New Medicaid drug rules: better care, more hassle

Article Abstract:

New Medicaid drug regulations will benefit poor patients but may be detrimental to physician-pharmacist relations. The rules will require pharmacists to screen prescriptions for duplication of therapy, drug-disease contraindications, interactions with other drugs, dosage information and other factors. Pharmacists are required to intervene if a prescription does not fit within the state's guidelines for acceptable use of a particular drug. While the rules will assist patients who are frequently shuttled from provider to provider, they may set up conflicts between physicians and pharmacists.

Drug stores and proprietary stores, Pharmacists

---

Proposed rules would protect doctors under risk contracts

Article Abstract:

The Health Care Financing Administration has proposed rules to limit the financial risk of physicians under Medicare and Medicaid managed care contracts. The rules will ensure that health maintenance organizations (HMOs) do not withhold necessary treatment because of physician incentive plans. If physicians are under substantial risk, HMOs must provide stop-loss insurance and conduct surveys of Medicare and Medicaid enrollee's satisfaction with access to services.

Contracts, Medicare, United States. Centers for Medicare and Medicaid Services

---

High Medicare outpatient costs may spur rules

Article Abstract:

Physicians have taken advantage of Medicare reimbursement rules that encourage physicians to perform procedures in an outpatient setting. In addition, hospitals have been given a large source of revenue since the Medicare laws were changed. Physicians groups have also benefited by operating their own surgery centers and referring patients to them. However, escalating outpatient costs may prompt legislation ensuring that physicians are not abusing self-referrals.

Hospitals, Services, Surgery, Outpatient, Ambulatory surgery

Similar abstracts:

• Abstracts: MDs help in federal executions? Proposed rules on lethal injections surprise medical community. The executioner's assistant: is it ethical for physicians to participate? Medical groups say no
• Abstracts: Medicare offers electronic pay in computer claims push. Rules changed to avoid interest on delayed claims
• Abstracts: AMA launching ethics institute for research, outreach projects. After ethics dilemma, marrow transplant rejected
• Abstracts: Consultative geriatric assessment for ambulatory patients: a randomized trial in a health maintenance organization
• Abstracts: Is medicine doing more to accommodate families? HIV tests urged for pregnant women; CDC guidelines caution that testing should be standard, but voluntary

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.