Healthcare Finance

A mushrooming contract dispute between Detroit Medical Center physicians and affiliated teaching hospital Wayne State University could threaten WSU's accreditation, potentially depriving the city's uninsured of their main source of indigent care. At present, the jointly-administered teaching program hosts about 900 residents and 700 faculty physicians. These physicians provide about 40 percent of the primary care in Detroit and most of the care for the area's uninsured, according to the …

CMS has proposed new rules that would limit the "in-office ancillary services" exception to federal self-referral law. Specifically, they're taking a closer look at the extent to which physicians may be taking excessive profit from a standard diagnostic services, particularly MRI, CT and PET scans. While federal law bans doctors from referring patients to outside facilities in which they have a financial interest, the rules make an exception for tests doctors perform on site or at a …

A Texas cardiologist has been awarded $22.5 million in appeal to his his suit against three rival cardiologists and the Presbyterian Hospital of Dallas. A previous jury had found in favor of his charges of breach of contract, defamation, business disparagement, tortious interference with a contract, and intentional infliction of emotional distress and awarded him a $366 million judgment, but the judge hearing the appeal reduced the award.

The dispute dates back to 1998, when a …

New Jersey's Horizon Blue Cross Blue Shield health plan, which insures 3.2 million consumers, has settled a class action suit claiming its reimbursement practices had treated thousands of doctors unfairly. The suit, which was filed in 2002 on behalf of about 40,000 of the state's physicians, contended that the HMO--along with United Healthcare and Cigna Healthcare--was paying doctors late and reducing payments unfairly. In settling the suit, which doesn't involve a payout by the health …

Tired of being rated by insurance plans, government agencies and consumers? Well, if you're a family physician, here's your chance to create your own scorecard. The American Academy of Family Physicians (AAFP) has set plans to launch what it calls a "massive" payer report card, grading the plans on their contracting process, customer service, payment rates, claims processing performance, formulary, responsiveness and more, assigning a grade from A to F. AAFP is collecting the responses …

Though the U.S. population is aging rapidly--and living longer--few young doctors are going into geriatrics. This is creating a crisis in care for the elderly, with only one geriatrician available per 5000 patients, according to The New York Times. While medical students enjoy geriatrics rotations, they're overwhelmingly choosing to specialize in more glamorous, higher-tech fields such as cardiology and oncology, the Times reports. They're also opting for …

A Kansas hospital has sued Coventry Health and Life Insurance Company and its South Care PPO over $3.2 million in disputed claims. In the suit, North Kansas City Hospital says that it is actually owed a total $5 million, but that under the terms of its HMO contract, it will go into arbitration to recover the $1.8 million it says it is owed there. The hospital recently announced that it would drop its contract with Coventry as of January 2007. In prior years, Coventry claims have …

While overall physician pay has remained fairly level, a small handful of specialties saw double-digit increases in pay, according to this year's edition of an annual survey by compensation consultants Sullivan, Cotter and Associates. According to the study, which surveyed 264 healthcare organizations, neurosurgeons enjoyed a dramatic jump in overall cash compensation between 2004 and 2006, with totals climbing 28.1 percent during that period. Compensation for pathology (25.6 percent), …

Is this a sign that the retail clinic model has flaws, or just one company's struggles to establish its footprint? Retail clinic operator Take Care Health Systems recently pulled out of Portland, OR, breaking away from its relationship there with partner RiteAid. This week SSM Healthcare, a St. Louis-area health system, has announced that it will be severing its partnership with Take Care. …

The National Labor Relations Board has found that Sutter Roseville Medical Center must pay workers back wages interest after locking them out for four days in 2002. The ruling upholds the decision made by an administrative law judge in 2004. The NLRB finding will affect about 450 workers, each of whom should get an average of $444, for a total payout of about $200,000, according to The Sacramento Bee. Workers, including nurses and operating room techs, had staged a …