COA Report 2006

Fall 2006 | View/Download PDF

• President’s Column, Medicare: Just Walk Away – Larry Herron, M.D.
• People in the News
• Department of Managed Health Care is Proposing Several Regulations
• Legislative Update
  • Good News . . .COA-Sponsored SB 1670 Is Signed Into Law
  • Limited Permit X-Ray Technicians—Operate Digital X-Ray Equipment
  • SB 736 (Speier) – Diagnostic Imaging Services
• Eighty-Six Prop 86 by Ralph DiLibero, MD, LACMA President
• Orthopaedic Office Managers Work to Expand BONES
• Worker’ Compensation News
  • Patients Are Being Harmed by Delays in Treatment
  • Workers’ Comp Gains Haven’t Eased the Pain of Tough Cases
  • COA Develops a Resource Center
  • DWC Medical Director Meets with Orthopaedic Groups
  • Work on Updating the OMFS to Begin Soon
  • CSIMS Alerts Members That QME Reports are Being Retroactively Reviewed
  • DWC Adds Doctors to Staff
  • Rating Bureau Projects Loss Ratios Down 31% in California

Summer 2006 | View/Download PDF

• President’s Column, Medical Provider Networks (MPN): A good Idea Gone Bad – Larry Herron, M.D.
• People in the News
• Workers’ Compensation News
  • Good News—25% Increase for Medical-Legal Evaluations
• Highlights from COA’s 2006 Annual Meeting/QME Course
• Federal Workers’ Compensation System
  • U.S. Department of Labor and other Carriers -Ways To Streamline Authorizations for Medical Services and Payment of Claims
• Medicare News
  • CMS Recovery Audit Contract (RAC) Initiative
• Orthopaedic Surgeons Get Involved in the Primary Election
• Workers’ Compensation News
  • DWC Addresses Complaints About Inappropriate Utilization Review Programs and Denials—Propose Fines and Penalties
  • The COA-developed DWC UR Complaint Form can be found on Page 10 of this newsletter.
  • DWC Works to Remove the $100 Lien Filing Fee
  • DWC/UCLA Study on Access to Medical Care
  • DWC Issues Newsline Reminding Claims Administrators of their Payment Obligation for Medical Treatment Provided to Injured Workers
  • Adjustments to the DMEPOS Medical Fee Schedule Posted on DWC Web Site
  • DWC Posts Information on Reporting Suspected Medical Care Provider Fraud
  • DWC Posts Regs on Repackaged Medications
• An Orthopaedic Surgeon’s Thoughts on the Workers’ Compensation Utilization Review Quandary by F. Ray Nickel, M.D., Ventura
• Coding Information
  • Medicare Improperly Pays for Consultations
  • Medicare to Stop Mailing Standard Paper Remittance (SPR) for those Providers also Receiving Electronic Remittance Advice (ERA)
  • Orthopaedic Coding Articles of Interest

Spring 2006 | View/Download PDF

• President’s Column, Annual Meeting/QME Course, OPAC Activities, 2006 Legislative Issues – Richard Santore, M.D.
• People in the News
• Overview – 2006 Annual Meeting/QME Course
• State Legislative News
  • Leasing of MRI/CT/PET AB 2805 (Blakeslee)
  • Limited Permit X-Ray Technicians
  • SB 912 (Ducheny/Runner) – Medi-Cal Cuts
  • AMA Forms a Physician Task Force on Scope of Practice Issues
• Medicare News
  • Part D Prescription Drug Benefit
  • Limits on Physical Therapy Services Are Back
  • New Payment Policy for Imaging Services
  • CMS has not deleted the Synvisc medication HCPCS code
• Correct Coding Rules of Interest to Orthopaedic Surgeons
• Workers’ Compensation: Apportioning Disability to Causation by Stuart A. Green, M.D.
• News from the Medical Board of California
  • The Following Legislation will be Chaptered into Law January 1, 2006
    • AB 1195 (Coto)
    • SB 231 (Figueroa)
    • SB 367 (Speier)
    • SCR 49 (Speier)
  • Medical Board Seeks Physician Reviewers
• Workers’ Compensation News
  • Gallagher Bassett Services—Alert