News from CMS

>> CMS recently announced that a 60-day supplier bidding period for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies will begin at the end of October. (Source) CMS’s Jonathan Blum said, “Competitive bidding is an essential tool to help Medicare pay appropriately for health care—important [...]

Extending Medicare Drug Coverage May Lower Other Costs

A recent study showed that extending Medicare Part D coverage to Medicare enrollees who previously had limited or no drug coverage may result in lowering other medical costs. (Source) According to the study, prescription drug spending for newly enrolled beneficiaries without previous coverage rose by $41 a month, $27 a month for those who’d had [...]

Pharmaceutical Industry Agrees to Cut Drug Costs

The Wall Street Journal reports that the pharmaceutical industry has agreed to cut the cost of Medicare drugs to prevent larger cuts President Barack Obama may impose to fund his health care reform plan. Under the cost-cutting plan, the drug industry would pay for half the Medicare drug’s price when it’s not covered by the [...]

CMS News: Preventable Readmissons, Bidding Program Resumed

The Centers for Medicare and Medicaid Services (CMS) has announced a pilot program called the Care Transitions Project, designed to reduce preventable hospital readmissions. (Source) The national program, running through summer 2011 in 14 communities, will look at readmission rates at hospitals and develop ways to reduce readmissions. Acting administrator Charlene Frizzera said one in [...]

CMS Quick Links for Tuesday

Last week the Centers for Medicare and Medicaid Services (CMS) announced that it would postpone implementation of a competitive bidding rule for durable medial equipment providers until April. CMS was required do another round of bidding and make changes, so the implementation date was pushed back. The comment period for the final rule ends on [...]

HHS: Medicare Part D Beneficiaries Overcharged

According to a report released by the U.S. Department of Health and Human Services Office of the Inspector General, private insurers under Medicare Part D have overcharged beneficiaries and taxpayers by billions of dollars since the program began in 2006. (Kaiser Network) An estimated 80 percent of private insurance companies owe Medicare $4.4 billion. The [...]

Medicare Advantage and Part D Under Obama

Last summer, President George W. Bush vetoed a bill that would have halted a 10.6 percent Medicare physicians pay cut. Democrats proposed to reduce payments to Medicare Advantage (MA) plans to fund the physicians pay cut. President Bush reportedly vetoed the bill because it would “harm beneficiaries by taking private health plan options away from [...]

Medicare News: MedPAC and Part D

The Medicare Payment Advisory Commission (MedPAC) has recommended that hospitals receive full market basket Medicare payment increases in fiscal year 2010. (Kaiser Network) Among the proposals is a 1.6 percent payment increase recommendation for long term care hospitals based on quality of care delivered. A final vote will come in January. MedPAC advises Congress on [...]

Medicare Part D’s Home-Infusion Therapy Coverage Gap

The Wall Street Journal reports that a gap in Medicare coverage makes the hospital-to-home care swap more difficult. Under “home-infusion therapy,” patients can receive cost-effective care in their own homes and forgo lengthy hospital stays. But Medicare doesn’t fully cover home-infusion therapy. For instance, the list of intravenous drugs has grown, and patients can get [...]

State of the Medicare Coverage Gap in 2007

The Kaiser Family Foundation has released a report on the costs and consequences of the Medicare Part D coverage gap in 2007. The coverage gap, also called the “doughnut hole,” is the period of time during the year when a beneficiary is not covered and is responsible for paying drug costs out of pocket. The [...]

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