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BCBS settles suit; claims must be filed by Oct. 19
October 19 is the deadline for physicians to file claims as part of the settlement of a class action suit against Blue Cross Blue Shield Association (BCBS). BCBS has agreed to distribute more than $131 million to eligible physicians who provided services to any patient covered by the insurer between May 22, 1999, and May 31, 2007. Notices about the settlement and claim forms were mailed to physicians on July 27. If you think you may be eligible and have not yet received a notice, visit: http://www.hmosettlements.com
Physician compensation not keeping pace with inflation; groups losing money
According to a Medical Group Management Association survey, the median compensation for specialists rose just 1.7 percent during 2006, while compensation for primary care physicians rose 2 percent and inflation rose 3.2 percent during the same span. “Physician Compensation and Production Survey: 2007” also states that, in 2006, specialists reported increases in production (gross charges) of 2.3 percent overall, and primary care physicians reported a 3.7 percent increase. Overall, compensation for 60 percent of polled specialties failed to keep up with inflation in 2006.
A survey of medical groups conducted by the American Medical Group Association (AMGA), an industry advocacy group, finds that, although 92 percent of specialties noted modest increases (average 4.8 percent) in compensation in 2006, medical groups operated at an average loss of $119 per physician during that year. Organizations in the Western region were the only ones operating at a profit, at $17,317 per physician. Organizations in the Southern region operated with the greatest deficits, losing $6,046 per physician.
New Medicare rules for ASCs
The U.S. Centers for Medicare and Medicaid Services (CMS) is accepting public comments on a proposed rule that would revise the requirements that ambulatory surgical centers (ASCs) must meet in order to bill Medicare. Changes outlined in the proposal include but are not limited to: implementing a more comprehensive quality assessment and performance improvement condition (QAPI); requiring the ASC’s governing body to be responsible for the oversight and accountability for the updated QAPI program; adding a new disaster preparedness plan standard; adding requirements for radiologic services provided in an ASC to ensure they are parallel to the requirements for furnishing laboratory services; adding a new patient rights condition to address disclosure of physician financial interests in the ASC; and adding a comprehensive patient assessment requirement to ensure appropriate and safe surgery.
For more information: http://tinyurl.com
Senate bill would require full disclosure of payments to physicians
The New York Times reports that a bill recently introduced in the U.S. Senate would require drug manufacturers and medical device makers to publicly report almost all payments and gifts to physicians. Under terms of the bill, free drug samples and financing for clinical trials would not have to be disclosed, but payments or benefits made “directly, indirectly, through an agent, subsidiary or other third party” would have to be disclosed. Companies that don’t comply with the disclosure law would be subject to a $10,000 fine for each infraction.