NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
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Practicing Telemedicine Raises Legal Considerations for Rheumatologists
With the evolution and advancement of technology, it was only a matter of time before such changes affected the medical industry. Although the concept of telemedicine dates back more than 50 years, emphasis on cost-effective quality healthcare coupled with technological advancements has caused a resurgence of telemedicine in recent years. What constitutes telemedicine largely depends…
Avoid the Trap of Balance Billing
It is no secret that payers and providers have conflict as it relates to reimbursement rates for medical services, and there is another stakeholder, the patient, that plays an important role in the financial impact of healthcare reimbursement. Usually, patients are faced with unforeseen bills from their providers due to an unpaid portion of a…
Not Junk Mail: Social Security Letter Can Cut Medicare Costs
CHICAGO (Reuters)—A letter arrives in the mail with this opening line: “We are writing to let you know how you can get help paying your Medicare costs.” Your fraud detector probably goes on high alert—the mailboxes of retirees routinely are stuffed with bogus come-ons. But this letter is no scam. More than 2 million seniors…
Patient Can’t Always Access Complete Medical Records, Doctors Say
(Reuters Health)—Technology makes it possible for patients to access medical records online, but a thicket of legal issues may still keep people from always seeing everything in their chart, some doctors say. The Health Insurance Portability and Accountability Act (HIPAA) gives U.S. patients the right to access their medical records and control who else has…
Drug Company Gifts Linked to Doctors’ Prescribing Habits
(Reuters Health)—Doctors who receive payments or gifts from pharmaceutical companies are more likely to prescribe brand name medications, a new study suggests. Dr. James Yeh, of Brigham and Women’s Hospital in Boston, and colleagues write May 9 online in JAMA Internal Medicine that some states require doctors to report what they receive from drug companies….
Preparing for Increased HIPAA Audits Among Smaller Rheumatology Providers
Recent enforcement activities of the Department of Health and Human Services’ Office for Civil Rights (OCR) have shown an increase in fines and penalties assessed against smaller providers for failing to comply with the privacy, security and breach notification requirements of the Health Insurance Portability and Accountability Act (HIPAA). Historically, OCR has focused on larger…
Why Physicians Say Sick Days Aren’t Worth the Trouble
A recent JAMA Pediatrics article found that 83% of clinicians admitted to coming to work while sick and 95% admitted to knowing that it could be dangerous for their patients.1 “The decision to work sick is shaped by systems-level and sociocultural factors,” the study authors wrote. In speaking with rheumatologists on the matter, I found…
Ryan Wants to End Obamacare Cost Protections for Sick Consumers
WASHINGTON (Reuters)—U.S. House of Representatives Speaker Paul Ryan (R-Wis.) called on Wednesday for an end to Obamacare‘s financial protections for people with serious medical conditions, saying these consumers should be placed in state high-risk pools. In election-year remarks that could shed light on an expected Republican healthcare alternative, Ryan said existing federal policy that prevents…
Rheumatologist Finds Opportunity for Continual Learning in Rheumatology, Karate
Robert Thoburn, MD, finds discipline and the opportunity for continual learning in both rheumatology and karate, an activity he has pursued for decades. Karate Lessons “I was fortunate to have had the opportunity to learn karate and achieve a black belt,” Dr. Thoburn says. “I used my training journal and [did] extensive research to write a…
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