>> 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 not only to maintain Medicare beneficiaries' access to high quality medical items and services, but also to lower the cost … [Read more...] about News from CMS
Long Term Care Providers and Health Care Form
How will President Barack Obama's massive health care reform proposal affect long term care providers? With a bill of over 1,000 pages and a budget in the trillions, the shift is bound to have a big impact. According to a story in Kaiser Health News, despite worries to the contrary, providers would benefit over the long term under the proposed plan. Nancy Chockley, president of the National Institute for Health Care Management, said, "Everyone has been nicked a little bit, but they are all … [Read more...] about Long Term Care Providers and Health Care Form
2010 Payment Rate Changes
CMS announced that acute care hospitals will see a 2.1 percent payment rate increase as part of an inflation update. Skilled nursing facilities face a Medicare payment reduction of $360 million as part of a $1.050-billion case-mix adjustment decrease and a $690 million market-basket increase. Alan Rosenbloom of the Alliance for Quality Nursing Home Care said, "The nursing home community rightly fears the $12-$16 billion in cuts are just the tip of the iceberg. As Congress continues to … [Read more...] about 2010 Payment Rate Changes
Medicare Fraud Strike Force in Texas
According to the Houston Chronicle, there's a federal Medicare fraud strike force on the loose in Texas. The article highlights a number of Houston-area clinics committing Medicare fraud. Medicare fraud in the U.S. last year totaled $2.35 billion. There were 575 health fraud criminal actions and 342 civil actions filed. The task force has reduced identification of Medicare fraud from months to days, thanks to improved technology. Justice Department spokeswoman Melissa Schwartz said, "There … [Read more...] about Medicare Fraud Strike Force in Texas
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 a $150 quarterly cap, and $13 a month for who'd had a $350 cap. The study also found that spending for other forms of medical care for the … [Read more...] about Extending Medicare Drug Coverage May Lower Other Costs
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 gap under Part D. Over 10 years, pharmaceutical companies will sacrifice $80 billion by covering a larger share of brand-name prescription drug costs. The health care … [Read more...] about Pharmaceutical Industry Agrees to Cut Drug Costs
Texas Register Updates: Changes to Physicians Assistants Section, Etc.
The following information was obtained from the June 12 issue of the Texas Register: Public Hearings The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 1, 2009, at 9 a.m. to receive public comment on rate increases for the Community Based Alternatives waiver program, the Community Living Assistance and Support Services waiver program, the Deaf-Blind with Multiple Disabilities waiver program, and others. The hearing will be held in the Lone Star … [Read more...] about Texas Register Updates: Changes to Physicians Assistants Section, Etc.
Obama Proposes Medicaid and Medicare Cuts
Last week President Barack Obama proposed to cut $313 billion from Medicaid and Medicare over the next 10 years as part of so-called health reform, in addition to the $635 billion in cuts in his FY 2010 budget. (Source) The president proposes to expand coverage to "millions" who don't have it, while bringing down the cost of care. How does he intend to accomplish these seemingly opposing goals? Among other things, limiting growth of Medicare's fee-for-service payments and cutting subsidies to … [Read more...] about Obama Proposes Medicaid and Medicare Cuts
Texas Register Updates: Per Diem Rates, Consulting Contract
The following information was obtained from the May 8 issue of the Texas Register: Public Notices The Texas Health and Human Services Commission (HHSC) adopted the following per diem reimbursement rates: Per Diem Rates for Large, State-Operated ICF/MR Services Large State-Operated ICF/MR Facilities-Medicaid Only clients Adopted interim daily rate: $409.98 Large State-Operated ICF/MR Facilities-Dual-eligible Medicaid/Medicare clients Adopted interim daily rate: $392.41 HHSC … [Read more...] about Texas Register Updates: Per Diem Rates, Consulting Contract
Information Letters: MDS Admission Assessment, Etc.
The Texas Department of Aging and Disability Services (DADS) released four information letters: Minimum Data Sets (MDS) Admission Assessment In a letter to Nursing Facility (NF) providers, DADS clarified when an MDS admission assessment should be submitted as well as the appropriate reasons for the assessment if the form is dually coded for Omnibus Budget Reconciliation Act and Medicare. Download the three-page letter for more information. Integrated Care Management (ICM) and … [Read more...] about Information Letters: MDS Admission Assessment, Etc.
