Medi-Cal Clinical Pathology Payment Update
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The CSP had previously informed you of our success of the CSP in reversing the Medi-Cal policy change that would have denied reimbursement for the professional component of clinical pathology in the hospital setting. The announced policy that took effect on Feb. 1, 2010 was reversed that month, but the claims processing system could not be changed back in time to prevent claims denials. The March Medi-Cal Bulletin did announce that the policy change had been reversed. The claims processing system was changed back on March 26, 2010 so claims processed on that date and later will be paid correctly.
We have been informed that the Electronic Payment Correction (EPC) that will reprocess and pay all claims submitted between February 1st and March 26th will likely not be performed until early July. You do not need to resubmit any of those claims and they will be paid when the EPC is run. There are a number of EPCs that are in queue and it takes time to get them performed.
New Regulation From Medical Board Requires Physicians to Post Notice
We have been contacted by some members who have learned of the new regulation effective June 27, 2010 which requires all physicians to notify patients that they are licensed by the Medical Board of California. All physicians, including pathologists, must either post a notice via specific type of sign, include the notice in a statement signed by the patients (or their representative) and retain it in the patient file, or include the notice in a statement on letterhead, discharge instructions or other document given to a patient (or their representative), where the notice is in 14 point type immediately above the patient signature line.
You can see the specifics by going to www.mbc.ca.gov and looking at the Notice to Consumers Regulation. The CSP is in contact with the Medical Board to determine if pathologists can be exempted or the requirement modified to take into account that patients may not see the pathologists or visit the clinical laboratory. We will be advocating for some changes during the short window of time before the requirement begins.
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