Category: CMS

The Alzheimer’s Association is disappointed by the Centers for Medicare & Medicaid Services draft coverage decision on brain amyloid imaging, particularly given the clear, scientific consensus recommendations provided to CMS by the Association and the Society for Nuclear Medicine and Molecular Imaging regarding appropriate, limited coverage, only in specific populations. From: http://www.news-medical.net/news/20130706/Alzheimers-Association-upset-with-CMS-draft-decision-on-brain-amyloid-imaging.aspx

When a Medicare patient heads home from the hospital, the last thing they want is to be part of the revolving door of readmission that costs the healthcare industry and Medicare billions of dollars each year. From: http://www.news-medical.net/news/20130704/Researchers-develop-program-to-reduce-hospital-readmissions-by-more-than-half.aspx

USA Today reports that the inspector general’s report noted that one of the factors keeping the government from recouping these funds was problems with a new accounting system. Meanwhile, Modern Healthcare reports that these types of overpayments are some of the most difficult to collect. From: http://www.news-medical.net/news/20130703/IG-report-24543-million-in-Medicare-overpayments-remain-uncollected.aspx

Often-stated assumptions that medical imaging tests are one of the factors driving health care spending increases are being undermined by a new research study showing that physicians are ordering diagnostic imaging exams on an increasingly lower percentage of their interactions with Medicare patients. The study, conducted by the Harvey L. Neiman Health Policy Institute and…

A California proposal to fine large companies that have workers on Medi-Cal came up short in an initial vote in the Assembly amid strong business opposition. The proposed fines could reach about $5,000 per full-time employee who receives Medi-Cal, the state Medicaid program for the poor. The bill, AB 880, garnered 46 votes in the…

Hospitals and doctors are feeling the health care law heat as officials try to reduce readmissions and increase quality of care in the Medicare program. PBS NewsHour looks at the law’s hospital readmissions penalties and Medpage Today explains what the hospitals are doing. From: http://www.news-medical.net/news/20130702/Hospitals-doctors-consider-changes-amid-Medicare-hospital-readmissions-scrutiny.aspx

With most state legislative sessions coming to a close, 23 states and the District of Columbia have agreed to expand the program, as laid out under the health law. Many of the others will leave billions of federal dollars on the table, while a handful are still undecided. From: http://www.news-medical.net/news/20130702/Nearly-half-of-states-opt-not-to-expand-Medicaid.aspx

While Medicare fraud fighting efforts already have taken a big hit thanks to a combination of layoffs and budgetary issues at the U.S. Department of Health & Human Services Office of Inspector General, a new report indicates more cuts almost assuredly are looming. read more From: http://www.fierceemr.com/story/layoffs-budget-cuts-hamper-medicare-anti-fraud-efforts/2013-07-01?utm_source=rss&utm_medium=rss

A collapse of the company that managed the District’s Medicaid claims — D.C. Chartered Health — left health care providers without any way to be reimbursed for care they gave under the District’s Medicaid program. From: http://www.news-medical.net/news/20130629/DC-officials-plan-2447M-Medicaid-payback-after-claims-processor-collapse.aspx

A proposed rule released Thursday would cause home health agencies to experience a 1.5 percent reduction in their Medicare payments for 2014, which the Centers for Medicare & Medicaid Services estimates could reduce payments to these facilities by $290 million next year. From: http://www.news-medical.net/news/20130629/CMS-proposes-Medicare-payment-adjustment-for-home-health-agencies.aspx