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Private Plan Profiling, Reimbursement under Close Watch by AMA, New York Officials

Scrutiny of insurers’ physician profiling and reimbursement practices continues from both the medical and legal communities, with expansion of a New York attorney general investigation and a recent study by the AMA. Last week, Andrew Cuomo issued subpoenas to Aetna Inc., CIGNA, UnitedHealth Group and WellPoint, Inc., in a broadening investigation of possible fraud that includes the accuracy of reimbursements. Separately, a recent AMA study looked at the Wellmark Blue Cross and Blue Shield “incent and rewards” program and United Healthcare’s Premium Designation program. As part of the study, the AMA created charts that help physicians analyze and spot both problems and merits within each program. Learn more about physician profiling.

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Support ‘Surgery by Surgeons’ Efforts During 2008 Legislative Session
Many state legislatures across the country are convening or will soon convene for their 2008 legislative sessions. Join the Academy and your state ophthalmology society’s “surgery by surgeons” advocacy initiative to preserve patient access to quality medical eye care services. Your involvement is critical to our success in states across the nation.

 

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