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  • Medicare
  • Mounting evidence that physician self-referral encourages unnecessarily higher use of certain services more than justifies the introduction of the Promoting Integrity in Medicare Act today in Congress. (apta.org)
  • The Alliance for Integrity in Medicare (AIM) coalition's new online presence is designed to educate providers, legislators, and the public on the impact of physician self-referral on the Medicare system, and to solidify support for the Promoting Integrity in Medicare Act (HR 2914), a recently introduced bill that seeks to close self-referral loopholes. (apta.org)
  • Isn't this all tied back to Medicare 'physician status' that the APTA chose to give up on? (apta.org)
  • In addition to the physician-referral scheme, the settlement also covered several allegations of Medicare billing fraud, which included "unbundling" Medicare services in order to submit them as separate claims. (bostoninjurylawyerblog.com)
  • Results of the study not only inform physical therapist practice, but they help to clarify issues that have been at the heart of a policy debate over the reach of the Stark law, a law intended to prohibit referrals to a business that has a financial relationship with the referring provider under Medicare. (apta.org)
  • The new study also fills in some of the gaps left in a 2014 report from the US General Accountability Office (GAO), which looked at self-referral for physical therapy across all health conditions under Medicare. (apta.org)
  • Two federal statutes regulate self-referral under Medicare and Medicaid: section 1877 of the Social Security Act, commonly called "Stark II" for its author, Rep. Pete Stark of California, and the so-called antikickback statute. (managedcaremag.com)
  • primary care physi
  • The marked increase in referral rates is likely due to increased specialization in medical care, and increasing responsibilities for primary care physicians during a typical visit. (healthcanal.com)
  • Minnesota and Pennsylvania primary care physicians (n = 164), completed surveys before (e.g., 1993) and after (2003) VFC, rating their likelihood on a scale of 0 (very unlikely) to 10 (very likely) of referring a child to the health department for immunization. (biomedcentral.com)
  • We surveyed 340 primary care physicians in 2003 from Minnesota and Pennsylvania, of whom 26 were determined ineligible because they had retired, died, no longer saw children, or moved out of state. (biomedcentral.com)
  • 1993
  • The researchers found a 92 percent increase in referral rates (from 4.83 to 9.29 percent) over the last decade, analyzing a nationally representative sample of 845,243 ambulatory patient visits from the National Ambulatory Medical Care Surveys, 1993-2009 . (healthcanal.com)
  • Maryland, for example, has a strict 1993 ban on physician self-referral that just this year a state appeals court upheld. (managedcaremag.com)
  • patient's
  • During the office medical visit or at the patient's bedside, physicians are frontline educators and treatment providers, and the U.S. Public Health Service (PHS) guidelines confirm the physician's role as essential for providing tobacco dependence services [ 3 ]. (hindawi.com)
  • I applaud the APTA for their efforts to try and limit self referral while also agreeing that more time and attention should be spent on teaching the public about physical therapy and working with insurance companies to make copay's and deductibles more affordable so that patient's will actually be able to use the physical therapy benefits that insurance companies say they have. (apta.org)
  • medical
  • Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols. (uwmedicine.org)
  • Physicians reported barriers to providing help, including inadequate knowledge and skills for delivering smoking cessation interventions because of limited medical education and training [ 2 ]. (hindawi.com)
  • offices
  • I am also concerned about the major hospital systems that are signing up all the MD offices and pushing the same sort of referral monopolies. (apta.org)
  • procedures
  • Health plans have tried to curtail this urge with radiology benefit management companies for imaging and appropriate-use criteria for other procedures, largely in the absence of meaningful regulations, according to people who have studied physician self-referral. (managedcaremag.com)
  • situations
  • APTA strongly supports all efforts to eliminate self-referral situations and relationships that compromise patient access and quality or add cost," said APTA President Paul A. Rockar Jr, PT, DPT, MS. "APTA has worked hard to reach a solution to close this loophole, and we are pleased to see this important legislation introduced. (apta.org)
  • years
  • For many years, the rate of referrals stayed flat, until about ten years ago, when they began a steady climb. (healthcanal.com)
  • Each center is staffed by knowledgeable physicians with years of education and training in their specific fields. (fwortho.com)
  • APTA has been working for years on Capitol Hill to fight physician self-referral. (apta.org)
  • We have been having this push since I was in PT school over 25 years ago and it is getting old--that we spend what we spend on THIS and yet our public still doesn't understand what a PT does, why they might need one and what on earth a 'Doctor' of PT does or is! (apta.org)
  • Dr. Rosenstein has years of experience handling high risk pregnancies. (jerryrosensteinmd.com)
  • area
  • and as I'm new to the area, don't have a doctor yet. (rockclimbing.com)
  • I'd love to find a doctor in the West Las Vegas area that has had pregnant climbers as clients before (or best of all, was one herself! (rockclimbing.com)
  • A family physician's $366,000 base salary - nearly double the salary of other physicians in the same area. (bostoninjurylawyerblog.com)
  • Well my wife passed away and anyhow I lost the name of the Dr. I live in Phoenix area and there is an ilads Dr. I am going to Dr. F. and nothing is happening. (whatislyme.com)
  • Also you might want to read through this post as it lists support groups you can join in California or Arizona (online groups) and they would certainly have names of doctors for you in your area. (whatislyme.com)
  • Also if you are on Facebook, you can add me and I can post a question for you and have people send you their info on doctors in your area. (whatislyme.com)
  • visits
  • The results are staggering: over the same time period, the estimated absolute number of visits resulting in a referral increased 159 per cent, from 40.6 million to 105 million. (healthcanal.com)
  • physical therapy
  • It turns out that fewer physical therapy sessions and a greater use of passive modalities doesn't wind up saving money-in fact, the LBP episodes addressed through self-referral averaged $889 in insurer-allowed costs, compared with $602 for non-self-referred episodes-a 49% difference. (apta.org)
  • issue
  • The new website offers background on the issue, links to studies that confirm the damaging effects of self-referral, a press kit, and ways to easily take action and support the coalition's efforts. (apta.org)
  • Self-Referral 101" takes a more textual approach to explaining the issue. (apta.org)
  • I feel the physician self referral issue is the focus of the APTA internally and not of the PT professionals themselves. (apta.org)
  • There is a long history behind why physician self-referral is an issue that strikes at the very heart of our survival as a profession. (apta.org)
  • status
  • Specifically, given our previous data on reported out-referral in Minnesota and Pennsylvania prior to the VFC program [ 10 - 12 ], we determined the reported out-referral of children by insurance status now, a decade later. (biomedcentral.com)
  • rate
  • But the higher rate of referrals doesn't tell the whole story, according to the study's authors, who analyzed what happened next-and how much it wound up costing. (apta.org)
  • trends
  • Those who have documented self-referral trends are holding out hope that a shift away from fee-for-service payment may yet curb these temptations, but they also say health plans would be better served by tougher regulations. (managedcaremag.com)
  • climb
  • Do you honestly think a obgyn doctor is going to say go ahead and climb and risk the liability, med malpractice, being sued. (rockclimbing.com)
  • name
  • I believe some time ago you sent me the name of an ilads Dr. in San Diego‚Ķit was a female. (whatislyme.com)