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Jan.
17, 2005 |
|
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IMAGING
•ACC Weighs
in on Imaging Recommendations to Congress
•Texas Chapter Alerts
Members to Imaging Threat
|
REIMBURSEMENT
•CIGNA
Claims Deadline Approaches
•Medicare
Fraud Alert |
MEDICAL
LIABILITY REFORM
•Medical
Liability Victory in Maryland
•DMLR
Backs Bush Call for Liability Reform |
LEGISLATIVE/REGULATORY
•MedPAC
Supports Specialty Hospital Moratorium
|
| IMAGING |
ACC Weighs
in on Imaging Recommendations to Congress
On Jan. 12,
the Medicare Payment Advisory Commission (MedPAC)
approved, without dissension, six recommendations
on medical imaging that will be included in
a March 2005 report to Congress. The recommendations,
premised on the notion of inappropriate growth
of imaging services by unqualified providers,
state that Congress should require the Centers
for Medicare and Medicaid Services (CMS) to
develop standards for physicians who interpret
imaging studies and for providers who perform
diagnostic imaging services. The ACC plans
to  send
a letter to the MedPAC Commissioners to express
continued concerns
with the recommendations. |
Texas
Chapter Alerts Members to Imaging Threat
The Texas Chapter
of the ACC alerted its members last week to
pending legislation that would severely limit
physicians’ ability to refer patients
for imaging tests. The proposal is supported
by the Texas Radiological Society, although
a specific bill has yet to be introduced.
Members
of the Texas Chapter can visit www.tcacc.org
or contact Adam Nelson at advocacydiv@acc.org
to find out more. |
REIMBURSEMENT |
|
CIGNA
Claims Deadline Approaches
Physicians
affected by the 2004 CIGNA settlement have
until Feb. 18, 2005 to submit their claims.
The settlement stems from class-action lawsuits
filed by several medical societies against
regional and national managed care companies,
including CIGNA, for wrongfully denying
physician
reimbursement for certain procedures. For
instructions on filing a reimbursement claim,
click
here. |
Medicare
Fraud Alert
CMS recently
issued an alert to Medicare providers about
an organized group who is attempting to fraudulently
obtain sensitive provider information
for financial gain. To review a copy of this
fraud alert click
here.
|
| MEDICAL
LIABILITY REFORM |
Medical
Liability Victory in Maryland
Physicians
in Maryland will receive some relief from
skyrocketing insurance premiums as the state
legislature overrode the governor’s
veto to pass a medical liability reform
law. The legislation creates a one-year
2 percent tax on HMOs to finance a 5 percent
limit on medical liability insurance increases.
The new law also reduces caps on non-economic
damages from $1.6 million to $650,000, implements
stricter
requirements for expert medical witnesses,
and requires mediation unless both parties
agree to waive this option. |
DMLR
Backs Bush Call for Liability Reform
In a press
release issued Jan. 5, Doctors for Medical
Liability Reform (DMLR) expressed their support
for President Bush’s recent push for
congressional action on medical liability
reform. Bush traveled to Illinois this month
to bring attention to the effect of frivolous
lawsuits on doctors around the country. As
a member of DMLR, the ACC will be working
with Congress to pass legislation that has
repeatedly passed the House, but stalled in
the Senate. To learn more about DMLR’s
plans
for the 2005 legislative session, visit www.protectpatientsnow.org. |
| LEGISLATIVE/REGULATORY |
MedPAC
Supports Specialty Hospital Moratorium
MedPAC Commissioners
voted last week to extend a current moratorium
on physician-owned specialty hospitals to
June 2006. The decision came as part of the
Commission’s larger discussion of the
current DRG prospective payment system and
how it should be modified to better reflect
the cost of care in an inpatient setting.
The specialty hospital moratorium was originally
scheduled to expire this June, but the Commission
agreed more time was needed to evaluate the
impact of specialty hospitals on acute-care
hospitals and to start implementation of DRG
refinements to the inpatient-care payment
system. |
