Bulletin Board
Bulletin Board
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 October agenda were: restructuring Medicare Part D improving Medicare payment for low-volume and isolated outpatient dialysis facilities updates to the methods used to assess the adequacy of Medicare’s payments for physicians and other health professionals population-based outcome measures: avoidable hospitalizations and emergency department visits aligning benefits and cost-sharing under a unified payment system for post-acute care policy options to modify the hospice aggregate cap MedPAC is an [...]
New in Medicaid Medical Transportation: Uber and Lyft
State Medicaid programs focused on ensuring that beneficiaries keep their doctor appointments are increasingly looking to ride-sharing services to supplement the providers already participating in their medical transportation programs. Today, Lyft is working with approximately 35 state Medicaid programs while Uber, at least so far, participates only in Arizona’s program. While ride-sharing is not going to replace other medical transportation programs – for one thing, most Uber and Lyft cars are not equipped to serve individuals with serious disabilities – they can help supplement services that today typically require patients [...]
ACA May be Improving, Saving Lives
The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest. While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments. Among them: High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage. Fewer 19-26 year-olds, now [...]
CMS Adopts Methodology for Medicaid DSH Cuts
Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services. But it is not clear when that new methodology may actually be used. Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans. While this has been the case, the decline in the number of uninsured has not been as [...]
Court Halts Medicare Site-Neutral Payment Changes
The Centers for Medicare & Medicaid Services did not have the authority to implement the site-neutral payment system for Medicare-covered outpatient services that it introduced last year, a federal court has concluded. According to the court, CMS exceeded its authority because it …was not authorized to ignore the statutory process for setting payment rates in the Outpatient Prospective Payment System and to lower payment rates only for certain services provided by certain providers. In general, hospitals oppose the movement toward site-neutral payments and independent physician groups support it. The court [...]