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Managed Care March 2001 Mark D. Abruzzo	'Final' Stark Regulations Still a Work in Progress The Stark Law generally prohibits physicians from referring Medicare patients for certain designated health services to entities with which the physician (or immediate family members) has a financial relationship...
Managed Care March 2005	Family practice base salary continues to improve Base salaries of family practice physicians increase.
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Deal Diagnosis Healthcare real estate transactions not only are driven by economic factors, but also by compliance with federal and state healthcare laws.
Managed Care July 2001 John Otrompke	Stark Allows Federal Regulators To Review Claims Records Fully HMO executives, as well as the providers and physicians who contract with them, should have by now felt the changes in their daily work lives resulting from the government's increased scrutiny of health plans' operations under the fraud-and-abuse compliance laws...
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Understanding Federal Healthcare Laws Commercial real estate professionals who work with medical office development must be aware of the federal healthcare fraud and abuse laws.
Managed Care December 2000 Michael Levin-Epstein	Outpatient PPS Regulations Latest Source of Anti-HCFA Anger The Health Care Financing Administration continues to be one of the most besieged agencies in the federal government. Now, providers are attacking the agency's rules for the prospective payment system (PPS) for hospital outpatient services...
Managed Care February 2001 Michael Levin-Epstein	Mainstream Media Misinterpret HCFA's Policy on Medical Errors Is the Health Care Financing Administration changing its policy on disclosure of medical errors to Medicare beneficiaries? The issue is causing a tremendous amount of confusion among physicians and health plans. To HCFA, however, the fuss is much ado about nothing...
Managed Care July 2006 Michael Levin-Epstein	High-Tech Imaging Full of Kickback Dangers Health plans and their members could save billions of dollars a year if radiology costs could be contained. Some managed care companies begin to take a hard look at what's behind the explosion in costs for radiological services.
Commercial Investment Real Estate May/Jun 2014	Medical Office Fever Sales of medical office buildings topped $6.7 billion in 2013, according to Real Capital Analytics, proof that this niche sector remains attractive to investors.
Managed Care September 2002	Medicare holds down physician pay Compensation increased at a comparatively small rate from 2000 to 2001 for both primary care physicians and specialists, according to the Medical Group Management Association.
Managed Care January 2007	Medicare's P4P Program Under Fire Before It Has Begun Just before adjourning last month, the outgoing Congress passed legislation that would set up a pay-for-performance program in Medicare.
BusinessWeek June 23, 2011 Drew Armstrong	The Simplest Rx: Check on Your Patient Doctors and insurers cut costs by sharing information.
Managed Care July 2000 Michael Levin-Epstein	Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen.
Managed Care April 2006 John Carroll	Some Specialist Societies Feel Left Out of AMA-CMS Deal on P4P Many physicians question the fairness of a deal between the American Medical Association and the government that give doctors a bonus when they follow certain rules.
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Managed Care December 2007 John Carroll	How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use.
Managed Care September 2003	Primary care pay falls again Primary care physicians' compensation continues to decline, according to the American Medical Group Association's 2003 Medical Group Compensation and Productivity survey.
Managed Care May 2002 Patrick Mullen	Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years
Managed Care February 2001 Michael Levin-Epstein	HIPAA Privacy Rules Create Uncertainty, Compliance Woes When it comes to information-sharing, just when does 'no' mean 'no'? What about conflicting statutes? We have two years to sort it out...
Managed Care October 2000 Maureen Glabman	Giving Some Ground to Physicians Helped Turn Health System Around One hospital system accepted the general wisdom a few years ago by acquiring physician practices. Now it bucks the new wisdom by holding on to them...
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.
Managed Care May 2007	Self-Referral Persists Despite Stark II Law Loopholes in federal and state laws that curb physician referral to diagnostic imaging providers in which they have a financial stake (self-referral) are allowing physicians to stretch how they are paid and for what.
Managed Care April 2001 Michael Levin-Epstein	President's Privacy-Rule Review Creates Controversy, Confusion The final medical privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) stand out in terms of controversy and confusion. The end game is still cast in doubt...
Commercial Investment Real Estate May/Jun 2013 Mauldin & Maddron	Medical Office Momentum The Affordable Care Act takes some risk out of healthcare property investment.
Managed Care July 2007	AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients.
Managed Care January 2002 Michael Levin-Epstein	HHS Seems To Soften Hard Line on Kickbacks Do two recent advisory opinions from the Health and Human Services Office of the Inspector General signal some moderation in federal policy on what constitutes a kickback? Maybe. Or then again, maybe not...
Managed Care August 2001	GAO: Consultants Point Docs Toward Federal Law Violations The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical...
Managed Care November 2002 Sharon Baker	Applause, Catcalls Greet Retainer Medicine Proponents tout personalized care and easy access, and imply superior health care. Critics fear "elitist" practices.
Pharmaceutical Executive May 1, 2006 Musacchio & Hunkler	More Than a Game of Keep Away The Prescribing Data Restriction Program takes effect in July. The AMA explains how individual doctors can keep their prescribing habits safe from reps, and how pharma can keep using the anonymous data -- if the industry polices itself.
Managed Care March 2007 John Carroll	Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.
Managed Care April 2000 Mark Abernathy	Avoid Common Problems In Risk-Sharing Contracts These arrangements too often become a hindrance instead of a help. Simple precautions today can help prevent major headaches later on.
Managed Care August 2002 Maureen Glabman	Lobbyists That the Founders Just Never Dreamed of The "right ... to petition the government" has come a long way in over 200 years, and health care organizations are not shy in exercising it.
Managed Care March 2006	Standard Measures In Works For P4P Push Uncle Sam has decided to get behind the pay-for-performance effort in a big way, something some physician associations are less than thrilled about.
Managed Care October 2000	Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections...
Financial Planning July 1, 2011 Suzanne Sataline	Code Blue? Many financial planners say their physician clients are fretting that they won't have enough money saved to retire on schedule, and that their savings won't hold through their elderly years.
BusinessWeek February 20, 2006 Arlene Weintraub	Should Doctors Own Hospitals? Controversy builds over a fast-growing, profit-driven business in which specialty hospitals are partly owned and run by doctors.
Managed Care October 2000 Patrick Mullen	Interview: Steven B. Epstein, J.D. This pioneering medical legal authority says health plans and physicians should stop fighting over scraps the government throws them...
Financial Advisor June 2010 Andrew Gluck	Advising Doctors As medical economics change for the worse, both physicians and their financial advisors are getting organized.
BusinessWeek January 20, 2011 Anna Edney	The Doctors in the House Have an Agenda Republican physician-lawmakers want to dismantle a Medicare cost-cutting board that could hit doctors in their wallets.
Managed Care February 2002 Donna J. Senft	Laws Governing Peer Immunity, Physician Credentialing Upheld A federal court in Maryland recently addressed challenges to several laws governing physician credentialing...
Managed Care May 2001 Jeffrey J. Denning	How To Challenge Medicare Payments Less than 6 percent of Medicare payments are protested. Of those, about 6 in 10 result in increased compensation for the physician. Odds are on your side...
Managed Care May 2001 Michael Levin-Epstein	Prescription Drug Talk Cooled Off Faster Than a Texas Thunderstorm Medicare reform -- and especially prescription drug benefits within Medicare -- no longer appears to be the burning issue it once was on Capitol Hill. The culprits: priorities and money...
Salon.com December 1, 1999 James B. Stewart	Who's watching the docs? The code of silence in hospitals allows deadly mistakes to happen, but some simple reforms could help...
Managed Care July 2007 John Carroll	Unlocking a Trove of Quality Data A bill before Congress would give analysts a powerful tool for sifting through Medicare data on the performance of hospitals and physicians.
Managed Care July 2003 Ed Silverman	A Little Something For the Physicians Health plans know that getting along with physicians is important, and many are trying new initiatives. Here are some successes.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
AskMen.com April 15, 2001 Joshua Levine	Choosing The Right Doctor Choosing a doctor is one of the most important decisions you can make. It's probably best made when you are healthy and have some time to think about a number of possibilities. If you don't have a doctor or are thinking about changing doctors, now may be the best time to look...
Managed Care May 2000 Michael Levin-Epstein	Marketing Medicare+Choice? Mind Your Ps and Qs, Says OIG A lot of Medicare HMOs' marketing materials don't cut it, says a report by the Office of the Inspector General. It adds that the Health Care Financing Administration is partly to blame....
BusinessWeek January 6, 2011 Justin Blum	Why Medicare Can't Catch the Fraudsters One provider's claims were paid despite unusual billing patterns
Managed Care August 2000 Bob Carlson	'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others.