The creation of a public health insurance plan - optional for patients, of course - is one of the biggest obstacles to passing a bipartisan health reform bill.

It's also a highly politically sensitive subject, as a recent spat between the AMA and The New York Times shows. The Times ran an article today stating that the AMA "is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system."

We've wrapped up day two of our 2009 Medicare Provider Enrollment Workshop in Denver and, as I'm typing this, the sun is dipping beneath the rugged skyline, dominated by the eastern range of the Rocky Mountains. Sadly, the (presumably) majestic, snow-capped peaks are hidden by a layer of smoky smog, which has been floating above the city of Denver all week.

Three committees in the House of Representatives released an outline of their health care reform bill, which they hope to pass by August. Here's a list of the proposed changes to Medicare. As always, we're interested in your thoughts.

The carrier WPS produced a fact sheet on modifier 22 (increased procedural services) June 8. We wrote about the modifier this week, noting denial rates for claims with the modifier have crept upward from 2005-2007. More than one in every four of these claims are denied by Medicare.

It's the second day of our 2009 Medicare Provider Enrollment Workshop and the hotel conference room is packed. Dennis Grindle, our speaker, cracks a joke about how frustrated practices are with CMS's unforgiving and sometimes unclear enrollment rules.

"As you can see, I'm not affiliated with CMS," he says. "That's why there's no bullet-proof screens up here around my podium."