anthem rescinds policy to reduced payments for e&m services

After receiving strong pressure from the physician community, Anthem has decided to rescind its policy to reduce payments for E&M services reported with CPT modifiers 25. As reported previously, concerns have been raised regarding Anthem's policies on the retrospective denial of payment for emergency room visits, restrictions on advanced imaging in hospital outpatient facilities, and denial of payment for monitored anesthesia care or general anethesia for cataract surgery.

Anthem's decision to rescind this policy reflects the growing recognition of the need for a different type of dialogue and engagement between health plans and the physician community to improve health care quality, access, and affordability.

Recently, the American Medical Association & Anthem released a joint statement indicating that they will be pursuing opportunities for collaboration in the following areas:

  • Enhance consumer and patient health care literacy
  • Develop/enhance and implement value-based payment models for primary and specialty care physicians
  • Improve access to timely, actionable data to enhance patient care
  • Streamline and/or eliminate low-value prior authorization requirements.


OMBC announces Changes to Cme cycle

Effective January 1, 2018 the Continuing Medical Education Cycle (CME) will change from three (3) to two (2)  years.  This change in the CME cycle will align with the two (2) year license renewal cycle.  Under this new CME cycle change, licensees will have to complete 100 hours (to include a minimum of 40 AOA 1A or 1B hours).  Physicians will be required to submit documentation of the 100 hours in the two (2) years preceding your license renewal.    For more information regarding this change please click on the following link:



OPSC's Current legislative bill list 

Please click here to see a comprehensive list of the Bills that OPSC is monitoring.


OPSC's 2017 Legislative Report to the Membership

2017 Legislative Session Ended on September 16th with the Legislature's biggest accomplishment being California's status as a stronghold against President Trump.  To read the complete report please click here.

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