subject: Medicare Certification and Physician-Owned Hospitals Controversy [print this page] Medicare Certification and Physician-Owned Hospitals Controversy
Word has it that physician-owned hospitals that have not yet opened or received Medicare certification are in a mad dash to change this before 2011. The reason is, according to Kaiser Health News/USA Today, that the federal health reform law will bar new physician-owned facilities from Medicare after that date.
"Apparently the new health care plan is putting a chokehold on physician-owned hospitals," says Alan Weinstock, insurance broker at http://www.MedicareSupplementPlans.com. "Once again it's a clash between the for-profit, physician-owned hospitals and influential groups like the American Hospital Association."
The AHA has long criticized the physician-owned hospital model for focusing primarily on profitable care procedures, such as orthopedics and cardiac care, and routinely dismissing money-losing areas of care, such as emergency departments and burn centers. The chief complaint is that physician-owned hospitals focus more on profitable services and healthier patient groups.
In the meantime, some of the affected physicians-owned hospitals are looking to the courts for help by suing the federal government, claiming that the overhaul is unconstitutional.
Impact of ACA on Physician-Owned Hospitals
According to a provision in thePatient Protection Affordable Care Act of 2010 (ACA), there is an immediate restriction on expansion for existing physician-owned hospitals.The ACA also requires that new doctor-owned facilities be certified by December 31, 2010 in order to participate in Medicare.
At the present time there are approximately 265 existing physician-owned hospitals in the United States. An estimated 29 new physician-owned hospitals are expected to open by the December deadline.What this means to Medicare beneficiaries is that many of them may be affected by this new provision if their primary care physician and/or hospital is part of a physician-owned hospital group.
If you are a Medicare beneficiary, you can protect yourself from increased health care costs by making sure you still have appropriate health insurance coverage.
A Few Tips for Medicare Beneficiaries
If you are a current Medicare beneficiary, now is the time to review your coverage. Here's what to do:
Check to find out whether or not your hospital is physician-owned by contacting them directly. Here's a partial list of physician-owned hospitals in the United States.
Before you set up a new appointment, contact your hospital to see if this new provision affects you.
Compare Medicare Advantage and Medicare supplement insurance providers to make sure your hospital is within your network for 2011. To find a great Medicare supplement insurance provider visit http://www.MedicareSupplementPlans.com.
When selecting a primary care doctor, specialist, hospital or medical group, get input from those you know and trust: family and friends.
It's up to Medicare beneficiaries to stay abreast of their coverage and options. And that can mean all you have to do is make a phone call or point your mouse and click.
