Medicare Raises Nursing Home Payments; Part D Costs Lower Than Expected

The Centers for Medicare and Medicaid Services (CMS) has announced that payment rates for nursing homes will increase by $780 million next year. (Source) The payment increase (3.4 percent) is the result of a recalibration of the annual market basket calculation. CMS acting administrator Kerry Weems said CMS was “committed to providing high quality care [...]

Replace Medicare Part D?

Medicare Part D isn’t even three years old, and a lawmaker already wants to replace it. Congressman Dennis Kucinich, a Democrat from Ohio, introduced a measure that would replace Medicare Part D with a new program ostensibly to lower costs. According to the bill, Medicare would negotiate directly with drug companies for prescription drug discounts [...]

Medicare Pays Up to 30 Percent More for Medications Under Part D Plans

According to a report released by the House Committee on Oversight and Government Reform, Medicare Part D paid about 30 percent more for prescription drugs in the program’s first two years than Medicaid would have paid for the same drugs. This has cost the program about $3.7 billion. (Kaiser Network) Drug company Johnson & Johnson [...]

E-Prescribing and Lock-In Pricing

If a physician adopts e-prescribing technology in 2009 and 2010, he/she will receive a 2 percent bonus in Medicare payments. Those who don’t will see reductions in reimbursements. (Kaiser Network) Contained in the bill that delays a 10.6 percent Medicare reimbursement rate cut are details of an electronic prescribing incentive program, which is designed to [...]

Medicare Physician Reimbursement Cut Delay?

A 10 percent reduction in reimbursements for Medicare physicians could be delayed for 18 months, if Democratic Congressman Max Baucus’s plan is successful. (Kaiser Network) Medicare physicians will see their reimbursements cut by 10 percent beginning July 1, 2008. Under Baucus’s plan, the cut would be delayed until 2010, and reimbursement rates would be raised [...]

CMS Changes Rules To Reduce Medicare Drug Plan Reassignments

On Monday, the Centers for Medicare and Medicaid Services (CMS) announced new rules that will allow low-income Medicare Part D prescription drug program beneficiaries to remain enrolled in their current plans instead of facing reassignment at the end of the year. The new rules will be effective May 31, 2008. (Source) The new rules apply [...]

GAO Releases Reports on Medicare Part D and SCHIP

According to a Government Accountability Office (GAO) released last month, the Centers for Medicare and Medicaid Services (CMS) may have made $90 million worth of “questionable” payments to Medicare Part D contractors hired to help launch the program. (Kaiser Network) Some payments didn’t comply with terms of the contracts, the GAO found. Jeff Nelligan, CMS [...]

Medicare Part D Open Enrollment

Number of Beneficiaries Caught in Coverage Gap Reduced, Study Says

According to a new study published in the Health Affairs journal, Medicare Part D has “dramatically reduced” the number of beneficiaries caught in the coverage donut hole. The donut hole, also known as the coverage gap, is the period of time during the year when a beneficiary is not covered and is responsible for paying [...]

Medicare News: Anemia Treatment, Off-Label Use Issue

Earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced that it will limit Medicare coverage for anemia medications in cancer patients. CMS will cover medications to treat anemia caused by chemotherapy but won’t cover medications for anemia caused by cancer. (Kaiser Network) Roger M. Perlmutter, a physician and spokesman for the drug [...]

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