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Cigna is restarting its rule that if someone submits a modifier 25 on a bill that they must also send in medical records. This is for EM claims with CPT codes 99212-15.
UnitedHealth Group will reduce the use of prior authorizations by 20% for non-urgent surgeries and procedures. This will begin in the third quarter.
A new report shows most 86% of physicians feel overworked and one third are considering early retirement. This does not bode well for the profession. This will cause movement for the employed physicians. To top it all off there is another reduction in physician pay of 2.4%. Not good.
Another report tears into the AHA fort their unbridled and non-logical stance on facility fees. There is really no excuse for them except for absolute greed. They truly give nothing for those fees which are in some cases humongous. Insurers, including Medicare, pay them and I have never figured out why as they add greatly to healthcare costs.
Still another article has detailed the the fear of the "non-profit" hospitals have against physician owned hospitals. They are deathly afraid of losing money.
Optum continues to metastasize. It recently purchased Crystal Run Healthcare including 400 providers and 30 locations..
Biden has declared that DACA people can now apply for Ocare and Medicaid. No legislation. No executive order. Top
HCA Florida Hospital is back in the news and not for anything good. They have had issues with medical staff governance and accusations of unsterile and dangerous conditions in the hospital. Now a US Senator from the state and a US Representative have sent a letter asking for answers to questions. The hospital says they will respond to the letter but the prior story was due to the physician who they kept from being seated as chief o staff was the cause of all their problems. Doubtful.
HCA continues to upset the locals. They own Transylvania Regional Hospital and according to the community they are making a mess of it. The community states they are not keeping primary care physicians and HCA say we hired a surgeon. Whoops. The community says that HCA is not listening to them. Maybe the community is right.
Idaho's Bonner General Hospital has announce it will cease OB services. It is the only hospital in Sandpoint, Idaho. The next nearest labor and delivery area is almost 50 miles away. They lack pediatricians to staff the neonatal resuscitations. They do not state that they do not have people to deliver babies but claim that the Idaho law regarding abortions is driving physicians to leave. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.