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 Rising CMS Orthopedic Payments for 2009
By Walter Eisner (posted April 29, 2008)
If you treat orthopedic problems in the elderly who have complications and comorbidities, you’re going to like CMS’s proposed payment system for 2009. Read about how to maximize your reimbursements.
July 1 Physician Pay Cuts Unlikely
By Walter Eisner (posted April 17, 2008)
Senator Max Baucus, Democrat of Montana, is arguably the most important U.S. Senator for physicians who don't want to see their Medicare physician fees cut by 10% on July 1. He is Chairman of the Senate Finance Committee.
Docs Support National Health Insurance
By Walter Eisner (posted April 7, 2008)
What’s the best way to insure the nation’s citizens? Apparently, according to physicians, through a national health insurance program.
MedPAC Considers Sunshine Act and Disclosures
By Walter Eisner (posted March 28, 2008)
The Medicare Payment Advisory Commission (MedPAC) waded into the physician payment disclosure debate at its March meeting and has decided to work until the fall to develop its own position.
Is Thermal Intradiscal Therapy Reasonable and Necessary? CMS Wants to Know
By Walter Eisner (posted January 21, 2008)
CMS is opening a national coverage determination (NCD) to complete a thorough review of the evidence to determine if thermal intradiscal therapy is reasonable and necessary for coverage under the Medicare program.
No Action Required by Physicians to Get 0.05% Increase
By Walter Eisner (posted January 14, 2008)
CMS has received a number of inquiries asking whether physicians need to take any special action to get paid the new 0.05% Medicare Physician Fee Schedule payments. The answer is no.
Physician Medicare Payment Cuts Delayed Until July
By Walter Eisner (posted January 4, 2008)
President Bush signed legislation on December 29 that temporarily delays a scheduled 10.1% physician Medicare payment cut by six months.
Medicare Physician Payment Cuts Reportedly Delayed Six Months in Senate Deal
By Walter Eisner (posted December 19, 2007)
Democratic Senate Finance Committee Chairman Max Baucus and Republican ranking member Charles (Senator Sunshine) Grassley have reportedly hammered out a deal to delay by six months a scheduled 10% cut in Medicare physician pay rates.
FzioMed Seeks New Technology Add-On Payments
By Walter Eisner (posted December 6, 2007)
John Krelle, CEO of FzioMed, told OTW that the company is seeking new technology payments for its Oxiplex® Gel for spine procedures in the fiscal year 2009 under the inpatient payment (IPPS) rule.
“Physician, Benchmark Thyself”—Rick Guyer’s NASS Farewell Address
By Walter Eisner (posted November 20, 2007)
Outgoing NASS President Rick Guyer, M.D. told his colleagues that while technology and data give physicians tools to regain control over medical decisions and their practices, they will still have to accept physician-created benchmarks to evaluate themselves. Read our take on his farewell address.
Doctor Ranking Agreement Reached
By Walter Eisner (posted November 15, 2007)
The good news is that New York Attorney General Andrew Cuomo has reached a doctor ranking agreement with another large insurer. The bad news is that Cuomo has reached another doctor ranking agreement.
U.S. Senate Working to Restore Scheduled 10% Physician Medicare Payment Cuts
By Walter Eisner (posted November 9, 2007)
The Senate Finance Committee reportedly held a closed meeting on Wednesday, November 7, to discuss the automatic 10.1% reduction of physician fees for Medicare services that is scheduled to take effect January 1, 2008. The details of the proposed Medicare package remain undetermined.
Cigna and NY Attorney General Agree on Physician Ranking Oversight
By Walter Eisner (posted November 5, 2007)
Physicians and other healthcare providers are being subjected to more and more performance measures as payers try to get the healthcare system to be more "efficient." These measures will reward some and punish others.
A Collaborative Approach to Reimbursement: Coding for Motion Preservation Technologies
By Elizabeth Hofheinz (posted October 30, 2007)
In 2004 Applied Spine Technologies, Inc. set out to obtain codes for posterior dynamic stabilization. This turned into a landmark collaborative effort with other companies across the spine community.
Here is the story of how companies can compete on technology and collaborate on reimbursement.
Medicare to Stop Paying for Hospital Errors
By Walter Eisner (posted August 23, 2007)
Starting October 1, 2008, Medicare is implementing a new rule under which it will no longer pay for hospital errors that it says could reasonably have been prevented. The Bush administration estimates the new policy will save Medicare $20 million a year.
New York Attorney General Threatens Insurers Over Physician Ranking Plans, Accuses Them (Gasp!) of Profit Motive
By Walter Eisner (posted August 21, 2007)
Private insurers and CMS have been jumping all over the quality measurement healthcare bandwagon, looking to make better decisions about where to spend healthcare dollars.
Final Denial for Lumbar Discs
By Walter Eisner (posted August 17, 2007)
That's it. Done. Finished. No Medicare payments for artificial discs for the lower back for seniors. CMS drove the final nail into that coffin last Tuesday.
No Hypertension for Orthopedics in Final 2008 IPPS Rule
By Walter Eisner (posted August 14, 2007)
CMS’ final IPPS Rule for 2008 includes more DRGs, more quality measures, and smaller payments for replacement devices but generally raises reimbursements for orthopedics (with the exception of 360° fusions). Diagnosis with comorbidities such as hypertension will see the highest increases. Guess what? PearlDiver data shows that hypertension is one of the most common comorbidities for spinal disorder diagnoses. Get the details here.
Charité Gets CIGNA Coverage
By Walter Eisner (posted July 27, 2007)
Good news for DePuy Spine's Charité Disc. Shortly after having a major lawsuit dismissed in a California court over the device, the company announced on July 25 that CIGNA, one of the nation's largest health insurers, will now cover artificial disc replacement for single-level degenerative disc disease in a select group of individuals.
Does CMS Coverage Guarantee Private Coverage? Surprise!
By Walter Eisner (posted July 24, 2007)
CMS coverage doesn’t have the impact on private coverage that many device manufacturers think it does. Read what the Deciders at private insurers find important in making their coverage decisions.
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Orthopedic Decisions Start Here. 
