Medicare Compliance & Reimbursement

Plus: Why most seniors aren't seeking generic alternatives.

An anesthesiologist who routinely billed for sedation and nerve-block services for two patients at the same time violated the "continuous presence" requirement of the anesthesia codes, ruled the U.S. District Court for New Jersey.

That decision came in response to anesthesiologist Kenneth Zahl's appeal of an Administrative Law Judge (ALJ) ruling that he owed thousands to Medicare. Anesthesiologists in Zahl's practice would supervise two patients at once--one received sedation and nerve block in the pre-operative area, the other received these services in the operating room.

Your Older Patients Aren't Talking To You About Their Med Costs

Nearly a third of seniors report not having talked to their doctors about all the medications they're taking within the past year, according to an article in the January 2007 Journal of General Internal Medicine. Also, 27 percent of seniors who stopped taking their medications because of side effects or perceived lack of effect didn't tell their doctors this fact.

A startling 40 percent of seniors don't adhere to their prescribed course of medication. And where seniors fail to comply for cost reasons, 39 percent of them won't disclose this fact to their doctors, even when cheaper alternatives are available. Meanwhile, 38 percent of seniors who failed to take meds for cost reasons switched to a cheaper drug--and those tended to be the seniors who discussed this fact with their doctors.