UnitedHealth to Adjust COVID Vaccine Underpayment

UnitedHealthcare will reprocess claims for COVID vaccine administration after federal investigators found the insurer had underpaid millions of providers, paying 40% less than the Medicare rate. It was the only national payor that had not agreed to pay at least $40 for vaccine administration and it has also underpaid physicians for COVID testing kits. Providers do not need to take any action for the adjustments to be processed. In California, SB 510, sponsored by the California Medical Association, will ensure that all residents are able to receive vaccination and testing. The law takes effect January 1, but is retroactive to March 4, 2020, when a public health emergency was declared.

Highlights from the AMA 2021 Telehealth Immersion Program

 

The AMA will host a Telehealth Immersion Program mini-boot camp from 2-4 pm on December 7 that will provide participants with a recap of the 2021 Telehealth Immersion Program, highlight physician and practice wins, and provide an overview of the telehealth landscape for the future, including key policy changes for 2022. Click here to register. 

Congress passed the No Surprises Act last December to shield patients from massive, unexpected bills when they get treatment from hospitals or doctors outside their insurance company’s network. Long, hard-fought negotiations with providers and insurers finally yielded an agreement that lawmakers from both parties thought was fair: a 30-day negotiation period that would be followed by arbitration when agreements cannot be reached. But now many doctors, their medical associations, and members of Congress are arguing the rule released by the Biden administration in September for implementing the law favors insurers and doesn’t follow the spirit of the legislation.

The effective date for any changes made will be January 1, 2022. In making decision for the 2022 participation year, physicians should be aware that the Centers for Medicare and Medicaid Services (CMS) recently released the final fee schedule and policies for next year. As always, physicians have three choices regarding Medicare: Be a participating provider; be a non-participating provider; or opt out of Medicare entirely.

 

The policies in the rule are scheduled to take effect on January 1, 2022 and cover diverse topics, including the 2022 reimbursement rates and Medicare conversion factor, telehealth and other services involving communications technology, and updates to the Quality Payment Program (QPP) through Merit-based Incentive Payment System (MIPS) activities, methodology, and payment adjustments, amongst other provisions. 

Are You Ready for California’s Electronic Prescribing Mandate?

 

Beginning on January 1, almost all prescriptions written in California must be transmitted electronically. The electronic prescribing mandate was contained in a law passed by the California State Legislature in 2018. The law is partially based on the Medicare electronic prescribing for controlled substances requirement, which is also set to take effect on January 1. The state mandate applies to almost all prescriptions, not only those for controlled substances.

Dues Discount Ends December 15 

ACCMA members who renew their 2022 membership by December 15 qualify for a 5% discount on their dues. Click here to pay your dues online. Nonmembers who join now and pay in full for 2022 will receive the remaining months of this year for free. Click here to join now!

Congressional Doctors Lead Bipartisan Revolt Over Policy on Surprise Medical Bills, Kaiser Health News, 11/17/21

Why Health-Care Workers Are Quitting in Droves, The Atlantic, 11/16/21

Pfizer Will Allow Its Covid Pill to be Made and Sold Cheaply in Poor Countries, The New York Times, 11/16/21

Millions of Helpline Calls Reveal How COVID Affected Mental Health, Nature, 11/17/21 

New Staff Onboarding Series

Now available! Current and new staff can receive on-demand training on HIPAA, OSHA, and customer service. Intended for all staff encountering patients in person or by telephone, this course covers customer service techniques, the Occupational Safety and Health Act (OSHA), and the Health Insurance Portability and Accountability Act (HIPAA). For questions, contact Jenn Mullins, Education and Event Associate, at jmullins@accma.org.

Click here to register. 

The California Medical Association's (CMA) wellness program (CMA Wellness) is pleased to launch free, online wellness engagement groups for health care providers who conduct patient screenings for adverse childhood experiences (ACEs). Treating patients with multiple ACEs or toxic stress can potentially impact your personal wellness and increase feelings of burnout. CMA Wellness's engagement groups will support providers by offering subject matter experts, best practices, and an open forum to share experiences, facilitated by trained, volunteer physicians. Each monthly webinar is organized around a prevailing theme with a stakeholder co-host to provide a variety of perspectives with a general discussion and breakout rooms. Registration is required, and providers will be joining the Tuesday series for a 6‑month duration.

For more information and to register, click here.

Virtual Grand Rounds: COVID-19 and the Holidays

Register here.

AMA 2021 Telehealth Immersion Program: What’s Next for Telehealth?

Tuesday, December 7, 2021 | 2:00 – 4:00 PM

FREE | Presented by the American Medical Association

 

This interactive session will provide participants with a recap of the 2021 Telehealth Immersion Program, highlight physician and practice wins, and provide an overview of the telehealth landscape for the future, including key policy changes for 2022.

 

Register here.