Bulletin Board
Bulletin Board
CMS Rejects Bid to Impose Lifetime Limit on Medicaid Services
The Centers for Medicare & Medicaid Services has denied a request from the state of Kansas to impose a lifetime limit on the Medicaid benefits individuals may receive. In a move that the agency appeared to signal last week and that appears to have national implications, CMS administrator Seema Verma explained that We have determined that we will not approve Kansas’ recent request to place a lifetime limit on Medicaid benefits for some beneficiaries…We seek to create a pathway out of poverty, but we also understand that people’s circumstances change, [...]
A Look at Medicaid Managed Care
With 74 million people enrolled in Medicaid managed care plans – roughly 71 percent of the U.S. Medicaid population – the Health Affairs Blog has taken a broad look at Medicaid managed care, addressing the question of how it works, whether it’s working, and what its future may be. The two-part report notes that some Medicaid managed care companies are highly profitable and that this profitability has increased in recent years. It also notes that the manner in which these companies serve their members varies greatly, that their medical loss [...]
Time to Raise the Bar on Preventable Hospital Readmissions?
A new report suggests that hospitals can have the greatest impact on reducing preventable readmissions within seven days of discharge and not through the 30-day mark at which they are currently judged by Medicare. According to a study published in the Annals of Internal Medicine, Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. The study, conducted at 10 academic medical centers and involving more than 800 of their [...]
Nursing Homes Turning Away Addicted Patients
Nursing homes frequently refuse to serve patients being treated with medication to serve opioid addictions. They do so even though opioid addiction is considered a chronic disease and recognized as such under the Americans With Disabilities Act. While some nursing homes claim not to be aware of the obligation to serve such patients, others choose not to do so, with some claiming they lack the resources or expertise to serve such patients or that abstinence from opioid use is superior to medication as a treatment for opioid addiction. As a [...]
CMS Mulls Direct Provider Contracting for Medicare
The Centers for Medicare & Medicaid Services is seeking public input on a proposal to permit Medicare beneficiaries to enter into direct contracts with primary care and multi-specialty providers. According to CMS, A DPC [direct provider contracting] model would aim to enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have actively chosen this type of care model. The request for information, issued earlier this week, seeks public input on experience with direct provider contracting and [...]