The rates for services are set by the government
Posted on: September 25, 2024 at 10:42:36 CT
XRob
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and then everybody negotiates down from there. Except the government, who just says we're going to pay you $0.13 on the dollar or something like that. Insurance companies generally don't bother to validate medical providers, they just wait and see if the government does, and will negotiate their own deals with providers that they accept. If a provider (say a hospital like MLK in Los Angeles) loses accreditation with Medicare, then the government won't pay them for services and insurance companies will follow in suit.