MEDICARE COSTS: Higher When MD Care Billed as Outpatient
Senior citizens receiving treatment from hospital-owned doctors' offices are paying higher out-of-pocket fees than those who seek care from independent physicians, according to a report released Monday by the Department of Health and Human Services Office of the Inspector General. The study of 200 hospitals indicates that some "may be improperly treating physician practices they own as outpatient departments when they bill Medicare." The result is higher expenses for patients, even though they are not receiving any additional treatment benefits from the hospital-owned offices. Medicare recipients typically pay only 20% for a regular doctor's appointment, but must usually pay 50% or more for outpatient treatment. In addition, "government payments to outpatient departments are also higher because of the way overhead costs are accounted for." June Gibbs Brown, HHS Inspector General, wants "to require hospitals to treat all physician practices they own as separate entities for billing purposes." But Medicare Deputy Administrator Michael Hash believes that the regulation would be "impractical" due to gray areas in hospital-doctor relations. New Medicare regulations designed to "eliminate cost discrepancies when the same service is provided in different settings" and clarified rules for billing in hospital-owned offices will help alleviate the problem, he says (Love, AP/Syracuse Post-Standard, 9/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.