MACRA…An Open Letter to Andy Slavitt

I am not a physician, so have no credentials to be telling the Centers for Medicare and Medicaid Services (CMS) how to run hospitals, much less physicians how to treat patients. However, as part of a clinic struggling to get reasonable reimbursement for the care we provide, I can speak directly to the issues about…

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North Dakota Medicaid and the Wrong-Sized Paper

I have posted often about the methods insurance companies use to avoid payment on claims, whether it’s the claim submission process itself in “The 1500 and it’s Sidekick the EOB,” or more recently, increasingly novel ways payers use to deny payment in “North Dakota Medicaid and Erectile Dysfunction.” Physicians often complain about the difficulty of…

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Sent to a Rural Hospital to Die

Rural hospitals are struggling in many areas, in part because the Critical Access Hospital (CAH) designation was created by the Centers for Medicare and Medicaid Services (CMS) to make rural hospitals band-aid stations. CAH staff is there to triage patients and send most to specialists in metropolitan hospitals. As with many CMS schemes, all the…

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