The payment increase applies to physicians practicing in family medicine, general internal medicine, pediatric medicine and related subspecialties, such as board certified pediatric cardiologists. The rule clarifies that primary care services delivered by medical professionals working under the personal supervision of a qualifying physician, such as nurse practitioners, also are eligible for the higher payment rate (Reichard,
Video: Medicare and Medicaid: What’s it all mean?
13 Recent Medicare, Medicaid Issues
1. Hospital outpatient departments will receive Medicare payment rate increases of 1.8 percent, while ambulatory surgery center Medicare rates will increase by 0.6 percent, according to CMS’ final rule on outpatient policy and payments. 2. CMS issued its final rule on the Medicare physician fee schedule for 2013, saying Medicare reimbursement rates for physicians will be slashed by 26.5 percent on Jan. 1, 2013, unless Congress bypasses the sustainable growth rate. 3. Starting Jan. 1, 2013, through the end of 2014, certain primary care physicians will see their Medicaid payments increase to Medicare rates. 4. The American Hospital Association and four hospitals sued HHS over denied Medicare payments resulting from RAC audits. 5. The American Hospital Association and the Association of American Medical Colleges commissioned Dobson DaVanzo & Associates to look at bundled payments and provide analysis on different episode-based payment bundles that providers could expect. The study looked at 16 MS-DRG families that represent a significant portion of Medicare’s fee-for-service payments. 6. Additional imaging service referrals by providers who self-referred cost Medicare approximately $109 million from 2004 through 2010, according to a U.S. Government Accountability Office report. 7. A new study in the Archives of Internal Medicine revealed that per capita Medicare spending is growing three times faster for seniors in the United States compared with seniors in Canada. 8. CMS approved Washington’s HealthPathWashington initiative — a project that aims to improve the care of state residents enrolled in both Medicare and Medicaid. 9. Here is a list of total Medicare beneficiaries by state in 2012. 10. As federal and state agencies attempt to reduce the growth of spending for people eligible for both Medicare and Medicaid, new research showed it may be hard to find large savings in new demonstration programs. 11. The Medicaid expansion provision of the Patient Protection and Affordable Care Act will start in 2014, adding millions of people to Medicaid rolls, but hospitals and other providers may not understand how to best tailor their medical and business practices to take advantage of the provision. 12. Here is a table of Medicaid cost-containment actions 50 states and Washington, D.C., have taken in 2012. 13. In a recent webinar, Ken Perez, senior vice president of marketing and director of healthcare policy for MedeAnalytics, broke down the current state of Medicare, discussing everything from the politicization of Medicare to detailed breakdowns of presidential Medicare plans.
Rowan woman gets prison for Medicare fraud
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Daily Kos: Elderly will be hit hard by Romney’s Medicare, Medicaid plans
As it turns out, what we know for sure about Mitt Romney’s assault on senior citizens may pale compared to what we don’t. Romney, after all, has promised to magically offset $5 trillion in tax cuts and $2 trillion in new defense spending over the next decade by closing as yet unnamed tax credits, deductions and deductions. But among Uncle Sam’s $1.1 trillion in annual tax expenditures are a host of tax breaks for the elderly. That figure is forecast to hit almost $1.4 trillion by 2015. While the home mortgage and health expense deductions top that list, untaxed Social Security benefits will reach $44 billion annually in three years. And that’s just one example. Mitt Romney has called for raising the retirement age to 67 for those now 55 and under. (In his 2008 campaign, Romney supported President Bush’s proposal to privatize the retiree pension system.)
CMS Raises Medicaid Rates For Some Doctors
Modern Healthcare: CMS Details Medicaid Primary-Care Payments Boost The CMS issued a final rule late Thursday temporarily increasing primary-care physician payments from Medicaid. The rule (PDF), which implements a provision of the Patient Protection and Affordable Care Act, details the extent and target of the increase, which takes effect in January and lasts through 2014. The provision is designed to match Medicare rates, but the rule specifically covers only the difference between the Medicare rate and states’ Medicaid rates as of July 1, 2009. The additional federal funding may not be enough to increase the rate to Medicare levels because some states have enacted Medicare provider rate cuts since mid-2009 (Daly, 11/1).
Health Care Politics: Vouchers, Block Grants, Medicare and Medicaid | Elections 2012
Cossy Hough, LCSW, has been a social worker since 1992. She worked for several years as a community-based case manager and worked from 1997 to 2009 as an administrator with the Texas Department of State Health Services, Case Management for Children and Pregnant Women program. Ms. Hough has experience with program planning, policy development and evaluation, as well as social welfare initiatives and legislative analysis. Her direct practice experience also included medical social work and provision of mental health services. She is a member of the Texas Chapter of NASW.
SANS: Centers for Medicare & Medicaid Services Win 2012 National Cybersecurity Innovation Award
To effectively reduce risk across the widely distributed network of sites, CMS first developed a process to assess the relative security of each datacenter and normalized these security scores across the variety of security tools providing the feeds. The resulting product is a single, cohesive, apples-to-apples scoring solution that pinpoints critical risks, provides remediation information, and creates visibility in a manner that drives rapid remediation responses. CMS demonstrated initial success with this system in 2010 by developing a vulnerability risk scorecard and letter grading system to foster healthy competition among the contractors. Through this program, CMS reduced the average host risk scores at two high-risk data centers by over 68% between July 2010 and January 2011.
Medicare and Medicaid Costs (Utility Post)
The go-to source on Medicare Advantage is the official Medpac report (pdf), which currently finds MA plans costing on average 7 percent more than conventional Medicare. This is less than the premium a few years ago; apparently (pdf) because several changes in Medicare policy more or less incidentally put the squeeze on MA plans. So far those plans are still expanding, but time will tell.
Tommy Thompson: Who Better Than Me To Do Away With Medicare, Medicaid?
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Manhattan Moment: Obama and Biden will turn Medicare into Medicaid
In his debate with Paul Ryan last Thursday, Vice President Biden basically proposed demolishing Medicare Part D, the enormously successful — and bipartisan — program for covering prescription drugs for seniors. Today, Medicare Part D strikes a careful balance between protecting seniors from high drug costs, while encouraging pharmaceutical companies to invest in the next generation of treatments for serious diseases like Parkinson’s, depression, Alzheimer’s and cancer. Biden’s plan would destroy that balance, imperiling innovation, killing jobs and threatening seniors’ access to innovative medicines.