MedWorm: Medicare

5 Flawed Arguments Against Medicare Premium Support

The Heritage Foundation Papers: Health Care — Tue, 07 Feb 2012 21:51:00 +0100

The introduction of the bipartisan Wyden–Ryan premium support plan for Medicare ensures that reform of the government’s largest health entitlement program will continue to be a major topic of debate in 2012. (Source: The Heritage Foundation Papers: Health Care)

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Six Key Elements of Medicare Premium Support Proposals

The Heritage Foundation Papers: Health Care — Tue, 07 Feb 2012 21:43:00 +0100

Premium support proposals to reform the Medicare program would provide beneficiaries with a financial contribution to purchase Medicare coverage (Source: The Heritage Foundation Papers: Health Care)

House and Senate at Impasse on Medicare

NYT — Tue, 07 Feb 2012 18:36:22 +0100

Lawmakers in both parties say they want to give doctors a small increase in Medicare payments, but they cannot agree on how to pay for it. (Source: NYT)

War Savings for 'Doc Fix' Complicated by Congressional RulesWar Savings for 'Doc Fix' Complicated by Congressional Rules

Medscape Today Headlines — Tue, 07 Feb 2012 16:32:53 +0100

Congressional rules could get in the way of using war savings to fix Medicare's sustainable growth rate formula. Kaiser Health News (Source: Medscape Today Headlines)

Government health spending seen hitting $1.8 trillion

Reuters: Health — Tue, 07 Feb 2012 13:32:25 +0100

WASHINGTON (Reuters) - Government spending for Medicare, Medicaid and other healthcare programs will more than double over the next decade to $1.8 trillion, or 7.3 percent of the country's total economic output, congressional researchers said on Tuesday. (Source: Reuters: Health)

National Quality Forum endorses 2 American College of Surgeons NSQIP measures

EurekAlert! - Social and Behavioral Science — Tue, 07 Feb 2012 05:00:00 +0100

(Weber Shandwick Worldwide) Two outcomes-based measures from the American College of Surgeons National Surgical Quality Improvement Program were recently endorsed by the National Quality Forum. The two measures, surgical site infection and urinary tract infection, were developed by ACS in partnership with the Centers for Medicare and Medicaid Services, as possible national outcomes measures that could be adopted by the governmental body as early as 2015. (Source: EurekAlert! - Social and Behavioral Science)

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Comparative Effectiveness of Oxaliplatin vs Non-Oxaliplatin-containing Adjuvant Chemotherapy for Stage III Colon Cancer

JNCI — Tue, 07 Feb 2012 05:00:00 +0100

Conclusion The addition of oxaliplatin to 5-FU appears to be associated with better survival among patients receiving adjuvant colon cancer treatment in the community. (Source: JNCI)

Laparoscopic versus Open Colectomy for Colon Cancer in an Older Population: A Cohort Study

World Journal of Surgical Oncology — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: In this older population, laparoscopic colectomy practice patterns were associated with factors which likely correlate with tertiary referral centers. Although short-term and long-term survival are comparable, laparoscopic colectomy offers shorter hospitalizations and less intensive care. (Source: World Journal of Surgical Oncology)

House and Senate at Impasse on Medicare

NYT Health — Tue, 07 Feb 2012 02:43:09 +0100

Lawmakers in both parties say they want to give doctors a small increase in Medicare payments, but they cannot agree on how to pay for it. (Source: NYT Health)

House and Senate at Impasse on Medicare Payments to Doctors

NYT Health — Tue, 07 Feb 2012 01:37:18 +0100

Lawmakers in both parties say they want to give doctors a small increase in Medicare payments, but they cannot agree on how to pay for it. (Source: NYT Health)

'Heart Team' Key for Medicare TAVI Coverage

MedPage Today Public Health — Mon, 06 Feb 2012 18:37:10 +0100

(MedPage Today) -- Highly skilled "heart teams" from high-volume centers are part of the requirements for Medicare reimbursement for transcatheter aortic valve implantation (TAVI) proposed by the Centers for Medicare & Medicaid Services. (Source: MedPage Today Public Health)

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GAO: Implantable industry may be taking providers, payors for a ride on pricing

Cardiovascular Business News — Mon, 06 Feb 2012 15:06:56 +0100

The Government Accountability Office (GAO) has found that sellers of implantable medical devices are negotiating widely varying prices from different hospitals for the same devices and keeping their pricing strategies a secret. The lack of transparency may have major ramifications for Medicare, as hospitals with less purchasing power pass their costs along. (Source: Cardiovascular Business News)

Unspent war funds eyed to avoid years of Medicare doctor pay cuts

American Medical News - GOVERNMENT — Mon, 06 Feb 2012 12:00:00 +0100

The budgetary shift from winding down military actions in Afghanistan and Iraq could offset the large price tag associated with eliminating the SGR. (Source: American Medical News - GOVERNMENT)

Medicare PQRS: Quality reporting or else

American Medical News - GOVERNMENT — Mon, 06 Feb 2012 12:00:00 +0100

The Medicare physician quality reporting system will use participation in 2013 to determine who will be penalized starting in 2015. (Source: American Medical News - GOVERNMENT)

Questions Emerge About Whether War Savings Can Pay for 'Doc Fix'

News stories via the Rural Assistance Center — Mon, 06 Feb 2012 06:00:00 +0100

Kaiser Health News brings together a variety of articles discussing how hospitals, physicians and some members of Congress want to use war savings as a way to get rid of Medicare's sustainable growth rate formula, but congressional rules could complicate things. (Source: News stories via the Rural Assistance Center)

Washington Watch: SGR Action Starts Up Again

MedPage Today Public Health — Sat, 04 Feb 2012 22:01:44 +0100

WASHINGTON (MedPage Today) -- This week in Washington marked the resumption of a congressional committee tasked with fixing the problem with the sustainable growth rate (SGR) formula for Medicare physician reimbursement. (Source: MedPage Today Public Health)

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Former Little Rock Business Owner Sent to Prison for Medicare Fraud

Arkansas Business - Health Care — Fri, 03 Feb 2012 23:08:49 +0100

Archibong Edem-Effiong, 58, now of Houston, who owned Joshua Medical Link Corp. in Little Rock, had pleaded guilty in October. (Source: Arkansas Business - Health Care)

Guidelines Lead Femtosecond Laser Users to Billing Safe HarborsGuidelines Lead Femtosecond Laser Users to Billing Safe Harbors

Medscape Today Headlines — Fri, 03 Feb 2012 22:19:08 +0100

New guidelines aid femtosecond laser users in Medicare billing compliance. Medscape Medical News (Source: Medscape Today Headlines)

Corporate Whistle Blower Center Urges ER Physicians Or Hospital...

PRWeb: Medical Pharmaceuticals — Fri, 03 Feb 2012 06:24:02 +0100

The Corporate Whistle Blower Center is urging Emergency Room Physicians, nursing managers, or hospital accounting, or coding staff to turn in their hospital for Medicare, or Medicaid fraud, if the...(PRWeb February 01, 2012)Read the full story at http://www.prweb.com/releases/2012/2/prweb9156050.htm (Source: PRWeb: Medical Pharmaceuticals)

Candidates propose Medicare shift to defined contribution

Managed Healthcare Executive Magazine Online — Fri, 03 Feb 2012 05:00:00 +0100

GOP candidate Mitt Romney argues that his proposal to convert Medicare from a defined-benefit program to a defined-contribution program will rescue Medicare by creating competition among plans and drive down costs. Republican Paul Ryan and Democratic Senator Ron Wyden have a similar proposal. (Source: Managed Healthcare Executive Magazine Online)

Study: Hospitals Overpay for Devices

RWJF News Digest - Quality/Equality — Fri, 03 Feb 2012 05:00:00 +0100

Some hospitals pay thousands of dollars more than others for big-ticket medical devices such as defibrillators and hip replacements, and a portion of the higher costs could be passed on to the federal Medicare program, a new government report says. Note: Viewing this article may require a subscription. (Source: RWJF News Digest - Quality/Equality)

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CMS Releases Details Of Proposed National Coverage For TAVR

Forbes.com Healthcare News — Fri, 03 Feb 2012 02:46:39 +0100

On Thursday the Centers for Medicare & Medicaid Services (CMS) released a memo containing details of its proposed Medicare coverage for TAVR (transcatheter aortic valve replacement). The memo is a response to a formal request for national coverage determination (NCD) from the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC). The memo will be open for public comment until March 3, after which a final determination will be made. (Source: Forbes.com Healthcare News)

AMA, AHIMA at odds on ICD-10

Healthcare IT News — Thu, 02 Feb 2012 23:01:04 +0100

While the American Medical Association (AMA) is calling for a halt to ICD-10, the American Health Information Management Association (AHIMA) is countering by urging all to stay the course toward the Oct. 1, 2013 deadline. In the letter sent Thursday to Department of Health and Humans Services Secretary Kathleen Sebelius., AMA CEO James Madara, MD urged HHS “to make good on its commitment to improve the regulatory climate for physicians.” read more (Source: Healthcare IT News)

Understanding Medicare Premium Support and its Key Features

The Heritage Foundation Papers: Health Care — Thu, 02 Feb 2012 19:31:00 +0100

For the next generation of taxpayers and retirees, there is no better option than premium support. (Source: The Heritage Foundation Papers: Health Care)

Medicare Pay Policy on Transplant Drugs Slammed

MedPage Today Geriatrics — Thu, 02 Feb 2012 16:32:58 +0100

(MedPage Today) -- Medicare's failure to provide lifelong coverage for immunosuppressive therapy after kidney transplant is bad for patients and for the system's finances, two researchers argued. (Source: MedPage Today Geriatrics)

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Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA): Applicability to Hospital Inpatients and Hospitals With Specialized Capabilities

Federal Register updates via the Rural Assistance Center — Thu, 02 Feb 2012 15:22:44 +0100

This request for comments from the Centers for Medicare & Medicaid Services addresses the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients. (Source: Federal Register updates via the Rural Assistance Center)

Pharmacists say marketing of Medicare drug plans is misleading

American Medical News — Thu, 02 Feb 2012 12:59:50 +0100

A community pharmacy association has asked the Centers for Medicare & Medicaid Services to allow disgruntled patients to switch Part D plans midyear. (Source: American Medical News)

Enrollment Up, Premiums Down in Medicare Advantage Plans

MedPage Today Public Health — Thu, 02 Feb 2012 10:43:10 +0100

WASHINGTON (MedPage Today) -- Enrollment in Medicare Advantage plans has risen by 10% in the past year and premiums have dropped by 7%, despite billions of dollars in reimbursement cuts to the program, HHS officials announced Wednesday. (Source: MedPage Today Public Health)

Medicaid Program; Covered Outpatient Drugs

Federal Register updates via the Rural Assistance Center — Thu, 02 Feb 2012 06:00:00 +0100

This proposed rule from the Centers for Medicare & Medicaid Services would revise requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the Patient Protection and Affordable Care Act of 2010. This proposed rule would also revise other requirements related to covered outpatient drugs, including key aspects of Medicaid coverage, payment, and the drug rebate program. (Source: Federal Register updates via the Rural Assistance Center)

Health Reform Law Saves $2.1 Billion for 3.6 Million Americans with Medicare

News stories via the Rural Assistance Center — Thu, 02 Feb 2012 06:00:00 +0100

Nearly 3.6 million people with Medicare saved $2.1 billion on their prescription drugs in 2011 due to the Affordable Care Act according to data issued today by the Department of Health and Human Services (HHS). (Source: News stories via the Rural Assistance Center)

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Bill Would Improve Medicare Payment for Small, Rural Hospitals

News stories via the Rural Assistance Center — Thu, 02 Feb 2012 06:00:00 +0100

AHA News Now article reports that Reps. Cathy McMorris Rodgers (R-WA) and Mike Thompson (D-CA) today introduced the Rural Hospital and Provider Equity Act, a bill that would improve Medicare payment for rural hospitals that serve a disproportionate share of low-income patients, and adjust the low-volume adjustment for small prospective payment system hospitals that do not qualify as critical access hospitals. (Source: News stories via the Rural Assistance Center)

AMCP objects to proposed reporting requirements for Part D

Drug Topics - Top News — Thu, 02 Feb 2012 05:00:00 +0100

The Academy of Managed Care Pharmacy is not pleased with changes to the Medicare Part D reporting requirements proposed by the Centers for Medicare and Medicaid Services. (Source: Drug Topics - Top News)

CMS's Final Regulations on Accountable Care Organizations

The Heritage Foundation Papers: Health Care — Wed, 01 Feb 2012 21:59:00 +0100

The Centers for Medicare and Medicaid Services (CMS) has issued final regulations for Accountable Care Organizations (ACOs). The outcome is disappointing (Source: The Heritage Foundation Papers: Health Care)

Congressional Panel Backs Repeal of SGR

MedPage Today Public Health — Wed, 01 Feb 2012 21:13:47 +0100

WASHINGTON (MedPage Today) -- Democratic and Republican lawmakers who are negotiating tax break extensions and Medicare reimbursement rates for doctors agree on one thing: The sustainable growth rate (SGR) formula should be fully repealed. (Source: MedPage Today Public Health)

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Medicare Advantage Premiums Down 7 Percent on Average, Enrollment Up 10 Percent

News stories via the Rural Assistance Center — Wed, 01 Feb 2012 16:32:00 +0100

Medicare Advantage premiums have fallen by 7 percent on average and enrollment has risen by about 10 percent since this time last year, HHS Secretary Kathleen Sebelius announced today. (Source: News stories via the Rural Assistance Center)

In Massachusetts, Blues Ink Pact with Partners HealthCare to Implement Alternative Quality Contract with Global Payment

Dark Daily — Wed, 01 Feb 2012 11:00:12 +0100

Early evidence is that the AQC arrangement encourages providers to more carefully utilize ancillary services, including clinical laboratory and pathology testing Much attention is being given to the new healthcare payment models being introduced by the Medicare program during 2012. However, quietly—and with much less publicity—private health plans are deploying innovative, value-based payment models. These [...] (Source: Dark Daily)

Medicare Advantage's enrollment is up; premiums are down

USATODAY.com Health — Wed, 01 Feb 2012 06:22:56 +0100

Premiums for the Medicare Advantage program have dropped an average of 7% while enrollment has grown by 10%. (Source: USATODAY.com Health)

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates; Corrections

Federal Register updates via the Rural Assistance Center — Wed, 01 Feb 2012 06:00:00 +0100

This document from the Centers for Medicare & Medicaid Services corrects technical errors that occurred in the Addendum of the final rule entitled Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates which appeared in the August 18, 2011 Federal Register. (Source: Federal Register updates via the Rural Assistance Center)

Medicare program's enrollment up, premiums down

USATODAY.com Health — Wed, 01 Feb 2012 05:12:15 +0100

Premiums for the Medicare Advantage program have dropped an average of 7% while enrollment has grown by 10%. (Source: USATODAY.com Health)

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Advanced directives lower end-of-life medicare spending.

The American Journal of Nursing — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Kayyali A, Rosenberg K, Singh Joy SD PMID: 22277870 [PubMed - in process] (Source: The American Journal of Nursing)

Dr. Bob Moffit on Obamacare and the End of Medicare As We Know It: Heritage in Focus Podcast

The Heritage Foundation Papers: Health Care — Wed, 01 Feb 2012 05:00:00 +0100

In this week's Heritage in Focus podcast, Dr. Bob Moffit discusses his new paper, "Obamacare Ends Medicare As We Know It." David Weinberger hosts. (Source: The Heritage Foundation Papers: Health Care)

Disparities in access to care at high‐volume institutions for uro‐oncologic procedures

Cancer — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS:On average, old, sick, poor, and Medicare patients were less likely to be treated at high‐volume hospitals for uro‐oncologic surgery. Similarly, black patients were less likely to have a radical cystectomy at a high‐volume hospital, and female patients were less likely to have an Nx at a high‐volume hospital. Selective referral of individuals who are less likely to receive care at such institutions may represent a health care priority intended to optimize outcomes across all population strata. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

Cardiac Computed Tomography—Evidence, Limitations and Clinical Application

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

Coronary CT angiography and coronary calcium scoring offer a new approach to the diagnosis of coronary artery disease (CAD). They hold significant promise in improving patient outcomes, through identification of atherosclerosis and improved risk assessment.Coronary calcium scoring has proven predictive value concerning the occurrence of future cardiovascular events and outperforms current risk evaluation methods such as the Framingham Risk Score.Coronary CT angiography allows visualisation of the coronary artery lumen, detection of stenoses as well as visualisation of both calcified and non-calcified plaque.The accuracy of coronary CT angiography to detect obstructive coronary artery disease has been established by numerous trials. In particular the negative predictive value of the test ap...

Physician groups urge Congress to use war funds to eliminate flawed Medicare SGR

Modern Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Your professional groups are demanding legislators repeal Medicare’s sustainable growth rate formula. See how much it could cost, and why taking from the war chest could work. (Source: Modern Medicine)

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Percutaneous Needle vs Surgical Breast Biopsy: Previous Allegations of Overuse of Surgery Are in Error

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: The previously published statement in the American Journal of Surgery that 30% of breast biopsies are done surgically is erroneous. Medicare data indicate that the true surgical breast biopsy figure is somewhere between 2% and 18%. Given that the recommended rate is 10%, it seems that surgeons and radiologists are collaborating well and that surgical breast biopsy is not being overused. (Source: Journal of the American College of Radiology : JACR)

Dramatically Increased Musculoskeletal Ultrasound Utilization From 2000 to 2009, Especially by Podiatrists in Private Offices

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: The MSK ultrasound volume increase among nonradiologists, especially podiatrists, was far higher than that among radiologists from 2000 and 2009, with the highest growth in private offices. These findings raise concern for self-referral. (Source: Journal of the American College of Radiology : JACR)

Patient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure

American Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Background: The purpose of this study was to determine patient and hospital characteristics associated with 4 measures of quality of inpatient heart failure care used by both the primary payer of heart failure care in the United States (Center for Medicare and Medicaid Services) and the main hospital accrediting organization (The Joint Commission).Methods: We used data from Get With The Guidelines Program for patients hospitalized with heart failure. Eligibility for receiving care based on the Center for Medicare and Medicaid Services performance measures was determined for assessment of left ventricular ejection fraction (LVEF; n = 60,601), use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) if LVEF (Source: American Heart Journal)

The prevalence of defensive orthopaedic imaging: a prospective practice audit in pennsylvania.

The Journal of Bone and Joint Surgery. American volume — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: In a prospective practice audit of orthopaedists, defensive imaging was found to be both common and costly. Recent litigation experiences and longer duration of orthopaedic practice were independent predictors of an increased use of defensive practices in ordering imaging studies. This real-time audit showed that a large proportion of MRI studies were ordered for primarily defensive medicine reasons. PMID: 22298064 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

The Challenges Ahead for Accountable Care Organizations (ACOs).

The American Journal of Managed Care — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Chernew ME, Fendrick AM, Ginsburg PB, Pawlson G, Scanlon D, Sennett C, Sweet B Abstract Besides offering financial incentives to both physicians and healthcare organizations, accountable care organizations (ACOs) are designed to offer quality patient care while keeping costs down. The law states that an ACO must manage all of the healthcare needs for a minimum of 3 years for at least 5000 Medicare beneficiaries. In February 2012, the first round of applications for the ACO Shared Savings Program were accepted. Practices and insurers are announcing plans to create ACOs. By making providers equally responsible for their respective patients while giving financial incentives to avoid unnecessary procedures, ACOs aim to raise the quality and value of patient care. However, ther...

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'Doc Fix' Easily Covered by War Savings, Says CBO'Doc Fix' Easily Covered by War Savings, Says CBO

Medscape Today Headlines — Wed, 01 Feb 2012 04:18:18 +0100

Freezing Medicare rates through 2022 at current level would cost $316 billion, but military pullouts in Afghanistan and other countries will free up far more money, according to the Congressional Budget Office. Medscape Medical News (Source: Medscape Today Headlines)

Medicare demos fall short on savings

MD Consult: News: Top Stories — Wed, 01 Feb 2012 00:00:00 +0100

Read the full story on MD Consult: Medicare demos fall short on savings (Source: MD Consult: News: Top Stories)

Wide Use of Doc ID Numbers Makes Fraud Easy

MedPage Today Public Health — Tue, 31 Jan 2012 21:23:30 +0100

(MedPage Today) -- Widespread distribution of physician identifiers makes it easy to fraudulently bill insurers in the doctor's name, two MDs who work at the Centers for Medicare and Medicaid Services charged. (Source: MedPage Today Public Health)

Government health spending seen hitting $1.8 trillion

Reuters: Health — Tue, 31 Jan 2012 20:56:22 +0100

WASHINGTON (Reuters) - Gvernment spending for Medicare, Medicaid and other healthcare programs will more than double over the next decade to $1.8 trillion, or 7.3 percent of the country's total economic output, congressional researchers said on Tuesday. (Source: Reuters: Health)

How to fix Medicare, Redux

Forbes.com Healthcare News — Tue, 31 Jan 2012 15:39:24 +0100

The Republican Presidential primary’s shift down south to Florida has brought discussions of healthcare, particularly Medicare, back to the forefront of the national discourse. With its struggling economy and sizeable elderly population, social welfare programs like Medicare, Medicaid and Social Security are top of mind to Florida voters. (Source: Forbes.com Healthcare News)

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Cigna completes $4B purchase of HealthSpring

bizjournals.com Health Care:Biotechnology headlines — Tue, 31 Jan 2012 15:13:49 +0100

Cigna has completed its previously announced $4 billion acquisition of HealthSpring, a move that expands its presence in the Medicare managed-care market. The acquisition adds more than a million individuals to Cigna’s existing 70 million members HealthSpring of Nashville, Tenn., has 340,000 Medicare Advantage members in 11 states — including Pennsylvania and New Jersey — and Washington, D.C., as well as a large, national stand-alone Medicare prescription drug business with more than 800,000 customers... (Source: bizjournals.com Health Care:Biotechnology headlines)

Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer

Cancer — Tue, 31 Jan 2012 05:00:00 +0100

CONCLUSIONS:The incremental harms of adjuvant chemotherapy with 5FU/oxaliplatin versus 5FU alone were modest in patients with stage III colon cancer who were insured by Medicare and Medicaid. The additional harms in patients aged ≥75 years largely were restricted to outpatient events and did not extend to an increased rate of hospitalization or early death. Cancer 2012. © 2012 American Cancer Society (Source: Cancer)

How Safe Are Our Hospitals?

RWJF News Digest - Quality/Equality — Mon, 30 Jan 2012 18:29:42 +0100

Centers for Medicare and Medicaid Services’ website, Hospital Compare, began reporting patient safety ratings for thousands of the nation’s hospitals, including those in the Washington area, in October 2011. (Source: RWJF News Digest - Quality/Equality)

TAVI Reimbursement Rollout Repeat of Carotid-Stenting DebacleTAVI Reimbursement Rollout Repeat of Carotid-Stenting Debacle

Medscape Today Headlines — Mon, 30 Jan 2012 16:58:27 +0100

Now that the FDA has approved a transcatheter aortic valve, cardiac surgeons and cardiologists are working together to put all of their ducks in a row to secure national Medicare coverage for the procedure. Heartwire (Source: Medscape Today Headlines)

Frequently Asked Questions Section 6411(a) of the Affordable Care Act

Rural web sites and other tools via the Rural Assistance Center — Mon, 30 Jan 2012 14:43:55 +0100

Collection of common questions covering general information on the Medicaid RAC (Recovery Audit Contractor) and operational guidance to States. -- Centers for Medicare and Medicaid Services (Source: Rural web sites and other tools via the Rural Assistance Center)

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State Medicaid RACs At-A-Glance

Rural web sites and other tools via the Rural Assistance Center — Mon, 30 Jan 2012 14:39:03 +0100

Map summarizes the status of each state and territory RAC program, based on the information submitted in its Medicaid State Plan Amendment (SPA.) During the implementation phase of these RAC programs, this website will be updated on an ongoing basis. -- Centers for Medicare and Medicaid Services (Source: Rural web sites and other tools via the Rural Assistance Center)

Surgeons insist TAVI reimbursement rollout won't be repeat of carotid-stenting debacle

theHeart.org — Mon, 30 Jan 2012 14:00:55 +0100

CBO: Medicare demos didn't save much money

American Medical News - GOVERNMENT — Mon, 30 Jan 2012 12:00:00 +0100

A report details the lessons learned from Medicare demonstration projects that tried to reduce costs and improve quality of care. (Source: American Medical News - GOVERNMENT)

Six Reasons Why You May be Paying More for your 2012 Medicare Part D...

PRWeb: Medical Pharmaceuticals — Mon, 30 Jan 2012 07:31:07 +0100

Seniors and other Medicare beneficiaries who did not change their Medicare Part D plan coverage may now be finding that their 2012 Medicare Part D prescription drugs are costing them more than they...(PRWeb January 27, 2012)Read the full story at http://www.prweb.com/releases/2012_Medicare_PartD_Drugs/Are_You_Paying_More/prweb9141262.htm (Source: PRWeb: Medical Pharmaceuticals)

Affordable Care Act Will Save States and Taxpayers $17.7 Billion on Prescription Drugs

News stories via the Rural Assistance Center — Mon, 30 Jan 2012 06:00:00 +0100

Provisions in the health care reform law, the Affordable Care Act, will save taxpayers and States an estimated $17.7 billion over five years on prescription drugs bought through Medicaid, according to estimates in a proposed rule issued today by the Centers for Medicare & Medicaid Services (CMS). (Source: News stories via the Rural Assistance Center)

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New‐Onset Treatment‐Dependent Diabetes Mellitus and Hyperlipidemia Associated with Atypical Antipsychotic Use in Older Adults without Schizophrenia or Bipolar Disorder

Journal of the American Geriatrics Society — Mon, 30 Jan 2012 05:00:00 +0100

ConclusionUse of atypical antipsychotics in older adults for conditions other than schizophrenia and bipolar disorder was associated with incident treatment of diabetes mellitus but not of hyperlipidemia, suggesting that older adults may be susceptible to the adverse metabolic consequences of these agents. (Source: Journal of the American Geriatrics Society)

Washington Week: Jobs Not Health Fueled State of Union Ardor

MedPage Today Primary Care — Sun, 29 Jan 2012 20:47:50 +0100

WASHINGTON (MedPage Today) -- Healthcare failed to be a callout at the State of the Union address, while lawmakers eyed possible savings from the scaling down of the wars in Iraq and Afghanistan as a source of funds for a Medicare doctor payment fix during a busy week inside the beltway. (Source: MedPage Today Primary Care)

More Data Needed on Carotid AtherosclerosisMore Data Needed on Carotid Atherosclerosis

Medscape Today Headlines — Fri, 27 Jan 2012 22:31:15 +0100

The Centers for Medicare and Medicaid Services' Medicare Evidence Development and Coverage Advisory Committee met to once again discuss the latest available evidence on different treatments of carotid atherosclerosis, and the only clear message was these questions remain a moving target. Heartwire (Source: Medscape Today Headlines)

Medicare Overpaid Billions in 2010, GAO Says

MedPage Today Public Health — Fri, 27 Jan 2012 22:11:21 +0100

WASHINGTON (MedPage Today) -- The U.S. government overpaid private insurance companies administering Medicare Advantage plans by as much as $3.1 billion in 2010, according to a new report from the Government Accountability Office. (Source: MedPage Today Public Health)

OIG: Feds Don't Know Who's Opted Out of Medicare

MedPage Today Public Health — Fri, 27 Jan 2012 20:43:16 +0100

WASHINGTON (MedPage Today) -- Medicare doesn't adequately track which physicians are opting out of Medicare, making it nearly impossible to determine who is cutting ties with the program and why, according to an OIG memo. (Source: MedPage Today Public Health)

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Bipartisan Policy Center calls for more, better health IT

Healthcare IT News — Fri, 27 Jan 2012 18:58:17 +0100

A think tank with a healthcare task force chaired by former Senators Tom Daschle, a Democrat, and Bill Frist, MD, a Republican, is advocating for improved and better-used health information technology. Among the group's recommendations is "robust" data exchange. read more (Source: Healthcare IT News)

CMS' Tavenner spotlights innovation

Healthcare IT News — Fri, 27 Jan 2012 16:17:06 +0100

Marilyn Tavenner, acting administrator for the Centers for Medicare & Medicaid Services, expressed urgency in pressing forward with the “triple aim” goals of better individual healthcare, better population health and lower costs called for in the health reform law. Speaking Jan. 26 at the Care Innovations Summit in Washington, DC, Tavenner highlighted the work of the CMS Innovation Center. read more (Source: Healthcare IT News)

The price sensitivity of Medicare beneficiaries: a regression discontinuity approach

Health Economics — Fri, 27 Jan 2012 15:10:45 +0100

ABSTRACTWe use 4 years of data from the retiree health benefits program of the University of Michigan to estimate the effect of price on the health plan choices of Medicare beneficiaries. During the period of our analysis, changes in the University's premium contribution rules led to substantial price changes. A key feature of this ‘natural experiment’ is that individuals who had retired before a certain date were exempted from having to pay any premium contributions. This ‘grandfathering’ creates quasi‐experimental variation that is ideal for estimating the effect of price. Using regression discontinuity methods, we compare the plan choices of individuals who retired just after the grandfathering cutoff date and were therefore exposed to significant price changes to the choices ...

The Impact of Remote Patient Monitoring (Telehealth) upon Medicare Beneficiaries with Heart Failure

Telemedicine and e-Health — Fri, 27 Jan 2012 14:41:20 +0100

Telemedicine and e-Health , Vol. 0, No. 0. (Source: Telemedicine and e-Health)

Federal Government Agrees to Open Access to Medicare Data about Individual Doctors

Dark Daily — Fri, 27 Jan 2012 11:00:26 +0100

Experts predict employers will use this data to create “report cards” on individual physicians In a big step forward for public access to data about provider outcomes, the Department of Health and Human Services (HHS) will make its enormous Medicare claims database more broadly available to the public. Both the press and the public will [...] (Source: Dark Daily)

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Corporate Whistle Blower Center Urges Healthcare Medical Device &...

PRWeb: Medical Pharmaceuticals — Fri, 27 Jan 2012 06:33:34 +0100

In 2010 the US GAO estimated that Medicare fraud alone was at least $60 billion dollars in the United States. This number does not reflect an estimate of what Medicaid fraud could be. The Corporate...(PRWeb January 25, 2012)Read the full story at http://www.prweb.com/releases/2012/1/prweb9136322.htm (Source: PRWeb: Medical Pharmaceuticals)

Elder Self‐Neglect and Hospitalization: Findings from the Chicago Health and Aging Project

Journal of the American Geriatrics Society — Fri, 27 Jan 2012 05:00:00 +0100

ConclusionReported elder self‐neglect was associated with higher rates of hospitalization in this community population. Greater severity of self‐neglect was associated with a greater rate of hospitalization. (Source: Journal of the American Geriatrics Society)

Age Patterns of Incidence of Geriatric Disease in the U.S. Elderly Population: Medicare‐Based Analysis

Journal of the American Geriatrics Society — Fri, 27 Jan 2012 05:00:00 +0100

ConclusionThe developed computational approaches applied to the nationally representative Medicare‐based data sets allow reconstruction of age patterns of disease incidence in the U.S. elderly population at the national level with unprecedented statistical accuracy and stability with respect to systematic biases. (Source: Journal of the American Geriatrics Society)

Ron Paul's Plan for Medicare Reform: Legalize Pot

Forbes.com Health News — Thu, 26 Jan 2012 20:33:59 +0100

Libertarians are constantly lecturing the rest of us about the purity of their principles. Conservatives are just as statist as liberals, goes the refrain: conservatives simply want to use government intervention as an instrument for their own ends. So, then, why is it that the libertarian champion in the GOP Presidential race, Ron Paul, has the field's weakest stance on Medicare reform? (Source: Forbes.com Health News)

Medicare cuts, ACOs to cause slowdown in diagnostic ECG device market

Healthcare IT News — Thu, 26 Jan 2012 16:04:34 +0100

A new report from Millennium Research Group shows that declining demand in private practices for diagnostic electrocardiography (ECG) devices will contribute to slow growth in the U.S. market – despite a growing number of older patients who require the devices. The study finds that reasons for declining private practice demand range from Medicare funding cuts to the impact of accountable care organizations. read more (Source: Healthcare IT News)

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Cardiologists Seek Ways to Improve Medicare Policy (with video)

MedPage Today Geriatrics — Thu, 26 Jan 2012 15:00:00 +0100

(MedPage Today) -- The Centers for Medicare & Medicaid Services is revising its guidance on the use of a policy called "coverage with evidence development," and the American College of Cardiology has some ideas about how to improve the policy. (Source: MedPage Today Geriatrics)

Medicine: Use War Money for Medicare

Blogged_Arteries — Thu, 26 Jan 2012 06:00:00 +0100

Texas Medical Association joined the American Medical Association and dozens of other state and national medical organizations in urging Congress to permanently stop the fiscally irresponsible cycle of scheduled cuts and short-term patches to Medicare physician payments. (Source: Blogged_Arteries)

Texans Tops in Meaningful Use

Blogged_Arteries — Thu, 26 Jan 2012 06:00:00 +0100

More Texas physicians are meeting federal meaningful use criteria in adopting electronic health records (EHRs) than in any other state, according to an analysis of Centers for Medicare & Medicaid Services data by the Institute for Health Technology Transformation. (Source: Blogged_Arteries)

Center for Medicare and Medicaid Innovation Aims to Cut Health-Care Costs

RWJF News Digest - Quality/Equality — Thu, 26 Jan 2012 05:00:00 +0100

The Obama administration touts it as a key solution to the nation’s runaway health-care spending: a new national center set up by the 2010 health-care law to test and implement groundbreaking ways to cut costs while improving patient care. (Source: RWJF News Digest - Quality/Equality)

Medicare Panel Punts on Best Tx for Carotid Plaque

MedPage Today State Required CME — Thu, 26 Jan 2012 00:43:15 +0100

BALTIMORE (MedPage Today) -- The Medicare Evidence Development and Coverage Advisory Committee (MedCAC) has voted that there's not enough evidence to provide a clear answer on what is the best treatment -- surgery, stents, or medication -- for Medicare patients with carotid atherosclerosis. (Source: MedPage Today State Required CME)

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Medicare, Medicaid, tort reform in play in Florida primary

MD Consult: News: Top Stories — Thu, 26 Jan 2012 00:00:00 +0100

Read the full story on MD Consult: Medicare, Medicaid, tort reform in play in Florida primary (Source: MD Consult: News: Top Stories)

The Wyden–Ryan Proposal — A Foundation for Realistic Medicare Reform

New England Journal of Medicine — Wed, 25 Jan 2012 22:00:05 +0100

New England Journal of Medicine, Volume 0, Issue 0, Ahead of Print. (Source: New England Journal of Medicine)

Obamacare: Obama Ends Medicare As We Know It

The Heritage Foundation Papers: Health Care — Wed, 25 Jan 2012 19:03:00 +0100

Obamacare makes massive changes to Medicare. Obamacare contains more than 160 provisions to the program that increases government’s control over the delivery of care, hits doctors with unsustainable payment cuts, and leaves taxpayers with higher deficits. (Source: The Heritage Foundation Papers: Health Care)

Hospitalists Play Critical Role in Primary Care

Physicians Practice — Wed, 25 Jan 2012 18:00:02 +0100

Hospitalists provide essential primary care in the hospital for the extremely sick, chronically ill patient population responsible for the majority of Medicare spending. (Source: Physicians Practice)

Medicare fraud charges filed against 5 Pa. cardiologists

AuntMinnie.com Headlines — Wed, 25 Jan 2012 17:46:31 +0100

A whistleblower suit filed this week in a U.S. District Court in Pennsylvania (more) (Source: AuntMinnie.com Headlines)

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Healthcare gets short shrift in State of the Union, GOP response

Healthcare IT News — Wed, 25 Jan 2012 15:40:25 +0100

Neither President Obama, in his State of the Union Address, nor Indiana Governor Mitch Daniels, in his Republican response, said very much about healthcare. read more (Source: Healthcare IT News)

Potential complications of Medicare reimbursement policy regarding health-care-associated infections.

American Journal of Health-System Pharmacy : AJHP — Wed, 25 Jan 2012 14:50:02 +0100

Authors: Frei CR, Daniels KR PMID: 22261939 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Practicing in two states: Consult Medicare on office location

Modern Medicine — Wed, 25 Jan 2012 05:00:00 +0100

Beginning a full-time, house-call geriatric practice in one state while living in another creates a payment dilemma. (Source: Modern Medicine)

CBO: Medicare cost-savings demonstrations a bust

Modern Medicine — Wed, 25 Jan 2012 05:00:00 +0100

Two decades of studies intended to reduce Medicare spending didn’t save much money, the Congressional Budget Office says. Learn more about the failed plans. (Source: Modern Medicine)

Correcting an address with Medicare

Modern Medicine — Wed, 25 Jan 2012 05:00:00 +0100

Typos and filing mistakes can create a huge Medicare billing problem, as one writer discovered. Here's what to do if you get 'disowned.' (Source: Modern Medicine)

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Physician fee schedule rate change delayed

Modern Medicine — Wed, 25 Jan 2012 05:00:00 +0100

The Centers for Medicare and Medicaid Services (CMS) released the final rule for its physician fee schedule November 1 and stated that providers would see an across-the-board reduction of 27.4% for services in 2012, but much is still unclear about this change. (Source: Modern Medicine)

Valentine’s Day last chance to break up with Medicare

Modern Medicine — Wed, 25 Jan 2012 05:00:00 +0100

This year the government is giving physicians extra time to drop their Medicare participation. But you do face one snag if you let the relationship linger too far into 2012. (Source: Modern Medicine)

Should Medicare reimbursement for carotid artery stenting be extended to standard and low risk symptomatic and asymptomatic patients with carotid stenosis?

Vascular — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Gray WA, Macdonald S, Schneider PA PMID: 22277741 [PubMed - as supplied by publisher] (Source: Vascular)

Factors Associated With the Initiation of Disease-Modifying Antirheumatic Drugs in Newly Diagnosed Rheumatoid Arthritis: A Retrospective Claims Database Study.

Clinical Therapeutics — Wed, 25 Jan 2012 05:00:00 +0100

CONCLUSIONS: Among managed care enrollees in the present analysis, 37% of patients newly diagnosed with RA were not being treated with DMARDs in the first 12 months after diagnosis. Time to DMARD initiation plateaued after 90 days, suggesting that if a patient was not prescribed a DMARD soon after RA diagnosis, he or she was not likely to receive one. PMID: 22284901 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)

Medicare Panel to Consider Carotid Therapy Evidence

MedPage Today State Required CME — Tue, 24 Jan 2012 18:43:12 +0100

WASHINGTON (MedPage Today) -- The Centers for Medicare and Medicaid Services (CMS) is seeking information on which carotid atherosclerosis treatments work best to prevent stroke and death in Medicare patients. (Source: MedPage Today State Required CME)

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iMedicor to provide CMS-certified gateway for secure and private exchange of health information

Healthcare IT News Press Releases — Tue, 24 Jan 2012 14:51:42 +0100

iMedicor (PINKSHEETS: VMCI) today announced it is adding esMD (Electronic Submission of Medical Data) and HIH (Health Information Handler) technology and certifications to iMedicor's flagship service, the HIPAA-compliant Social Health Information Exchange (SocialHIE). read more (Source: Healthcare IT News Press Releases)

Health Net to sell Medicare Part D business to CVS

American Medical News - BUSINESS — Tue, 24 Jan 2012 13:11:25 +0100

At least one stock analyst believes the deal positions the company to be acquired by another health insurer. (Source: American Medical News - BUSINESS)

Structural/organizational characteristics of health services partly explain racial variation in timeliness of radiation therapy among elderly breast cancer patients

Breast Cancer Research and Treatment — Tue, 24 Jan 2012 07:35:09 +0100

We examined the role of surgical facility characteristics and distance to care in explaining racial/ethnic variation in timing of initiation of guideline-recommended radiation therapy (RT) after breast conserving surgery (BCS). We used Surveillance Epidemiology and End Results-Medicare data to identify women ages 65 and older diagnosed with stages I–III breast cancer and treated with BCS in 1994–2002. We used stepwise multivariate logistic regression to examine the interactive effects of race/ethnicity and facility profit status, teaching status, size, and institutional affiliations, and distance to nearest RT on timing of RT initiation, controlling for known covariates. Among 38,574 eligible women who received BCS, 39% received RT within 2 months, 52% received RT within 6&n...

NCPA to CMS: Offer special enrollment period for seniors who feel they were duped by preferred networks

Drug Topics - Pharmacy News — Tue, 24 Jan 2012 05:00:00 +0100

Medicare patients who believe they were duped into enrolling in a “preferred network” with inadequate pharmacy access should be granted a special enrollment period to sign up for a new Medicare Part D prescription drug plan, the National Community Pharmacists Association told the federal agency in a letter. (Source: Drug Topics - Pharmacy News)

Creating Community Collaboration to Improve the Care of Patients With High Blood Pressure: Lessons From Rochester, New York

The Journal of Clinical Hypertension — Tue, 24 Jan 2012 05:00:00 +0100

This report describes the process to date and hopefully will stimulate conversations about mechanisms to encourage similar collaboration within other communities. (Source: The Journal of Clinical Hypertension)

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NCPA to CMS: Offer special enrollment period for seniors who feel they were duped by preferred networks

Drug Topics - Top News — Tue, 24 Jan 2012 05:00:00 +0100

Concurrent Use of Warfarin and Antibiotics and the Risk of Bleeding in Older Adults

The American Journal of Medicine — Mon, 23 Jan 2012 23:45:00 +0100

Conclusion: Among older continuous warfarin users, exposure to antibiotic agents—particularly azole antifungals—was associated with an increased risk of bleeding. (Source: The American Journal of Medicine)

Lawsuit Alleges Unnecessary PCIsLawsuit Alleges Unnecessary PCIs

Medscape Today Headlines — Mon, 23 Jan 2012 22:40:39 +0100

A new whistle-blower lawsuit filed in US District Court claims that five cardiologists from two medical practices in Erie, PA defrauded Medicare by performing unnecessary cardiac and vascular surgeries and interventional procedures between 2001 and 2005. Heartwire (Source: Medscape Today Headlines)

Cardiologists accused of defrauding Medicare by performing unnecessary cardiac procedures

theHeart.org — Mon, 23 Jan 2012 21:30:18 +0100

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Dying in U.S. Nursing Homes with Advanced Dementia: How Does Health Care Use Differ for Residents with, versus without, End-of-Life Medicare Skilled Nursing Facility Care?

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:22 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 43-50. (Source: Journal of Palliative Medicine)

ACR Urges Conference Committee to Include H.R. 3269

American College of Radiology — Mon, 23 Jan 2012 20:36:00 +0100

On Friday, January 20, chairman of the American College of Radiology's (ACR) Board of Chancellors, John Patti, MD, FACR, sent a letter to the House and Senate conferees urging the inclusion of H.R. 3269, the Diagnostic Imaging Services Access Protection Act, within a forthcoming, long-term Medicare proposal. (Source: American College of Radiology)

CBO: Raising Medicare age to 67 would save $148 billion over decade

American Medical News - GOVERNMENT — Mon, 23 Jan 2012 11:45:21 +0100

Increasing the Medicare eligibility age would prompt more Americans to delay retirement, but it also would lead to higher out-of-pocket costs for enrollees. (Source: American Medical News - GOVERNMENT)

Medicaid medical homes saved $1 billion in North Carolina

American Medical News - GOVERNMENT — Mon, 23 Jan 2012 11:45:21 +0100

However, sicker enrollees and those eligible for both Medicare and Medicaid have posed more challenges for the program. (Source: American Medical News - GOVERNMENT)

Robotic, open RP both carry high risk of post-op adverse effects

Modern Medicine — Mon, 23 Jan 2012 05:00:00 +0100

The risks of incontinence and sexual dysfunction are high after both robot-assisted laparoscopic radical prostatectomy and open radical prostatectomy among Medicare-age men, results of a recent multicenter study show. (Source: Modern Medicine)

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Factors Associated With 30-Day Readmission Rates After Percutaneous Coronary Intervention [Original Investigation]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions Nearly 1 in 10 patients undergoing PCI were readmitted within 30 days. Thirty-day readmission after PCI was associated with a higher risk of 1-year mortality. (Source: Archives of Internal Medicine)

Tests and Expenditures in the Initial Evaluation of Peripheral Neuropathy [Original Investigation]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions Patients diagnosed as having peripheral neuropathy typically undergo many tests, but testing patterns are highly variable. Almost one-quarter of patients receiving neuropathy diagnoses undergo high-cost, low-yield magnetic resonance imaging, whereas few receive low-cost, high-yield glucose tolerance tests. Expenditures increase substantially in the diagnostic period. More research is needed to define effective and efficient strategies for the diagnostic evaluation of peripheral neuropathy. (Source: Archives of Internal Medicine)

A snapshot of smokers after lung and colorectal cancer diagnosis

Cancer — Mon, 23 Jan 2012 05:00:00 +0100

CONCLUSIONS:After diagnosis, a substantial minority of patients with lung and colorectal cancers continued smoking. Patients with lung cancer had higher rates of smoking at diagnosis and after diagnosis; whereas patients with colorectal cancer were less likely to quit smoking after diagnosis. Factors that were associated with continued smoking differed between lung and colorectal cancer patients. Future smoking‐cessation efforts should examine differences by cancer type, particularly when comparing cancers for which smoking is a well established risk factor versus cancers for which it is not. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

Why the United States Center for Medicare and Medicaid Services should not extend reimbursement indications for carotid artery angioplasty/stenting.

Vascular — Mon, 23 Jan 2012 05:00:00 +0100

Authors: Abbott AL, Adelman MA, Alexandrov AV, Barnett HJ, Beard J, Bell P, Björck M, Blacker D, Buckley CJ, Cambria RP, Comerota AJ, Connolly ES, Davies AH, Eckstein HH, Faruqi R, Fraedrich G, Gloviczki P, Hankey GJ, Harbaugh RE, Heldenberg E, Kittner SJ, Kleinig TJ, Mikhailidis DP, Moore WS, Naylor R, Nicolaides A, Paraskevas KI, Pelz DM, Prichard JW, Purdie G, Ricco JB, Riles T, Rothwell P, Sandercock P, Sillesen H, Spence JD, Spinelli F, Tan A, Thapar A, Veith FJ, Zhou W PMID: 22271806 [PubMed - as supplied by publisher] (Source: Vascular)

Medicare Demo Projects Saved Little Money

MedPage Today State Required CME — Sun, 22 Jan 2012 03:13:11 +0100

WASHINGTON (MedPage Today) -- Several demonstration projects aimed at saving the Medicare program money have yielded few positive results, according to a report from the Congressional Budget Office. (Source: MedPage Today State Required CME)

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Opinionator: What We Give Up for Health Care

NYT Health — Sat, 21 Jan 2012 22:41:04 +0100

If liberals care about middle-class salaries, public education and other state-funded services, they need to care about controlling health care costs as much as conservatives do. (Source: NYT Health)

Is U.S. Health Spending Finally Under Control?

RWJF News Digest - Quality/Equality — Sat, 21 Jan 2012 14:54:20 +0100

“Growth in U.S. health spending remains slow in 2010” was the headline of a news release on Jan. 9 by the Centers for Medicare and Medicaid Services, part of the Department of Health and Human Services. (Source: RWJF News Digest - Quality/Equality)

Medicare Outpatient Reimbursement at Stake!

ASHA Action Alerts — Sat, 21 Jan 2012 05:00:00 +0100

Enroll as a Data Collection Site Today! (Source: ASHA Action Alerts)

Capitol Hill Report: Budget Offsets Could Fix SGR for One Year—or Permanently

American Academy of Neurology — Sat, 21 Jan 2012 00:06:07 +0100

Fixing the Medicare Sustainable Growth Rate (SGR) formula remains a top issue as we inch closer to the March 1 deadline for congressional action to prevent a 27.4 percent cut in Medicare physician reimbursement. (Source: American Academy of Neurology)

CWF president argues with feds over healthcare spending

Healthcare IT News — Fri, 20 Jan 2012 15:05:40 +0100

Karen Davis, president of the Commonwealth Fund and a nationally recognized economist, has a bone to pick with the federal government's recent report on U.S. healthcare spending. Growth in U.S. health spending remained slow in 2010 and the health share of the gross domestic product was unchanged from 2009, the Centers for Medicare and Medicaid Services reported. read more (Source: Healthcare IT News)

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Ohio governor proposes Medicaid shared savings

American Medical News — Fri, 20 Jan 2012 13:09:24 +0100

Gov. John Kasich also wants a single care manager and benefits access point for people eligible for both Medicare and Medicaid. (Source: American Medical News)

Osteoporosis Is So Slow, Bone Density Retests Can Wait, Study Says

NYT — Fri, 20 Jan 2012 07:37:20 +0100

A new study is asking whether frequent bone density measurements make sense for the majority of older women whose bone density is not close to an osteoporosis danger zone on an initial test. (Source: NYT)

Most Medicare Demo Projects Fail to Raise Quality, Cut CostsMost Medicare Demo Projects Fail to Raise Quality, Cut Costs

Medscape Today Headlines — Thu, 19 Jan 2012 23:59:01 +0100

A new study from the Congressional Budget Office found that, for one thing, you cannot phone in quality. Medscape Medical News (Source: Medscape Today Headlines)

Survey: Hospitals' RAC audits usually managed by one compliance employee

Cardiovascular Business News — Thu, 19 Jan 2012 16:43:59 +0100

The Health Care Compliance Association, a nonprofit trade association for healthcare compliance professionals, determined that hospital audits conducted through the Centers for Medicare & Medicaid Services’ Recovery Audit Contractor program are usually handled by compliance departments and that they generally take a single full-time employee to manage. (Source: Cardiovascular Business News)

Osteoporosis Is So Slow, Bone Density Retests Can Wait, Study Says

NYT Health — Thu, 19 Jan 2012 16:31:00 +0100

More Medicare beneficiaries getting breast cancer screening

AuntMinnie.com Headlines — Thu, 19 Jan 2012 15:05:55 +0100

Recent studies have documented a drop in mammography screening rates in the (more) (Source: AuntMinnie.com Headlines)

States put tech to work on Medicaid enrollment

Healthcare IT News — Thu, 19 Jan 2012 14:23:44 +0100

More than half of states expanded and simplified their Medicaid and Children’s Health Insurance Programs’ eligibility, enrollment and renewal procedures in 2011, often using technology to streamline and automate processes. That efficiency helped states to continue their coverage for low-income adults and children at the same level as the previous year. Enhanced federal funding drove many states to begin major development work to modernize decades-old eligibility and enrollment systems. read more (Source: Healthcare IT News)

Osteoporosis Is So Slow, Bone Density Tests Can Wait, Study Says

NYT — Thu, 19 Jan 2012 04:30:09 +0100

A new study is asking whether frequent bone density measurements make sense for the majority of older women whose bone density is not close to a danger zone on an initial test. (Source: NYT)

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Barnstorming, Directing, Producing: Integration of a Clinical Pharmacist Across the Full Spectrum of Palliative Care Services (341) Program Chiefs SIG

Journal of Pain and Symptom Management — Thu, 19 Jan 2012 03:24:50 +0100

Compare clinical pharmacist goals of care with Hospice Medicare Conditions of Participation. (Source: Journal of Pain and Symptom Management)

Osteoporosis Is So Slow, Bone Density Tests Can Wait, Study Says

NYT Health — Wed, 18 Jan 2012 22:50:41 +0100

A new study is asking whether frequent bone density measurements make sense for the majority of older women whose bone density is not close to a danger zone on an initial test. (Source: NYT Health)

Physician Guilty of Medicare Fraud Put Patients at RiskPhysician Guilty of Medicare Fraud Put Patients at Risk

Medscape Today Headlines — Wed, 18 Jan 2012 22:25:41 +0100

Prison-bound Alexander Popov, MD, not only signed off on fraudulent claims but also led seriously ill patients to think they were receiving bona fide care. Medscape Medical News (Source: Medscape Today Headlines)

Duluth man indicted on health-care fraud

bizjournals.com Health Care:Biotechnology headlines — Wed, 18 Jan 2012 21:05:12 +0100

A federal grand jury in Atlanta on Wednesday indicted Duluth, Ga., resident David Song Sen Cui on allegations of $5.5 million in Medicare fraud. According to U.S. Attorney Sally Quillian Yates, the charges and other information presented in court, from November 2008 through August 2011, Cui ran the Atlanta Hope Medical Group Inc. clinic in Doraville, Ga. The clinic claimed to provide physical therapy services for elderly patients. The clinic actually offered massage services performed by unlicensed massage therapists, the federal government claims... (Source: bizjournals.com Health Care:Biotechnology headlines)

Is the Conservative Establishment Against Entitlement Reform?

Forbes.com Health News — Wed, 18 Jan 2012 18:35:49 +0100

Lasting entitlement reform will require both Republicans and centrist Democrats to come together. That involves???yes???compromise with the dastardly forces of statism. Because we don't have 40 years to fix Medicare. We have to fix it now. From where I sit, it's what some describe as the "establishment" that is doing the most to make that happen. (Source: Forbes.com Health News)

CMS to host webinar series on bundled payment initiatives

Cardiovascular Business News — Wed, 18 Jan 2012 16:32:22 +0100

The Centers for Medicaid & Medicare Services will host a series of webinars dedicated to helping healthcare organizations understand bundled payment programs as part of its accelerated development learning session series. (Source: Cardiovascular Business News)

Amendments to Regulations Regarding Eligibility for a Medicare Prescription Drug Subsidy

Federal Register updates via the Rural Assistance Center — Wed, 18 Jan 2012 15:24:40 +0100

This final rule from the Social Security Administration adopts, without change, the interim final rule with request for comments published in the Federal Register on December 29, 2010. The interim final rule incorporated changes to the Medicare prescription drug coverage low-income subsidy (Extra Help) program made by the Patient Protection and Affordable Care Act enacted in March 2010. (Source: Federal Register updates via the Rural Assistance Center)

Commentary on ‘The DOPPS Practice Monitor for US Dialysis Care: Trends Through April 2011’: No Surprises Yet

American Journal of Kidney Diseases — Wed, 18 Jan 2012 13:56:37 +0100

The initial announcement, finalization, and ultimate implementation of the end-stage renal disease prospective payment system (PPS), also called the expanded bundle, were accompanied by much angst in the nephrology community and agitation among high-profile stakeholders. Overnight, fee-for-service reimbursement by the US Centers for Medicare & Medicaid Services (CMS) to dialysis providers for many dialysis-related services, including most medications administered in the dialysis unit, was replaced by adjusted lump-sum payments for each hemodialysis treatment provided. Included in these new per-session payments were many of the most costly elements of dialysis care, including erythropoiesis-stimulating agents (ESAs), intravenous iron supplements, and intravenous vitamin D analogues, along w...

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Let’s Move! Fitness Challenge and other Prince George’s County health events for Jan. 19-26

Wash Post Health — Wed, 18 Jan 2012 13:17:36 +0100

Maryland legal aid seminar Information on Medicare, medical assistance, access to health care, exploitation, neglect and available resources. For age 50 and older. Thursday 1-3 p.m., Laurel-Beltsville Senior Activity Center, 7120 Contee Rd., Laurel. 301-206-3355. Free; registration required. Read full article >> (Source: Wash Post Health)

Medicaid Program; Disproportionate Share Hospital Payments - Uninsured Definition

Federal Register updates via the Rural Assistance Center — Wed, 18 Jan 2012 06:00:00 +0100

This proposed rule from the Centers for Medicare & Medicaid Services addresses the hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments under the Social Security Act. (Source: Federal Register updates via the Rural Assistance Center)

14 senators express concern about limits on Medicaid generic drug reimbursements

Drug Topics - Pharmacy News — Wed, 18 Jan 2012 05:00:00 +0100

Fourteen U.S. senators recently expressed their concerns with the Centers for Medicare and Medicaid Services’ proposed Federal Upper Limits for Medicaid generic drug reimbursements. (Source: Drug Topics - Pharmacy News)

MedPAC votes to cut hospital E/M pay to practice level

Modern Medicine — Wed, 18 Jan 2012 05:00:00 +0100

A Medicare Payment Advisory Commission recommendation to pay hospitals and medical offices equally for some work draws ire from some professional organizations. What's your group's stance? (Source: Modern Medicine)