Medicare Issues

With over 42 million beneficiaries Medicare is the largest payer in the United States. Under Medicare people over age 65 and people who are qualified by disability are provided with health insurance coverage. Physicians are paid by Medicare using payment rates set by the annual Physician Fee Schedule. These payment rates are calculated using the Sustainable Growth Rate (SGR) formula which ties physician payments to growth in the overall economy. This formula has threatened to cut physician payments every year since 2001.

Physician Fee Schedule

Other Payment Issues

Quality Improvement, Pay-for-Performance and Care Coordination

Coding

Prescription Drug Benefit

Medicare Carriers

Additional Issues under Medicare

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