Surgery

News & Analysis as of

CMS Designates Global Surgery as “Potentially Misvalued Services”

In the recently proposed 2015 Physician Fee Schedule, CMS devoted significant resources to discussing potentially misvalued services, which I believe is code for places where CMS would like to reduce reimbursement. One of the...more

Medicare Appeals Panel Invalidates National Coverage Determination Prohibiting Coverage for Gender Reassignment Surgery

On May 30, 2014, the Departmental Appeals Board (DAB) issued a decision invalidating the long-standing National Coverage Determination (NCD) prohibiting Medicare payment for transsexual surgery (now known as gender...more

Health Alert (Australia) - 14 October 2013

In This Issue: - Judgments - Legislation - Reports - Excerpt from Judgments: JUDGMENTS - Commonwealth - 8 October 2013 - Faye Mason v Military Rehabilitation and Compensation Commission...more

Getting the Best Medical Care: a Newsletter from Patrick Malone - September 2013

In This Issue: - Introduction - The Facts About Drug Therapy - Spinal Injections Don't Measure Up - Surgery as a Last Resort - Watchful Waiting Can Be Your Friend - Introduction: Back pain is...more

7th Circuit Rules Employee May Recover Monetary Damages In ERISA Claim For Unpaid Benefits Against Insurer Who Denied Coverage...

The Seventh Circuit’s recent decision in Kenseth v. Dean Health Plan, Inc. provides a means for employees to collect monetary relief on their claim for benefits if they can show that the terms of the plan were not clear, and...more

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