The shortage of nurses in the United States is well documented. As baby boom-generation nurses retire and others leave the profession because of burn-out, the shortage will continue to increase. What is not discussed as often in mainstream press is the shortage of physicians. The shortage of primary care doctors will have the most impact on people without insurance and people who'll need long term care, such as older Americans. Because a medical education is so expensive, many are opting to … [Read more...] about Primary Care Physician Shortage
CMS News: Preventable Readmissons, Bidding Program Resumed
The Centers for Medicare and Medicaid Services (CMS) has announced a pilot program called the Care Transitions Project, designed to reduce preventable hospital readmissions. (Source) The national program, running through summer 2011 in 14 communities, will look at readmission rates at hospitals and develop ways to reduce readmissions. Acting administrator Charlene Frizzera said one in five patients leaving hospitals will be readmitted within the next month, and 75 percent of those … [Read more...] about CMS News: Preventable Readmissons, Bidding Program Resumed
Texas Register Updates: Contract for Flew v. Hawkins Study, Etc.
The following information was obtained from the April 3 issue of the Texas Register: Public Notices The Texas Health and Human Services Commission (HHSC) announced the award of contract 529-08-0187-00001 to the Altarum Institute to provide a court-ordered study in compliance with Frew v. Hawkins to determine whether there are barriers causing Class Members to receive no care or receive only emergency department or inpatient hospital care. The contract is valued at $562,698.50. HHSC … [Read more...] about Texas Register Updates: Contract for Flew v. Hawkins Study, Etc.
Texas Register Updates: Texas Medical Board Emergency Rule, Etc.
The following information was obtained from the March 27 issue of the Texas Register: Public Notices The Texas Health and Human Services Commission (HHSC) announced its intent to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act, which will modify the reimbursement methodology for clinical laboratory services in the Texas Medicaid State Plan as a result of Medicaid fee changes. HHSC also announced its intent to submit an … [Read more...] about Texas Register Updates: Texas Medical Board Emergency Rule, Etc.
Long Term Care News Links
Last week, Senate Finance Health Subcommittee Chair Jay Rockefeller (D-W.Va.) proposed giving the Medicare Payment Advisory Commission (MedPAC) jurisdiction over Medicare reimbursement decisions. At present, MedPAC advises Congress on Medicare issues. Rockefeller said, "You take a MedPAC and give them the money and the time to ... go all around the country and they can dissect health care. To me, they're a lot better deal than having Congress do it and politics do it." (Source) In an … [Read more...] about Long Term Care News Links
GAO: Fraud and Abuse Increased Medicare Home Health Services Spending
According to a new Government Accountability Office (GAO) report, Medicare fraud and abuse by home health care providers resulted in a 44 percent increase in spending over five years. (Kaiser Network) The GAO reviewed home health care payments from 2002 to 2006 and found that the number of Medicare beneficiaries increased 17 percent and spending reached $13 billion. The increases were caused by some providers exaggerating medical conditions and other providers billing the government for … [Read more...] about GAO: Fraud and Abuse Increased Medicare Home Health Services Spending
New Legislative Bills
The following bills were introduced this month and may affect providers: HB 166 - Relating to providing home- and community-based support services under the Medicaid program to persons who are deaf-blind with multiple disabilities. HB 510 - Relating to the registration of certain assisted living facilities; providing penalties. HB 1186 - Relating to the transfer or discharge of certain residents in certain assisted living facilities. HB 1398 - Relating to a pilot project to establish … [Read more...] about New Legislative Bills
MedPAC Supports CMS Changes to MA Payment Scale
MedPAC, the group that advises Congress on Medicare issues, says it supports the Centers for Medicare and Medicaid Services's (CMS) decision to change the scale used to adjust the reimbursement rate for Medicare Advantage (MA) plans based on a beneficiary's level of sickness. This method is designed to prevent over- and underpayments. (Kaiser Network) From MedPAC's March 5 letter (PDF): CMS is proposing an adjustment to risk scores to recognize differences between the coding practices in … [Read more...] about MedPAC Supports CMS Changes to MA Payment Scale
MedPAC’s 2009 Report to Congress
The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare issues, released its 2009 report to Congress. The report includes payment policy recommendations for nine payment systems: hospital inpatient, hospital outpatient, physicians, ambulatory surgical center, outpatient dialysis, skilled nursing, home health, inpatient rehabilitation facilities, and long-term care hospitals. From the press release: FEE-FOR-SERVICE PAYMENT UPDATE … [Read more...] about MedPAC’s 2009 Report to Congress
CMS Quick Links for Tuesday
Last week the Centers for Medicare and Medicaid Services (CMS) announced that it would postpone implementation of a competitive bidding rule for durable medial equipment providers until April. CMS was required do another round of bidding and make changes, so the implementation date was pushed back. The comment period for the final rule ends on March 17, 2009. (Kaiser Network) CMS would like to make it easier for Medicare beneficiaries with conditions like epilepsy, mental illness, and … [Read more...] about CMS Quick Links for Tuesday
