Tag Archives: Medicare

Trying to Destroy Healthcare the Ostrich Way

Ostriches reportedly stick their heads in a hole if they see something they fear. If they can’t see it, then it must have gone away. President Trump, with most republicans lawmakers going along, is trying that same tactic on the … Continue reading

Posted in Government, Medical Politics | Tagged , , , , , , | 1 Comment

Gluteus Maximus

I ordered atorvastatin (generic Lipitor) for one of my patients with high cholesterol and Medicare Part D coverage. It was denied. We then appealed it (prior authorization). A fax from Maximus Federal Services said their decision was, “UNFAVORABLE.” They said … Continue reading

Posted in Government, Pharmaceuticals | Tagged , , , , , | 3 Comments

Medicare Audits – Or How I Spent Part of Labor Day Weekend

Some weekends I go to my office to try and catch up on paperwork. This Labor Day weekend I had to ‘labor’ away part of it to satisfy a Medicare requirement. I received a fax from a medical supplier saying … Continue reading

Posted in Government | Tagged , , | 4 Comments

Medicare Payment Formula Finally Changed – Win or Loss?

Congress passed a  law in 1977 linking Medicare payments for physician services to growth in the economy.  Because it failed to take into account inflation and other factors, Congress has had to act 17 times to prevents cuts to physician … Continue reading

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Patient Satisfaction / Physician Dissatisfaction

Have you received a survey after you visit your doctor? You may be surprised to learn that how you rate them may affect their pay, their mental health, and even possibly your health. Surveys, as administered by Press Ganey, and … Continue reading

Posted in Business of Medicine | Tagged | 1 Comment

How to Get Rich – A Guide for Pharmaceutical Companies

Thanks to Congress, Medicare is not allowed to negotiate for the cost of medications. The bill was shepherded through by congressman Tauzin, the chairman of the House Energy and Commerce Committee that regulates the industry, who subsequently stepped down then … Continue reading

Posted in Business of Medicine, Medical Politics, Pharmaceuticals | Tagged , , , | 2 Comments

Up in Arms, Up in Smoke

If you apply for health insurance, you may find you have to pay higher rates if you’re a smoker. Now federal regulators are trying to decide if insurers who participate in the Affordable Care Act (aka ObamaCare) exchanges can add … Continue reading

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Cataracts and Hip Fractures

A recent study showed that cataract surgery helps prevent hip fractures. It looked at a sample of Medicare patients with cataracts who did or did not have cataract surgery.  Those who had cataract surgery had a 16% less change of … Continue reading

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Testing Tribulations

When I was an internal medicine resident, one of my staff attending’s, Dr. Charles Reasner, used to ask, “What is the indication for ordering a TSH?” This is a test of thyroid function (thyroid stimulating hormone), and he was asking … Continue reading

Posted in Clinical, Government | Tagged , | 2 Comments

Penny Wise, Pound Foolish

A patient of mine has been on cyclobenzaprine, a muscle relaxer, intermittently for over a year. Now her insurance, a Humana, Medicare plan, said they will no longer cover it. I pointed out to them that the medication is generic … Continue reading

Posted in Business of Medicine, Pharmaceuticals | Tagged , , | 2 Comments