Physician Notes: Physician Pay Formula Is Broke - Will Congress Fix It?

Why This Topic Matters

The article highlights policy and billing developments that may affect physician reimbursement, Medicare coverage administration, and compliance-related contracting issues. It also flags federal transmittals and a payer settlement that may be important to organizations monitoring changes in physician reimbursement and claims handling.

Article Sections

1. Medicare physician payment outlook

   Discusses concerns about future Medicare physician reimbursement and the broader policy issue behind the payment formula.

2. CIGNA class-action settlement

   Summarizes a payer settlement involving claims-payment disputes raised by specialists and the general context of the lawsuit.

3. CMS transmittals affecting physicians

   Reviews several CMS change requests addressing physician-related billing, coverage, and administration topics.

4. Skilled nursing facility arrangements

   Notes CMS clarification related to physician agreements with skilled nursing facilities and the factors affecting those arrangements.