tci Medicare Compliance & Reimbursement - 2005 Issue 35

PPO: PPOs To Fill Gaps Managed Care Plans Create

Incentives will burn a hole in feds' pockets.Medicare will spend as much as $60 billion over a decade to entice preferred provider organizations to offer coverage to 4 million new beneficiaries in areas that managed care plans don't currently serve, concluded the authors of a recent analysis. An Aug. 23 Health Affairs article stated that under the terms of the Medicare Prescription Drug, Improvement, and Modernization Act, private insurance plans began submitting bids in June 2005 to the Centers for Medicare and Medicaid Services to provide coverage to new Medicare beneficiaries. The study predicts that because PPOs...

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