Abstracts » Health

Private contracting suit dismissed, but plaintiffs claim victory

Article Abstract:

US District Judge Nicholas Politan has dismissed a lawsuit brought by Lois Copeland, MD, and five Medicare patients to allow them the right to organize a private payment system. He ruled that patients are not prohibited from paying for services with their own funds and asking their physicians not to bill Medicare. According to one lawyer, however, physicians who follow this path may still face administrative sanctions imposed by the Health Care Financing Administration.

Cases, Laws, regulations and rules, Prices and rates, Medical fees

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Medicare can extrapolate to demand repayment

Article Abstract:

The Supreme Court has ruled in favor of the Department of Health and Human Services with respect to its methods of calculating overpayments to physicians for Medicare and Medicaid services. Sample audits are used to check a doctor's records for evidence of overpayment, and the results obtained by the sample are used as a basis to estimate overcharges. Lawyers for the defense claim that the process does not permit physicians sufficient grounds to defend themselves.

Usage, Discipline, Accounting and auditing, Statistics, Statistics (Data)

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Doctors less willing to settle on claims

Article Abstract:

An AMA poll indicates that physicians are increasingly unwilling to settle malpractice claims because of National Practitioner Bank reporting requirements. The bank is a repository for disciplinary information, designed to weed out incompetent doctors. The problem is the bank's inclusion of nuisance claims, which physicians are inclined to settle regardless of their validity. The AMA has suggested the omission of settlements under $30,000.

Standards, Malpractice, Medical malpractice

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