Medicare Part D Scams

CMS is warning people against scams regarding the Medicare prescription plan, This scheme is called the “$299 Ring” for the typical amount of money Medicare beneficiaries are talked into withdrawing from their checking accounts to pay for a nonexistent prescription drug plan. Consumers can report these cases to their local law enforcement agencies or call [...]

Hospital Quality Report; New Provider Letter

The Government Accountability Office (GAO) has released a report titled, Hospital Quality Data (PDF). According to the report, hospitals that don’t submit clinical data for patients lose 0.4 percent of Medicare payment updates. This information is necessary to calculate a hospital’s quality measure. To ensure that publicly released data are reliable, the Centers for Medicare [...]

Proposed Increase in Payment Rates for Texas Medicaid Nursing Facilities and Associated Increases in Staffing and Spending Requirements for Facilities Participating in the Enhanced Direct Care Staff Rate

Texas HHSC has posted a letter regarding payment rates. It begins, On February 14, 2006, the Health and Human Services Commission (HHSC) received a letter from House Speaker Tom Craddick and Lieutenant Governor David Dewhurst authorizing the expenditure of $75 million in General Revenue and $115.7 million in Federal Funds at the Department of Aging [...]

California’s Plan to Improve Nursing Homes in Jeopardy; New Provider Letter

More states would face cuts in nursing home funding in President Bush’s proposed FY 2007 budget. Last week I blogged about the proposed budget’s effect on Louisiana. An accounting firm called BDO Seidman and the American Health Care Association analyzed the FY 2007 budget proposal and found that Louisiana would face a $70.2 million cut [...]

Employee Benefits: They’re Not for Everyone

ERISA does not require Employers to define their benefits plans in such a way as to provide coverage for all employees

Texas Pharmacists Lobby White House

A group of pharmacists in Texas is lobbying the White House, demanding to be reimbursed for giving away prescription drugs to Medicare beneficiaries. From CNNMoney.com: “If pharmacists don’t receive immediate relief, some will go broke,” Bill Pittman, a former president of the Texas State Board of Pharmacy who is chairman of Pharmacists for Bush, a [...]

States to be Reimbursed for ‘Dual Eligibles’ Payments

Mark McClellan, administrator for the Centers for Medicare and Medicare, has assured states that they will be reimbursed for payments for “dual eligibles,” beneficiaries who qualified for Medicare and Medicaid coverage. Medicare’s prescription drug program has caused much confusion, and some beneficiaries had trouble getting prescriptions filled because they missed the January 1 deadline to [...]

Louisiana Faces $70.2 million Medicaid Cut

An accounting firm called BDO Seidman and the American Health Care Association analyzed the FY 2007 budget proposal and found that Louisiana would face a $70.2 million cut in Medicaid funding for nursing homes, which would represent the ninth highest reduction of all states analyzed. The cuts would add to the state’s woes in the [...]

Texas Medical Board Disciplines Doctors

The Texas Medical Board has disciplined 36 doctors for various violations, including those based on quality of care, drug and alcohol impairment, inappropriate conduct in the physician-patient relationship, and unprofessional conduct. One doctor is alleged to have prescribed drugs to her husband and children, and to herself under aliases. Another doctor took a call and [...]

Medicare Will Cover Obesity Surgery

According to the Centers for Medicare and Medicaid Services, Medicare is expanding coverage for bariatric surgery. From the press release: CMS reviewed new data and analyses which demonstrate that surgeons with more experience have similar outcomes for patients of all ages. After reviewing the evidence and considering recommendations of professional societies and other experts in [...]

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