tci Medicare Compliance & Reimbursement - 2007 Issue 31

INDUSTRY NOTES: Rural Counties Could Reap More Cash From Geographic Payment Fix

Plus:  Doctor gets one-year sentence for false billing.Physicians who are getting shortchanged by the current geographic payment system have a new ally in the Government Accountability Office (GAO). The problem: Medicare has 89 physician payment localities and adjusts your payment levels depending on which locality you're in. Seven California counties have sued the Department of Health & Human Services, saying their doctors receive much lower rates than doctors in nearby counties. The GAO notes that Medicare allowed some states to consolidate their entire state into one payment locality in the 1990s, while other states are still fragmented.More...

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