Medicare

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|

Hospitals Improving on Medicare Value-Based Measures

U.S. hospitals continue to improve their performance under Medicare’s value-based purchasing program. In FY 2018, 57 percent of hospitals will receive Medicare bonuses from the program, up from 55 percent in FY 2017. Bonuses are generally small but for some hospitals will be more than three percent. Roughly half of all hospitals will experience changes in their Medicare base rates. The worst performers will see their payments decline 1.65 percent. In FY 2018, hospitals that succeed in the program will share $1.9 billion in bonus payments. Funding for those payments in this budget-neutral program comes from CMS withholding two percent [...]

iqtsupport2017-11-10T06:00:07-05:00November 10, 2017|Medicaid regulations, Medicare|

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C. Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were: the merit-based incentive payment system a unified payment system for post-acute care telehealth a redesign of Medicare’s hospital value incentive program Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site.

iqtsupport2017-10-11T06:00:23-04:00October 11, 2017|Medicare, MedPAC|

House Committee to Hold 340B Hearing

The House Energy and Commerce Committee’s oversight subcommittee will hold a hearing on Wednesday about the 340B Drug Pricing Program. At the hearing, titled “Examining How Covered Entities Utilize the 340B Drug Pricing Program,” the subcommittee hopes …to hear directly from entities participating in the program to get a better understanding of how the program is used, including how much money is saved, the types of drugs purchased and prescribed within the program, how entities track their savings, and how those savings are used to improve patient care. Learn more about the hearing and the witness list from the subcommittee’s [...]

iqtsupport2017-10-10T06:00:39-04:00October 10, 2017|Medicare|

340B Changes Would Hurt Hospital Margins

Proposed changes in the federal section 340B prescription drug discount program would hurt hospital margins. So says Moody’s Investors Service, the credit rating agency. According to Moody’s, the margins of non-profit hospitals are already under pressure because revenue increases are not keeping pace with prescription drug costs. Reductions of payments under the 340B program recently proposed by the Centers for Medicare & Medicaid Services would make a challenging situation worse, Moody’s speculates. Under the 340B program, eligible hospitals purchase prescription drugs at a discount, supply them to eligible outpatients, and use the savings they gain to provide additional services and [...]

iqtsupport2017-10-09T06:00:51-04:00October 9, 2017|Medicare, Medicare cuts, Medicare regulations|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met last week in Washington, D.C. Among the issues they discussed during their two days of meetings were Medicare coverage policy, Medicare coverage of telehealth services, pharmacy benefit managers and specialty pharmacies, and physician supervision requirements in critical access and small rural hospitals. Go here to see the issue briefs and presentations that were discussed during the meeting.

iqtsupport2017-09-13T06:00:10-04:00September 13, 2017|Medicare, MedPAC|

MedPAC Comments on Proposed Physician Fee Schedule

The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018. Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program. See CMS’s comment letter here.

iqtsupport2017-09-12T06:00:52-04:00September 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, MedPAC|

Medicare ACOs Showing Promise

Medicare’s Shared Savings Program and its accountable care organizations are showing promise as a means of reducing Medicare spending and improving the quality or care. Or so concludes the U.S. Department of Health and Human Services’ Office of the Inspector General. According to a new OIG report, Over the first 3 years of the program, 428 participating Shared Savings Program ACOs served 9.7 million beneficiaries. During that time, most of these ACOs reduced Medicare spending compared to their benchmarks, achieving a net spending reduction of nearly $1 billion. At the same time, ACOs generally improved the quality of care they [...]

iqtsupport2017-09-07T06:00:13-04:00September 7, 2017|Accountable Care Organization, ACO, Medicare|