States eye equal Medicare pay for rural, urban doctors

Article Abstract:

States such as Ohio, Oregon and Wisconsin are considering instituting state-wide rates for physician Medicare reimbursement. In the past, rural physicians have received somewhat less reimbursement than urban doctors. Under the new plans, the rates for rural physicians would be raised while the rates for urban physicians are lowered. While many rural doctors back the plan, some urban physicians object to it, citing factors that drive down their salaries such as the increased number of Medicaid patients they treat.

Laws, regulations and rules, Practice, United States. Centers for Medicare and Medicaid Services, Prospective payment systems (Medical care)

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HHS probe questions hospital expenses, but investigators' motives also under fire

Article Abstract:

A Health and Human Services Department (HHS) investigation of hospital administrative expenses revealed instances of fraud, but the investigation appears to be a gratuitous attempt to justify Medicare cuts. Many of the abuses were tied to physician recruitment, and in one instance a hospital even sought reimbursement for a physician tennis tournament. Hospitals may be justified in crying foul. The HHS audit was not representative of hospitals and covered only a portion of expenses in a given audit year.

General medical & surgical hospitals, Hospitals, Ethical aspects

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Auditors at the gate: how a Medicare audit works and what to do to protect yourself

Article Abstract:

Physicians can safeguard themselves against Medicare audits in a number of ways. Learning Medicare's rules, keeping excellent records, being alert to warning signs of an impending investigation, maintaining a system for handling an audit and conducting occasional internal reviews are all ways for physicians to avoid an audit. Trouble signs that may trigger an investigation are described, and a step-by-step description of an audit is presented.

Auditing

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