The Kaiser Network recently highlighted a story from the Wall Street Journal about fraud in private sector Medicare and Medicaid managed care plans. (Kaiser Network) In the 1990s, the federal government moved more Medicare and Medicaid beneficiaries to managed care plans in the private sector to reduce costs. Although some believed the private sector would have incentives to conduct business ethically and prevent fraud, others believe a new kind of fraud has cropped up. An excerpt: The … [Read more...] about More Fraud Found in Private Sector Managed Care Plans?
Republicans Propose ‘Significant’ Cuts to Medicare and Medicaid
In an effort to retain tax cuts and tax breaks proposed by President George W. Bush, congressional Republicans have proposed a fiscal year 2009 budget that would cut Medicare and Medicaid spending. (Kaiser Network) In anticipation of the Bush administration's tax cuts expiring at the end of 2010, Democrats have proposed a budget of $3 trillion to fund domestic programs. Yesterday, both sides of the aisle began debating competing budget proposals. In other Medicaid news, a hospital … [Read more...] about Republicans Propose ‘Significant’ Cuts to Medicare and Medicaid
House Seeks to Expand SCHIP Through Budget Reconciliation Bill
Although President George W. Bush twice vetoed bills that would have expanded the State Children's Health Insurance Program (SCHIP), Democrats in the House of Representatives are still trying to find ways to expand the program. (Kaiser Network) Last week, Charles Rangel, chair of the House Ways and Means Committee, said the House budget reconciliation bill would include provisions to expand SCHIP and stop a 10 percent Medicare physician payment reduction. The measure would increase SCHIP … [Read more...] about House Seeks to Expand SCHIP Through Budget Reconciliation Bill
GAO Says Medicare Advantage Plans Can Cost More Than Traditional Medicare
According to a recent Government Accountability Office (GAO) report, Medicare Advantage (MA) plans can cost more than traditional Medicare for certain services like home health care, nursing homes, and certain hospital stays. (Kaiser Network) Under MA plans, the government pays a subsidy to private insurance companies to offer such plans, whose purpose is to keep premiums very low. In light of the GAO's findings, the Centers for Medicare and Medicaid Services announced that it will collect … [Read more...] about GAO Says Medicare Advantage Plans Can Cost More Than Traditional Medicare
Bush Administration Proposes to Raise Medicare Drug Premium
The Bush administration has proposed to raise Medicare drug benefit premiums for "higher-income" beneficiaries. (Kaiser Network) The proposal includes a cap on non-economic damages in medical malpractice suits and a requirement for health care providers to implement electronic records. The proposal isn't a move to placate House Democrats (the part about raising premiums for high earners), however; under the 2003 Medicare law, President Bush is required to submit a Medicare savings … [Read more...] about Bush Administration Proposes to Raise Medicare Drug Premium
House Democrats Consider New SCHIP and Medicaid Funding Bill
Last week, House Democrats failed to override President George W. Bush's veto of the State Children's Health Insurance Program (SCHIP) expansion bill. This week, they're considering drafting a new bill that would expand SCHIP, place a moratorium on rules limiting Medicaid eligibility, and provide a temporary boost to the federal medical assistance percentage for Medicaid. (Kaiser Network) Will Democrats garner enough votes for the proposed bill to override a presidential veto? Probably not. … [Read more...] about House Democrats Consider New SCHIP and Medicaid Funding Bill
AHA Objects to Medicare Auditing Program Expansion
The American Hospital Association (AHA) and other groups objected to and began a campaign against the expansion of a pilot program to audit Medicare claims, citing concerns about contingency fees. (Kaiser Network) Under the program, private-sector auditing firms will examine Medicare claims by hospitals and other providers, and the firms will receive contingency fees based on how much money their assessments save the government. Hospital groups believe that such fees encourage auditors to be … [Read more...] about AHA Objects to Medicare Auditing Program Expansion
Information Letters: Accounting System Upgrade, Etc.
The Texas Department of Aging and Disability Services (DADS) reminded all Long Term Services and Supports Providers that DADS is planning to upgrade its financial accounting system and expects a delay in payment processing for all claims billed while the system is unavailable. Download the letter for more information. DADS informed Home and Community-Based Services (HCS) Providers and Mental Retardation Authorities about activities that must take place when an HCS provider notifies DADS of … [Read more...] about Information Letters: Accounting System Upgrade, Etc.
Kaiser Releases Medicare Report
The Kaiser Network has released a reported titled "Financing Medicare: An Issue Brief," which gives an overview of Medicare's future, including funding issues and challenges. In other Medicare news, lawmakers say they will resume the business of Medicare, State Children's Health Insurance Program (SCHIP), and Medicaid policy changes in 2008. One issue on the list is preventing a 10 percent cut in Medicare physician fees. Other issues include genetic non-discrimination and discussing the Bush … [Read more...] about Kaiser Releases Medicare Report
Provider and Information Letters: Health Care Decisions, Treatment Consent, Etc.
Since December 11, the Texas Department of Aging and Disability Services (DADS) has issued provider and information letters to the following: Nursing Facilities Authority to Make Health Care Decisions (letter) Rules and Regulations Concerning Provider Continuing In-service Education for Certified Nurse Aides (letter) Home and Community Support Services Agencies Medicare Treatment Consent Requirements (letter) Primary Home Care and Community Attendant Services Providers … [Read more...] about Provider and Information Letters: Health Care Decisions, Treatment Consent, Etc.
