Insurers alter cost formula, and patients pay more
A landmark settlement reached with New York State in 2009 required insurance companies to finance an objective database of doctors' fees that patients and insurers nationally could rely on. Gov. Andrew M. Cuomo, then the attorney general, said it would increase reimbursements by as much as 28 percent. Though the settlement required the companies to underwrite the new database with $95 million, it did not obligate them to use it. So by the time the database was finally up and running last year, the same companies, across the country, were rapidly shifting to another calculation method, based on Medicare rates, that usually reduces reimbursement substantially.
- Governors Push to Expand Role of PAs, Telemedicine
- 3 More Pioneer ACOs Say They Will Quit
- Ebola in the U.S.: Reason to Fear, to Hope, to Prepare
- Why Open Payments Irks Physicians
- Top Provider Billing Mistakes Are Changing
- Overcoming a Payer Mix 'Nightmare'
- Employee Engagement: Make It Meaningful
- These Algorithms Reduce Readmissions
- Payer Calls for More Primary Care Docs, Team Care
- Difficult Patients: It's Not Them, It's You, Doctor