Cedars-Sinai Medical Center

medical staff pulse newsletter

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Dec. 6, 2013 | Archived Issues

Recognition for Honjo, Reich, Slattery, Azizzadeh, Steiner

Physician News

Tomoyuki Honjo, MD, PhD, has received honors for his work on a vaccine to treat aortic aneurysms; Heidi Reich, MD, has won a Sports Spectacular Endowed Fellowship; William H. Slattery, MD, and Babak Azizzadeh, MD, have completed a book on the facial nerve; and Jerrold H. Steiner, MD, has been honored by the Tower Cancer Research Foundation.

» Read more


Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - November 2013 (PDF)

Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

Helping Patients With Individual Insurance Policies Understand Changes in Coverage

Some patients with individual health insurance plans (not employer- or group-provided insurance) have raised concerns about being able to stay with their doctors as changes in the health insurance marketplace are implemented. This especially resonates with patients who have chronic or persistent conditions where treatment likely will carry over into the next calendar year.

The plan-by-plan fact sheet in the PDF link below provides a summary of changes — listed by insurance company — that relates to individual and family coverage and highlights those plans that provide full coverage for care from Cedars-Sinai and most of its physicians.

Plan-by-Plan Insurance Fact Sheet (PDF)

In the Covered California exchange, Health Net is the only insurance company offering PPO plans (Bronze, Catastrophic and Tribal) that provide full coverage for care from Cedars-Sinai and most of its physicians. Health Net also is the best option when purchasing a policy through an insurance company or agent, as Cedars-Sinai is participating in the Health Net Platinum, Gold, Silver, Bronze and Catastrophic PPO plans.

If you are a Health Net PPO-contracted physician, your patients with individual or family coverage who are not in a current plan that is eligible for grandfathering can select one of these plans and continue their care with you.

Patients who are in the middle of care and have received notice from their health insurance carrier that they need to switch plans in order to continue individual and family coverage may be able to keep their doctor or hospital for a limited time in the event you are not participating as a contracted provider in their new plan. This is called "continuity of care."

Please note that patients must initiate the request for continuity of care from their plan, and the physician and hospital must agree to keep them as a patient. When requesting continuity of care, patients must provide the name of their physician and hospital (if hospital services are needed), their current medical condition, and the treatments they are receiving. Click the PDF link below for an informational sheet on continuity of care that can be given out to your patients.

Fact Sheet on Continuity of Care (PDF)

Only patients with certain kinds of health problems/conditions can get continuity of care:

Type of Problem/Condition

How Long Continuity of Care Is Available

Acute condition (i.e., pneumonia)

As long as the condition lasts

Serious chronic condition (i.e., heart disease, diabetes)

No more than 12 months, usually until the patient completes a period of treatment and the doctor can safely transfer care to another doctor

Pregnancy

During pregnancy and immediately after the delivery (post-partum period)

Terminal illness

As long as the person lives

Care of a child under 3 years

For up to 12 months

Already-scheduled surgery/procedure (i.e., knee surgery, colonoscopy)

Surgery/procedure must be scheduled to happen within 180 days of the change in health plans.


Note: Any exceptions will be for a limited period of time.
Source:
California Department of Managed Health Care

For the most up-to-date information, please visit cedars-sinai.edu/insurance or email questions to insurance@cshs.org.