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Article: Aetna and AMA lock horns over Medicare.(Practice Trends)
- Article from:
- Skin & Allergy News
- Article date:
- March 1, 2008
- Author:
CopyrightCOPYRIGHT 2008 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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Aetna Inc. reported that it is working with the American Medical Association and state medical societies to resolve issues involving nonparticipating physicians after the AMA complained that the insurer was paying those physicians just 125% of Medicare rates and then telling patients they didn't need to pay the rest.
In a letter to Aetna, Dr. Michael Maves, AMA's chief executive officer and senior vice president, noted that Aetna's policy--implemented last June--falls to take into account different practice costs that are reflected by physicians' billed charges.
"It is simply arbitrary and capricious for Aetna to deem 125% of Medicare to be a fair ...