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• Ario Confirmed as Insurance Commissioner
  The state Senate on July 3, 2008, unanimously confirmed Joel Ario as insurance commissioner.
• Medicare Advantage Plans Require Nondiscrimination Policies
  Capital BlueCross is requiring providers that participate with its Medicare Advantage plans to confirm that they have a nondiscrimination policy in place.
• Funding Available to Help Physicians Acquire eHealth Technology
  Funding to help acquire health information technology is now available to physicians in central and western Pennsylvania.
• Cigna Will Stop Reimbursing for Preventable Serious Complications
  Cigna has joined a growing movement to stop reimbursing hospitals for preventable serious complications.
• File Your Claims On Time to Benefit from Recent Class Action Settlements
  Get a brief overview of several important deadlines that are approaching for physician action in three recent settlements of class action lawsuits against Blues plans.
• Details of the Recent Class Action Settlements
  Get details on three recent settlements of class action lawsuits against Blues plans.
• Health Insurers May Drop Concierge Care Physicians
  Physicians who practice concierge care may run the risk of being dropped by health insurers, including United Healthcare and Cigna.
• CMS Clarifies PFFS Plans Access to Medical Records
  Practices that have signed contracts with Medicare Advantage private-fee-for-service plans or that have treated a PFFS beneficiary may have to give the plans access to medical records.
• Aetna and Coventry Postpone Policy Changes to Sedation Coverage
  Two health insurers have postponed policies that would have stopped covering the cost of anesthesiologists for most colonoscopies.
• Insurer Accidentally Posts Physicians’ Social Security Numbers on Web
  Health Net Federal Services (HNFS) posted Social Security numbers of some Pennsylvania physicians on the Internet for about two months.
• Aetna, Cigna Reimburse for Online Consultations
  The insurers will reimburse for online consultations for physicians who subscribe to the RelayHealth web service.
• UnitedHealthcare Offers Educational Webcasts for Physicians
  Learn about United's website and online tools during their weekly webcasts.
• Aetna Tries to Set Payment Levels for Out-of-Network Physicians
  Aetna is trying to set payment levels for out-of-network physicians at 125 percent of the Medicare fee schedule and telling patients that they do not have to pay the remaining balance.
• UnitedHealthcare Changes Preventive Medicine and Screening Policy
  UnitedHealthcare will now reimburse both a preventive service and a problem-oriented E&M service submitted with modifier 25 for the same patient on the same date of service.
• Online Calculator Computes Patient’s Payment Responsibilities
  Highmark Blue Cross and Blue Shield’s online calculator can estimate a patient’s financial responsibility at the time of service.
• Highmark Changes Definition of Personal Supervision for “Incident-to” Billing
  Highmark Blue Cross and Blue Shield will allow some allied health professionals to bill under their cooperating physicians’ provider numbers for services performed when physicians are out of the office.
• Workers' Compensation Medical Cost Containment (PA Code)
  Regulations implementing the Workers' Compensation Act relating to payments for medical treatment by insurers or self-insured employers and the review of medical treatment of employees with work-related injuries and illnesses.
• Highmark Blue Shield Multiple Surgery Guidelines
  Highmark has routinely reimbursed physicians for multiple surgical procedures in a downward stepping stone method. Here's a synopsis of their reimbursement guidelines.
• Highmark Blue Shield Changes Credentialing Policy
  Beginning in January, Highmark Blue Shield will credential all general practitioners who set an age limit of 13 years and older for Highmark members.
• Access Plus and Pay for Performance (P4P)
  An overview of Access Plus and P4P programs in general

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