iqtsupport, Author at DeBrunner & Associates

CBO Targets Health Care in Options for Reducing Deficit

Every year the Congressional Budget Office publishes a menu of options for reducing federal spending and the federal budget deficit. As in the past, this year’s compendium includes a number of options to reduce federal health care spending and raises federal revenue through health care initiatives. The cost-cutting options include: establish caps on federal spending for Medicaid limit states’ taxes on health care providers reduce federal Medicaid matching rates change the cost-sharing rules for Medicare and restrict Medigap insurance raise the age of eligibility for Medicare to 67 reduce Medicare’s coverage of bad debt consolidate and reduce federal payments for [...]

iqtsupport2018-12-18T09:34:31-05:00December 18, 2018|deficit reduction, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare reimbursement policy|

HIPAA Overhaul Coming?

The U.S. Department of Health and Human Services has issued a request for information about stakeholders’ views on regulations implementing the Health Insurance Portability and Accountability Act, popularly known as HIPAA, leading to conjecture that the administration may be planning to revise the federal government’s application of the federal health care privacy law enacted in 1996. According to an HHS news release, “This RFI is another crucial step in our Regulatory Sprint to Coordinated Care, which is taking a close look at how regulations like HIPAA can be fine-tuned to incentivize care coordination and improve patient care, while ensuring that [...]

iqtsupport2018-12-17T06:00:58-05:00December 17, 2018|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

MedPAC Mulls Billing Change for Nurse Practitioners, Physician Assistants

Medicare would permit nurse practitioners and physician assistants to bill directly for their services under a proposal being considered by the Medicare Payment Advisory Commission. Currently such services are billed as “incident to” physician services, but according to a report in Becker’s Hospital Review, MedPAC staff told commissioners there are problems with “incident to” billing because it “obscures policymakers’ knowledge of who is providing care for beneficiaries,” “inhibits accurate valuation of fee schedule services,” and “increases Medicare beneficiary spending.” Staff also said that physician assistants and nurse practitioners increasingly practice outside of primary care. MedPAC is an independent congressional agency [...]

iqtsupport2018-12-13T06:00:59-05:00December 13, 2018|Medicare, Medicare reimbursement policy, MedPAC|

For Nursing Homes, Medicare Giveth and Medicare Taketh Away

Nearly 4000 skilled nursing facilities will receive bonuses from Medicare this year while nearly 11,000 will be penalized under Medicare’s Skilled Nursing Facility Value-Based Purchasing Program. The program, created in 2014, rewards nursing homes that keep low the number of patients who must be admitted to hospitals during the year and penalizes those with the highest hospital admission rates. Successful nursing homes will receive bonuses of as much as 1.6 percent for each Medicare patient they serve while those that had too many hospital admissions will face penalties of nearly two percent for all of their Medicare patients. On the [...]

iqtsupport2018-12-12T06:00:03-05:00December 12, 2018|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: Medicare payments for physician and other health professionals services payments for ambulatory surgical centers payments for hospital inpatient and outpatient care Medicare’s hospital quality incentive program payments for skilled nursing facilities payments for long-term care hospitals payments for inpatient rehabilitation facilities payments for outpatient dialysis services payments for hospice care payments for home health services the Medicare Advantage program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. [...]

iqtsupport2018-12-11T06:00:45-05:00December 11, 2018|hospitals, Medicare, Medicare reimbursement policy, MedPAC|

Moody’s: Tough Year Ahead for Non-Profit Hospitals

Non-profit hospitals may not fare well financially in 2019, suggests Moody’s Investor Services, the financial services and rating company. The challenge, according to Moody’s: Revenue growth will be constrained as the sector continues to face numerous challenges, including low patient volume growth and higher bad debt as co-pays and deductibles rise. In addition, Expense growth is anticipated to slow through cost-cutting measures and lower increases in drug prices. However, expenses will still outpace revenues due to the ongoing need for temporary nurses, continued recruitment of employed physicians, wage increases associated with lower unemployment, innovative specialty drugs, and increased use of [...]

iqtsupport2018-12-07T06:00:27-05:00December 7, 2018|hospitals|

CMS Introduces New Waivers

The Centers for Medicare & Medicaid Services has introduced four new “state relief and empowerment waivers” that are widely viewed as new vehicles for states to circumvent Affordable Care Act requirements to implement their own new approaches to health care. Through “account-based subsidies” waivers, states may direct public subsidies into defined-contribution, consumer-directed accounts that individuals use to pay for health insurance premiums or other health care expenses. “State-specific premium assistance” waivers enable states to create their own subsidy programs. “Adjusted plan options” authorizes states to provide financial assistance for different types of health insurance plans, including short-term and other health [...]

iqtsupport2018-12-03T06:00:13-05:00December 3, 2018|Affordable Care Act, health care reform|

Number of Uninsured Children Rises

For the first time since 2008, the number of uninsured children in the U.S. increased in 2017, according to a new report from the Georgetown University Health Policy Institute. While the total increase in the number of uninsured children is small – just 276,000 – 2017 marked the first time in nearly a decade that the number of uninsured children has risen. For the year, 3.9 million were uninsured, up from 3.6 million in 2016. Passage of the Affordable Care Act and extension of the Children’s Health Insurance Program (CHIP) have contributed to declines in the number of uninsured children. [...]

iqtsupport2018-11-30T06:00:36-05:00November 30, 2018|Uncategorized|

OIG Cites “Vulnerabilities” in Medicare Wage Index System

The Office of the Inspector General of the U.S. Department of Health and Human Services has “…observed significant vulnerabilities in the [Medicare area] wage index system…” As a result of these vulnerabilities, Medicare has overpaid 272 hospitals by more than $140 million over the past 13 years. The vulnerabilities the OIG identified that contributed to these overpayments are: absent misrepresentation or falsification, CMS lacks the authority to penalize hospitals that submit inaccurate or incomplete wage data; Medicare Administrative Contractors’ limited reviews do not always identify inaccurate wage data; the rural floor decreases wage index accuracy; and hold-harmless provisions in federal [...]

iqtsupport2018-11-29T06:00:57-05:00November 29, 2018|Medicare regulations|

Administration Seeks Industry Guidance on Rollback of Anti-Kickback Laws

Characterizing its objective as a “regulatory sprint to coordinated care,” the Department of Health and Human Services’ Office of the Inspector General this summer asked stakeholders for their input on how it might ease federal anti-kickback laws in ways that promote better coordination of care and cooperation between different types of caregivers while not encouraging fraud that costs consumers and taxpayers. At the heart of this effort are laws that limit the ability of doctors and hospitals to work together. Hospitals, for example, currently have limited tools with which to influence the behavior of doctors serving Medicare and Medicaid patients [...]

iqtsupport2018-11-27T11:00:02-05:00November 27, 2018|Medicare|

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