Legal

A quest to determine why physicians drop Medicare from their practices, and what effect it has on healthcare has ended in failure. See what roadblock got in the way.

One major group is fighting the switch, and another is urging its members not to wait. Learn the reasoning behind their positions.

More people in Massachusetts have health insurance now than when mandated coverage was enacted. Despite the gains, costs are still climbing. Learn the national implications.

National insurer WellPoint announced a medical home program that could raise your compensation by 50%. Eligibility won’t be easy and could affect your whole practice.

Your professional groups are demanding legislators repeal Medicare’s sustainable growth rate formula. See how much it could cost, and why taking from the war chest could work.

Two decades of studies intended to reduce Medicare spending didn’t save much money, the Congressional Budget Office says. Learn more about the failed plans.

A new Oregon law requires concierge and other “retainer” practices to register and be certified by the state. Find out why.

Referrals from primary care physicians and specialists more than doubled from 1999 to 2009, a recent analysis found. See why experts disagree on the reason behind the growth.

This year the government is giving physicians extra time to drop their Medicare participation. But you do face one snag if you let the relationship linger too far into 2012.

The California Hospital Association (CHA) is suing state and federal officials to block a 10% cut in government reimbursements to healthcare providers who treat low-income patients under the state's Medi-Cal program. The CHA claims the cuts will force many hospitals to close their skilled nursing facilities.

A new study from an international organization confirms what you probably suspected already: The American healthcare system is uneven, expensive, and inefficient.

The author has seen a troubling rise in fraud, graft and discount doctoring since insurers have raised premiums, copays, and deductibles to maddening heights.

Unreasonable expectations invite disaster, but turning away a patient can cost you revenue. Where do you draw the line? Every doctor answers differently.

The Centers for Medicare and Medicaid Services (CMS) released the final rule for its physician fee schedule November 1 and stated that providers would see an across-the-board reduction of 27.4% for services in 2012, but much is still unclear about this change.

Physicians need to be more cost-conscious, but not at patients? expense, according to the new ethics manual from the American College of Physicians (ACP). Read why in this exclusive interview with ACP President Virginia Hood.

Government and commercial health plans must now use an electronic tracking number to match your claim and the plan’s payment, according to a federal rule that went into effect this year.

Reforming team-based payments and expanding the scope-of-practice for nurses could boost primary care access in the United States, according to a policy analysis by a nonprofit group.

The CEO of an accountable care organization participating in a U.S. Department of Health and Human Services initiative says he is confident his network of 180 primary care physicians will earn a cost-savings incentive throughout the 3-year program.

The federal Joint Select Committee on Deficit Reduction failed to reach agreement on a deficit-reduction proposal, which means that doctors still face a 27% cut in Medicare payments effective January 1. Predictably, the decision elicited strong reactions from organizations representing primary care physicians. Read what the organizations are saying on your behalf and their suggestions for future action.

If your office isn’t prepared to submit claims using version 5010 electronic transaction standards, take a breath but keep on working. With so many of your fellow physicians in the same position, the Centers for Medicare and Medicaid Services has decided to wait until March 31 to begin enforcing adherence to the standards. Some caveats apply, however.

Physicians are doing their part to improve the lackluster economy. Healthcare employment grew by 12,000 jobs in October, with 8,000 of those jobs in doctors' offices, according to the Bureau of Labor Statistics. This after September saw the highest growth in healthcare employment in 9 years. Find out how that rate compares with growth in other industry sectors and how long you can expect the healthcare boom to last.

Have you and your colleagues expended significant time and money to understand and meet the requirements of a law that may be declared unconstitutional? The answer is not clear at this point, but at least the issue is headed toward resolution. The U.S. Supreme Court has agreed to rule on the constitutionality of the Patient Protection and Affordable Care Act, with oral arguments likely this spring and a decision later next year. Find out what issues before the court could have the biggest effect on your practice.

The American Medical Association House of Delegates has voted to “work vigorously to stop implementation of ICD-10” by an October 2013 deadline. But don’t get your hopes up. The smart money is probably on the government. Find out what the Centers for Medicare and Medicaid Services said about changing the deadline, and why the agency is so anxious to start using the new coding system.

A new government initiative will begin awarding $1 billion in funds next March to physician offices and other healthcare sites exploring creative ways to deliver high-quality medical care and reduce costs for people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program. Projects that can be up and running in 6 months or less and demonstrate a model for sustainability after the 3-year award period will have priority. Find out why it might be worth a look to see if your practice can qualify.

Responding to a new report that says growing pains for health information technology are creating some short-term safety issues, technology experts say physicians should remember one immutable fact: The new systems are far less dangerous than the old paper-based systems still used by many practices. The Institute of Medicine said there have been reported cases of patient injury related to medication dosing errors, failure to detect fatal illnesses, and treatment delays due to poor human-computer interactions or loss of data. Read on to learn how can you avoid these errors when using technology in your practice.

A liberal advocacy group says that liability reform in Texas shouldn’t be a model for the rest of the nation because the only beneficiaries are doctors and malpractice insurance companies. It also maintains that healthcare is scarcer in the state and more expensive than the national average-claims disputed by supporters. You might be interested in what the report says about the drops in the frequency and dollar amounts of liability payments since malpractice caps were instituted.

Here’s something you may not want to hear as you scramble to meet the October 1, 2013, deadline for ICD-10 conversion: ICD-11 will be available about 2 years later. That reality was discussed at the recent American Health Information Management Association meeting, which featured a speaker from the World Health Organization, the developer of the International Classification of Diseases. Find out why the next conversion might not be as burdensome.

Nearly half of physician practices do not meet national standards to qualify quality as a Patient-Centered Medical Home, with smaller, single-specialty groups being the least likely to qualify, according to a new study. Ninety percent of Americans receive care from those smaller practices, however. Learn how solo and single-specialty practices can even the playing field to meet medical home standards.

The government is jumping the gun in trying to develop metadata standards for healthcare technology, according to two industry groups. Those standards are proposed for meaningful use stage 2 and could affect your electronic health record implementation. Find out what prompted concerns that standards are too early for metadata, which embed descriptive information about the meaning and use of data.

Making sure all of your older patients receive necessary vaccines is a challenge; 34% of adults aged more than 65 years fail to get a seasonal influenza vaccine and 40% lack pneumococcal vaccinations. Your electronic medical record system could provide an effective solution, however. A recent study reports that EMR reminders increase pneumococcal vaccination rates by 50% and raise influenza vaccination rates 20%, compared with usual care. How can this system work for you, and how much of your time will it require?