PRACTICE MANAGEMENT

December 14, 2022: 11:00AM to 1:00PM “Medicare Changes 2023 and Beyond”

This presentation will provide your practice with an overview of the policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective for Calendar Year 2023 and beyond.

Join us as we discuss:

• Telehealth Services • Updates to Other Evaluation and Management (E/M) Visits • Behavioral Health Services • CY 2023 Quality Payment Program • Noridian Compliance • Other Medicare Part B issues

You will walk away with the resources to help you maneuver regulatory and procedural challenges that impact your practice.

Target Audience: Physicians, billers, office managers/practice administrators

Presenter: Cheryl Bradley, Associate Director, CMA Center for Economic Services

Chery has over 25 years’ experience in the Medicare Program and has held a variety of responsibilities including Education and Training Specialist, Medical Review Analyst, and has worked with providers in virtually all specialties across all the CA Medicare contractors. Cheryl is a credentialed instructor known for speaking at conferences, state associations, and for numerous organizations. She provides problem solving assistance to CMA member physicians on a number of healthcare issues. She is skillful at using humor to help providers navigate this difficult program.

March 8, 2023: 11:00AM to 1:00PM “2023 Employment Law Updates”

Jamie Bossuat, a shareholder and employment

lawyer at Kroloff will present an update on the most pressing issues in employment law and will offer practical suggestions for reducing liability. Issues will include recent changes in wage and hour requirements, updates to leave of absence laws, and current litigation trends.

CMA PRACTICE RESOURCES

LAST DAY TO CHANGE YOUR MEDICARE PARTICIPATION STATUS FOR 2023 IS DECEMBER 31

UHC delays Designated Diagnostic Provider program in CA until Jan. 1, 2022

It’s that time of year again—time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31,2022 to make changes 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, physicians should be aware that the Centers for Medicare and Medicaid Services (CMS) recently released the final rule and policies 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 nonparticipating provider; or opt out of Medicare entirely. Details on each of the three participations options are as follows:

A participating physician must accept Medicareallowed 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. Non-participating 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.

There is also information on physicians’ Medicare participation options in the California health-law-library. Nonmembers can purchase documents for $2 per page.

MEDI-CAL RADS WILL NO LONGER BE MAILED DUE TO SUPPLY CHAIN ISSUES

Recently, the California Department of Health Care Services (DHCS) announced that Medi-Cal will no longer mail Remittance Advice Details (RADs), Electronic Fund Transfer (EFT) statements or No Pay documents. According to DHCS, this change was necessitated due to supply chain issues. However, DHCS has clarified that it will continue printing documents until its supply is exhausted.

Providers who have not yet transitioned to PDF RADs (which includes the embedded financial summary information) are strongly encouraged to do so at this time. To sign up for PDF RADs:

Log in to your Medi-Cal account on the Medi-Cal Providers website under the Transactions tab.

Click on the “Other” tab

Click on the “Remittance Advice Detail (RAD)” link

Once enrolled, the PDF RAD and Medi-Cal Financial Summary are accessible on under the Transaction Services page. To access the transaction, providers must have a signed Medi-Cal Point of Service Network/Internet Agreement form on file. For any questions regarding PDF RAD access, contact the Medi-Cal Telephone Service Center at (800) 5415555.

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PROVIDERS

PROVIDERS Dominic Pennisi, M.D., Internal Medicine PROVIDERS Dominic Pennisi, M.D., Internal Medicine Dominic Pennisi, M.D., Internal Medicine Guido Abellera, M.D. Humayun Popal, NP Guido Abellera, M.D.Guido Abellera, M.D. Humayun Popal, NPHumayun Popal, NP

Teresa Magana, FNP Teresa Magana, FNPTeresa Magana, FNP

Stockton

Stockton 1503 E. March Lane, Suite A Stockton 1503 E. March Lane, Suite A Phone: (209) 446-4455 1503 E. March Lane, Suite A Phone: (209) 446-4455 Phone: (209) 446-4455

Stockton

Stockton 123 S. Commerce Street, Suite D Stockton 123 S. Commerce Street, Suite D Phone: (209) 467-6825 123 S. Commerce Street, Suite D Phone: (209) 467-6825 Phone: (209) 467-6825

Lodi

Lodi 835 S. Fairmont Avenue Lodi 835 S. Fairmont Avenue Phone: (209) 365-9331 835 S. Fairmont Avenue Phone: (209) 365-9331 Phone: (209) 365-9331