It seems that all the changes in the healthcare system over recent decades have been top down, and without a lot of input from the folks at the delivery end.
Professional organizations from the New York State area protested an audit of clinical records by a managed care company, claiming unspecified standards had led to demands for large repayments. While the company stated it ended the audit only until standards could be defined, the organizations touted the power of presenting a unified front.
Is the Office of the Inspector General unfairly targeting psychiatrists? The OIG recently reported negative findings for Medicare claims filed by psychiatrists. Will it continue to do so in the study planned for this year?
Is consent necessary for medical records to be utilized for treatment, payment and health care operations? The medical records privacy rule demands it. Will prepayment and postpayment audits by insurance companies be cut back? The Medicare Education and Regulatory Fairness Act of 2001 is an attempt to solve this and other issues.
With so many Americans lacking appropriate health care insurance and so much of the large insurance companies' premiums going to overhead and profit, it makes sense to move forward with a single payer system. The author discusses some of the basic features of a proposed system.
With new pharmaceuticals entering into the market, sales calls on psychiatrists rose 5% from October 1998 to October 1999. Increasingly, industry-supported dinners, meetings and educational activities are the norm, with physicians leading the lectures. Meanwhile, the reps often have useful information for the practicing clinician, such as new treatment options and how to dilute or split medications to make them easier to take or cost less.
Without clear guidance from government regulators, mistakes are easy to make and, rather than raising concerns in a businesslike fashion, the first notification of a problem often comes when the enforcement action shows up at the door.
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