Bulletin Board
Bulletin Board
Socio-Economic Factors’ Role in Skilled Nursing Facility Finances
Skilled nursing facilities located in communities with higher-than-typical numbers of low-income and minority patients are under greater financial stress than comparable facilities located in other communities. Nursing homes that serve higher proportions of Medicaid patients the same challenge. And both of these conditions detract from the quality of care such facilities provide. These are the findings of a new study published in the journal Health Services Research. According to the study, Medicaid-dependent nursing homes have a 3.5 percentage point lower operating ratio. Those serving primarily racial minorities have a 2.64-point [...]
Bill Seeks to Block 340B Cut
Legislation introduced in Congress would block the attempt by the Centers for Medicare & Medicaid Services to slash $1.6 billion in annual payments to hospitals for prescription drugs for outpatients prescribed through the federal section 340B prescription drug discount program. Earlier this month CMS finalized its plan to reduce controversial 340B payments and shift $1.6 billion in savings into Medicare provider payments. If adopted, the bipartisan legislation co-sponsored by Representatives David McKinley (R-WV) and Mike Thompson (D-CA) would prevent the reduction of 340B payments, which are made to hospitals that [...]
Medicaid Retroactive Eligibility: A Dying Practice?
A growing number of states are ending or limiting retroactive eligibility for Medicaid: the practice of Medicaid reimbursing providers for the care they deliver to Medicaid-eligible patients for up to three months even if those patients had not previously enrolled in Medicaid. Arkansas, Indiana, and New Hampshire have ended the practice for some categories of Medicaid patients and Iowa joined them on November 1. In addition, Delaware, Maryland, Massachusetts, and Utah impose some limits on retroactive Medicaid eligibility for at least some Medicaid-eligible individuals. While the purpose of retroactive eligibility [...]
Administration Moving Away From Value Pay?
First, new Medicare programs for lump-sums payments for cardiac care and joint replacements were scaled back. Then, additional doctors were exempted from a new payment system that would have paid them more for the results they produce than for the quantity of care they provide. Next, the Department of Health and Human Services presented a document outlining a new direction for its Center for Medicare and Medicaid Innovation. And it announced that it was seeking input from doctors on payment policy. All suggest that if the Trump administration is not [...]
GAO Urges Medicare Action on Opioids
The Centers for Medicare & Medicaid Services is not doing enough to oversee the prescribing of opioids to Medicare beneficiaries. Or so concludes the U.S. Government Accountability Office. According to the GAO, CMS provides guidance to Medicare drug plans “…but does not analyze data specifically on opioids.” Also, according to the GAO, …CMS does not identify providers who may be inappropriately prescribing large amounts of opioids separately from other drugs, and does not require plan sponsors to report actions they take when they identify such providers. As a result, CMS [...]