News Briefs
News Briefs
HCFA revises rules for MSP
The Health Care Financing Administration (HCFA) has revised its policy on its Medicare Secondary Payer (MSP) requirements, cutting back on the number of times data must be collected and how long they have to be kept.
The MSP requirements, aimed at determining if a payer other than Medicare should have first responsibility for a patient’s medical bill, have long been a thorn in the side of access managers because of the time-consuming procedures associated with meeting them.
Under the new policy, according to a report in the on-line news service AHA News Today, HCFA requires providers to collect or verify MSP information only during the initial beneficiary admission or encounter instead of at every outpatient encounter with a Medicare beneficiary, as was previously required.
On the record retention issue, HFCA now only recommends, instead of requires, that MSP questionnaires be retained 10 years (five years is generally recognized as the standard for records retention in the field). Also under the new requirements, providers do not need to ask the MSP questions of Medicare beneficiaries who are members of a Medicare+Choice organization.
Finally, teaching hospitals are not required to collect this information to obtain Indirect Medical Education. MSP requirements for hospitals acting as reference labs will be addressed later.
Rates improve for providers
The National Health Information’s 2000 Capitation Survey finds notably higher per-member per-month (PMPM) rates covering nearly all categories and specialties.
Survey findings in the risk contracting market reveal recent premium increases being passed along to physicians and other providers in their contracts. Additionally, as poorly performing groups are dropping out of the market, better performers with higher rates are pushing the overall average up.
The report also assuages fears of a mass exodus from capitation, as 78% of survey respondents said they were seeking more capitation or maintaining their current level of risk agreements. Other survey highlights showed average global PMPM rates increased 7.4% compared with the 1999 average, rising from $107.88 to $115.95. The average commercial primary care rates increased 8.8%, rising from $11.07 to $12.05 PMPM.
Study: Consumers want high tech, high touch’
A study of patients and physicians by Harris Interactive and AriA Marketing’s research group, shows that U.S. consumers want to manage their own health care through a combination of on-line, phone, and nurse triage services.
The study found that with the average time a doctor spends with a patient declining to 15 minutes or less, consumers want personalized care and information from their doctors, delivered by the most effective medium — face-to-face interaction, the phone or the Internet; 86% of respondents don’t like automated answering systems for scheduling appointments.
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