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PubMed1980

Health Care Financing Administration--Medicare program; reimbursement for radiological services furnished to a hospital inpatient by a physician in the field of radiology. Final rule.

These regulations define "radiological services" for which the Medicare program provides for payment at 100 percent of reasonable charges. Section 1833(2)(1)(B) of the Act provides for the 100 percent reimbursement for "radiological services" when furnished to hospital inpatients by physicians in the field of radiology. CUrrent administrative guidelines restrict the 100 percent reimbursement to services in which X-rays or rays from radioactive substances are used. Proposed regulations published on January 25, 1979 (44 FR 5162) would have extended the 100 percent reimbursement to other diagnostic imaging services such as ultrasound. On the basis of information acquired through public comments on the proposed regulations, we have concluded that there is not sufficient reason at this time to extend the 100 percent reimbursement to services not already so reimbursed. Accordingly, these regulations follow current operating instructions and define "radiological services" as those in which ionizing radiation is used for diagnostic or therapeutic purposes.

Institutional Practice↗
PubMed1980

Medicare program: reimbursement of hospital-based physicians--Health Care Financing Administration. Notice of revised injunction relating to enforcement of rules.

On March 11, 1980, (45 FR 15550) HCFA announced in the Federal Register that it would begin, effective July 1, 1980, enforcing uniformly the regulations to deny charge payments under Part B of Medicare for the alleged professional components of clinical laboratory services. However, on June 5, 1980, the United States District Court for the Eastern District of Arkansas preliminarily enjoined this action during the pendency of a lawsuit filed there on May 28, 1980, challenging the policies in the March 11, 1980 notice. On June 20, 1980 we published a notice, at the direction of the court, informing the public of this injunction (45 FR 41635). On November 20, 1980, the court modified its June 5 order by specifying the circumstances in which HCFA is precluded from denying Part B charge payments for clinical laboratory services. This notice informs the public of the terms of the revised injunction.

Hospital Departments↗
PubMed1986

Progress report--clinical pathology consultations. CAP Reimbursement Committee.

The CAP Washington office, under the aegis of the Council on Government and Professional Affairs, provides information and guidance to College members and state pathology societies on relationships of pathologists with governmental bodies, and on reimbursement issues. This article reports the findings of a survey conducted in autumn of 1985 to assess progress in implementation of reimbursement for clinical pathology consultations by the Medicare carriers.

Data Collection↗
PubMed1987

Guideline report. Projecting MRI utilization: two new approaches.

In today's competitive marketplace, hospitals must carefully analyze the financial impact of acquiring new technologies. The high cost of magnetic resonance imaging (MRI), one of the most prominent new technologies, makes it critical for hospitals to evaluate thoroughly the financial risks of providing this service. To determine whether it is likely to generate a sufficient number of MRI scans to break even financially, a hospital must carefully analyze its patient case mix. In 1984, the American Hospital Association (AHA) developed a method, the AHA MRI Utilization Model, for performing such an analysis. The original AHA model projected a hospital's potential demand for MRI procedures based on an analysis of that hospital's inpatient discharge data. The widespread use of the original AHA MRI Utilization Model by over 500 hospitals and a number of state health planning agencies has significantly influenced the diffusion of MRI throughout the United States. The original AHA model had several limitations, however: it ignored scans that might be performed to evaluate secondary diagnoses; its estimate of follow-up scans and replacement of CT by MRI was based on information from 1978; and it lacked a mechanism for considering outpatient scans. These limitations, together with the rapid evolution in clinical applications for MRI, led the AHA to improve its original MRI utilization projection methodology. In 1986, the AHA developed a new second generation MRI Utilization Model that employs two independently derived methodologies. The AHA's revised ICD-9-CM Projection method was developed by Richard diMonda, M.S.B.M.E., M.B.A.; the Diagnosis Related Groups (DRG) Projection Method was developed by Earl P. Steinberg, M.D., M.P.P. The second generation model has several advantages over the original model: it utilizes the opinions of a greater number of experts, as well as experts from more varied backgrounds; experts' opinions were obtained in 1986, rather than 1984, and so are more relevant to current patterns of practice; experts' opinions are employed to project CT, as well as MRI volume when both technologies are available, and the extent to which MRI will replace CT; total inpatient and outpatient scans are calculated; and hospital-specific adjustment factors are used to adjust for variations in patterns of practice across institutions. The DRG projection method also adds the ability to consider MRI and CT scans used to evaluate comorbid conditions and complications, as well as scans performed on patients who turned out to have no pathology. In addition, the DRG method provides a projection of potential MRI and CT volume in 1990, as well as currently.

Diagnosis-Related Groups↗
PubMed1989

The future of the PA profession. Panel discussion.

Growth and opportunity are the catchwords for the PA profession into the 1990s. Numerous changes can be expected, along with stimulating new challenges. Concern about the survival of the profession has waned. Current focus is on expansion of the profession to meet demands of America's changing health care delivery system. A distinguished panel of PA leaders discusses such issues as diversity within the profession, growth of hospital-based PAs, HMOs, public policy, PA education, the growing job market, and expanding roles of PAs.

Education, Graduate↗
PubMed1979

The paid chief of staff: issues and options.

Creating the position of chief of staff to achieve a more formal arrangement between hospital and medical staff involves making a complex set of decisions--should he be elected or appointed, to whom will he report, who should pay him, what are his responsibilities? Dr. Fifer addresses these issues, suggests some options, and recommends ways to make the new arrangement effective.

Institutional Practice↗