Contents tagged with medicare
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AAFP, specialty organizations develop strategy to avoid Medicare payment cut
AAFP, specialty organizations develop strategy to avoid Medicare payment cut
posted 09.13.11
AAFP met with representatives from seven medical societies and seven professional organizations last … more
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Deliberations present opportunity, risks in Medicare physician pay
Deliberations present opportunity, risks in Medicare physician pay
posted 08.23.11
Out of last month’s debate on the U.S. debt ceiling and the resulting legislation, the Budget Control Act of 2011 … more
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Déjà vu all over again, the Medicare physician fee debate is back
Last month’s debate on the U.S. debt ceiling brought to light the ugly side of how we finance the nation’s operations, and as lawmakers move forward on a deal to reduce the deficit, they will inevitably turn their eyes to one of the country’s biggest expenses: Medicare. Federal spending for fiscal year 2010 totaled $3.5 trillion and Medicare comprised 15 percent of the total amount.
However, with crisis comes opportunity and a convergence of factors may make this the time to address a structural deficit in how the country pays physicians and other providers for the services they provide to Medicare beneficiaries.
Under the debt deal, a 12-member joint committee has until Thanksgiving to formulate a plan to cut at least $1.2 trillion in spending over the next 10 years. Then, recommendations made by the so-called “supercommittee” must go before Congress and pass by a simple majority in both chambers by Christmas. If the committee can’t agree on cuts or Congress fails to pass them, a series of across-the-board reductions would be triggered. One cuts pay to Medicare providers by up to 2 percent starting in 2013, which experts estimate would add up to around $12 billion.
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It’s time to read up on the RAC
Okay, if you haven’t started getting serious about educating yourself about the Recovery Audit Contractor program, it’s about time you should.
RACs are third parties hired by the Centers for Medicare and Medicaid Services to ensure that physicians are being paid correctly for Medicare Part A and B services. They identify all “improper payments,” whether the physician received too much or too little, and in return receive a share of the booty—I mean, spoils—I mean, identified payments. [Don’t mind me, it’s Friday.]
CMS released an update in late April that showed that in its first 18 months, the permanent RAC program had identified a total of $365.8 million in total improper payments—$312.2 million in overpayments and $52.6 million in underpayments. The agency attributed the four big reasons for improper payments to incorrect coding and billing for bundled services.
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Is it time to declare independence from the RUC?
In a recent opinion column published in Kaiser Health news, two prominent voices in health care policy gave primary care physicians a piece of revolutionary advice: Quit the RUC.
If you don’t know what the RUC is, you aren’t alone.
RUC stands for the Relative Value Scale Update Committee, a group of 29 physicians from various medical specialties that meets three times a year to advise the Centers for Medicare and Medicaid Services on Medicare physician fee reimbursement and how certain procedures should be valued. Created by the American Medical Association in 1991, the committee has no official government standing, yet it yields great power.
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Congress approves 12-month SGR extension, AAFP calls for permanent fix
Congress approves 12-month SGR extension, AAFP calls for permanent fix
posted 12.09.10
Congress has passed a 12-month extension of the Medicare physician payment rate. The U.S. Senate approved … more
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Congress approves 12-month SGR extension, AAFP calls for permanent fix
Congress approves 12-month SGR extension, AAFP calls for permanent fix
posted 12.09.10
Congress has passed a 12-month extension of the Medicare physician payment rate. The U.S. Senate approved … more
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Latest Medicare cut looms
Latest Medicare cut looms
MGMA study predicts sharp physician reaction to pay cut
posted 11.02.10
Unless Congress acts before the end of the month, payments to physicians for the services they … more
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21.3 percent Medicare pay cut goes into effect
21.3 percent Medicare pay cut goes into effect
Senate sends short extension, positive update to House
posted 06.18.10
The Centers for Medicare and Medicaid Services began processing Medicare … more
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Who’ll be there to care for me?
By John Kurt Frederick, M.D.
He slowly totters into the exam room with his daughter-in-law in tow. The plastic grocery bag holds all his pill bottles and his metal walker looks like it has been well used. A faint smell of urine wafts from him and his shirt is stained with breakfast. He manages to make it into the room. With difficulty he turns stiffly and lands his bottom in the exam room chair.
He is my newest Medicare patient, an elderly parent of a friend. He recently moved to the area to be nearer to his only son, his existence now too difficult to manage alone. His medical problems are myriad and complex and he takes a recipe of pills several times a day. I smile and welcome him to Austin as I gently grip his gnarled hand. We converse briefly before I dive into the box of medical records and the sack of pill bottles, many expired, many duplicated, and all powerful and dangerous in their own right.
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