reimbursements news from FierceHealthcare

It looks like some California medical groups and IPAs are profiting from their participation in pay-for-performance programs--but not that much. According to the Integrated Healthcare Association, Read more...

If you're a physician-businessperson, it's looking like 2008 is going to be a particularly tricky year to navigate. Not only will physicians face a 10.1 percent Medicare cut, Medicare may also cut Read more...

The American Medical Association recently drafted a letter to the Senate Finance Committee, stating that the Medicare Bill currently under Senate consideration should not reverse a reduction shift Read more...

Medical technology provider Stryker Corp., along with former outpatient therapy division Physiotherapy Associates, have agreed to pay $16.6 million to settle allegations that they'd submitted false Read more...

Anemia drug sales have taken a beating since Medicare tightened rules to limit when it would pay for them. Now, Aetna has set limits on anemia drug reimbursements too, issuing new rules that follow Read more...

When Congress changed the way Medicare paid oncologists in 2003--cutting reimbursements by 30 to 40 percent--critics charged that patients would have less access to care. However, a new study Read more...

> Health plan Highmark is vigorously questioning a recent report noting large differences in reimbursements for cardiac surgeries in the Pittsburgh area. Read more...

The American Medical Association has begun its latest no-holds-barred campaign to make Congress cancel a scheduled Medicare reimbursement cut. As part of its campaign, AMA is publicizing the results of its survey of 9,000 physicians, which found that more than half would to limit the number of Medicare patients they accept if the planned 10 percent cut is implemented. (Sure, there's a bit of grandstanding going on here--but the pain is real, too.) Patients aren't the only ones who would …

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The current system Medicare used to gradually bump up reimbursement rates for physicians isn't fair, and should be replaced by one which takes physician practice costs into account, a group of 87 medical organizations told Congress. The group, which includes the American Medical Association, notes that hospitals and nursing homes are paid based on their costs. However, physicians are paid based on a formula known as the sustainable growth rate (SGR), tied to the U.S. economy, which has …

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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 …

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