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LEGAL UPDATE
John Fanburg, JD, and Dean Wang, JD
What's Weighing on the Minds of Your Docs?
Your physicians' hot-button concerns can affect your facility.
W
e recently surveyed more than 400 New Jersey physicians, including surgeons and
anesthesiologists, to find
out what business and regulatory
issues weighed most heavily on
them. Their 3 top concerns:
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MONEY TALKS
Your physicians'
concerns over
reimbursement
can have a
significant
influence over
your facility's
operations.
Out-of-network limits
Insurers nationwide contin-
ue their efforts to limit out-of-network reimbursements and to keep
physicians in-network. Some have been
enlisting state help. New Jersey insurers
supported legislation that would prohibit out-of-network providers
who furnish services at contracted facilities from billing the patient
beyond his in-network co-pay, co-insurance or deductible. New York
Gov. Andrew Cuomo has called for limits on out-of-network charges
and prohibitions on "excessive" charges for emergency services.
(California Gov. Jerry Brown recently vetoed a similar proposal.) If
you rely on out-of-network billing strategies, it may be time to consider whether they're still viable.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2012
