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Physician job search strategy shifts as Internet booms, economy busts
When orthopedic surgeon John Kemp, MD, looked for a job fresh out of residency 22 years ago, he used a lot of paper and stamps mailing resumes to practices in areas of the country where he wanted to work, not knowing if there was even a job available. A year ago, when Dr. Kemp decided it was time to leave private practice in Littleton, Colo., he turned to listings on the Internet -- no paper, no stamps, no guessing if someone had an opening. On Aug. 1, he started as director of sports medicine at Avera Marshall Regional Medical Center in Marshall, Minn. The Internet "gives you a lot more selection and, therefore, a lot more options," Dr. Kemp said. In-house recruiters handling doctor hiring are feeling the same way. A recent survey of 166 recruiters at hospitals and physician groups found that most rely heavily on Internet job postings, as well as word-of-mouth, to locate physicians for open positions. They were using physician search firms less than other tools, citing bot [Read more]
CMS probes Humana's lobbying tactics on reform
A federal inquiry at the behest of a key Democratic lawmaker into an insurance company's attempt to influence the health system reform debate has prompted a groundswell of criticism from GOP leaders, who likened the government's actions to a "gag order" on reform critics. At the urging of Senate Finance Committee Chair Max Baucus (D, Mont.), the Centers for Medicare & Medicaid Services is investigating Louisville, Ky., based Humana for allegedly sending misleading information to its Medicare Advantage beneficiaries. CMS says the insurer may havemade false claims about the impact that pending health reform legislation could have on the coverage status of beneficiaries. "CMS is concerned that, among other things, this information is misleading and confusing to beneficiaries [and] represents information to beneficiaries as official communications about the Medicare Advantage program," the agency stated in a Sept. 18 letter to Humana. "As we continue our research into this issue, we [Read more]
850,000 doctors could be hit by potential data breach from insurer's stolen laptop
A file containing identifying information for every physician in the country contracted with a Blues-affiliated insurance plan was on a laptop computer stolen from a BlueCross BlueShield Assn. employee. It is not yet known whether any identity theft has resulted from the data breach. The file included the name, address, tax identification number and national provider identifier number for about 850,000 doctors, Jeff Smokler, spokesman for the Chicago-based Blues association, said Oct. 6. That number represents every physician who is part of the BlueCard network, which allows Blues members to access networks in other states, Smokler said. Some 16% to 22% of those physicians listed -- as many as 187,000 -- used their Social Security numbers as a tax ID or NPI number, Smokler said. The association updates its file of BlueCard network physicians weekly, Smokler said. An unidentified employee downloaded the unencrypted file onto his personal computer to work on it at home, a practi [Read more]
Health system reform sees rebound in public support
After declining in August, public support for a variety of aspects of health system reform increased in September, according to the Kaiser Family Foundation Health Tracking Poll. Fifty-three percent of Americans said in mid-September that the country would be better off if President Obama and Congress adopted health reform, an increase from August's 45% and the 51% reported in July. Republicans and independents also softened their opposition: 49% of Republicans said families would be worse off if health reform passes, down from 61% in August. The percentage of independents saying so dipped to 26%, a decrease of 10 percentage points. "Opinion in the coming months is hard to predict, but as the focus shifted from the town halls and hot-button issues to the president, the Congress and the core issues in the legislation that affect people the most, the summer downturn in support was largely erased," said Drew Altman, PhD, Kaiser's president and CEO. The poll of 1,203 adults was [Read more]
Medicaid pay could be cut again when stimulus money runs out
Federal stimulus funding has helped state Medicaid programs avoid drastic reductions in eligibility and physician fees, but program directors already are contemplating such cuts when the additional federal support runs out at the end of next year. States faced unprecedented financial pressures in fiscal 2009, which ended on June 30 for most states. They experienced a surge in new Medicaid enrollees and a historic decline in tax revenues. States coped by trimming or freezing Medicaid fees and restricting benefits, among other actions, according to a ninth annual survey of state Medicaid directors released Sept. 30 by the Kaiser Family Foundation and Health Management Associates. Medicaid enrollment grew by 5.4% in fiscal 2009 -- the highest rate in six years -- while total program spending increased by 7.9%, the fastest pace in five years. The enrollment spike was the main reason spending grew, according to report co-author Vernon K. Smith, PhD, principal with Health Management As [Read more]
Anti-abortion group wants Illinois to enforce parental notice -- now
An anti-abortion group is asking the Illinois Supreme Court to order immediate enforcement of a state law requiring physicians to notify a minor's parent or legal guardian at least 48 hours before performing an abortion. The Parental Notice of Abortion Act of 1995 was blocked from taking effect for more than a decade until the high court in 2006 finally issued mandated rules allowing young women to ask a court to bypass the notice requirement. It would be up to the court to decide if a waiver is in the minor's best interest. After additional litigation, the 7th U.S. Circuit Court of Appeals in July upheld the law's constitutionality in Zbaraz v. Madigan and dissolved a long-standing injunction preventing its implementation. The statute took effect Aug. 4. But concerns from the medical community about compliance prompted the state medical board to delay enforcement of the law by three months. Under the act, any doctor who does not act in good faith to obey the law would face a mis [Read more]
Medicaid claims lack key data that could help find fraud
Medicaid claims information submitted by states to the Centers for Medicare & Medicaid Services is slow in being released to the public and often does not contain many data elements that can assist in fraud detection, according to a report by investigators from the Dept. of Health and Human Services Office of Inspector General. In an Aug. 26 letter to Cindy Mann, the director of the CMS Center for Medicaid and State Operations, OIG states that CMS did not fully disclose or document information about the accuracy of data collected by the Medicaid Statistical Information System. Timely, accurate and comprehensive data can be used to help interagency efforts in combating health care fraud, the report notes. States must submit claims files to CMS within 45 days after the end of each quarter. The system is designed to serve as an accurate database pertaining to standardized enrollment, eligibility and paid claims of Medicaid beneficiaries. In a review of MSIS files, OIG determined [Read more]
California nursing association says insurers reject 22% of claims
California Attorney General Jerry Brown has launched an investigation into insurance companies' claims-processing practices, on the heels of a report that found health plans in the state reject about a fourth of all claims. Based on information from the state's Dept. of Managed Health Care, the California Nurses Assn. in September reported that claims denial rates for the largest plans averaged 22% between 2002 and 2009. The denial rates include any time a claim was not paid -- whether the claim was a duplicate, was sent to the wrong insurer, was made for an ineligible patient or had incomplete information. For the first half of 2009, the group reported that denial rates for the six biggest plans ranged from a high of 39.6% for UnitedHealth Group's PacifiCare to 6.4% for Aetna (www.calnurses.org/media-center/press-releases/2009/september/california-s-real-death-panels-insurers-deny-21-of-claims.html). In a Sept. 3 statement announcing his office's inquiry, Brown said, "These h [Read more]
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