Reimbursement news and information

Senate Finance Committee Chairman Max Baucus opened the panel's first hearing in six years on Medicare physician pay with assertive rhetoric about scrapping the hated sustainable growth-rate formula this year. .
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Because of the program's history of low payments, fewer than half of U.S. doctors and other healthcare professionals accept Medicaid patients, according to a recent study. For those that do, getting an appointment sometimes can take months because of the high demand, particularly among specialists.
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Physician advocates see signs of progress in the Senate Finance Committee's hearing Tuesday—the panel's first in six years on replacing Medicare's physician payment system.
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The CMS and Medicare beneficiaries could have saved an estimated $510 million on drugs used to treat end-stage renal disease in 2011 if the reimbursement rate more accurately reflected current usage of these drugs, according to a report from HHS' inspector general's office.
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A, jury concluded that Tuomey Healthcare in Sumter, S.C., violated the False Claims Act by submitting tens of thousands of illegal bills to Medicare worth $39 million.
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Providers are coalescing around a five-year transition period before moving to a new Medicare physician payment system, according to a House Republican involved in developing the replacement.
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HHS' inspector general's office is launching an in-depth investigation into cases where Medicare hospice beneficiaries get inpatient care, following unusual billing patterns that surfaced during recent research on the $1.1 billion industry.
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LIVONIA, Mich.—Blue Cross and Blue Shield of Michigan and Trinity Health-Michigan have signed a three-year reimbursement contract that gives Trinity's 12 hospitals in Michigan financial incentives for improving care with affiliated physicians. Blue Cross has similar contracts with...
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While recent research showed small, rural hospitals registered worse mortality outcomes than their larger urban and suburban counterparts, they fare no worse than their larger counterparts on mortality following common, low-risk surgical procedures, such as appendectomy and knee replacement.
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As the care delivery models of hospitals and health systems evolve, healthcare executives and managers predict a major shift in admissions from inpatient to outpatient settings.
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