Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Fees”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1997

Medicare program; physician fee schedule conversion factor for calendar year 1998 and sustainable growth rate for fiscal year 1998--HCFA. Final notice.

This final notice announces the calendar year 1998 Medicare physician fee schedule conversion factor and the fiscal year 1998 sustainable growth rate for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1846(d) and (f), respectively, of the Social Security Act. The 1998 Medicare physician fee schedule conversion factor is $36,6873. The sustainable growth rate for fiscal year 1998 is 1.5 percent.

Aged↗
PubMed1998

OIG ruling puts common fee arrangement in question. PPMCs: not dead yet, but facing major changes.

A recent opinion by the Office of Inspector General has found that physician groups that pay management companies a percentage of revenue for marketing and network development may be in violation of federal anti-kickback statutes. Although it affects only the practice that sought the opinion, this decision could spark major changes in the way PPMCs and practices structure fee arrangements. In the future, more emphasis will have to be put on safeguards against abusive billing practices and over-utilization. The future of PPMC arrangement may be fixed fee agreements, but these, too, will have to be customized to each particular practice-PPMC relationship.

Fee Schedules↗
PubMed1998

In California, Medi-Cal managed care is superior to Medi-Cal fee-for-service.

This is a comparative analysis of California's "experiment" in Medi-Cal managed care. It compares managed care to fee-for-service in the area of quality. In March 1993, the California State Department of Health Services issued a State Strategic Plan for Medi-Cal Managed Care. The goal: to transfer the delivery of care for the majority of the state's Medi-Cal population from a predominantly fee-for-service payment system to capitated managed care. The state of California has steadily increased its commitment to the large-scale expansion of managed care within the Medi-Cal Program in order to improve beneficiaries' access to quality preventative and primary health care while acting as a prudent purchaser of services. This study examines one Local Initiative--Inland Empire Health Plan--created as a not-for-profit, joint powers, public entity by Riverside and San Bernardino counties, California.

California↗
PubMed1998

Medicare program; revisions to payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1999--HCFA. Final rule with comment period.

This final rule makes several policy changes affecting Medicare Part B payment. The changes that relate to physicians' services include: resource-based practice expense relative value units (RVUs), medical direction rules for anesthesia services, and payment for abnormal Pap smears. Also, we are rebasing the Medicare Economic Index from a 1989 base year to a 1996 base year. Under the law, we are required to develop a resource-based system for determining practice expense RVUs. The Balanced Budget Act of 1997 (BBA) delayed, for 1 year, implementation of the resource-based practice expense RVUs until January 1, 1999. Also, BBA revised our payment policy for nonphysician practitioners, for outpatient rehabilitation services, and for drugs and biologicals not paid on a cost or prospective payment basis. In addition, BBA permits certain physicians and practitioners to opt out of Medicare and furnish covered services to Medicare beneficiaries through private contracts and permits payment for professional consultations via interactive telecommunication systems. Furthermore, we are finalizing the 1998 interim RVUs and are issuing interim RVUs for new and revised codes for 1999. This final rule also announces the calendar year 1999 Medicare physician fee schedule conversion factor under the Medicare Supplementary Medical Insurance (Part B) program as required by section 1848(d) of the Social Security Act. The 1999 Medicare physician fee schedule conversion factor is $34.7315.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1983

Availability of information and records to the public; fees for providing information and records; procedures and appeals--SSA. Notice of proposed rulemaking.

The Social Security Administration (SSA) announces proposed changes in the fees it charges for providing records from its files and record related services. These proposed changes will conform SSA's fee schedule to that recently published by the Department of Health and Human Services (HHS). The proposed rules also implement the discretion given the Secretary of Health and Human Services by section 2207 of the Omnibus Budget Reconciliation Act of 1981 to charge the full cost of providing certain information and records. The proposed rules do not change SSA's longstanding policy of generally not charging an individual for information needed to assure that our records concerning her or him are correct. In preparing these amendments, we deleted from SSA's rules several provisions concerning Medicare information. The Health Care Financing Administration (HCFA) has published separate regulations governing the availability of Medicare information and records. We have also clarified the rules for handling requests for information about individuals under the Privacy Act and the Freedom of Information Act (FOIA) and incorporated HHS' recent rules on who has authority to release or deny records in this revised material.

Fee Schedules↗
PubMed1987

Establishing fees for continuing care retirement community services.

A CCRC is the only type of housing alternative that typically provides an integrated continuum of services that older persons need at different times during retirement. But if CCRCs are to remain financially viable, they must establish fees for their services that take into account the type, scope, and amount of services provided and adjust the fees periodically as economic conditions warrant.

Actuarial Analysis↗
PubMed1985

Medicare program; physician fee freeze sanctions--HHS. Notice of proposed rulemaking.

This notice of proposed rulemaking sets forth OIG procedures for the imposition of civil money penalties and Medicare program exclusions on physicians who choose not to be participating physicians and who raise charges to Medicare beneficiaries in violation of the freeze on such fees contained in Section 2306 of Pub. L. 98-369 (the Deficit Reduction Act of 1984). The proposed rule also modifies existing regulations to permit the OIG to impose civil money penalties and assessments on those who choose to be participating physicians under the Medicare program and who violate their participation agreements as set forth in Section 2306. This regulation does not pertain to HCFA's responsibility for the Physician Fee Freeze.

Fees, Medical↗
PubMed1987

Medicare program: application fees for health maintenance organizations--HCFA. Final rule.

This rule sets forth regulations governing the charging of application fees by the Federal government for the following. An entity that seeks qualification as a Federal health maintenance organization (HMO). An HMO that seeks expansion of its service area or qualification of a regional component of its organization as an HMO in itself. We intend that these fees cover the administrative costs incurred in making these determinations.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1987

Effects of selected fee schedule options on physicians' Medicare receipts.

The Congress has indicated interest in modifying the system by which Medicare pays for physicians' services, and implementation of a Medicare fee schedule may be the most feasible change in the near term. In this article, the effects on physicians' Medicare receipts of a variety of fee schedules are simulated using 1984 Medicare claims data for a nationally representative sample of physician practices. The results show that reasonable choices concerning specialty and geographic differentials would shift payments away from surgical specialists and urban areas toward generalists (general practitioners, family practitioners, and internists) and less urban areas.

Data Collection↗
PubMed2000

User-fees for family-planning methods: an analysis of payment behaviour among urban contraceptors in Bangladesh.

The study was carried out to review the experience with the existing user-fee (pricing) strategies and examine the socioeconomic and demographic factors associated with payment behaviour among contraceptors in urban Bangladesh for selected contraceptive methods, such as injectables, pill, and condom. Data for the study were drawn from a survey of more than 5,000 married women of reproductive age in Zone 3 of Dhaka city, Bangladesh, within the sample frame of the Urban Panel Survey of the ICDDR,B's former Urban MCH-FP Extension Project. The findings of the study showed that most (80%) urban contraceptors have been paying for selected family-planning services. This indicates the existence of a notable demand for contraceptives which suggests that there is scope for improved financial sustainability of the family-planning programme through charging appropriate user-fees for contraceptives with proper analyses of willingness-to-pay among the contraceptors and price elasticities of demand. Higher socioeconomic status of households, marked by higher levels of education and house rent, and location of residence in non-slum areas, is predictive of paying for contraception. Households having 1-3 living child(ren) are also more likely to make payment for the selected contraceptive services.

Adult↗
PubMed2001

User fees, health staff incentives, and service utilization in Kabarole District, Uganda.

OBJECTIVE: To determine the impact of user fees on the utilization of health services in a community-based cost-sharing scheme in Kabarole District, western Uganda. METHODS: Of the 38 government health units that had introduced user-fee financing schemes, 11 were included in the study. Outpatient utilization was assessed as the median number of visits per month before and after cost sharing began. FINDINGS: After the introduction of cost sharing, overall utilization of general outpatient services, assessed by combining the data from all the participating units, dropped by 21.3%. Utilization increased, however, in facilities located in remote areas, while it decreased in those located in urban or semi-urban areas. The increased utilization in remote facilities was considered to be largely attributable to health workers' incentive payments derived from cost-sharing revenues. CONCLUSIONS: Incentive payments led the health workers to offer improved services. Other factors may also have been influential, such as an improved drug supply to health facilities and increased public identification with community projects in remote areas.

Attitude of Health Personnel↗
PubMed2001

Medical fees. A history of how the doctor was paid in Australia.

Medical fees are an important part of medical practice, yet they have always been a bone of contention. This article is the first in a series of three that will look at the way the doctor was paid. It examines the role of medical fees in early medical practice in Australia.

Australia↗
PubMed2002

Medicare's fee schedule for hospital outpatient care.

Medicare's hospital outpatient prospective payment system (OPPS) went live on August 1, 2000, after a decade of developmental work. The new system introduced a fee schedule that replaced the cost-related methods that Medicare previously used to reimburse various hospital outpatient services. Hospitals are now paid predetermined rates or fees based on the Ambulatory Patient Classification (APC) groups assigned to the services that Medicare patients receive during outpatient encounters. The new system aims to simplify Medicare's intricate cost-based reimbursement policies, improve hospital efficiency, ensure that payments are sufficient to compensate hospitals for reasonable Medicare costs, and reduce Medicare coinsurance amounts for beneficiaries. Implementation of OPPS-related administrative and operational changes has been a major challenge for hospitals.

Accounting↗
PubMed2002

Heart failure program proves that DM works--even under fee-for-service.

DM has a place in fee-for-service medicine. With ever-increasing pressures on the bottom line, a growing number of health care organizations are considering what DM can do to help them better meet their budgets as well as patient needs. In fact, even fee-for-service settings are experimenting with DM programs--in some cases, with solid success. See how a large integrated system in Minnesota was able to boost care of heart failure patients while turning a money-losing diagnosis into a profitable one.

Delivery of Health Care, Integrated↗
PubMed2002

Medical device technology user fees.

The introduction of user fees for premarket approval applications and 510(k)s will put additional thrust into the revolution in new products. AdvaMed explains why the fees are important.

Device Approval↗
PubMed2003

Preventive care in managed care and fee-for-service plans: is it cost effective?

Lack of coverage, knowledge, and physician guidance, and low socioeconomic status are major barriers to receiving preventive care. Compared with fee-for-service insurance, managed care promotes prevention through more generous coverage, physician incentives, and patient education, and members of MCOs use more preventive services than do members of fee-for-service plans. However, cost effectiveness of prevention has not been previously examined. A study of seven preventive services suggests that managed care enrollees more frequently obtained four preventive services, including two less-effective ones. For less-effective services, it may be prudent to base disease-risk assessment on key factors other than age and sex, and screen only patients at high risk. Effective screening strategies must be identified, especially for the underserved, low-income population.

Cost-Benefit Analysis↗
PubMed2003

Negotiating an innovative uniform infusion therapy fee: a managed care case study.

The medical director of this health plan established an innovative uniform infusion therapy fee whereby the plan pays a uniform infusion fee across all sites of care and contracts separately for delivery of the drug itself. The concept works successfully on three levels: (1) for plan members; (2) for plan providers; and (3) for the plan itself. This case study sets forth the conceptual and operational decisionmaking sequences involved. Establishing the innovative process required two primary elements: (1) coordinated decision making within all departments that were affected by the model; and (2) a champion to carry the project to a successful conclusion.

Ambulatory Care Facilities↗