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4 Min Read

How to dispute incorrect financial data before it goes public

Physicians can review reports about their financial interactions with manufacturers of drugs and medical devices now through Aug. 27 under the Physician Payments Sunshine Act (also known as the Open Payments program).

Medicare & Medicaid
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3 Min Read

Who's leading ACOs: physicians or hospitals?

The first national survey of accountable care organizations (ACO) examines who is playing the strongest leadership and ownership roles in the development of these new models of care.

Payment & Delivery Models
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4 Min Read

8 things you should know about Medicare's proposed payment rule

If the policies set forth in the 2015 Medicare Physician Fee Schedule proposed rule take effect, physicians will be in for a lot of changes—many of them unfavorable—next year. Here are the top eight things that you should know.

Medicare & Medicaid
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2 Min Read

Court considers: Can doctors sue insurers for underpaid claims?

In North Jersey Brain and Spine Center v. Aetna, a physician practice that received assignments of benefits from patients with employer-sponsored health plans sued the insurer for denying and underpaying medically necessary surgeries for three different patients.

Judicial Advocacy
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2 Min Read

Physicians should know about their personal data, AMA tells CMS

Personally identified data about physicians not publicly available soon could be shared with government agencies, law enforcement and Medicare contractors without physicians’ knowledge, under a new “system of records” announced by the Centers for Medicare & Medicaid Services (CMS).

Medicare & Medicaid
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2 Min Read

Court squelches challenge to customary practice of medicine

In Kentucky Board of Chiropractic Examiners v. Barlow, an appeals court upheld the ability of physicians to provide expert review and testimony in keeping with their full scope of practice and training.

Judicial Advocacy
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1 Min Read

Avoid 2016 Medicare penalty: Use a registry for quality reporting

Physicians who don’t successfully report for Medicare’s Physician Quality Reporting System (PQRS) this year will face a 2 percent payment penalty in 2016.

Medicare & Medicaid
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3 Min Read

What you should consider when planning a team-based care model

As team-based models of delivering care become an increasingly common way to improve care coordination and efficiency, a new report offers guidance for the crucial elements physicians should consider when planning such a team.

Scope of Practice
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3 Min Read

Doctors tell CMS to put the brakes on new medical staff rules

A final rule revising Medicare’s conditions of participation for hospitals could impact physicians’ role in hospital governance and patient care activities. Under the latest final rule, published in May and scheduled to take effect July 11, a multi-hospital health system would be permitted to have a single, integrated medical staff.

Payment & Delivery Models