Medicare

House to Set Sights on Medicare, Medicaid Cuts in 2018

The House of Representatives will pursue entitlement spending cuts next year, House Speaker Paul Ryan recently explained on a radio program. That means Medicare, Medicaid, and possibly even Social Security. Ryan said that We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking. Learn more about Ryan’s remarks, the administration’s priorities, and what other members of Congress are saying [...]

iqtsupport2017-12-14T06:00:11-05:00December 14, 2017|Medicaid, Medicare, Medicare cuts|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week. Among the issues on the agenda of the independent agency that advises Congress on Medicare payment issues were: payment adequacy for physicians and other health professional services An alternative to the merit-based incentive payment system (MIPS) payment adequacy for hospital inpatient and outpatient services payment adequacy for ambulatory surgical center services payment adequacy and improving the equity of payments for skilled nursing facility services payment adequacy for inpatient rehabilitation services payment adequacy for long-term-care hospital services payment adequacy for home health services payment adequacy for outpatient dialysis services payment [...]

iqtsupport2017-12-13T06:00:25-05:00December 13, 2017|hospitals, Medicare, MedPAC|

Hospitals, Trade Groups Differ on Supervision Requirements

According to provider representatives and trade groups, the requirement that physicians supervise the administration of outpatient therapeutic services to Medicare patients in critical access and small rural hospitals is onerous and could limit patient access to such services. The people who run those hospitals don’t agree. That is the conclusion reached by the Medicare Payment Advisory Commission, which looked into the matter after Congress overturned a Centers for Medicare & Medicaid Services supervision requirement in the 21st Century Cures Act because, as MedPAC observed, CAH and rural hospital representatives…expressed concerns that, because they have difficulty recruiting physicians to practice in [...]

iqtsupport2017-12-12T06:00:08-05:00December 12, 2017|Medicare, Medicare regulations|

CMS Publishes Quality Measures Under Consideration for 2018

The Centers for Medicare & Medicaid Services has published a list of quality measures it is considering implementing in Medicare quality programs in the coming year. The list consists of 32 proposed measures, down significantly from the nearly 100 it proposed last year. These measures are subject to comment by the National Quality Forum and stakeholders. Go here to see a commentary from CMS explaining what it hopes to accomplish and how it is pursuing those goals and go here to see a CMS document presenting the 32 proposed quality measures.

iqtsupport2017-12-06T06:00:01-05:00December 6, 2017|Medicare, Medicare regulations|

The Battle Over 340B

Hospitals and other health care providers say it is an essential tool in ensuring access to care, and to prescription drugs, for their low-income patients. Pharmaceutical companies say it has expanded beyond its original purpose and is being used by hospitals to pad their profits. Members of Congress are divided: some are supportive and some are skeptical. The section 340B program that requires drug companies to provide discounts to selected hospitals and other providers that serve large numbers of low-income patients has been the subject of controversy in recent years. During that time, the administration has generally sided with hospitals [...]

iqtsupport2017-11-30T06:00:01-05:00November 30, 2017|Medicare, Medicare regulations|

Is Readmissions Reduction Program Hurting Some Patients?

A new study suggests that the decline in avoidable hospital readmissions of Medicare patients driven by the federal program’s hospital readmissions reduction program may be harming cardiac patients. According to a new study published in the journal JAMA Cardiology, while the readmissions reduction program has reduced readmissions among heart failure patients from 20 percent before the program was launched to 18.4 percent, the mortality rate among the same patients rose from 7.2 percent to 8.6 percent – 5400 more deaths a year. To learn more about the study, its results, why experts believe this may be happening, and information about [...]

iqtsupport2017-11-29T06:00:23-05:00November 29, 2017|Medicare|

Telehealth on the Upswing

A number of recent developments suggest that serving patients with the assistance of telehealth services will become more commonplace in the near future. The Medicare MACRA and MIPS payment programs will include new billing codes for telehealth services, according to regulations published earlier this month. Also earlier this month, the House passed legislation, The Vets Act (H.R. 2123), that would authorize the Veterans Administration to make greater use of telehealth. And when the U.S. Department of Health and Human Services’ Office of the Inspector General recently announced plans to audit Medicaid programs for telehealth payments, it cited among its reasons [...]

iqtsupport2017-11-28T06:00:17-05:00November 28, 2017|Medicaid, Medicare, Medicare regulations|

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 care for especially large proportions of low-income patients. Go here [...]

iqtsupport2017-11-17T06:00:15-05:00November 17, 2017|Medicare|

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 moving away for paying for quality rather than quantity it [...]

iqtsupport2017-11-15T06:00:55-05:00November 15, 2017|Medicare|

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 is lacking information that it could use to assess how [...]

iqtsupport2017-11-13T06:00:13-05:00November 13, 2017|Medicare|