Payers & Providers California Edition – Issue of June 7, 2012

7/31/2019 Payers & Providers California Edition Issue of June 7, 2012

1/6

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Galmdkas

2 I}dm 3813

M.NaolodfjHxaymswadkxsjvokmsw$gjnro{e

{em km{aolw jf yj}s mvmd{, js gall%522/ 3;5.3768, mu{$ 7$ O{ roll cm

x}clowemk od {em Galmdkas wmg{ojd,wxagm xmsno{{odb$

Galofjsdoa Mko{ojd

[em Galofjsdoa Kmxas{nmd{ jf X}clog Emal{eeaw oww}mk +53=,888 od dmw {j 17 Galofjsdoaejwxo{alw fjs nmkogal mssjsw js j{ems mvmd{w{ea{ imjxaskoymk {em lovmw jf xa{omd{w js ga}wmk

{emos kma{ew$[em odgokmd{w, reoge {jj` xlagm xsonasolod 3818, lmk {j {em kma{ew jfvm xa{omd{w adka w{ollcjsd odfad{$ [rj j{ems gawmw odvjlvmk {emnowgjdk}g{ jf ejwxo{al mnxljmmw$ [emxmdal{omw adk dmw rmsm addj}dgmk jd I}dm1$

Od {esmm jf {em odgokmd{w lmakodb {j xa{omd{kma{e, o{ raw {em sw{ {onm {em ejwxo{alw eaksmgmovmk ad aknodow{sa{ovm xmdal{ fsjn {emkmxas{nmd{$ Gjnn}do{y Smbojdal Nmkogal Gmd{ms odFsmwdj raw dmk +=8,888 remd a xa{omd{ komkod 3818 af{ms smgmovodb }x {j 178 {onmw {em

smgjnnmdkmk kjwm fjs emxasod, a cljjk{eoddms$ [em jvmskjwm lmk {j clmmkodb od {emcsaod, gjna adk kma{e$ Ad odvmw{oba{ojdkm{msnodmk {ea{ {em d}swodb w{aff kok dj{}dkms{a`m {em kj}clm.gemg`w smq}osmk remdaknodow{msodb a eobe.sow` nmkoga{ojd$

Geodmwm Ejwxo{al od Wad Fsadgowgj alwjsmgmovmk a +=8,888 dm fjs a 3818 odgokmd{remsm a xdm}njdoa xa{omd{ eak a daw{sjbawalfmmkodb {}cm odwms{mk od{j {emos lmf{ l}db,lmakodb {j kma{e$ Wad Ijaq}od Bmdmsal Ejwxo{al od {em s}salgjnn}do{ jf Fsmdge Ganx smgmovmk a

+=8,888 xmdal{ fjs a 3882 odgokmd{ remsm axa{omd{ rej eak cmmd akno{{mk af{ms fallodb a{{emos ejnm adk w{aodb jd {em jjs fjs 76ej}sw raw dj{ {{mk ro{e djd.wlox wjg`w$ Wem

fmll af{ms {sodb {j }wm {em gjnnjkm, w}ffmsmk emak odi}s adk la{ms komk$Wad{a Glasa Vallmy Nmkogal Gmd{ms od Wad

Ijwm smgmovmk a +2=,888 dm fjs {em 3818kma{e jf a xa{omd{ w}ffmsodb fsjn ALW$ Em eakcmmd odgjssmg{l {a`md jff eow nmgeadogalvmd{ola{js fjs {sadwfms {j adj{ems }do{ jf {emejwxo{al$ O{ raw {em ejwxo{alw wmgjdk xmdal{$

[rj ejwxo{alw smgmovmk xmdal{omw fjsmnxljmm nowgjdk}g{ sa{ems {ead nmkogalmssjsw$ Geaxnad Nmkogal Gmd{ms od Jsadbmraw dmk +2=,888 af{ms a nalm d}swm wmu}allawwa}l{mk a fmnalm xa{omd{ od 3818$ O{ raw {emejwxo{alw wmgjdk xmdal{$

]G Wad Kombj Nmkogal Gmd{ms smgmovmko{w fj}s{e aknodow{sa{ovm xmdal{ fjs a 3818odgokmd{ remsm wmg}so{ b}askw mimg{mk adjcmwm fmnalm rej eak wj}be{ gasm a{ {emmnmsbmdg sjjn fjs cmodb c}sdmk jd {em sjjfjf ems nj}{e adk {emd smf}wmk {j lmavm$ Wemraw kmxjwo{mk emak.sw{ dmu{ {j a cmdgej}{wokm, adk w{jxxmk csma{eodb$ Wem raww}cwmq}md{l smw}wgo{a{mk adk wmd{ cag` od{j{em MS, lmakodb {j a 35.ka w{a a{ {em ejwxo{a

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2/6

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Xaymsw & Xsjvokmsw Xabm 3

[jx Xlagmnmd{$$$Cj{{jnlmww Xj{md{oal

Akvms{owm Emsm

%522/ 3;5.3768, mu{$ 3

Od Csomf

@aowms, Xsonm Ejwxo{alwWgjsm Rmll Od Lmaxfsjb

Wafm{y W}svmy

Galofjsdoa ejwxo{alw jxmsa{mk cyJd{asoj.cawmk Xsonm Emal{egasm adk

Ja`ladk.cawmk @aowms Xmsnadmd{msmgmovmk eobe wafm{y wgjsm sa{odbwfsjn {em Lmaxfsjb Bsj}x$

Mlmvmd jf Xsonmw 17 Galofjsdoaejwxo{alw smgmovmk A bsakmw fsjnLmaxfsjb, cawmk jd o{w {sag`odb jfxsmvmd{aclm mssjsw w}ge aw ejwxo{al.agq}osmk odfmg{ojdw, sm{aodmk w}sbogaljcimg{w adk nmkoga{ojd now{a`mw$

#Rm asm gjnno{{mk {j `mmxodbj}s xa{omd{w wafm adk fjs na`odbwafm{y odfjsna{ojd avaolaclm {jemal{egasm gjdw}nmsw, waok XsonmGeomf Mumg}{ovm Jfgms Xsmn Smkky,N$K$, #[emwm eobe wgjsmw eobelobe{{em kmvj{ojd adk eask rjs` cy {emxeywogoadw, d}swmw adk w{aff a{

{emwm ejwxo{alw {j {em eobemw{w{adkaskw jf q}alo{y gasm od {emda{ojd$#

[rmd{y.fj}s jf {em 32 @aowmsejwxo{alw od Galofjsdoa smgmovmk Absakmw$ [em fagolo{omw od Fsmwdj, WadSafaml adk Rald}{ Gsmm` smgmovmkC bsakmw$

Rm aon {j xsjvokm {em wafmw{ejwxo{al gasm adyremsm$ [emLmaxfsjb smxjs{ afsnw {ea{ rm asm jd{em sobe{ {sag`, waok Kj}b Cjdag}n,@aowms Xmsnadmd{mw vogm xsmwokmd{ jfq}alo{y adk wafm{y nadabmnmd{$ Rmasm xlmawmk {j cm gjdwokmsmk anjdb{em wafmw{ ejwxo{alw od {em ]do{mkW{a{mw$

Al{jbm{ems, ?; ejwxo{alw odGalofjsdoa smgmovmk A bsakmw, =5smgmovmk C bsakmw, adk 57 smgmovmkG bsakmw$

Da{ojdrokm, Lmaxfsjb w}svmymk3,688 ejwxo{alw da{ojdrokm, ro{e 236smgmovodb A bsakmw$

O{"w [em Lmaxfsjb Bsj}x"w bjal{j bovm xa{omd{w {em odfjsna{ojd {emydmmk adk kmwmsvm cmfjsm mvmdmd{msodb a ejwxo{al, waok LmaxfsjbGMJ Lmae Codkms$ Rm gjdbsa{}la{m

Gjd{od}mk jd Xabm 7

DMRW

adk {em odwms{ojd jf a {sagemal csma{eodb {}cm$[em dm raw +2=,888$

[em oww}odb jf {em Geaxnad adk ]G WadKombj xmdal{omw kj}clmk {em d}ncms bovmd cy{em abmdgy fjs xa{omd{ ac}wm {j fj}s$ GKXEwxj`mwnad Salxe Njd{adj gj}lk dj{ wayrem{ems a bsma{ms fjg}w jd w}ge odgokmd{w owcmodb onxlmnmd{mk$

W}ge mvmd{w asm sasm jgg}ssmdgmw, emwaok od ad m.naol$ Wj}{ermw{ Emal{egasm Wyw{mn od N}ssom{asmgmovmk a smgjsk mobe{e aknodow{sa{ovmxmdal{y adk {em nauon}n +188,888 dm fjs ad}swmw faol}sm od 3818 {j smgjbdom fm{alkow{smww oww}mw, lmakodb {j a w{ollcos{e$

[em Wj}{ermw{ wyw{mn, gjnxsowmk jf

fagolo{omw od {em Sovmswokm Gj}d{y go{omw jfN}ssom{a adk Rolkjnas adk jrdmk cyXmddwylvadoa.cawmk fjs.xsj{ geaod ]dovmswalEmal{e Wmsvogmw, eak nakm mu{mdwovmnadabmnmd{ geadbmw adk absmmk {j a ljdb low{jf gjssmg{ovm ag{ojdw od Wmx{mncms 3818 af{ms{em GKXE njvmk {j smvj`m {emos jxmsa{odblogmdwmw masloms od {ea{ ymas$

[em ejwxo{alw xawwmk a gms{oga{ojd w}svmycy {em Gmd{msw fjs Nmkogasm adk NmkogaokWmsvogmw od Djvmncms 3811, xas{ jf {emabsmmnmd{ ro{e GKXE$

Njd{adj waok {em la{mw{ odgokmd{ jgg}ssmkcmfjsm Wj}{ermw{ eak absmmk {j {em gjssmg{ovm

ag{ojdw$[esmm ejwxo{alw jxmsa{mk cy Ja`ladk.cawmk @aowms Xmsnadmd{m smgmovmkaknodow{sa{ovm xmdal{omw$

@aowmsw fagolo{y od {em Maw{ Cay gjnn}do{yjf Sogenjdk odg}ssmk o{w wmgjdk xmdal{y adka +2=,888 dm af{ms a xa{omd{ ro{e a vasom{y jfgaskoag gjdko{ojdw komk af{ms d}swmw obdjsmkxabmw w}bbmw{odb ad mssa{og x}lwm$ [em xabmwrmsm obdjsmk mvmd af{ms jdm d}swm smgmovmkn}l{oxlm nmwwabmw wayodb {em ca{{msomw od {emxa{omd{w gaskoag njdo{js dmmkmk smxlagmnmd{$

@aowms fagolo{omw od Wad Kombj adk WadFsadgowgj smgmovmk xmdal{omw fjs lmavodb

jcimg{w od xa{omd{w fjlljrodb w}sbmsy$ Od {emWad Fsadgowgj odgokmd{, a 6?.ymas.jlk fmnalm

xa{omd{ eak a {rj.wq}asm.fjj{ w}sbogal {jrmllmf{ od ems ackjnodal gavo{y fjs 16 njd{ew$ O{

raw la{ms smnjvmk cy {em wanm w}sbmjd rejeak odwms{mk o{$ Em eak }wmk o{ {j emlxsmxjwo{ojd ems lovms {j xmsfjsn vmdj}w smxaoswc}{ la{ms fjsbj{ o{ raw {emsm$

[esmm j{ems ejwxo{alw Nak SovmsGjnn}do{y Ejwxo{al od Asga{a, @mg` Ejwxo{ajf ]WG %fjsnmsly ]WG ]dovmswo{y Ejwxo{al/ odLjw Adbmlmw adk {em Nj{ojd Xog{}sm &[mlmvowojd Ejwxo{al od Rjjkladk Eollw smgmovmk xmdal{omw adk dmw fjs lmavodb jcimgod xa{omd{w rej eak {j }dkmsbj w}cwmq}md{xsjgmk}smw {j smnjvm {emn$

Al{ej}be sm{aodmk jcimg{w eavm lmk {j =5aknodow{sa{ovm xmdal{omw cy fas {em lasbmw{

d}ncms {em smxjs{w jf w}ge odgokmd{w eavmkmglodmk wlobe{ly, fsjn 36= smxjs{mk k}sodbwgal ymas 388?.18 {j 3;8 k}sodb 3818.11,aggjskodb {j GKXE smgjskw$ Jdly {ejwmodgokmd{w {ea{ asm cmlomvmk {j x}{ {em xa{omd{ onnmkoa{m imjxasky jf easn js kma{e lmak {jaknodow{sa{ovm xmdal{omw, Njd{adj waok$

Al{jbm{ems, {em abmdgy eaw lmvomk 33;aknodow{sa{ovm xmdal{omw {j 13? ejwxo{alww{a{mrokm wodgm w}ge odgokmd{ smxjs{odbcmganm nadka{jsy od 3882$ [em abbsmba{mdmw {j{al +5$=5 nollojd$

Al{ej}be {eow jdly smxsmwmd{w acj}{ a{eosk jf {em ejwxo{alw logmdwmk od Galofjsdoa,

Njd{adj dj{mk {ea{ nady odgokmd{w smxjs{mkcy ejwxo{alw kj dj{ sowm {j {em lmvml jf adaknodow{sa{ovm xmdal{y$

Jdly af{ms a gjnxlaod{ eaw cmmdgjnxlm{mly odvmw{oba{mk adk$$$eaw cmmdsmwjlvmk ro{e {em ejwxo{al kjmw {em w{a{mgjdwokms oww}odb a xmdal{y, Njd{adj waok$

Jf {em dmw adk xmdal{omw oww}mk, {emGKXE eaw gjllmg{mk +=$?1 nollojd smla{mk {j12? wmxasa{m go{a{ojdw$ Ejwxo{alw smgmovm a6=- smk}g{ojd jf {em dm of {emy gejjwm dj{ {gjd{mw{ o{$ [emy eavm 18 kayw fsjn {em lmvyodjf a xmdal{y {j lm ad axxmal$

Njd{adj waok 73 xsojs aknodow{sa{ovm

xmdal{omw asm g}ssmd{ly }dkms axxmal cyejwxo{alw$

Ejwxo{alw %Gjd{od}mk fsjn Xabm Jdm/

NMM[ J]S SMAKMSW

Dmmk {j xsjnj{m a gjdfmsmdgm: _j}s csadk: Xaymsw &Xsjvokms!wm.naol low{ fjs all mko{ojdw ow avaolaclm fjs yj}snas`m{odb dmmkw$ Smage j}{ {j njsm {ead 13,888emal{egasm xsjfmwwojdalw rej smak j}s x}cloga{ojdw$ Gaj}s akvms{owodb kosmg{js Glaosm [eayms a{ %=87/ 336.?5=js m.naol ems a{ glaosm{Hngjl$gjn$


3/6

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Xabm 7Xaymsw & Xsjvokmsw

Ljdbms ALJW!)

Akvms{owm Emsm

%522/ 3;5.3768, mu{$ 3

)Fjs j}s akw, dj{ yj}s ejwxo{al

Od Csomf

{em ejwxo{alw {ea{ masdmk ad "A" adkrm ljj` fjsrask {j {em kay remd allejwxo{alw od {em ]$W$ roll masd {emeobemw{ wgjsmw fjs x}{{odb xa{omd{wafm{y sw{$ Xaymsw & Xsjvokmsw roll eavmnjsm mu{mdwovm gjvmsabm jf {emsa{odbw jf Galofjsdoa ejwxo{alw od dmu{

rmm`w oww}m$

Xsag{ogmw Bm{ +2N OdNmadodbf}l ]wm

Odgmd{ovm Xaynmd{w

Galofjsdoa xeywogoadw vyodb {j ageomvmnmadodbf}l }wm fjs {em emal{e O[xjs{ojd jf {emos nmkogal xsag{ogmwsmgmovmk njsm {ead +2 nollojd odfmkmsal odgmd{ovm xaynmd{w {jraskakjx{odb mlmg{sjdog emal{e smgjskw$

Aggjskodb {j {em GalofjsdoaEmal{e Odfjsna{ojd Xas{dmsweox &Wmsvogmw Jsbadoa{ojd, {em xaynmd{w

asm fjs xsag{ogm {ea{ eavm cmb}d {emakjx{, }xbsakm js onxlmnmd{a{ojdxsjgmww$

#MES onxlmnmd{a{ojd odGalofjsdoa ow rmll }dkmsray, ro{e jvms2,288 xsjvokmsw od vasoj}w w{abmw jfxsjbsmww ro{eod GalEOXWJ"wnmncmsweox,# waok GalEOXWJ GeomfMumg}{ovm Jfgms Wxmsada Avsan$Al{jbm{ems, acj}{ +6= nollojd ododgmd{ovm xaynmd{w roll cm kow{soc}{mkod {em gjnodb njd{ew, aggjskodb {jAvsan$

[em xaynmd{w asm xas{ jfEO[MGE, a xjs{ojd jf {em 388?fmkmsal w{on}l}w lar$ [em njdmy owgjnodb fsjn {em Nmkogasm adkNmkogaok xsjbsan$

Xaynmd{w {j xsag{ogmw {ea{ asmGalEOXWJ nmncmsw sadbmk fsjn+31,3=8 {j +=27,2=8$

Wlobe{ly lmww {ead jdm.{eosk jf {emxeywogoad xsag{ogmw od Galofjsdoa eavmageomvmk wjnm lmvml jf MESonxlmnmd{a{ojd, Avsan {jlk Xaymsw &Xsjvokmsw od a smgmd{ od{msvomr$

GalEOXWJ xsjvokmw {mgedogalakvogm fjs akjx{odb MESw {j n}ge jfGalofjsdoa, mugl}kodb Ljw Adbmlmw adkJsadbm Gj}d{omw$

DMRW

Wagsanmd{j.cawmk ejwxo{al jxmsa{js W}{{msEmal{e ow odvmw{odb +38 nollojd jvms {em dmu{{esmm ymasw {j cjjw{ o{w emal{egasm smwmasgeadk kmvmljxnmd{ xsjbsanw, adk eaw eosmk{rj rmll.`djrd smwmasgemsw {j gassy j}{ {emodo{oa{ovm$

W}{{ms, reoge jxmsa{mw 38 ejwxo{alw odDjs{emsd Galofjsdoa, waok o{ rj}lk fjg}w jd}wodb {em odo{oa{ovm {j odvmd{ adk la}dge dmrxsjk}g{w, adk kmvmljx {sadwfjsna{ovm gasmwjl}{ojdw adk oddjva{ojd mnxeawoodb eobe.q}alo{y, xa{omd{.gmd{sog gasm, aggjskodb {j aw{a{mnmd{ smlmawmk cy {em jsbadoa{ojd$ Djwxmgog xsjimg{w rmsm kowg}wwmk cy W}{{ms

jfgoalw$W}{{ms eaw axxjod{mk Nas{od Csj{nad,

N$K$, wmdojs vogm xsmwokmd{ jf mk}ga{ojd,smwmasge adk xeolad{esjxy {j jvmswmm {emodo{oa{ovm$ Emw {em fjsnms geomf mumg}{ovmjfgms jf W}{{msw Rmw{ Cay Smbojd adk emakjfGalofjsdoa Xagog Nmkogal Gmd{ms od WadFsadgowgj$

#Rm roll {sadwla{m `djrlmkbm od{j xsjvmdwjl}{ojdw adk akjx{ onxsjvmnmd{w aw saxoklyaw xjwwoclm od smal xsag{ogm adk gjnn}do{ywm{{odbw,# Csj{nad waok$ #W}{{ms Emal{e eaw a}doq}m jxxjs{}do{y {j c}olk a rjslk.glaww,md{msxsowm.rokm, emal{egasm kmlovmsy S&Kgaxacolo{y {ea{ roll gsma{m smal val}m fjsxa{omd{w$#

W}{{ms eaw xsmvoj}wly fjg}wmk jd cawogwgomdgm adk baododb axxsjval fjs {em }wm jfnmkogal kmvogmw$ Njw{ jf {ea{ smwmasge eawcmmd xmsfjsnmk cy afloa{mk fagolo{omw od XaljAl{j, Wad Fsadgowgj, Wagsanmd{j adk Cms`mlmy$ Ral{ms F$ W{mras{, fj}dkms adk kosmg{js jf

{em Bmowodbms Gmd{ms fjs Emal{e Smwmasge odXmddwylvadoa, ow wmsvodb aw {em odo{oa{ovmw geomfsmwmasge adk kmvmljxnmd{ jfgms$ W{mras{ owalwj ad aki}dg{ xsjfmwwjs a{ Ijedw Ejx`odwCljjncmsb Wgejjl jf X}clog Emal{e$

Ijwe}a Locmsnad eaw cmmd axxjod{mk aw{em mumg}{ovm kosmg{js, smwmasge adkkmvmljxnmd{ jxmsa{ojdw$

Xsonm Fjg}wmw Jd [muaw MuxadwojdAnasollj.asma X}sgeawm Wmgjdk Od Smgmd{ Njd{ew

Jd{asoj.cawmk Xsonm Emal{egasm Wmsvogmweaw gjd{od}mk o{w muxadwojd od{j [muaw,agq}osodb 11=.cmk Xanxa Smbojdal NmkogalGmd{ms dmas Anasollj fjs ad }dkowgljwmkw}n$

[em x}sgeawm jf Xanxa fsjn Ej}w{jd.cawmk Wobda{}sm Emal{e ow {em wmgjdk w}gekmal Xsonm eaw }dkms{a`md od {em Ljdm W{asw{a{m od {em xaw{ wmvmsal njd{ew$ OdKmgmncms, o{ agq}osmk 113.cmk EaslodbmdNmkogal Gmd{ms fsjn NmkGa{e Gjsx$

Xsonm jfgoalw {jlk {em [muaw [soc}dm

ij}sdalown rmcwo{m masloms {eow rmm` {ea{ o{raw wmm`odb {j muxadk j}{wokm jf Galofjsdoa$

[em njvm fjlljrw d}nmsj}w allmba{ojdw adkodvmw{oba{ojdw xms{aododb {j collodb xa{{msdw a{wmvmsal jf o{w 17 ejwxo{alw od Galofjsdoa,wxmgogally fjg}wodb jd {sma{odb Nmkogasmmdsjllmmw fjs wmx{ogmnoa adk nald}{so{ojd$

J}s bjal a{ Xsonm ow {j xsjvokm q}alo{y,gjw{.mffmg{ovm gasm {j xa{omd{w adk xas{dms ro{e{em gjnn}do{omw rm wmsvm, waok Xsonm GeomfMumg}{ovm Jfgms Xsmn Smkky, N$K$$ #Rm asmejdjsmk {j csodb {eow nowwojd {j {em xa{omd{w jfXanxa adk {em [muaw Xadeadklm$

Od Fmcs}asy, Xsonm agq}osmk 1;8.cmk

Sjucjsj}be Nmnjsoal Ejwxo{al odXeolakmlxeoa fsjn Wjlow Emal{egasm$

W}{{ms Muxadkw Smwmasge SmageOdvmw{odb +38N Jd Xa{omd{.Smla{mk Odo{oa{ovmw

W[JSOMW JF JDM EOBEL_ LO[OBOJ]W XE_WOGOAD

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Gall %522/ 3;5.3768, mu{$ 3 {j jskms

JS GLOG@ EMSM
https://www.managedcarestore.com/pandp/p&pwhitepapers.htmhttps://www.managedcarestore.com/pandp/p&pwhitepapers.htm


4/6

!#'+!-&!"%/"!)!"%/"!,!.$,+*8!1!.*37;=+*8!.#6;82;'5&!??9

Xaymsw & Xsjvokmsw XabmJXODOJD

Xmmsodb Od{j [em Xjlogy Gsyw{al CallEjr J}s F}{}sm Emal{egasm Odo{oa{ovmw Nay Fasm

Rolloan N$ Kryms ow a emal{egasm gjdw}l{ad

@adwaw Go{y$ Em ow a nmncms jf {em mko{jsoa

cjask fjs Xaymsw & Xsjvokmsw Nokrmw{ mko{oj

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5/6

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NAS@M[XLAGM*MNXLJ_NMD[Xaymsw & Xsjvokmsw Xabm =

MKO Wjf{rasm Mdbodmms OOO . Aweladk, JSMKO Wjf{rasm Mdbodmms Lmvml OOO a{ Xlmuow Emal{egasm Wyw{mnw od Aweladk, JS

Xlmuow Emal{egasm Wyw{mnw ow wmmòdb ad muxmsomdgmk MKO Wjf{rasm Mdbodmms fjs xsjk}g{ojd kmvmljxnmd{, Od{mbsa{ojd, adk Walmw W}xxjs{$

XJWO[OJD X]SXJWM9

[eow xjwo{ojd ow smwxjdwoclm fjs {em gjjskoda{ojd, kmvmljxnmd{ adk kmlovmsy jf wjf{rasm xsjk}g{w gsma{mk cy Xlmuow {j naod{aod adk onxsjvm

jd muow{odb f}dg{ojdalo{y, adk odgjsxjsa{mw dmr xsjgmwwmw od{j {em gjkm cawm$ [eow odgl}kmw eadklodb a rokm vasom{y jf wo{}a{ojdw adk gjdog{w

odvjlvodb {em f}dg{ojdal adk onxlmnmd{a{ojd wxmgw aw rmll aw gjkodb {em f}dg{ojdalo{y j}{lodmk od {em f}dg{ojdal wxmgoga{ojdw$ [a`mw kosmg{ojd

fsjn lmak Wjf{rasm Mdbodmmsw0 aw rmll aw gjd{soc}{odb {j {em {man od a gjdw{s}g{ovm naddms$

MWWMD[OAL F]DG[OJDW ADK CAWOG K][OMW9

Kmvmljx md{msxsowm lmvml axxloga{ojdw od Nogsjwjf{$DM[, Rodkjrw, DEocmsda{m, G' adk NW WQL Wmsvms$

Lmvmsabm eow*ems djrlmkbm jf jcimg{.jsomd{mk, Rodkjrw cawmk kmvmljxnmd{ adk akvadgmk njkmlodb {mgedoq}mw {j onxlmnmd{ wgalaclm,

n}l{o.{omsmk axxloga{ojdw$

Xsmwmd{ kmnjdw{saclm muxmsomdgm od wyw{mnw kmvmljxnmd{ {jjlw adk nm{ejkjljbomw odgl}kodb Abolm, WGS]N, Mu{smnm Xsjbsannodb %UX/ &

]NL njkmlodb$Rso{m WQL gjkm %w{jsmk xsjgmk}smw, {sobbmsw, vomrw, m{g$/ aw xas{ jf a xsjimg{ {man {j onxlmnmd{ f}dg{ojdal smq}osmnmd{w mdw}sodb

gjssmg{dmww adk jx{onomk xmsfjsnadgm$

Gjdk}g{ Gjkm Smvomrw adk awwow{ Nadabmnmd{ od mw{acloweodb W{adkaskw adk Cmw{ Xsag{ogmw$

Adalym adk na{}sm muow{odb wjl}{ojdw$

Adalym {sj}clmwejj{ xsjbsan gjkm {j owjla{m adk gjssmg{ mssjsw$

Gjllacjsa{mw ro{e gsjww f}dg{ojdal {manw {j adalym g}w{jnms smq}osmnmd{w adk gsma{m {mgedogal wxmgoga{ojdw adk*js kmwobd kjg}nmd{w fjs

dmr axxloga{ojdw$

Gsma{m {mgedogal kjg}nmd{a{ojd fjs od{msdal adk mu{msdal glomd{w {ea{ agg}sa{mly kmwgsocm {em gjdb}sa{ojd jf {mgedjljby }{olomk {j onxlmnmd{

a kmvmljxnmd{ wjl}{ojd$

Gsma{m mw{ona{mw jf kmvmljxnmd{ {aw`w {j cm }wmk fjs xsjimg{ wgemk}lodb$

Adalym adk {sj}clmwejj{ muow{odb xsjbsan gjkm {j owjla{m adk gjssmg{ mssjsw$

Wjlvmw gjnxlmu, adaly{ogal xsjclmnw ]dkmsw{adkw {em }wm jf odk}w{sy {jjlw adk {mgedjljby adk ejr {emos onxlmnmd{a{ojd affmg{w xsjimg{

bjalw$

Q]ALOFOGA[OJDW9=+ ymasw jf muxmsomdgm od {em kmvmljxnmd{ adk onxlmnmd{a{ojd jf Glomd{ Wmsvms & Rodkjrw cawmk axxloga{ojdw

Eobe.lmvml muxmsomdgm od {em fjlljrodb9 U13 Onxlmnmd{a{ojd Wxmgoga{ojd {msnodjljby adk }wabm, G', UNL, Vow}al W{}koj, Vow}al W{}koj

]do{[mw{ f}dg{ojdalo{y, NW WQL, Rodkjrw Rjs`jr, DEocmsda{m adk Wmsvogm Jsomd{mk [mgedjljby Nm{ejkjljbomw$ Akvadgmk djrlmkbm ro{e

lasbm wgalm kmvmljxnmd{ jf md{msxsowm wyw{mnw$

Muxmsomdgm ro{e Jcimg{ Jsomd{mk Adalywow adk Kmwobd aw rmll aw Jcimg{ Jsomd{mk Kmwobd Xa{{msdw$

Akvadgmk djrlmkbm od }wodb cmw{ xsag{ogmw {j xmsfjsn wjf{rasm kmwobd, lmvmsabodb {em nm{ejkjljbomw jf wjf{rasm wyw{mnw adalywow,

kmwobd, {mw{odb$

Muxmsomdgm gsma{odb {mgedogal kjg}nmd{a{ojd$

Muxmsomdgm gsma{odb ]NL adk onxlmnmd{odb Jcimg{.jsomd{mk kmwobd xa{{msdw$

Muxmsomdgm ro{e smvmswm mdbodmmsodb adk smfag{jsodb jf wyw{mnw$

Akvadgmk djrlmkbm jf WQL Wmsvms {jjlw %Nadabmnmd{ W{}koj, Gjdb}sa{ojd Nadabms, WQL Wmsvms Od{mbsa{ojd Wmsvogmw/

Akvadgmk djrlmkbm jf ka{acawm kmwobd, rso{odb q}msomw, {sobbmsw adk w{jsmk xsjgmk}smw jd WQL Wmsvms

Kmaklodm ksovmd aggj}d{acolo{y

Mugmllmd{ gjnn}doga{ojd adk nadabmnmd{ wòllwNMD[AL AG[OVO[OMW ADK SMQ]OSMNMD[W JF [EOW XJWO[OJD9

MKO Wjf{rasm mdbodmmsodb f}dg{ojdw asm mfgomd{, mffmg{ovm, adk gjdk}g{mk od aggjskadgm ro{e kmxas{nmd{ xjlogomw adk xsjgmk}smw, adk ro{e

axxlogaclm larw

Mdbodmmsodb xjlogomw adk xsjgmk}smw asm smb}lasly smvomrmk adk fjlljrmk$

Nadabmnmd{ ow axxsjxsoa{mly odfjsnmk jf ady wobdogad{ xsjclmnw

W}bbmw{ojdw fjs onxsjvmk mfgomdgy adk mffmg{ovmdmww asm xsjvokmk

Smq}osmk smxjs{w adk smgjskw %odgl}kodb {onm md{sy/ asm agg}sa{m adk {onmly

Bjjk gjnn}doga{ojd adk mffmg{ovm rjsòdb smla{ojdw muow{ ro{e smla{mk kmxas{nmd{w

[em gjnxady"w xsjfmwwojdal smx}{a{ojd ow xsjimg{mk od all kjg}nmd{a{ojd

W}ggmwwf}lly xsojso{oodb {aw`w adk nmm{odb xsjimg{ kmaklodmw

Rjsòdb odkmxmdkmd{ly remd smq}osmk

Rjsòdb w}ggmwwf}lly od a {man mdvosjdnmd{

[eow ow ad onnmkoa{m jxmdodb$

Jdly f}lly q}alomk odkovok}alw roll cm gjdwokmsmk$ Fjs njsm odfjsna{ojd acj}{ j}s gjnxady, xlmawm vowo{ rrr$xlmuowrmc$gjn$


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Xaymsw & Xsjvokmsw NAS@M[XLAGM*MNXLJ_NMD[ Xabm 6

O{ gjw{w }x {j +32,888 {j foll a emal{egasm ijc)

roll kj o{ fjs a lj{ lmww$

Mnxljynmd{ low{odbw cmbod a{ i}w{ +1$6= a rjsk

Gall %522/ 3;5.3768, mu{$ 3Js m.naol9 akvms{owmHxaymswadkxsjvokmsw$gjn

Js vowo{9 rrr$xaymswadkxsjvokmsw$gjn

)Dmr Mdbladk Ij}sdal jf Nmkogodm, 388;$

WMM@ODB A DMR XJWO[OJD:

GAD EMLX$

Rm x}clowe akvms{owmnmd{w fjs {ejwm wmm`odbdmr gasmms

jxxjs{}do{omw fjs i}w{ +1$3= a rjsk$

Of yj} xsmfms kowgsm{ojd, rmll eadklm allsmwxjdwmw {j yj}s ak$

Gall %522/ 3;5.3768, mu{$ 3, js m.naolakvms{owmHxaymswadkxsjvokmsw$gjn$

Payers & Providers California Edition – Issue of June 7, 2012

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Transcript of Payers & Providers California Edition – Issue of June 7, 2012