On March 5, 2005, the Office of the Inspector General ("OIG") launched its Compliance 101 website. The website contains links to guidance and educational training materials for health care providers, practitioners and suppliers. The site contains segment-specific compliance guidance for nursing facilities, ambulance suppliers, physician practices, etc. Although the materials are from 1998-2008, the compliance program guidance is still relevant and details the high-risk areas for each health … [Read more...] about OIG Launches Compliance 101 Website
Physicians Avoid Medicare Payment Cuts
Last Friday, Congress voted to prevent a 27 percent cut in Medicare payments for physicians for 2012. The Kaiser Health Network's Jackie Judd interviewed colleague Mary Agnes Carey about the agreement. An excerpt: JACKIE JUDD: Good Day, this is Health on the Hill. I’m Jackie Judd. Breaking news from Capitol Hill where Senate and House negotiators have reached agreement on the "doc fix," so that physicians treating Medicare patients will not have payments slashed by 27 percent later this month. … [Read more...] about Physicians Avoid Medicare Payment Cuts
Obama’s 2013 Budget: Reduced Reimbursements
Once again providers will bear the brunt of budget cuts. The Obama administration's FY 2013 budget, released Monday, would cut spending on Medicare and Medicaid by close to $360 billion over the next 10 years, and most of the reduction is to providers and drug companies. Additionally, to compensate for ever-shrinking funds, the Obama administration proposed to raise Medicare premiums for retirees and higher-income seniors beginning in 2017. (Associated Press) The budget will become even … [Read more...] about Obama’s 2013 Budget: Reduced Reimbursements
Medicare/Medicaid News Around the Web
MedPAC, a group that advises Congress on Medicare, recommends an overhaul in the way skilled nursing homes are reimbursed. "Congress also should direct HHS to cut payments to skilled nursing facilities with relatively high risk-adjusted rehospitalization rates for their Medicare-covered skilled nursing facility stays." - McKnight's Raising the age of Medicare eligibility. "Medicare provides health insurance to almost everyone who is 65 or older. If the eligibility age was raised above 65, … [Read more...] about Medicare/Medicaid News Around the Web
Medicaid Cuts in Texas
If you treat a patient who receives both Medicare and Medicaid, your reimbursement will be limited. Earlier this year, lawmakers eliminated the Medicaid co-pay to save money in the state budget. As a result, providers might turn away more Medicaid and Medicare patients. An excerpt from the Dallas Morning News: "Doctors have to make the difficult decision whether to continue to treat these patients even though it doesn't make any financial sense,” said Steve Levine, a spokesman for the Texas … [Read more...] about Medicaid Cuts in Texas
ILs and PL: Cost Reporting, 1915(c) Waiver
DADS released eight information letters and one provider letter. CLASS CSAs, CLASS DSAs, and CDSAs: Effective January 1, 2012, a CMA and DSA can bill for pre-enrollment assessment activities on the same day. (Letter) ICF/MRs: DADS issued this letter to guide providers on using video surveillance cameras to monitor common areas. An excerpt: There is no state rule or federal requirement that specifically addresses the use of video surveillance cameras in ICFs/ID; however, 42 Code of … [Read more...] about ILs and PL: Cost Reporting, 1915(c) Waiver
TX Register Updates: Plan B, MRA Changes
The following information was obtained from the December 30 issue of the Texas Register: Proposed Rules HHSC proposed new §351.507, adverse licensing, listing, or registration decisions by HHS agencies, in Chapter 351, Coordinated Planning and Delivery of Health and Human Services. The changes would permit agencies that license or regulate certain specified entities to consider adverse licensing decisions made by other HHS licensing agencies when considering a license application or … [Read more...] about TX Register Updates: Plan B, MRA Changes
Medicare/Medicaid News
Medicaid cut challenges will get a hearing in Arizona. "Three public-interest law groups challenged an enrollment freeze for childless adults in the state's Medicaid program, the Arizona Health Care Cost Containment System. A lower-court judge and an Arizona appeals-court panel upheld the cuts and state lawmakers enacted the freeze as part of $500 million in AHCCCS reductions to help balance the current-year budget." - AZ Central States test health care reform flexibility. Essential benefits, … [Read more...] about Medicare/Medicaid News
Medicare/Medicaid News
CMS expands competitive bidding in Medicare. "The first phase of the program was successfully implemented for nine product categories in nine areas of the country on Jan. 1, 2011. To date, CMS monitoring data have shown a successful implementation with no changes in beneficiary health status. Today, CMS released the detailed schedule for Round 2 bidding. Registration will begin on December 5, and the 60-day supplier bidding period will begin in late January of 2012. " - CMS Medicare to … [Read more...] about Medicare/Medicaid News
Supreme Court to Review Health Care Reform Law
In March 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, which, among other things, would expand Medicaid to cover at least 30 million more Americans. The controversial law has been challenged numerous times. Some courts have ruled the law constitutional; others have ruled it unconstitutional. Perhaps the most controversial provision is the individual mandate, which requires uninsured individuals to purchase insurance or face fines. Earlier this … [Read more...] about Supreme Court to Review Health Care Reform Law
