January 2023
Wesley G. Bradford, MD, MPH
Beginning January 2023, all California physicians must provide the following Notice to Patients, include a quick response (QR) code to the Board’s Notice to Consumer webpage:
NOTICE TO PATIENTS:
Medical doctors are licensed and regulated by the Medical Board of California. To check up on a license or to file a complaint, go to www.mbc.ca.gov, email licensecheck@mbc.ca.gov, or call (800) 633-2322.
Physicians can comply by posting it in an area visible to patients; or provide the patient a written notice in the medical record acknowledging receipt and understanding, signed and dated by the patient; or include the notice above the patient signature line on letterhead, discharge instructions or other document given to the patient. The MBC has posted a notice template with QR code in multiple languages: https://www.mbc.ca.gov/licensing/Notice-to-Consumers.aspx.)
While the 6.5% of Medicare payment cuts originally planned this year was mitigated by the “omnibus budget package”, physicians still face a 2% reduction in the 2023 Medicare conversion factor. Physicians are still struggling with rising practice costs. The annual threat of Medicare payment cuts needs to be replaced by an annual inflationary update. (An unofficial alternate proposal: cut the lobbyists’ pay & bonuses!)
Medi-Cal woes: Beginning January 20, Medi-Cal Rx prior authorization is required for 39 more therapeutic classes, and on February 24 for the remaining therapeutic classes (except enteral nutrition) for Medi-Cal members over 21. For additional details, visit the reinstatement page of the Medi-Cal Rx website, https://medi-calrx.dhcs.ca.gov/home/education/?org.
California and some other states are suing the 6 largest insulin manufacturers and pharmacy benefit managers over alleged unfair business practices for conspiring to artificially raise the price of insulin by 600% over the past 2 decades (for off-patent drugs!). The civil suit seeks to prohibit the complex price setting & rebates driving up out-of-pocket costs, and to get monetary penalties & damage payments for diabetic Californians. (“Your money or your life!”)
DHCS announced a new Medi-Cal agreement with 5 commercial managed care plans starting January 2024 to ensure higher accountability for access to quality care: Anthem, Blue Shield, Community Health Group, Health Net, & Molina.
Under AB 852, low volume prescribers can now request an exemption from California’s e-prescribing mandate if they meet any of the following criteria:
- No more than 100 prescriptions/year; or,
- Practice in a natural disaster area; or,
- Are granted a waiver on other extraordinary circumstances.
These physicians must register with the California Board of Pharmacy with an online form to allow pharmacists to confirm exemption from the requirement.)
