News & Information
Painkiller Prescription Rates Vary Widely Among States
Written by Editor   
Tuesday, July 08, 2014 09:52 AM

U.S. health care providers wrote 259 million prescriptions for opioid painkillers in 2012, enough to give a bottle of the pills to every adult in the country.  A new report from the federal Centers for Disease Control and Prevention published Tuesday, shows prescribing rates vary widely by state. The highest rates are in the Southeast, led by Alabama. Providers in that state wrote 143 prescriptions for every 100 residents, while providers in Hawaii, the state with the lowest rate, wrote 52 for every 100 people, nearly three times fewer.  Other states with very high rates include Tennessee and West Virginia; states with low rates include California and New York.

Read more...
 
Special Fraud Alert: Laboratory Payments to Referring Physicians
Written by Editor   
Tuesday, July 08, 2014 09:46 AM

This Special Fraud Alert addresses compensation paid by laboratories to referring physicians and physician group practices (collectively, physicians) for blood specimen collection, processing, and packaging, and for submitting patient data to a registry or database. 

The Office of the Inspector General states "we have repeatedly emphasized that providing free or below-market goods or services to a physician who is a source of referrals, or paying such a physician more than fair market value for his or her services, could constitute illegal remuneration under the anti-kickback statute. This Special Fraud Alert supplements these prior guidance documents and advisory opinions and describes two specific trends OIG has identified involving transfers of value from laboratories to physicians that we believe present a substantial risk of fraud and abuse under the anti-kickback statute."

Read more...
 
Chiropractors Could Soon Clear Youth Athletes After Concussions
Written by Editor   
Tuesday, July 08, 2014 09:22 AM

Chiropractors in Ohio have won the latest round of an ongoing fight with Ohio physicians over who should be allowed to clear young athletes to play after suffering a concussion.

For two years, chiropractors have been trying to become part of a new state law designed to educate coaches and ensure young Ohio athletes are pulled from competition when they show concussion-like symptoms.   The Ohio health director will set up a committee of three physicians and three chiropractors to develop guidelines for diagnosis, treatment and clearance of concussions suffered by young athletes. It also will adopt minimum education requirements for those who clear athletes.

Read more...
 
Kansas BCBS Spinal Fusion Policy Change One Year Later
Written by Editor   
Tuesday, July 08, 2014 09:18 AM

Nearly a year after the Blue Cross and Blue Shield of Kansas made coverage changes to their spinal fusion policy, here are five things the media want us to know about the coverage changes:

1. The policy change went into effect in July 2013, requiring more non-surgical care and documentation before the insurer will cover lumbar spinal fusions. Manager of Corporate Communications for Blue Cross Blue Shield of Kansas Mary Beth Chambers said the policy change was made after reviewing a new body of research done in the past 10 years on the effectiveness of spinal fusion. The North American Spine Society released Coverage Policy Recommendations for Lumbar Spinal Fusion earlier this year, designed to help surgeons, providers, patients and payers make decisions about surgical intervention.

Read more...
 
Spinal Fusion Costs Spur Insurance Changes
Written by Editor   
Tuesday, July 08, 2014 07:20 AM

Over the past two decades, the search for relief from back pain led skyrocketing numbers of Americans to a costly procedure that bonds vertebrae together. But as evidence mounted that spinal fusion surgery was used too often for the wrong people, insurer Cigna decided in 2011 to see how its own members had fared.  The news was startling: 87 percent of customers who had spinal fusion to treat pain due to wear and tear on spinal discs were still in so much pain two years later that they needed more therapies or drugs. Nearly 15 percent had more surgery. Total cost of the post-surgery claims: $11 million. That's on top of the initial fusion surgeries, which can carry price tags of $100,000 each, though insurers don't pay that much.

There is a growing number of private insurers that limit the circumstances in which they'll pay for spinal fusions. In part because of this trend, the phenomenal growth in spinal fusions — a case study in the debate over runaway health costs — should slow down, according to a report last month from London-based industry analyst GlobalData.

Read more...
 
<< first < Prev 191 192 193 194 195 196 197 198 199 200 Next > last >>

Page 194 of 217