California Chapter Cardiology News

California Students To Become Lifesavers Under New Law Signed By Governor Brown



[September 26, 2016]California is poised to create a new generation of lifesavers thanks to Assembly Bill 1719 by Assemblymember Freddie Rodriguez (D-Pomona). Today Governor Jerry Brown signed the legislation that will require high school districts to include CPR instruction in health education classes required for graduation.

   According to the American Heart Association, nearly 326,000 people experience cardiac arrest outside the hospital each year, and sadly, only 10 percent survive. Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival.


Read Article


Dr. Myrvin H. Ellestad | August 17, 1921—September 14, 2016



[September 26, 2016] It is with deep sadness that Long Beach Memorial shares the loss of a beloved colleague.

Memorial Service
Wednesday, October 26, 2016 at 1 PM
Houssels Forum  |  Long Beach Memorial Medical Center

Dr. Myrvin H. Ellestad was a global pioneer in the practice of cardiology. He began working at Long Beach Memorial in May 1950 and was one of the original physicians from Seaside Hospital. Dr. Ellestad is widely recognized as the co-inventor of maximal treadmill exercise testing. His textbook, Stress Testing: Principles & Practice defined the field. Even at 95 years of age, Dr. Ellestad was actively involved in the completion of its 6th edition. His vision and indefatigable enthusiasm spearheaded the establishment of the Memorial Care Heart & Vascular Institute at Long Beach Memorial. Dr. Ellestad leaves behind an amazing legacy and will be greatly missed by all. He is survived by his wife, Lera, eight children, and six grandchildren.

For those who would like to honor Dr. Ellestad and his legacy, the Ellestad family requests that in lieu of flowers, donations may be directed to the Memorial Medical Center Foundation to support MHVI programs at Long Beach Memorial. Donations may be made by check to: Memorial Medical Center Foundation. Please note “Ellestad Memorial” on the memo line. Online donations may be made at:
https://www.Memorialcare.org/mmcf
Please contact Rev. Sheryl Faulk, 562-933-1452, for questions or needs.

Read More
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MACRA: A New Era of Medicare Payment



[September 9, 2016] The Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA, replaces an outdated Medicare payment system, setting into motion two pathways in which clinicians will participate in order to receive Medicare payment: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. While the details of MACRA are still being ironed out, it’s important to understand this new era of Medicare payment and the four core components that clinicians will be measured on: quality, resource use, clinical practice improvement and meaningful use of certified electronic health records. To help members navigate MACRA and prepare for the release of the final rule this fall, the ACC has launched a series of articles and resources available through the MACRA Information Hub on ACC.org. Be sure to review this list of frequently answered questions to get up-to- speed on how MACRA will impact you and your practice.
Read more on ACC.org


Help ACC Complete RUC Surveys

[March 23, 2016] Surveys related to the physician work to perform transthoracic echocardiography will be distributed to members in the next few days. If you are randomly selected and receive a survey, please take 15 - 30 minutes to thoughtfully complete it. Annual updates to the physician work relative values are based on recommendations from the Relative Value Scale Update Committee (RUC).

The RUC is an expert panel of the American Medical Association and specialty societies charged with developing relative value recommendations to Medicare. A key part of the RUC process is the completion of relative value surveys. Data from these surveys are used to establish the physician work that determines Medicare payment. Please contact James Vavricek at jvavricek@acc.org with any questions.

Read AMA Article


"The Passing of Supreme Court Justice Antonin Scalia during American Heart Month"

[February 14, 2016] PFrom Norman E. Lepor MD FACC, President, California Chapter of the American College of Cardiology.

"The unfortunate passing of Supreme Court Justice Antonin Scalia during American Heart Month is an unfortunate reminder that heart disease remains a major public health problem here in the United States and the industrialized world. His passing is also a reminder that one of the common manifestations of heart disease, sudden death occurs with no preceding symptoms. In the case of Justice Antonin, reports suggest that he had been enjoying a hunting trip and retired to bed feeling fine. Unfortunately, he died in his sleep. It is possible that his passing could have been prevented... "

Read Press Release


Hardship Exemption for MU 2015

[December 27, 2015] Because of a delay in the publication of regulations governing the Medicare meaningful use program, physicians are being urged to preemptively file for a 2015 hardship exemption to avoid penalties in 2016.

Physicians should apply for an exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. Doing so will not preclude physicians from receiving an incentive if they do meet meaningful use requirements, but applying can serve as a safety net in staving off a penalty.

In order to avoid a penalty under the meaningful use program, eligible professionals must attest that they met the requirements for meaningful use stage 2 for a period of 90 consecutive days during calendar year 2015. Unfortunately, however, the Centers for Medicare and Medicaid Services (CMS) did not publish the updated regulations for stage 2 meaningful use until October 16, 2015. As a result, eligible professionals were not informed of the revised program requirements until fewer than the 90 required days remained in the calendar year.

CMS has stated that it will grant hardship exemptions for 2015 if eligible providers are unable to attest due to the late publishing of the rule. However, under current law, CMS can only grant such exemptions on a case-by-case basis. This means that many eligible professions will be required to apply for exemptions and that CMS will have to act on each application individually. CMS has approved over 85 percent of hardship exemptions in the past.

Hardship applications will be available in early 2016 at http://www.cms.gov/EHRIncentivePrograms
.
For more information on the electronic health record (EHR) incentive program, see the CMS tipsheet.

 View "EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2015"


"Hospital To Home": CA ACC Qualiy Committee Goals to Help

[November 19, 2015] ACC California Chapter Case Report: The CA ACC Quality Committee’s goal to help our members improve the transition of their patients from the hospital to the community.

Authors: Pranav M. Patel, Sandeep Krishnan, Ajit Raisinghani, Amit Bahia, Jin Kim, Norman Lepor and the CA ACC Quality Committee members.

Chief Complaint: "Re-admitted to the hospital with HF and AMI"
I am sure that the majority of our members are aware of the quality measures and patient care readmission initiatives that occur in our hospitals. However, most of may not know the history and rationale behind these efforts and how the CA ACC can help to improve the quality core measures for the management of patients with acute myocardial infarction (AMI) and heart failure (HF) leading to improved patient outcomes.

 View the Full Report


California Prescription Drug Monitoring Program (PDMP): Mandatory CURES Registration Moved to July 2016

[November 10, 2015] You may be aware of the requirement for all physicians to register for CURES.

Legislation at the end of the legislative year changed to deadline for physicians to register for CURES July 1, 2016. The deadline was moved due to the Department of Justice trying to complete an automated application process which is not currently in place.

See below for information directly from the Department of Justice website regarding CURES.
 View Department of Justice website PDMP Registration


SGR is Repealed! Now What? Understanding MACRA

[November 3, 2015] View the special webinar for leadership focused on SGR.
 

EHR State of Mind Viral Video



[October 2015] EHR's suck. Let's make 'em better. Go to http://LetDoctorsBeDoctors.com and tell the IT and government folks what's up. And check out http://zdoggmd.com for lyrics, behind-the-scenes dopeness, and all our other videos. Please share.
View @ YouTube CA ACC YouTube

Boehringer Ingelheim Grant for Cardiology, Thrombosis and Stroke

[October 13, 2015] We have a posting on Trialect at www.trialect.com soliciting applications for Boehringer Ingelheim Grant sponsored by Boehringer Ingelheim, Germany. The following fields will be considered for this Grant Programme:

- Thromboembolic Disease (general)
- Atrial Fibrillation
- Stroke
- Deep Vein Thrombosis/Pulmonary Embolism
- Percutaneous Coronary Intervention
- Coronary Artery Disease and/or Peripheral Artery Disease

The programme offers four research grants to the maximum amount of €400 000 each that will be awarded in December 2015 for research projects running no longer than 18 months. Application deadline: 1 November 2015; Applications are encouraged from investigators worldwide. Please do not hesitate to refer your colleagues or fellows to apply for this grant. The details can be perused at Boehringer Ingelheim Grant.

Mended Hearts In The News During Atrial Fibrillation Awareness Month

[September 14, 2015] The risk of an AFib-related stroke can change over time. Billie Jean King, 39-Time Grand Slam Tennis Champion, spoke about what people can do to help protect themselves.

Read more at MyAFibRisk.com
View Good Morning America Video Mended Hearts mention @ 2:57
Listen to HuffPost Live Audio Mended Hearts mention @ 24:12
Listen to Bloomberg Radio Mended Hearts mention @ 4:23

ABIM Eliminates Double Jeopardy MOC Requirement

[July 3, 2015] In response to input provided by the ACC and other cardiology specialty societies (SCAI, HRS and HFSA) around the American Board of Internal Medicine’s (ABIM’s) new requirements for Maintenance of Certification (MOC), the ABIM today announced it is eliminating the requirement to maintain underlying certification in a foundational discipline in order to remain certified in a subspecialty. The ABIM Council unanimously passed the proposal to eliminate this “double jeopardy” provision, noting it was clearly an important topic to the internal medicine community. According to the ABIM, it will begin implementing the new requirement in the coming months, with the change to be fully effective as of Jan. 1, 2016. The change does not affect the requirement for initial certification. This announcement reflects the engagement and collaboration of ACC leaders, as well as the broader internal medicine community, on behalf of their members over the past year and a half. Eliminating the double jeopardy faced by interventional, electrophysiology, adult congenital heart disease and advanced heart failure colleagues who initially had to pass both the general cardiology and sub-subspecialty boards is among the several changes strongly recommended by the College and the broader internal medicine community.

More Info on the change and ACC’s ongoing efforts around MOC.

CMA works with DOJ to identify short-term solution to CURES upgrade problem

[June 24, 2015] In response to concerns raised by the California Medical Association (CMA), the Department of Justice (DOJ) has agreed to a short-term solution to prevent thousands of Controlled Substance Utilization Review and Evaluation System (CURES) prescribers and dispensers from losing access when the new system is launched on June 30. DOJ has committed to keeping the current version of CURES accessible for users who cannot access the new version because of browser compatibility issues. Without intervention, there would have been immediate and greatly reduced access to this valuable public health tool upon implementation of the new version.

Based on communications with DOJ, CMA has produced a summary of what CURES users should know about the launch of the new system, including updates on access and registration changes

More Info: Click to read the summary

Login for CURES (will be redirected to CURES 2.0

CHPI Review and Corrections Process


[April 28, 2015] The California Healthcare Performance Information System (CHPI) will publish healthcare quality measures for over 15,000 California physicians in July, 2015.
   
Quality information about individual physicians and physician practices will be included in this release to the public.

The CHPI team is getting ready to provide those physicians who are included in the public reporting an opportunity to preview their quality measures and the underlying data, and to submit corrections as necessary.

CHPI has established a Provider Review and Corrections web portal for this purpose. CHPI will mail unique login information, instructions for accessing the Provider Review and Corrections portal, and a paper copy of what will be displayed on the reporting website to all physicians who will be included in public reporting.

View What Your Letter Will Look Like
View Methodolgy CHPI Used
View Review Process Guidelines

Expert Journal Club Faculty Discussion of PROMISE Trial Now Available Online

[April 16, 2015] The March ACC Journal Club recorded discussion is now available online. Click here to view slides and hear experts Harlan Krumholz, MD, SM, FACC; Dipti Itchhaporia, MD, FACC; and Robert Harrington, MD, FACC discuss “Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease,” published in N Engl J Med. Visit http://www.ACC.org/ACCJournalClub, where you can access a link to the article online, learn more about the program, and access a past collection of Journal Club recordings and articles.

Also, take the Journal Club 2014 activity to earn 2 AMA PRA Category 1 CME Credits™ per month and up to 10 MOCII points! The activity includes links to past recordings and articles, as well as three multiple choice questions per session. This activity includes materials covering PARADIGM-HF, HPS2-THRIVE, INVEST, and more. Start the activity here: http://www.ACC.org/ACCJournalClub

Login to ACC to view slides and hear experts!

William Shatner Takes Stock of a Life Well Lived

[March 5, 2015] William Shatner owes his good health and being able to enjoy his active life to taking care of himself, regular exercise, healthy diet and having good genes inherited from his parents - and taking advice from good physicians, including his cardiologist. Cardiovascular disease is the number one killer in the United States. William Shatner shares that his cardiologist is an F.A.C.C., a Fellow of the American College of Cardiology. The F.A.C.C. is an honor achieved by completing advanced cardiovascular training.


William Shatner owes his good health and being able to enjoy his active life to taking advice from good physicians, including his cardiologist.  
View @ YouTube CA ACC YouTube
 

ABIM Announces Big Changes to MOC Process

[February 4, 2015] Richard J. Baron, MD, president and CEO of the American Board of Internal Medicine (ABIM), was released today to the internal medicine community outlines changes to its controversial Maintenance of Certification (MOC) program. In conversations with ACC leadership, Dr. Baron has expressed gratitude for the ACC’s support as well as its frank and constructive criticism during the past year of transition.

ACC’s Blog features a response from ACC President Patrick O’Gara, MD, FACC:
http://blog.acc.org/post/abim-announces-big-changes-moc-process/


Dr. Michael J. Davidson, Son of CA ACC Board Member Dr. Robert M. Davidson, Passes Away

[January 26, 2015] Our ACC California Chapter board member Dr. Robert M. Davidson and his wife lost their son in a tragic shooting at the Brigham and Women's Hospital in Boston, Massachusetts.

Dr. Michael J. Davidson, a cardiologist like his father and director of Endovascular Cardiac Surgery, was tragically killed on January 20, 2015 after sustaining gunshot wounds at the Shapiro Cardiovascular Center. His fatheer,Dr. Robert M. Davidson, a well-known cardiologist at Cedars-Sinai Medical Center in Los Angeles and our chapters board member, spoke at his sons memorial.

Read full news story of the Davidson memorial
Visit Davidson Memorial website

Davidson, 44, lived in Wellesley with his wife, Dr. Terri Halperin, a plastic surgeon in Brookline. They have three children, Kate, 9, Liv, 7, and Graham, 2. Halperin is seven months pregnant with their fourth child. A memorial fund has been established for his children. If you wish to donate, please visit
The Davidson Family Memorial Fund.


New Boss in Town: Cardiologist Rita Ng has a Baby

[November 16, 2014] Congrats to CA ACC member, former Board of Directors member, and Miss California Rita Ng and her husband Lieutenant Commander Carson Taylor Lawall, a Navy Neurologist and fellow graduate of UCSF School of Medicine. on the birth of their first child. Ng has been a Cardiologist for the past decade and currently works in the Cardiology Department at Kaiser Permanente in Richmond, CA. Their new baby is Logan Yusun Lawall-Ng, born November 2, 2014 at 3:14 AM, weighing 8 pounds, 5 ounces, measuring 20.8 inches.
Rita Ng

Dr. Houshang KarimiDr. Houshang Karimi Passes Away

[November 5, 2014] One of our ACC California Chapter members, Dr. Houshang Karimi, unexpectedly passed away recently. Dr. Karimi practiced in Riverside at the Riverside Medical Clinic, specializing in Cardiovascular Disease. Dr. Karimi graduated from the University of California, Irvine School of Medicine in 2001. He was an Associate Fellow of the ACC.

Dr. Karimi leaves behind a widow, Cynthia, and two children, Sabrina and Darius. A college fund has been established for his children. If you wish to donate, please visit
Houshang Karimi Memorial Fund for Kids College.

Journal Club 2014: Webinars and CME's

[September 17, 2014] ACC’s newest educational program, ACC Journal Club, offers opportunities to challenge emerging science, critique applicability to practice, consider practical point-of care solutions and cultivate future research opportunities that collective lead to improved cardiovascular health.

Start the Journal Club activity to earn 2 AMA PRA Category 1 CME Credits™ per month and up to 10 MOCII points by the end of the year. The activity includes links to past webinars and articles, as well as three multiple choice questions per session. ACC Journal club meets virtually evey third Wednesday at 5:00 PM PST. You can listen to all recorded sessions any time you wish and still receive MOC Credit!
Start your Journal Club 2014 Program Now

Petition on Allied Health Professional Issues in California

[September 10, 2014] CA ACC supports team-based care in all aspects of our patient care. Please review and consider signing SICP’s petition protesting the California State regulatory bodies which limit what CV techs can do in cath labs.
http://www.thepetitionsite.com/takeaction/864/279/437/

Radiation issues are specifically addressed in board exams for interventional cardiologists, radiation physicians and safety. See http://www.abim.org/pdf/blueprint/icard_moc.pdf

Arthur Hollman, MD, FRCP, FLS, Passes Away August, 2014: "We will miss our mentor from across the pond."

[August 20, 2014] Dr Arthur Hollman, the archivist and historian for the British Cardiovascular Society (BCS) and honorary member of the California Chapter of the American College of Cardiology (CAACC), passed away in August 2014.

In a tribute by John Gordon Harold, MD, MACC, MACP, FRCPI, FCCP, FAHA Immediate Past President American College of Cardiology , Dr. Harold wrote, in part:

"Dr. Hollman played a pivotal role in the evolution of the Twinning relationship which I developed between the British Cardiovascular Society and the California Chapter of the American College of Cardiology. In recognition of his efforts, Dr. Hollman was made an honorary member of the California ACC Chapter in 2013 (see plaque). The signing ceremony to commemorate the Twinning of the British Cardiovascular Society with the California Chapter of the American College Cardiology took place in 2009. This marked the first twinning of an ACC chapter with an international cardiovascular Society. Twinning programs allow ACC state chapters to collaborate on opportunities to improve overall heart health and cardiovascular care around the world. The BCS-CAACC program has facilitated the development of long-term relationships between cardiovascular professionals in the United States and the United Kingdom."

He continued: "Dr. Hollman was an icon in the British Cardiovascular Society and became a strategic partner in the evolution of the CAACC twinning relationship. We will miss our mentor from across the pond." Read full tribute to Dr. Arthur Hollman

Summer 2013: British Cardiovascular Society Archivist Dr. Arthur Hollman, M.D., FRCP, FLS, was awarded Honorary membership into the California Chapter at the 2013 Meeting of the British Cardiovascular Society, London, England. L to R: Dr. Arthur Hollman, Dr. Dipti Itchhaporia and Dr. John Harold.

ACC International Exchange for Early Career Cardiologists

[July 27, 2014] In an effort to facilitate international exchange for Cardiovascular Professionals, the Early Career Professional Council (ECPC) has developed an on-line resource for those interested in pursuing opportunities abroad. This tool is meant for use throughout the college and is a member benefit for all.
Read More on our Early Career page
ACC California Chapter

Dr. George Lafayette Smith, Jr., MD Passes Away April 15, 2014; Memorial Set for June 7

George Lafayette Smith, Jr., MD[May 4, 2014]
Dr. George Lafayette Smith, Jr., 71, died Tuesday at his home in Oakmont, CA, from apparent heart complications. Dr. Smith was the Northern California Governor of the American College of Cardiology. He was also member of the Board of Directors of the California Chapter of the ACC, and served as chair of the Cardio Political Action Committee as well as on the Nominations and Voluntary PCI Compliance committees.

Friends are invited to attend a Celebration of George’s life on Saturday, June 7, 2014 at 11:00 A.M. at the Sonoma Country Day School, 4400 Day School Place, Santa Rosa, CA.

Dr. Smith was a legendary physician, a soft spoken Southern gentleman, and a loving father and grandfather who always took time for his family, friends, and patients, no matter how many hours he had been working. He was the type of friend for whom everyone longs. He loved people and took the time to cultivate long-lasting friendships. He was an Epicurean, an historian, a teacher, a philosopher, and so much more. He was a voracious reader, with an encyclopedic memory. He had impeccable taste for food, wine, and all things cultural. He was a true Renaissance man with a flair for the exotic, and his barbecued chicken was the stuff of legend. He was an excited student of life, absorbing as much as he could at all times. There were never enough hours in the day for George. He was a lifelong runner, a hiker, a skier, and a golfer. He and his wife, Nancy Doyle, were active supporters of United Way, Sonoma Country Day School, Santa Rosa Symphony, the Green Music Center, San Francisco Opera, and the Hoover Institution of Stanford. They co-founded John Ash & Co. in 1981, helping put Sonoma County on the culinary world map. George loved the diversity of people and conversations that food and wine brought together.

George attended medical school at University of Tennessee and did his residency at the University of Colorado before going to Vietnam in 1971, where he served as Chief of Medicine at the 95th Evac Hospital in Danang, RVN. In 1972 he moved to San Francisco, where he did his cardiology fellowship at Presbyterian Hospital. In 1975, he moved to Sonoma County. He practiced cardiology until his retirement from clinical work in 2011. He then devoted more time to his interests in health care policy and reform. He was involved at Sutter Medical Center, Santa Rosa Memorial Hospital and nationally. As the Northern California Governor of the American College of Cardiology, he published and lectured nationally on these issues.

He was a member of the Hoover Institution’s Board of Overseers, which gave him opportunities to share ideas and various topics of economics, foreign affairs and national politics. He could hold his own with experts in most fields.

He is survived by his best friend of 45 years, Nancy Doyle, daughter Megan Smith, son Matthew Smith and his wife Carrie; grandchildren Daxton and Dahlia Girvin-Smith; sisters Lolly Stuart and Rachel O’Neill, and brother Thomas Smith, M.D.

In lieu of flowers, donations in his memory may be made to the Santa Rosa Symphony, 50 Santa Rosa Avenue, Ste.410, Santa Rosa, CA 95404.
Daniels Chapel of the Roses
Funeral Home and Crematory
525-3730
> The Press Democrat article about Dr. Smith
> More Photos of George Smith in our Gallery
ACC California Chapter

Free ACC On-Demand Webinars Whenever You Want

[April 29, 2014]
ACC has archived all of the webinars they’ve conducted over the years. To access an archived webinar, register using your ACC login or any other contact information. You will receive an email with your confirmation code and webinar access link.
> Search On-Demand Webinars
> On-Demand Webinar Index

CMS to Release Physician-Level Medicare Data

[April 10, 2014]
The Centers for Medicare and Medicaid Services (CMS) has announced the unprecedented release of data on the health care services delivered by individual physicians in 2012 and how much Medicare paid for these services. Starting April 9 or later, Medicare Part B Fee-For-Service data will be released on more than 880,000 health care professionals across all 50 states and will include 6,000 types of services and procedures.

While the ACC supports transparency as a tool that can improve the health care system, the College is disappointed and troubled that CMS has chosen to release granular physician payment data without the opportunity for review to ensure accuracy. Disclosure of physician payment data without risk adjustment or context will be easily misinterpreted, especially given an incomplete understanding of the cumbersome Medicare billing system. Not to mention, without context, the data will have zero impact on patient safety or efforts to reduce fraud and abuse.

The CMS announcement underscores the importance of physicians having meaningful conversations with patients about their conditions to ensure they are receiving the right test or procedure at the right time. The ACC is dedicated to ensuring appropriate patient care and the College had developed numerous member resources. ACC’s appropriate use criteria help inform individual patient care decisions, evaluate patterns of care by physicians over time, and serve as a framework for assessing appropriateness of care. The ACC’s registries are also important tools for identifying gaps in care and tracking improvement. Additionally, the ACC’s CardioSmart program delivers a network of tools and resources that empower patients to be engaged in their care decisions and enable a more effective clinician/patient dialogue.

CA ACC Member Featured on Cover of "Cardiovascular Business" March/April 2014 Issue

Raymond S. Yen, MD, of Foothill Cardiology
[March 26, 2014]
Raymond S. Yen, MD, of Foothill Cardiology/California Heart Medical Group in Southern California, listens intently during the 2013 American College of Cardiology Legislative Conference. Yen is featured on the cover of the "Cardiovascular Business" journal on the feature story "Physicians as Advocates: On Call in D.C.".
> Read Full Article
> Read Digital Edition of Issue

Federal Budget Overview of Select Health Provisions for 2015

[March 7, 2014]
On March 4, 2014, President Obama released his FY 2015 budget proposal to Congress. This is the base budget proposal that Congress will consider as it develops the federal budget for FY 2015. The President’s budget assumes enactment of certain legislative proposals that would make key changes in Medicare program policy and save $407 billion over 10 years. Some of these provisions could be addressed when Congress considers Medicare payment reform.
> Read Full Article

Expanding Medicare coverage for Cardiac Rehabilitation

[February 19, 2014] From CMS: Centers for Medicare & Medicaid Services.
CMS announced yesterday that Medicare coverage for cardiac rehabilitation will be expanded to include patients with chronic, stable heart failure. You can read more on the CMS website. CMS will provide more guidance in the coming weeks.
> Decision Memo for Cardiac Rehabilitation (CR) Programs - Chronic Heart Failure

Surviving the first month of Covered California: A tip sheet for physicians

[January 27, 2014] From the California Medical Association.
On January 1, 2014, California's health benefit exchange, Covered California, began providing health coverage to more 400,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect.
To that end, the California Medical Association has published a tip sheet, "Surviving the First Month of Covered California." The tip sheet is available free to members in CMA's online resource library.
> "Surviving the First Month of Covered California"

Noridian Medicare Jurisdiction E Part B Update

[January 5, 2014]
Ordering and Referring Denial Edits Will Be Implemented on January 6, 2014
PECOS – N264/N265 Denials
Are currently receiving the following error messages on your Remittance Advices (RAs)? Effective January 6, 2014, claims missing necessary referring/ordering physician information will be denied.

- N264 – Missing/incomplete/invalid ordering provider name
- N265 – Missing/incomplete/invalid ordering provider primary identifier

CMS will instruct contractors to turn on Phase 2 denial edits on January 6, 2014. These edits will check the following claims for a valid individual National Provider Identifier (NPI) and deny the claim when this information is invalid:
- Claims from clinical laboratories for ordered tests;
- Claims from imaging centers for ordered imaging procedures;
- Claims from suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for ordered DMEPOS; and
- Claims from Part A Home Health Agencies (HHAs).

For more information:
- MLN Matters Article SE1305, Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims (Change Requests 6417, 6421, 6696, and 6856)

Source: LEARNRESOURCE-L Email Update, National Institutes of Health, U.S. Department of Health and Human Services dated November 6, 2013

Ordering Referring Report: Suppliers may access the file maintained by CMS that contains the NPIs and the names of physicians and non-physician practitioners who have current enrollment records in PECOS and are of a type/specialty that is eligible to order and refer.

Claim Submission
- Ensure the physicians and non-physician practitioners on accepted orders and referrals have current Medicare enrollment records and are of a type/specialty that is eligible to order or refer in the Medicare program: Link
- Correctly spell the ordering/referring provider’s name.
- Do not use nicknames on the claim.
- Do not enter credentials
- Item 17 on Paper Claims: Enter the ordering/referring provider's name in the following order:
- First Name, Last Name (e.g., John Smith)
- Electronic Claims: The qualifier in the electronic claim, 2310A NM102 loop is a 1.
- Enter the individual NPI and ordering/referring provider name, not the organization.

Claim Processing
If the ordering/referring provider:
- Is not on the claim, the claim will not be paid.
- Is on the claim, Medicare will verify the ordering/referring provider is in PECOS and eligible to order and refer.
- Is not in PECOS or is in PECOS but is not of the specialty to order or refer, the claim will not be paid.

Resources
- APECOS – Self Paced Tutorial
- ACode List for Certain Designated Health Services (DHS)
- APECOS – Dear Physicians Letter
Welcome New Providers
- Top 10 To Do List
Latest Updates
- View Recent Medicare Updates Provider Contact Center, 855-609-9960, M–F 6 a.m.–5 p.m. PT
- Interactive Voice Response (IVR)
- Training Closures
Education & Outreach
- Ask the Contractor Teleconferences (ACT)
- Schedule of Events - Register for Workshops
- Workshop Materials, Tutorials and Prior Events
Hot Topics
· Beneficiary Incarceration
· ICD-10 Implementation
· PECOS Denials: 1/6/14
Medicare Partners
· Comprehensive Error Rate Testing (CERT)
· Durable Medical Equipment – JD
· Qualified Independent Contractor (QIC)
· Recovery Auditor

Transitional Care Program for 99495, 99496 - CMS Will Increase our Pay

[December 9, 2013]
What we Do NOW:
99213=2.11 RVUs=$78.91
99214=3.05 RVUs=$115.52

WITH TCP:
99495=4.82 RVUs=$163.00
99496=6.79 RVUs=$230.00

WHY?:
Minimize 30-day readmissions post discharge
Manage transition of patient care from inpatient setting to home-it’s good for the patient
Allowed as of 1/1/2013

REMEMBER:
Must be an established patient
Must be moderate to high medical decision making (MDM) which all CHF patients are
Transition of care FROM inpatient (i.e. acute hospital, long-term acute care hospital, rehabilitation facility, mental health facility, nursing home and skilled nursing facility)
Transition of care TO home, domiciliary, rest home or assisted living.

Things to Keep In Mind:
Not just CHF patients
All physicians
Reimbursement to first claim received by CMS contactor

Reporting Criteria:
Reporting period commences upon the date of discharge and for the next 29 days
Contact (can be face-to-face, telephone or electronic means) must be made with patient within TWO business days
Face-to-face contact with patient with SEVEN business days for high MDM and FOURTEEN business days for moderate MDM
Both initial and subsequent contacts can be made by either physician or a mid-level provider acting under the supervision of a physician
Management decision and medication reconciliation must occur no later than the day of the first face-to-face visit.

CA ACC Twitter

"When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied."
- Herophilus

Purpose of our California Chapter

The purpose of the Chapter shall be to contribute to the prevention of cardiovascular diseases, to ensure optimal quality care for the individuals with such diseases and to foster the highest professional ethical standards. In carrying out these purposes the Chapter shall function in consultation with the leadership of the College and as an advisor to local and state governmental and professional organizations concerning issues related to cardiovascular disease.

The Chapter shall, in the interests of patients, physicians, and the public in general, maintain a high level of social consciousness and involvement with socioeconomic issues which may influence access to high quality cardiovascular health care for all individuals.

The Chapter has been formed as a 501(c)(6) not-for-profit corporation underthe federal and California state tax codes. The Chapter maintains an Executive Office with a full time Executive Director and support staff. The Chapter also maintains a full time lobbyist and staff in Sacramento.