According to a Government Accountability Office (GAO) released last month, the Centers for Medicare and Medicaid Services (CMS) may have made $90 million worth of "questionable" payments to Medicare Part D contractors hired to help launch the program. (Kaiser Network) Some payments didn't comply with terms of the contracts, the GAO found. Jeff Nelligan, CMS spokesperson, said launching the Part D program "required some contract decisions outside of standard policy." You may download the … [Read more...] about GAO Releases Reports on Medicare Part D and SCHIP
Senate Votes to Delay Physicians Fee Cut and Extend SCHIP
Earlier this week, the U.S. Senate approved a bill that would delay a 10 percent physicians fee cut for six months. The Senate also voted to extend the State Children’s Health Insurance Program (SCHIP) through March 2009. (Kaiser Network) The bill would increase physicians fees by 0.5 percent for six months. Commenting on this action, the American Medical Association (AMA) said: "It is extremely disappointing that after all the hard work in the House earlier this year to replace two … [Read more...] about Senate Votes to Delay Physicians Fee Cut and Extend SCHIP
Information Letters: Relocation Contract Budget Changes, Etc.
In an information letter to relocation contractors, the Texas Department of Aging and Disability Services (DADS) explained changes that can be made to the relocation contract budget, effective immediately. For information about line items and transfers between line items, download the letter. DADS informed Community Living Assistance and Support Service Program Providers, Deaf Blind with Multiple Disabilities Program Providers, and Home and Community Services Program Providers that the … [Read more...] about Information Letters: Relocation Contract Budget Changes, Etc.
Medicare Budget News
Federal lawmakers are in budget negotiations this week. (Kaiser Network) One program under discussion is Medicare. The House of Representatives version of the Omnibus Appropriations bill includes $50 billion in cuts to Medicare Advantage plans. Max Baucus, a Democrat and chair of the Senate Finance Committee, wants to reduce cuts to $20 billion. Lawmakers will continue debating the budget bill today. Additionally, a 2004 moratorium on the building of new physician-owned specialty hospitals … [Read more...] about Medicare Budget News
AHA Responds to CMS Proposal to Change Medicare Reimbursement System
Earlier this week, the Centers for Medicare and Medicaid Services (CMS) proposed to change the way it pays Medicare reimbursements to hospitals. CMS seeks to encourage higher quality of care in hospitals by rewarding those that meet a certain threshold. To fund the "incentive payment pool," CMS will cut payments by a flat rate of 2 percent to 5 percent. The American Hospital Association (AHA) has responded to CMS’s proposal. Noting that the changes could create financial problems, AHA … [Read more...] about AHA Responds to CMS Proposal to Change Medicare Reimbursement System
Information Letter: NPI Contingency Period Ends March 1, 2008
In a three-page letter, the Department of Aging and Disability Services (DADS) informed Nursing Facilities, Community Services, ICF/MR, and Therapy Providers that the National Provider Identifier (NPI) contingency period ends on March 1, 2008. NPI will replace legacy provider identifiers. Providers’ claims can’t be paid if they are submitted without NPI data. For more information, download the letter here. … [Read more...] about Information Letter: NPI Contingency Period Ends March 1, 2008
CMS Set to Base Medicare Hospital Reimbursements on Quality of Care
Yesterday, the Centers for Medicare and Medicaid Services (CMS) proposed to change the way it pays Medicare reimbursements to hospitals. (Kaiser Network) CMS seeks to reduce payments by a flat rate (2 percent to 5 percent) to create an "incentive payment pool" for hospitals that meet quality of care thresholds. According to CQ HealthBeat, the plan would create a "Value-Based Purchasing Program." Under this program, a hospital's diagnosis-related group reimbursements would be based on quality … [Read more...] about CMS Set to Base Medicare Hospital Reimbursements on Quality of Care
Provider Letters: Workload Prioritization of Initial Certification Surveys, OASIS-B1
The Texas Department of Aging and Disability Services (DADS) issued a provider letter to Nursing Facilities and Hospitals Seeking Medicare Certification for a Skilled Nursing Care Unit to inform them about new policy documents issued by the Centers for Medicare and Medicaid Services (CMS) regarding workload prioritization on initial certification surveys. Attached to the two-page letter is a two-page Q&A memo. Download the letter and attachment here for more information. CMS published … [Read more...] about Provider Letters: Workload Prioritization of Initial Certification Surveys, OASIS-B1
Medicare Part D Open Enrollment
Outpatient Hospital Care Reimbursements to Increase
The Centers for Medicare and Medicaid Services (CMS) announced that Medicare outpatient hospital care reimbursements will increase by 3.8 percent in 2008. (Kaiser Network) According to CMS, this higher reimbursement rate was established because of the increased volume and complexity of outpatient hospital care services. Hospitals are required to report quality of care data, or they could see reimbursements reduced by 2 percent in 2009. In related news, CMS announced that it will reduce … [Read more...] about Outpatient Hospital Care Reimbursements to Increase
