Medical practice

A new law that would allow providers to include non-compete clauses in some physician contract is making headway in Tennessee. The bill, which applies to podiatrists, chiropractors, dentists, medicine and surgery doctors, optometrists and psychologists, would let providers bar doctors from practicing within a 10-mile radius of a practice where they'd once been employed--or within 10 miles of any facility where the provider offers services. (The last clause clearly attempts discourage the …

Managed care executives are understandably stressed by the cost of biologic drug treatments which, in extreme cases, can run as much as $100,000 per year. To address the problem, many plans are asking patients to pay larger percentages of the medications' cost. With some patients already spending hundreds of dollars a month, some are cutting back, and others can't afford to raise doses when necessary, physicians say. Other doctors have complained that health plans are using less-direct …

An established practice under which pharmaceutical companies offer physicians discounts on some anemia drugs is coming under fire, with critics arguing that the discounts could unduly influence how often the drugs are prescribed. A trio of anemia drugs, including Amgen's Aranesp and Epogen and Johnson & Johnson's Procrit, accounted for a whopping $10 billion in sales …

A new study has quantified something physicians already knew: that they contribute surprisingly big bucks to hospital revenue. The study, published by physician search firm Merritt, Hawkins & Associates, concluded that an average physician will generate $1.5 million in net revenue a year for affiliated hospitals. (MH&A got its data from hospital chief financial officers.) This number has actually fallen since 2004, when revenue generated by all specialists hit $1.9 million--a fact …

Sometime around 2011, a huge wave of aging baby boomers will turn 65 and become eligible for Medicare or Medicaid. And they'll need the coverage, as many can't afford the higher premiums that private health plans charge for those facing a long list of age-related chronic conditions. However, many will face obstacles in getting to physicians who, increasingly, are turning away patients with these types of coverage. To address the problem, hospitals are engaged in aggressive physician …

Blue Cross and Blue Shield of Florida has been ordered to pay $1.5 million to two hospitals as compensation for hospital bills it refused to pay. A jury found that the plan's HMO inappropriately refused to reimburse the two hospitals, Miami's Palmetto General Hospital and Coral Gables Hospital, for certain hospital pathologist services. Eight years ago, the health plan's Health Options HMO stopped paying hospital pathologists for supervising and interpreting tests. In the suit, the …

Most physicians will tell you that free drug samples are an important part of their practice. After all, patients who get samples can avoid co-pays, and more importantly, can begin treatment immediately. However, critics are increasingly protesting this practice, arguing that such samples prompt doctors to prescribe the new medications on hand rather than choosing the drug indicated by medical evidence. What's more, critics say, older drugs may sometimes be safer, as their side effects …

A new federal measure--sure to take some heat from lobbying groups--would allow Medicare to withhold payments from physicians and other providers who haven't paid federal taxes. The proposal follows a federal investigation which concluded that 21,000 providers owed $1.3 billion in back taxes just for the first nine months of 2005. Meanwhile, these providers were still receiving Medicare payments. The bill was introduced by Sens. Norm Coleman (R-MN) and Carl Levin (D-MI), who are ranking …

While many public health officials are excited about the Gardasil's potential to prevent cervical cancer, doctors are increasingly refusing to offer it to patients--including the pediatricians and gynecologists who are its most likely prescribers. These doctors say that reimbursements for the expensive vaccine are not high enough to justify the stocking and administrative costs of carrying it. For example, some insurance companies are reimbursing doctors $122 per shot, or just $2 more …

As if state healthcare administrators weren't facing enough problems already, they're now battling a lawsuit over free care provided after Hurricane Katrina. Doctors at a New Orleans-area hospital, West Jefferson Medical Center, have sued the state for $100 million. The 381 physicians bringing the suit argue that state officials should reimburse them for treating indigent patients, which they've done since August 2005 in the wake of the hurricane. The physicians estimate that 30 percent …