13 Recent Medicare, Medicaid Issues
1. Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions, said hospitals and health systems should start preparing for the worst when it comes to the fiscal cliff — Medicare cuts larger than the discussed 2 percent each year for 10 years with sequestration.
2. A study from the HHS Office of Inspector General found that hospitals and other Medicare providers filed 85 percent of payment appeals at the administrative law judge level, 56 percent of which went in favor of providers, and the OIG concluded that serious improvements are needed to clarify Medicare policies.
3. The American Hospital Association distributed a list of alternative strategies to reduce the federal deficit — policies "that don't simply cut Medicare and Medicaid payments."
4. CMS said it has paid more than $8.35 billion through the meaningful use program to date, and 400 hospitals registered for incentive payments through the program in October.
5. American Hospital Association President and CEO Rich Umbdenstock sent a letter to HHS and the Department of Justice, asking how hospitals can better improve the use of their electronic health records when billing Medicare and Medicaid.
6. The Center for American Progress released a report that outlined $385 billion in savings over 10 years for government spending on healthcare.
7. Connecticut hospitals that rely on Medicaid reimbursement may be falling on harder times, as increased Medicaid costs contributed to a total budget deficit of $365 million heading into next year.
8. The Arkansas Medicaid program is facing a $138 million shortfall next year, and Gov. Mike Beebe (D) said expanding Medicaid under the Patient Protection and Affordable Care Act would help fight that deficit.
9. The Office of Inspector General found skilled nursing facilities erroneously billed one-quarter of their claims in 2009, resulting in $1.5 billion in inappropriate Medicare payments.
10. AARP and five other professional organizations sent a letter to leaders in Congress, pressing them to avert the impending Medicare cut to physicians and replace the sustainable growth rate altogether.
11. When states endure higher rates of unemployment, they usually incur higher Medicare spending per capita and increased hospital use by Medicare beneficiaries, according to a study from Health Affairs.
12. Here are 36 statistics on the overall average all-payor margin at U.S. hospitals from 1999 through 2010, classified by teaching status.
13. According to a recent survey, 62 percent of hospital executives said existing commercial rates should be the starting point for provider network discussions in a health insurance exchange, while 26 percent said the starting point should be between commercial and Medicare rates.
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