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Source: 1stfind.com
Video: Tim Walz (Medicare Payments)
CBO Sets Price Tag For Delaying Scheduled Medicare Physician Payment Cuts: $271 Billion
Medpage Today: CBO: Delays In SGR Cuts To Cost $271 Billion The Congressional Budget Office (CBO) has released updated figures on the cost of repealing — or continuing to override — the cuts doctors are scheduled to receive under Medicare’s Sustainable Growth Rate (SGR) reimbursement formula. The fresh numbers give Washington lawmakers a better idea of the effect of changes they could make later this year to the SGR cuts. Physician reimbursements are scheduled to drop by 27% next year unless Congress acts, the CBO noted in the report. Every year since 2003, Congress has acted to override the SGR cuts by either maintaining or increasing payments when they were scheduled to drop. The CBO estimates that if cuts are blocked and payments sustained at current rates from now through 2022, it would cost an additional $271 billion from 2013 to 2022. Resetting payments to 2011 levels, only to increase them annually at 2% plus however much the gross domestic product (GDP) grows, would cost an additional $376.6 billion (Pittman, 8/1).
Source: kaiserhealthnews.org
Imaging Cuts in Proposed 2013 Medicare Fee Schedule Rule Potentially Dangerous, Unfounded and Unnecessary
Further cuts to imaging do little, if anything to safely bend the Medicare cost curve. Imaging use in Medicare is down since 2008. Medicare spending on scans is at the same level it was in 2003. Imaging is also the slowest growing of all physician services among privately insured Americans according to the Health Care Cost Institute. A multitude of studies show that medical imaging exams are directly linked to greater life expectancy, declines in mortality rates, and are generally safer and less expensive than the invasive procedures that they replace. Scans also reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays.
Source: newswise.com
Demand and compensation for primary care physicians is on the rise
Steve Messinger, partner at the healthcare consulting firm ECG, says primary care physicians’ two top priorities are fair compensation and flexibility of their schedule. A locum tenens career through Barton Associates meets both of those criteria, offering competitive rates, flexibility, and freedom from bureaucracy that comes with a permanent position. Now is a great time for primary care providers who have been considering a locums career to give it a shot. With primary care providers in such demand, we have a wide array of high-paying assignments available. In short, it’s a great time to be in family practice!
Source: bartonassociates.com
Medicare and The President’s Plan to Reduce the Deficit
Teaching Hospitals: Here again, MedPAC’s analysis suggests that Medicare is overpaying. Medicare is the single largest funder of graduate medical education (GME), laying out $9.5 billion in 2009. The goal is to compensate teaching hospitals for the indirect costs stemming from inefficiencies created from residents “learning by doing.” But MedPAC reports that these Indirect Medical Education (IME) add-on payments are significantly greater than the additional patient care costs that teaching hospitals experience. For example, MedPAC’s June 2010 report reveals that in 2009, Medicare paid $3.5 billion more than the empirically calculated indirect clinical costs associated with teaching. The Fiscal Commission also recommended reducing the IME adjustment. The President’s proposal would trim the IME adjustment by 10 percent beginning in 2013, and save approximately $9 billion over 10 years. If one assumes that the $3.5 billion overpayment in 2009 was typical, Medicare would need to cut IME adjustments by $35 billion over 10 years in order recoup lost tax dollars. Using that benchmark, a $9 billion cut does not seem Draconian.
Source: healthbeatblog.com
CMS Proposed Changes to 2013 Physician Fee Schedule
The Center for Medicare and Medicaid Services (CMS) released its’ proposed rule (Rule) for changes related to payment policies under the physician fee schedule and other areas on July 6, 2012. According to a copy of the Rule on the Office of Federal Register website, the Rule “…addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.” As is its’ custom, comments on the Rule may be submitted for a 60 day period after the initial date of filing for public inspection. Likely considered the most significant change is the projected 27 percent cut in Medicare payment rates as suggested by the sustainable growth rate (SGR) formula. However, there are indications that Congress may be acting to delay this projected cut. Representative Michael Burgess (R – TX) has said he will submit legislation that would delay the SGR cuts for one year. If historical precedent is any indication, some sort of delay related to the SGR cuts is highly likely. There is an emphasis on primary care in the Rule; likely a result of healthcare reform and the focus on patient care coordination. For family physicians, the Rule proposes a 7 percent increase in payments while other primary care practitioners would receive a 3 – 5 percent increase. While primary care providers will see increases, the Rule includes payment cuts to several specialty groups. The specialties or areas with the largest proposed cuts – on top of the proposed SGR reduction – are summarized in the chart below: Much of the proposed decline in imaging services is related to a reduction in payment when more than one imaging service is provided by the same physician(s) to the same patient, during the same session (visit), on the same day. This is simply an expansion of the multiple procedure payment reduction (MPPR) often utilized by Medicare. In such cases, the lower priced procedure would receive a 25 percent reduction in payment. Specifically for radiation oncology, payment cuts surround two services: intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). In both cases, CMS has reviewed the clinical times that were initially utilized to determine reimbursement for these services and has concluded that the times are too high based on current information. Also driving this reduction is a change in the interest rate assumption used to determine the payment component for practice expenses. The interest rate change would decline from 11 percent to a range of 5.5 – 8 percent which would impact services that require significant capital. The final rule is expected to be released on or around November 1.
Source: vmghealth.com
Rule Would Increase Payment to Family Physicians
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 6, 2012, which would result in an increase of payment for family physicians by approximately 7% and between 3% to 5% for other practitioners. The potential increase would result from updated payment policies and rates under the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2013. Under the MPFS, Medicare pays more than one million physicians and non-physician practitioners providing vital services to Medicare beneficiaries.
Source: bracheichler.com
Affordable Health Care Act may impact Medicaid and Medicare patients
Author Sandra Decker, PhD, an economist at the National Center for Health Statistics of the US Centers for Disease Control and Prevention (CDC) noted that the findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could increase Medicaid payment rates to primary care physicians in some states while boosting up the number of individuals with healthcare coverage. She reported a low acceptance rate of new Medicaid patients of 40.4% in New Jersey and a high of 99.3% in Wyoming. In general, acceptance rates generally were higher in states with higher Medicaid fee-for-services rates, expressed as a percentage of Medicare’s rates in 2008. For example, Medicaid rates in Wyoming in 2008 were close to 150% of the reimbursement for a Medicare patient; this marked the nation’s highest rate. In contrast, New Jersey’s Medicaid rates were the nation’s lowest: 37% of Medicare. Nationwide, the average Medicaid-to-Medicare fee ratio is 74.2.
Source: emaxhealth.com
Medicare Physician Fee Schedule
Improving Payment for Primary Care. The proposed rule includes a number of initiatives designed to increase payments for primary care. Payments for primary care would increase for a variety of reasons, including a proposed new payment for managing a beneficiary’s care when the beneficiary is discharged from certain health care facilities, such as a hospital, skilled nursing facility, inpatient rehabilitation facility, and other similar types of facilities. This would be achieved by creating a new procedure code for providing “post-discharge transitional care management services”, which would apply to all services related to transitional care management within 30 days following the date of discharge from an eligible facility.
Source: beneschhealthlaw.com
Congress Holds Hearings Fixing Flawed Medicare Physician Payment Formula
5010 AARP ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration Barack Obama Bill Nelson Bobby Lolley Centers for Medicare & Medicaid Services companionship services exemption Copays Department of Health and Human Services Department of Justice Department of Labor Elizabeth Hogue F2F Fair Labor Standards Act Federal Bureau of Investigation Florida Home Health Care Providers Inc. Gentiva Health Services George W. Bush Health Care Fraud Prevention and Enforcement Action Team (HEAT) HH CAHPS Hilda Solis HIPAA ICD-10 In-Home Aides-Partners in Quality Care Independence at Home Demonstration Kathleen Sebelius Lisa Remington Marco Rubio Marilyn Tavenner Medicare Fraud Strike Force MedPAC National Association for Home Care & Hospice National Private Duty Association Office of the Inspector General Open Door Forum Palmetto GBA Pam Bondi Patient Protection and Affordable Care Act PECOS Rick Scott Super Committee Supreme Court
Source: hcafnews.com
While western women are increasingly turning to the knife and having the size, shape and appearance of their labia enhanced, feminists and activists continue the campaign to end the practice of female genital mutilation affecting millions of women living in parts of Africa, Asia, and the Middle East. Female genital mutilation is a procedure that intentionally excises genital tissue leading to problems such as frequent bladder infections, childbirth complications and the risk of later surgery. The World Health Organization estimates that there are 100 to 140 million women who have had their lives damaged by FGM.
At last Connecticut has two medical groups that have been approved to participate in Medicare’s Accountable Care Organization (ACO) program. The two groups are: MPS ACO Physicians in Middletown and PriMed of Shelton. The ACO program is part of many efforts being undertaken to change how health care is both delivered and paid for; moving from a system that rewards volume to a system that rewards quality care and better outcomes.
In order for a gift to a trust to qualify for the annual gift tax exclusion, currently $13,000 per beneficiary, the IRS requires trust beneficiaries to be given formal written notice of their right to withdraw the gifted amount if they choose to do so (Crummey v Commissioner, 397 F.2d 82 (9th cir 1968)). CrummeyService.com technology reminds the grantor to make the gift to the trust, notifies the beneficiaries of their right to withdraw the gifted amounts, and provides an independent third-party record of the entire process.
There are many ways that information about Medicare coverage can be obtained online, several are fraudulent or unreliable. We only use information from government websites and simplify it to help you find reliable resources for seniors. In this post, we will only be using information from the government website and putting it in an easy to understand and simplified manner for you.
The Associated Press: Gov’t: Medicare Drug Plan Premiums Stable For 2013 It’s an economic indicator of sorts for seniors: The Obama administration says the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That’s the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the “doughnut hole.” There is a caveat on premiums. Because the number is an average, some beneficiaries may see their monthly cost go up, while others get a decrease (8/6).
The Associated Press: Gov’t: Medicare Drug Plan Premiums Stable For 2013 It’s an economic indicator of sorts for seniors: The Obama administration says the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That’s the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the “doughnut hole.” There is a caveat on premiums. Because the number is an average, some beneficiaries may see their monthly cost go up, while others get a decrease (8/6).
COLUMBUS, Ohio (AP) — Ohio Gov. John Kasich’s administration says it’s on track to convert the state Medicaid office into its own agency by next July. In an announcement Friday, Governor’s Office of Health Transformation Director Greg Moody said the office will move out of the Ohio Department of Job and Family Services. The move is the next step in the administration’s efforts to improve the performance of Ohio’s nearly $19 billion Medicaid program. The switch will be complete July 1, 2014. Moody said the change was recommended by two different study commissions in 2005 and 2006, and so it’s overdue. Removing Medicaid from the state’s social services agency will allow Job and Family Services to better focus on welfare benefits programs. ————————————— Web Producer: Ken Hines