Medicare Part B

Publication Title: 
Journal of Aging & Social Policy

The prospect of budget cuts in Medicare is likely to result in less generous reimbursements from Medicare and thus affects physicians' willingness to accept Medicare patients with the reduced payments. This study examines physicians' decisions about case-by-case assignment and participation in Medicare in relation to Medicare reimbursement generosity. A two-part model is applied to a database from a national survey of physicians.

Author(s): 
Zhang, M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The objective of this study was to examine the volume and rate of Medicare Part B claims for chiropractic spinal manipulation longitudinally from 1998 to 2004. METHODS: A descriptive retrospective analysis was performed on Medicare part B claims from 1998 to 2004 using the Medicare Part B Standard Analytical Variable Length File. Using a 5% random sample of Medicare part B claims, the total number of claims were determined for chiropractic spinal manipulation procedures, and the rate of chiropractic spinal manipulation procedures per 1000 beneficiaries.

Author(s): 
Whedon, James M.
Davis, Matthew A.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The purpose of this study was to measure geographic variations in the availability and use of chiropractic under Medicare. METHODS: A cross-sectional design was used to analyze a large nationally representative sample of Medicare data. Data from a 20% representative sample of all paid Medicare Part B fee-for-service claims for 2007 were merged with files containing beneficiary and provider data. The sample was restricted to adults aged 65 to 99 years. Measures of chiropractic availability and use were described and selectively mapped by state.

Author(s): 
Whedon, James M.
Song, Yunjie
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The purpose of this study was to define and characterize episodes of chiropractic care among older Medicare beneficiaries and to evaluate the extent to which chiropractic services were used in tandem with conventional medicine. METHODS: Medicare Part B claims histories for 1991 to 2007 were linked to the nationally representative survey on Assets and Health Dynamics among the Oldest Old baseline interviews (1993-1994) to define episodes of chiropractic sensitive care using 4 approaches.

Author(s): 
Weigel, Paula A. M.
Hockenberry, Jason M.
Bentler, Suzanne E.
Kaskie, Brian
Wolinsky, Fredric D.
Publication Title: 
The Spine Journal: Official Journal of the North American Spine Society

BACKGROUND CONTEXT: Concern about improper payments to chiropractic physicians prompted the US Department of Health and Human Services to describe chiropractic services as a "significant vulnerability" for Medicare, but little is known about trends in the use and cost of chiropractic spinal manipulation provided under Medicare. PURPOSE: To quantify the volume and cost of chiropractic spinal manipulation services for older adults under Medicare Part B and identify longitudinal trends.

Author(s): 
Whedon, James M.
Song, Yunjie
Davis, Matthew A.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To develop and test a self-report survey instrument that measures the work performed by chiropractors in the delivery of evaluation and management (E/M) services and spinal manipulative therapy (SMT). Work is one leg of a triad used to develop Resource-Based Relative Values Scales (RBRVS) for physician reimbursement. DESIGN: Reliability study modeled after a tool designed and tested by economists at Harvard University School of Public Health in the development of relative values scales for physician reimbursement.

Author(s): 
Hess, J. A.
Mootz, R. D.
Madden, C. W.
Perrin, E. B.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

BACKGROUND: Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician "work" is defined. OBJECTIVE: Results of work and time inputs from chiropractic physicians are compared with those reported by osteopathic and medical specialties. Last, implications for reimbursement of chiropractic fee services are discussed.

Author(s): 
Hess, J. A.
Mootz, R. D.
Publication Title: 
Federal Register

This final rule makes several changes affecting Medicare Part B payment.

Publication Title: 
Federal Register

This final rule makes several changes affecting Medicare Part B payment.

Publication Title: 
Federal Register

This rule addresses Medicare Part B payment policy, including the physician fee schedule that are applicable for calendar year (CY) 2006; and finalizes certain provisions of the interim final rule to implement the Competitive Acquisition Program (CAP) for Part B Drugs.

Author(s): 
Centers for Medicare & Medicaid Services (CMS), HHS

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