Agency Vacancies Create Complications

As I blogged last week, Mark McClellan, current Centers for Medicare and Medicare Services (CMS) administrator, is set to leave his post.
The Hill reports that Andrew von Eschenbach, President Bush’s nominee to lead the Food and Drug Administration (FDA), is facing obstacles to his confirmation. Will the same happen when Bush nominates someone to [...]

Medicare Fee-for-Service Plan Enrollment Increases

As more beneficiaries sign up for Medicare fee-for-service plans, “experts” are concerned that Medicare may be going private, which apparently is a bad thing.
Citing a New York Times story, the Kaiser Network reports that fee-for-service enrollments increased tenfold to 820,000 during the last two years. The federal government raised plan subsidies by an average [...]

Texas Register Updates: Transfer of Assets, Provider Payments

Texas Health and Human Services Commission (HHSC) has adopted new rules that affect various provisions of Chapter 358, Medicaid Eligibility. The following are new sections: (from the September 22 Texas Register):

§358.431 Transfer of Assets
§358.432, Home Equity Treatment
§358.433, Treatment of Entrance Fees for Individuals Residing in Continuing Care Retirement Communities

HHSC adopted the changes to incorporate mandatory [...]

Whistleblower Actions Under the Federal False Claims Act

Go the federal Department of Justice website (www.usdoj.gov), and you can read how the largest health care system and second largest employer in New Jersey agreed to pay $265 million to resolve a qui tam lawsuit’s allegations in of defrauding Medicare. Click here for the web page. The agreement could also mean huge rewards for [...]

CMS Pressured to Delay Changes to Medical Equipment Medicare Coverage

Unless the Centers for Medicare and Medicaid Services (CMS) delays a policy change, schedule to take effect on October 1, certain Medicare beneficiaries will be forced to use medical equipment, such as scooters and wheelchairs, that doesn’t suit their particular needs, say lawmakers and stakeholders. From Medical News Today:
Sen. Santorum noted that while the National [...]

Physicians Reject Offer To Block Reimbursement Rate Cuts

Last month I mentioned that the American Medical Association (AMA) and other doctors groups planned to lobby Congress during the August recess to block a scheduled reduction in Medicare reimbursement rates.
In the ongoing saga, one lawmaker recently made an offer that was easy to refuse: send us quality-of-care reports, and we’ll block the reduction. [...]

Provider Letter: Online Program Notifications

In a letter dated September 12, 2006, the Department of Aging and Disability Services informed providers that it will no longer send program notifications through the mail. Notifications will be posted online, effective October 1.
Providers can access notifications in two ways: 1) By following this link and clicking on “Communications,” where you’ll find [...]

Medicare Part D Windfall For Drug Companies…For Now

Some Democrats already believe Medicare Part D is a “Republican-engineered windfall” for pharmaceutical companies, but the good fortune may not last, say the experts. (Philadephia Inquirer)
According to Verispan, a health information company, Medicare Part D accounted for as much as 13.6 percent (Bristol-Myers Squibb) of drugs sales from January to July. Medicare Part D prescription [...]

Bob Dole Hosts Weekly Medicare Podcast

Senator Bob Dole has gone high-tech.
Every Monday, he hosts a podcast called Success: The Benefits of the New Medicare Drug Plan, with interviews from Medicare beneficiaries signed up for the new prescription drug program. (Medical News Today)
According to the site, there are 70+ days remaining until the enrollment period starts for Medicare Part D. Dole’s [...]

Texas Register Updates: Medicaid Payment Limits; Patients Rights

The Texas Health and Human Services Commission (HHSC) will submit Amendment Number 747 to the Texas State Plan for Medical Assistance. From the September 8 Texas Register:
Amendment 747 revises the methodology used by the State to estimate the Medicaid Upper Payment Limit (UPL) for hospital inpatient services. The UPL is the federal limit on Medicaid [...]

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