18 Recent Medicare, Medicaid Issues

Here are 18 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.

1. The Medicare Payment Advisory Commission approved a final recommendation, saying hospital inpatient and outpatient Medicare payments should be increased by 1 percent in fiscal year 2014 despite the fiscal cliff agreement. MedPAC recommended that CMS eliminate any update for ambulatory surgery centers.

2. Accelerating a three-year trend, spending per Medicare beneficiary rose just 0.4 percent in fiscal year 2012, far slower than the 3.4 percent increase in gross domestic product per capita.

3. CMS named 106 new accountable care organizations that will participate in the Medicare Shared Savings Program, effective Jan. 1.

4. California Gov. Jerry Brown (D) released his 2013-14 budget, and he indicated that the state, as expected, will expand its Medicaid program under the Patient Protection and Affordable Care Act.

5. CMS estimated that total Medicare and Medicaid electronic health record payments since the incentive program began in January 2011 surpassed $10.3 billion at the end of 2012.

6. State lawmakers are gearing up for policy discussions this year for fiscal year 2014 budgets, and a survey found one of the biggest topics to impact those talks will be Medicaid.

7. Following a recent report that Medicare Advantage plans were overpaid an estimated $598 million in 2007, the HHS Office of Inspector General released a report that found the private company charged with scouring certain Medicare claims for possible fraud focuses only a small portion of its efforts on the Medicare Advantage program.

8. New Mexico Gov. Susana Martinez (R) agreed to expand Medicaid to more low-income residents with additional federal money available through the healthcare law.

9. Hospitals in the Fort Wayne, Ind., region, on average, performed the best on CMS' Value-Based Purchasing Program, which went into effect this year, and Washington, D.C., hospitals collectively scored the worst, according to a regional analysis by Kaiser Health News.

10. The U.S. District Court for the District of Columbia ordered HHS to re-evaluate Medicare disproportionate share hospital payments for more than 100 hospitals and pay interest on any additional amounts owed after recalculation.

11. Oliver Fein, MD, a general internist at NewYork-Presbyterian Hospital in New York City and a professor of clinical medicine and public health at Weill Cornell Medical College, shared his thoughts on where Medicare stands today.

12. CMS said Maine can cut about 15,000 low-income residents from its Medicaid program, but the federal government protected another 21,000 from rollbacks sought by Gov. Paul LePage (R).

13. Florida Gov. Rick Scott (R) said he does not want to expand Medicaid in Florida under the healthcare reform law because it is too expensive, but an investigation by Health News Florida found that Gov. Scott's Medicaid figures were wrong and based on a flawed report — but he continued to use the figures despite warnings about the inaccuracies.

14. Beginning in July, the agency that administers Florida's managed care Medicaid program announced it plans to implement diagnosis-related group payments for hospital stays.

15. CMS announced the availability of $32 million in grants for public entities and private community organizations with approved proposals to identify and enroll children eligible for Medicaid and the Children's Health Insurance Program.

16. In his state of the state address, Idaho Gov. C. L. "Butch" Otter (R) announced he would not expand his state's Medicaid program to more people using additional money that would be made available under the federal healthcare reform law, making him the 10th Republican governor to do so.

17. National healthcare expenditures grew 3.9 percent in 2011, similar to growth rates in 2009 and 2010, meaning healthcare spending continues to grow at historically slow levels. However, CMS noted a few areas where national healthcare expenditures grew rapidly from 2010 to 2011, including Medicare spending.

18. The Supreme Court deferred to a previous federal appeals court ruling that Social Security recipients cannot reject Medicare coverage.

More Articles on Medicare and Medicaid:

Commonwealth Fund: 10 Policies That Can Stabilize Healthcare Spending
4 Lessons for Policymakers on Publicly Reporting Quality Data
Where Medicare Stands: A Discussion With Dr. Oliver Fein of Weill Cornell Medical College

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