FOR 2023 IS DECEMBER 31, 2022
It’s that time of year again—time for physicians to decide if they want to make changes to their Medicare participation status https://tinyurl.com/yck7u3kt
Physicians have until December 31,2022 to make changes https://tinyurl.com/4rjp2css for the 2023 participation year. The effective date for any changes made will be January 1, 2023.
In making the decision for the 2023 participation year, clinicians should be aware that the Centers for Medicare and Medicaid Services (CMS) recently released the final rule and policies https://tinyurl.com/2p86njsb for next year. The fee schedule has not been released yet.
As always, physicians have three choices regarding Medicare: Be a participating provider; be a non-participating provider; or opt-out of Medicare entirely. Details on each of the three participations options are as follows:
A participating physician must accept Medicare-allowed charges as payment in full for all Medicare patients. A participating provider receives 5% more reimbursement than a non-participating provider.
A non-participating provider can make assignment decisions on a case-by-case basis and bill patients for more than the Medicare allowance for unassigned claims. Nonparticipating physician fees are 95% of participating physician fees. If you choose not to accept assignment, you can charge the patient 9.25% more than the amounts allowed in the participating physician fee schedule (which equates to 15% of the non-participating fees).
Physicians who opt out of Medicare are bound only by their private contracts with their patients. Medicare’s limiting charges do not apply to these contracts, but Medicare does specify that these contracts contain certain terms. When a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract. As a result of the Medicare Access and CHIP Reauthorization Action of 2015 (MACRA), validated opt-out affidavits signed on or after June 16, 2015, will automatically renew two years after the effective date.
Physicians who want to change their participation status for 2023 must submit a signed Medicare Participating Physician or Supplier Agreement (CMS-460) to Noridian, California’s Medicare contractor, postmarked by December 31, 2022. The participation agreement will automatically renew each year. However, if there is a name or EIN (tax identification number) change, you will need to complete a new participation agreement.
For more information on open enrollment can be found on the Noridian website.
PRESIDENT Holly Spohn-Gross, DPM Lake Isabella, CA 93240
PRESIDENT-ELECT Diane M. Koshimune, DPM San Jose, CA 95119
IMMEDIATE PAST PRESIDENT Diane D. Branks, DPM Pomona, CA 91766
SECRETARY/TREASURER
Phong H. Le, DPM Sacramento, CA 95828
2022/2023 BOARD OF DIRECTORS
DIRECTORS Arman A. Kirakosian, DPM San Francisco, CA 94121
Heather R. McGuire, DPM Ventura, CA 93003
Alan W. Sue, DPM Mountain View, CA 94040
Douglas M. Taylor, DPM Walnut Creek, CA 94596
Ebonie E. Vincent, DPM Long Beach, CA 90813
PARLIAMENTARIAN Ronald D. Jensen, DPM Modesto, CA 95355
EXECUTIVE DIRECTOR Jon A. Hultman, DPM, MBA, CVA 7311 Greenhaven Drive, Suite 208 Sacramento, CA 95831 P: (916) 448-0248/(800) 794-8988
GENERAL COUNSEL C. Keith Greer, Esq. San Diego, CA 92128
GOVERNMENTAL REPRESENTATIVES Ryan Spencer Sacramento, CA 95814
STUDENT REPRESENTATIVES Nida Ahmed (CSPM@SMU)
Harsh Varshney (CPM@WesternU)
2022/2023 CPMA SOCIETY PRESIDENTS
ALAMEDA/CONTRA COSTA
Naleen Prasad, DPM Castro Valley, CA 94546 P: (510) 517-2721
CENTRAL VALLEY
Jack A. Harvey, DPM Modesto, CA 95336 P: (209) 823-2700
COACHELLA VALLEY
Steven L. Ginex, DPM Palm Desert, CA 92260 P: (760) 340-3232
INLAND
Jan Tepper, DPM Upland, CA 91786 P: (909) 920-0884
LOS ANGELES COUNTY
Ara O. Kelekian , DPM Montebello, CA 90640 P: (323) 346-0996
MID-STATE
Richard Motos, DPM Visalia, CA 93292 P: (559) 734-1171
MONTEREY BAY AREA
Bobby Yee, DPM Monterey, CA 93940 yeedoc@sbcglobal.net
N. CALIFORNIA KAISER
Christy King, DPM Oakland, CA 94611 P: (510) 752-6905
ORANGE COUNTY
Thomas Rambacher, DPM Mission Viejo, CA 92692 P: (949) 916-0077
REDWOOD EMPIRE
Rachel A. Hoyal, DPM Santa Rosa, CA 95404 P: (707) 546-2107
SACRAMENTO VALLEY
Eunice Cho, DPM Rocklin, CA 95677 P: (916) 435-5000
SAN DIEGO
Brittany Rice, DPM San Diego, CA 92108 P: (619) 291-0777
SAN FRANCISCO/SAN MATEO Jasper Lee, DPM San Francisco, CA 94123 P: (415) 731-6700 SAN LUIS OBISPO/SANTA BARBARA Faridi G. Sherieff, DPM Lompoc, CA 93436 P: (805) 736-8818 SANTA CLARA VALLEY Kevin Ragothaman, DPM Cupertino, CA 95014 (408) 358-6234 SHASTA REGION Michael L. Wilson, DPM Chico, CA 95928 P: (530) 895-3668 SOUTHERN CALIFORNIA HMO Suzette Lee, DPM Los Angeles, CA 90066 sleedpm@aol.com VENTURA COUNTY Anh Nguyen, DPM Oxnard, CA 93030 P: (805) 983-0222
The California Podiatric Physician is the official publication of the California Podiatric Medical Association. CPMA and the California Podiatric Physician assume no responsibility for the statements, opinions and/ or treatments appearing in the articles under an authors’ name. For editorial or business information and advertising, contact California Podiatric Medical Association, 7311 Greenhaven Drive, Suite 208 Sacramento, CA 95831; Telephone, (916) 448-0248; Facsimile; (916) 448-0258; E-mail; cpma@calpma.org.
