MEDICARE: Federal Ruling Kills Physician Contracting Rule
In a ruling some call "a huge win for seniors," a federal appeals court July 16 paved the way for seniors to "contract privately" with their doctors for services not covered by Medicare, the Washington Times reports. The ruling by the U.S. Court of Appeals for the District of Columbia follows a 1997 United Seniors Association lawsuit against HHS Secretary Donna Shalala, which charged that a provision of that year's Balanced Budget Act "prohibited Medicare beneficiaries from using their own money to provide for their own health care." Section 4507 had barred doctors who provided private care to Medicare recipients from filing Medicare claims for two years, a stipulation, Shalala argued, designed to "prevent doctors from coercing elderly patients into paying more for Medicare-covered services." The court ruled against her, finding that "the meaning of section 4507 is hardly plain on its face." USA's attorney, Kent Masterson Brown, said of the ruling, "The clarification by the Court of Appeals ... gives the power back where it should be: in the hands of the people, not the government" (Price, 7/25).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.