Chelsey Ledue

The Centers for Medicare & Medicaid Services has announced the capitation rates for Medicare Advantage plans for 2011.

West Bloomfield, Mich., physician Alan Silber and Detroit resident Hassan Reeves have been convicted by a federal jury for their roles in a $1 million Medicare fraud scheme.

The Employee Retirement Income Security Act gives hospitals the right to appeal any insurance claim to receive 100 percent of the due payment.

A Miami-area physician practice owner blames a “systemic failure” for closing his general practice in 2006 – just three years after purchasing the established office from a retiring physician.

Profile of Nancy Babbitt, administrator,Roswell Pediatric Center P.C. in Alpharetta, Ga.

Changes in practice operations deemed necessary to meet the 25 “meaningful use” criteria proposed as part of the federal electronic health record incentive program would lead to decreased provider productivity, according to the Medical Group Management Association.

The St. Joseph Heritage Medical Group concluded a yearlong journey recently when it achieved patient-centered medical home status from the National Committee for Quality Assurance.

Annual compensation for primary care and specialty care groups in academic practice slowed between 2008 and 2009, increasing only 2.93 percent for primary care physicians and 2.43 percent for specialists, according to a report by the Medical Group Management Association.

The Centers for Medicare & Medicaid Services has approved Colorado Medicaid’s proposal to collect a hospital provider fee, which is expected to yield $1.2 billion after federal matching funds are included.

Overall health plan member satisfaction has declined significantly in 2010, according to the J.D. Power and Associates 2010 U.S. Member Health Insurance Plan Study.