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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Attracting Physicians to Rural Medicine

  “American medicine is probably the best in the world, but they rush too much and do too much unnecessary surgery.” Dr. Bohdran Hordinsky (1991)   Having written about the problems with one-doc towns in rural areas, specifically rural North Dakota, I thought it would be helpful to provide an example of how the town…

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The Disappearance of Rural Obstetrical Care

The United States infant death rate has always been far higher than that in other developed countries. Now researchers are finding that in the United States, the maternal death rate is on the increase while it is going down in other countries. There are many possible reasons for these disturbing numbers. The American Congress of…

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CPC+, The New “Better” Physician Reimbursement from CMS

The Centers for Medicare and Medicaid Services (CMS) is constantly coming up with ways to cut payments to physicians in the name of improving health care quality. We had PQRS, then Meaningful Use. Statistical studies have shown that these attempts to reduce payments to physicians under the guise of improving the quality of care have…

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