13 Recent Medicare, Medicaid Issues

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Here are 13 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.

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1. Hospital outpatient departments will receive Medicare payment rate increases of 1.8 percent, while ambulatory surgery center Medicare rates will increase by 0.6 percent, according to CMS' final rule on outpatient policy and payments.

2. CMS issued its final rule on the Medicare physician fee schedule for 2013, saying Medicare reimbursement rates for physicians will be slashed by 26.5 percent on Jan. 1, 2013, unless Congress bypasses the sustainable growth rate.

3. Starting Jan. 1, 2013, through the end of 2014, certain primary care physicians will see their Medicaid payments increase to Medicare rates.

4. The American Hospital Association and four hospitals sued HHS over denied Medicare payments resulting from RAC audits.

5. The American Hospital Association and the Association of American Medical Colleges commissioned Dobson DaVanzo & Associates to look at bundled payments and provide analysis on different episode-based payment bundles that providers could expect. The study looked at 16 MS-DRG families that represent a significant portion of Medicare's fee-for-service payments.

6. Additional imaging service referrals by providers who self-referred cost Medicare approximately $109 million from 2004 through 2010, according to a U.S. Government Accountability Office report.

7. A new study in the Archives of Internal Medicine revealed that per capita Medicare spending is growing three times faster for seniors in the United States compared with seniors in Canada.

8. CMS approved Washington's HealthPathWashington initiative — a project that aims to improve the care of state residents enrolled in both Medicare and Medicaid.

9. Here is a list of total Medicare beneficiaries by state in 2012.

10. As federal and state agencies attempt to reduce the growth of spending for people eligible for both Medicare and Medicaid, new research showed it may be hard to find large savings in new demonstration programs.

11. The Medicaid expansion provision of the Patient Protection and Affordable Care Act will start in 2014, adding millions of people to Medicaid rolls, but hospitals and other providers may not understand how to best tailor their medical and business practices to take advantage of the provision.

12. Here is a table of Medicaid cost-containment actions 50 states and Washington, D.C., have taken in 2012.

13. In a recent webinar, Ken Perez, senior vice president of marketing and director of healthcare policy for MedeAnalytics, broke down the current state of Medicare, discussing everything from the politicization of Medicare to detailed breakdowns of presidential Medicare plans.

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