Dangerous path

Article Abstract:

The Department of Health and Human Services' (HHS) Physicians at Teaching Hospitals (PATH) retrospective audit initiative employs ethically dubious tactics, ultimately relying on unfair practices to perpetuate its crusade. The PATH audit addresses three issues related to Medicare Part B payments to teaching physicians; in all cases, HSS offers payment and investigatory options that compromise physician fiscal status and jurisdiction. The American Medical Association and other medical groups are preparing to fight PATH in the courts.

Administration of Human Resource Programs, ADMINISTRATION OF HUMAN RESOURCES, Dept of Health & Human Services, Medicare B, Editorial, Economic policy, United States. Department of Health and Human Services. Office of Inspector General

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Pay denied in E&M audits; more physician education on documentation rules urged

Article Abstract:

Pay has been reduced or denied in 60% of the cases resulting in an onging audit related to Medicaid evaluation and management services by physicians in the US. The audit report from the Health Care Financing Administration (HCFA) surprised and stunned the Practicing Physician's Advisory Council. The HCFA desires to enforce 1997 pay guidelines in the summer of 1998, but the American Medical Assn desires a delay.

Insurance claims adjustment, United States. Centers for Medicare and Medicaid Services

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Reduced benefits can mean more pay delinquencies

Article Abstract:

The reductions in health care benefits that are concomitant with reforming the health care system may result in greater patient payment delinquencies for physicians' practices. Physicians need to inform both their staffs and clienteles of the changes in their insurance and payment practices which are wrought by new health care policies to minimize the frequency of payment delinquencies.

Management, Health care reform, Collection (Accounting)

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