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Record Nr. |
UNINA9910810103603321 |
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Titolo |
Medicare payment policies to physicians [[electronic resource] /] / Katherine V. Bergen, editor |
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Pubbl/distr/stampa |
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New York, : Nova Science Publishers, 2009 |
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ISBN |
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Edizione |
[1st ed.] |
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Descrizione fisica |
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1 online resource (166 p.) |
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Collana |
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Health care issues, costs and access |
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Altri autori (Persone) |
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Disciplina |
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Soggetti |
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Medicare - Claims administration |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Note generali |
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Description based upon print version of record. |
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Nota di bibliografia |
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Includes bibliographical references and index. |
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Nota di contenuto |
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Intro -- MEDICARE PAYMENTPOLICIES TO PHYSICIANS -- CONTENTS -- PREFACE -- OPTIONS TO IMPROVE MEDICARE'SPAYMENTS TO PHYSICIANS, MAY 10, 2007 -- ENSURING ACCURATE PRICES -- MEASURING RESOURCE USE AND PROVIDING FEEDBACK -- ENCOURAGING COORDINATION OF CAREAND THE USE OF CARE MANAGEMENT PROCESSES -- PROMOTING THE USE OF PRIMARY CARE -- BUNDLING TO REDUCE OVERUSE -- LINKING PAYMENT TO QUALITY -- RATIVE-EFFECTIVENESS INFORMATION -- USING STANDARDS TO ENSURE QUALITY -- MEDICARE PAYMENT POLICIES* -- ABSTRACT -- INTRODUCTION -- MEDICARE PAYMENT PRINCIPLES -- Medicare Payment Rules -- Beneficiary out-of-Pocket Payments -- RECENT CONGRESSIONAL ACTIONSWITH RESPECT TO PROGRAM PAYMENTS -- MEDICARE PAYMENT POLICIES. PART A -- 1. Inpatient Prospective Payment System (IPPS) for Short-term, General Hospitals -- 2. Hospitals Receiving Special Consideration under Medicare's IPPS -- 3. IPPS-Exempt Hospitals and Distinct Part Units -- 4. Skilled Nursing Facility (SNF) Care -- 5. Hospice Care -- PART B -- 1. Physicians -- 2. Nonphysician Practitioners -- 3. Clinical Diagnostic Laboratory Services -- 4. Preventive Services -- 5. Telehealth -- 6. Durable Medical Equipment (DME) -- 7. Prosthetics and Orthotics -- 8. Surgical Dressings -- 9. Parenteral and Enteral Nutrition (PEN) -- 10. Miscellaneous Items and Services -- 11. Ambulatory Surgical Centers (ASCs) -- 12. Hospital Outpatient Services -- 13. Rural Health Clinics and Federally Qualified Health Center (FQHCs) Services -- 14. |
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Comprehensive Outpatient Rehabilitation Facility (CORF) -- 15. Part B Drugs/Vaccines Covered Incident to a Physician's Visit -- 16. Blood -- 17. Partial Hospitalization Services Connected to Treatment of Mental Illness -- 18. Ambulance Services -- PARTS A AND B -- 1. Home Health -- 2. End-Stage Renal Disease -- PART C -- Managed Care Organizations -- PART D. |
Outpatient Prescription Drug Coverage -- CRS REPORTS FOR ADDITIONAL INFORMATION -- CRS STAFF, BY MEDICARE ISSUE -- REFERENCES -- MEDICARE: PAYMENTS TO PHYSICIANS* -- ABSTRACT -- INTRODUCTION: THE MEDICARE FEE SCHEDULE -- Why the Fee Schedule Was Enacted -- Calculation of the Fee Schedule -- Beneficiary Protections -- Participation Agreements -- Submission of Claims -- Refinements in Relative Value Units -- SUSTAINABLE GROWTH RATE (SGR) SYSTEM -- Conversion Factor Calculation -- Update Adjustment Factor -- Sustainable Growth Rate (SGR) -- Major Changes in Update Calculation -- Criticisms of Current System -- Suggested Modifications -- Recent Actions -- OTHER ISSUES -- 2007 and 2008 Fee Schedules -- Imaging Services -- Impact of Spending Increases on Part B Premiums -- Access to Care -- Geographic Variation in Payments -- Medicare Versus Private Payment Rates -- Payments for Oncology Services -- Concierge Care -- RECENT LEGISLATION -- Changes Made by MMA, DRA, TRHCA -- Legislation in the First Session of the 110th Congress -- Legislation in the Second Session of the 110th Congress: MIPPA -- APPENDIX A. CALCULATION OF THE PHYSICIANFEE SCHEDULE UPDATE -- Calculation of the Physician Fee Schedule -- Calculation of the Update to the Conversion Factor (CF) -- Calculation of the Update Adjustment Factor (UAF) -- APPENDIX B.MMA, DRA, TRCHA, AND MMSEAPROVISIONS RELATING TO PHYSICIANS -- MMA -- DRA -- TRHCA -- MMSEA -- APPENDIX C. GEOGRAPHIC ADJUSTMENTSTO THE PHYSICIAN FEE SCHEDULE -- Legislative Background -- Calculation[37] -- APPENDIX D. DEVELOPMENT OF PRACTICE EXPENSEPAYMENT METHODOLOGY -- Practice Expenses -- APPENDIX E. PRIVATE CONTRACTING RULES -- How Private Contracting Works -- Issues -- REFERENCES -- INDEX. |
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