Medicare Fee Ordeal - Continued
As of Friday the Senate has passed a six (6) month patch to counter the Sustained Growth Rate formula cuts to physician fees.
The House will consider the patch next week, and is likely to pass the necessary legislation.
CMS contractors will process claims from June 1 forward - someday.
Stay tuned.
Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Sunday, June 20, 2010
Wednesday, May 13, 2009
Rationing or Evidence-Based?
Medicare has decided not to pay for virtual CT colonoscopies.
Medicare does cover regular invasive colonoscopies.
The x-ray procedure is a substitute for invasive colonoscopies. It is cheaper and non-invasive, but does involve x-ray radiation.
The invasive colonoscopy allows the surgeons to excise any pre-cancerous polyps found, saving a second procedure.
If the CT colonoscopy finds pre-cancerous growths, then a regular colo must be done to excise the polyps, thus causing two procedures instead of one.
Medicare does point out that the Medicare population, almost all of whom are 65 and over, may not be a good indicator for the under-65 population. Medicare is willing to look at future data.
These are the sorts of dilemmas health insurers must wrestle with. No decision will make everyone happy.
Rationing or evidenced-based medicine? Depends on your point of view.
Medicare does cover regular invasive colonoscopies.
The x-ray procedure is a substitute for invasive colonoscopies. It is cheaper and non-invasive, but does involve x-ray radiation.
The invasive colonoscopy allows the surgeons to excise any pre-cancerous polyps found, saving a second procedure.
If the CT colonoscopy finds pre-cancerous growths, then a regular colo must be done to excise the polyps, thus causing two procedures instead of one.
Medicare does point out that the Medicare population, almost all of whom are 65 and over, may not be a good indicator for the under-65 population. Medicare is willing to look at future data.
These are the sorts of dilemmas health insurers must wrestle with. No decision will make everyone happy.
Rationing or evidenced-based medicine? Depends on your point of view.
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