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 them" and urged Congress to send him a bill "that reduces the growth in Medicare spending, increases competition and efficiency, implements … [Read more...] about Medicare Advantage and Part D Under Obama
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 issues. In other Medicare news, Kaiser reports that close to 133,000 beneficiaries in Tennessee have not taken … [Read more...] about Medicare News: MedPAC and Part D
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 these treatments at home. Home drug administering costs between $150 and $200 a day, as opposed to $1,500 to $2,500 a day … [Read more...] about Medicare Part D’s Home-Infusion Therapy Coverage Gap
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 Kaiser study "quantifiesâ€¦the number of Medicare Part D plan enrollees in 2007" who reached the doughnut hole. The study does not include low-income beneficiaries who received … [Read more...] about State of the Medicare Coverage Gap in 2007
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 to those in skilled nursing facilities and to paying those facilities properly for that care" and assures that CMS will continue evaluating … [Read more...] about Medicare Raises Nursing Home Payments; Part D Costs Lower Than Expected
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 and do away with co-payments, premiums, and deductibles. (CQ Politics) In a statement, Kucinich said, "The privatized drug plan has been given a … [Read more...] about Replace Medicare Part D?
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 received a whopping $615 million more from Part D than it would have received from Medicaid. Lawmakers already are trying to fix the problem. Congressman Henry … [Read more...] about Medicare Pays Up to 30 Percent More for Medications Under Part D Plans
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 save money and reduce drug-related errors. The program will begin on January 1, 2009. Kerry Weems, acting administrator of the Centers … [Read more...] about E-Prescribing and Lock-In Pricing
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 by 1.1 percent. He also wants to increase and link reimbursements for primary care physicians (PCP) to quality of care. The … [Read more...] about Medicare Physician Reimbursement Cut Delay?
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 to beneficiaries eligible for the low-income subsidy under Part D. Under the existing rule, beneficiaries in plans that charge no premium are automatically … [Read more...] about CMS Changes Rules To Reduce Medicare Drug Plan Reassignments