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Restrictions on Medicare private contracting eased

Article Abstract:

The Health Care Financing Administration (HCFA) has relaxed restrictions that kept physicians from privately contracting with their Medicare patients. In a letter to psychotherapists seeking clarification of HCFA policy, HCFA policy-development bureau director Thomas Ault stated that physicians may enter into private contracts with Medicare patients, but only at patients' request. A 1992 lawsuit brought by Lois Copeland, MD, although dismissed by a federal judge, was seen by Copeland as a victory because it uncovered a lack of clear policy regarding such private contracts.

Administration of Public Health Programs, Physicians & Surgeons, Offices of Physicians (except Mental Health Specialists), Medicare B, Medicare, United States. Centers for Medicare and Medicaid Services

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Florida restrictions include rate-setting provision

Article Abstract:

Florida's Patient Self-Referral Act bars physicians from referring patients to medical facilities in which they have ownership interests, and caps rates facilities can charge for specific medical services. The statute, which was passed in Feb 1992, restricts referrals to joint venture diagnostic imaging centers, clinical laboratories and physical therapy centers. In addition, the law forbids facilities from charging more than 115% of what Medicare charges for the same service.

Florida, Social policy, Health facilities, Medical fees

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Referral ban softened: frustrated physicians OK self-referral if doctors disclose ownership interests

Article Abstract:

The American Medical Assn (AMA) has decided it is ethical for physicians to refer patients to medical facilities that they have an interest in as long as they disclose the information. The AMA has also ruled that physicians may not invest in medical facilities that they will refer patients to unless existing facilities are of poor quality or the physicians can prove the community would benefit from their financial backing of the new facilities.

American Medical Association

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