http://www.aapsonline.org/newsoftheday/003 from the Association of American Physicians and Surgeons Sat, 17 May 2008 08:31:26 +0000 http://wordpress.org/?v=2.3.2 http://www.aapsonline.org/newsoftheday/003#comment-22 Gail Burbridge, M.D. Wed, 26 Dec 2007 18:27:31 +0000 http://www.aapsonline.org/newsoftheday/003#comment-22 In my opinion, the only solution is balanced billing. Medicare patients can choose who they wish to see and make their own decisions. It is a violation of FTC policy to take advantage of the fact that Medicare controls approximately 65% of most of our practices. Private physicians should be able to decide how they charge and medicare should be able to go to the doctor of their choice. In my opinion, the only solution is balanced billing. Medicare patients can choose who they wish to see and make their own decisions. It is a violation of FTC policy to take advantage of the fact that Medicare controls approximately 65% of most of our practices. Private physicians should be able to decide how they charge and medicare should be able to go to the doctor of their choice.

]]> http://www.aapsonline.org/newsoftheday/003#comment-4 Gale Fri, 21 Dec 2007 17:48:39 +0000 http://www.aapsonline.org/newsoftheday/003#comment-4 Jesus, you mean the AMA is actually growing some balls and understands the need for confrontational negotiating....amazing!!! (But will it last?) Jesus, you mean the AMA is actually growing some balls and understands the need for confrontational negotiating….amazing!!! (But will it last?)

]]> http://www.aapsonline.org/newsoftheday/003#comment-3 John J. Kelly, M.D. Fri, 21 Dec 2007 11:46:54 +0000 http://www.aapsonline.org/newsoftheday/003#comment-3 This is an annual affront, but an even more devestating but little recognized affront is the increasing number of physicians who are being arbitrarily subjected to Prepayment Review, which can effectively halt nearly all Medicare payments indefinitely, as subcontractors clumsily intervene in the payment process. An eminent "legal eagle" of national renown on the subject of Medicare policy and regulation, Alice Gosfield, notes that physicians have essentially no rights to challenge this process, except to remind the subcontractors that they are not following published guidelines to notify physicians of the reason for the review, and its expected duration. The only viable choice is for the physician to have others assume the care of his Medicare patients, a process of transfer that published studies show drives up the cost of care, and of course interferes with the patient's right to the provider of their choice. This is truly a cause that should galvanize immediate nationwide physician action if national physician representative leaders were aware of the problem and its extent. It is likely that the true details of how these subcontractors are incentivized, and how ineptly these reviews are conducted will spur more national unity of physician response, and give immense "street cred" to the first physician organiztion that champions it. This is an annual affront, but an even more devestating but little recognized affront is the increasing number of physicians who are being arbitrarily subjected to Prepayment Review, which can effectively halt nearly all Medicare payments indefinitely, as subcontractors clumsily intervene in the payment process. An eminent “legal eagle” of national renown on the subject of Medicare policy and regulation, Alice Gosfield, notes that physicians have essentially no rights to challenge this process, except to remind the subcontractors that they are not following published guidelines to notify physicians of the reason for the review, and its expected duration. The only viable choice is for the physician to have others assume the care of his Medicare patients, a process of transfer that published studies show drives up the cost of care, and of course interferes with the patient’s right to the provider of their choice.
This is truly a cause that should galvanize immediate nationwide physician action if national physician representative leaders were aware of the problem and its extent. It is likely that the true details of how these subcontractors are incentivized, and how ineptly these reviews are conducted will spur more national unity of physician response, and give immense “street cred” to the first physician organiztion that champions it.

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