Medicare News
Obama budget freezes physicians' Medicare pay for 10 years
President Obama promised spending freezes during his first State of the Union address, but his $3.8 trillion fiscal 2011 budget request still would protect physicians from Medicare pay cuts and extend enhanced federal support for state Medicaid programs. Obama's proposal, unveiled Feb. 1, sets aside $371 billion over a decade to pay for the cost of preventing Medicare pay cuts under the sustainable growth rate formula. But the funding would only be enough to turn annual reductions into rate freezes, not to fund pay raises.
Medicare cost plans face uncertain future
Under federal law, the more than 20 Medicare cost plans operating in areas deemed to have sufficient competing Medicare Advantage options for beneficiaries must shut down by 2011 or else convert to Medicare Advantage plans themselves. But a December 2009 report from the Government Accountability Office said some insurers are worried about the effects those conversions would have on the program.
Appeals court rejects effort to sell Medicare physician claims data
A federal appeals court cited an injunctive order from three decades ago when it said a private company does not have a right to sell physicians' Medicare claims data to hospitals. The decision is the latest in a series of court actions protecting doctors' privacy against the release of such information for various purposes.In a ruling on Dec. 18, 2009, the 11th U.S. Circuit Court of Appeals said the government was not required to turn over physician claims information to Real Time Medical Data.
Help for Medicare beneficiaries expands
The Centers for Medicare & Medicaid Services will award new grant money to states in 2010 to support community outreach for Medicare beneficiaries. A total of $45 million in grants will be available to the 54 State Health Insurance Assistance Programs, or SHIPs, CMS announced Dec. 16, 2009. States must apply by Feb. 16, and funds will be awarded in April. The agency said the SHIP grants will help states provide more one-on-one counseling to assist beneficiaries with Medicare prescription drug and plan enrollment information.
Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman.
Retirees Snared by Medicare
Rules for enrolling in Medicare are complex. But when people postpone retirement past age 65, as many people are doing these days, it's easy to get caught up in red tape. Older adults can't get into Medicare any time they want. The easiest time to sign up is when you turn 65, and, if you're already collecting Social Security, enrollment is automatic.
The not-so-sweet side of closing 'doughnut hole'
Six years after Congress added a prescription drug benefit to Medicare, Democrats in the House and Senate are poised to make a central change that they and most older Americans have wanted all along: getting rid of a quirk that forces millions of elderly patients with especially high expenses for medicine to pay for much of it on their own. The closing of an unusual gap in Medicare drug coverage -- a gap that Republicans had, when they controlled Capitol Hill and the White House, insisted was needed for the government to be able to afford the program
Medicare physician pay cut delayed until March
President Obama has signed legislation that would prevent a 21.2% Medicare payment cut from taking place Jan. 1 by freezing physician rates for two months. The temporary patch, which expires after Feb. 28, 2010, is intended to give Congress additional time to craft a more lasting solution to the doctor pay problem. It piggybacked on the fiscal 2010 appropriations bill for the Defense Dept., which helps fund the wars in Afghanistan and Iraq. The White House announced Dec. 21 that the president had signed the legislation.
Medicare use, spending found to vary across country
Regional variations in the use of Medicare services across the U.S. do not directly translate to regional variations in spending, the Medicare Payment Advisory Commission noted in a Dec. 1 study. "The two should not be confused," MedPAC stated in the report compiled for Congress, which has been focused on reining in Medicare spending as it attempts to pass comprehensive health system reform.
Senate debates health reform bill with 1-year Medicare pay patch
Senators opened debate on national health system reform legislation on Nov. 30 in partisan fashion. Democrats talked up the bill's coverage expansions and health insurance reforms, and Republicans highlighted the measure's potential to increase both health insurance premiums and the federal deficit.The bill aims to improve the affordability of health insurance and expand government regulation of health plans. It also would implement Medicare cuts to help pay for it.
Should Doctors’ Pay Be Linked to Hospital Readmissions?
One in five Medicare patients winds up back in the hospital within a month of being discharged. At least some of these readmissions could be prevented with proper follow-up care; as part of the big health-care overhaul, Congress is likely to create financial incentives to push hospitals to lower readmission rates. But, as an M.D. points out in an essay in this morning’s New York Times, practicing docs — not hospital execs — decide whether to admit patients to the hospital.
Medicare, Medicaid spent $54 billion too much in 2009, White House says
Improper payments for health care made up a large portion of the $98 billion the federal government spent inappropriately in fiscal 2009. This total was an increase of $26 billion over the previous year, according to a report issued by the White House Office of Management and Budget. The Nov. 17 report concluded that Medicare fee for service improperly spent $24 billion in fiscal 2009, a rate equivalent to 7.8% of total outlays, and Medicaid improperly spent $18 billion, a rate of 9.6%. Medicare Advantage improperly spent $12 billion in 2009, a rate of 15.4% of total outlays on the private plans.
Should Doctors’ Pay Be Linked to Hospital Readmissions?
One in five Medicare patients winds up back in the hospital within a month of being discharged. At least some of these readmissions could be prevented with proper follow-up care; as part of the big health-care overhaul, Congress is likely to create financial incentives to push hospitals to lower readmission rates. But, as an M.D. points out in an essay in this morning’s New York Times, practicing docs — not hospital execs — decide whether to admit patients to the hospital.
House passes major Medicare payment reform; what will the Senate do?
Passage of a major Medicare physician pay overhaul in the House on Nov. 19 means attention on the issue turns back to the Senate, which in October rejected a similar measure due to its projected cost. The House bill, the Medicare Physician Payment Reform Act of 2009, passed by a vote of 243-183. The measure would repeal a 21.2% fee reduction scheduled for Jan. 1, 2010, and replace the sustainable growth rate formula
21.2% Medicare pay cut for doctors unless Congress acts
The final 2010 Medicare physician fee schedule confirms that physicians face a 21.2% pay cut starting Jan. 1, 2010, unless Congress adopts legislation to avert it. The official figure is only slightly lower than the 21.5% reduction the Centers for Medicare & Medicaid Services was predicting earlier this year. The Obama administration supports a permanent repeal of the current physician payment formula and has called on Congress to pass legislation to that effect.
House Health Bill Would Lower Medicare Payments, Report Finds
A fresh analysis of the House health care reform plan has sounded a warning about the impact proposed Medicare cuts would have on seniors and could spell trouble for Senate Majority Leader Harry Reid's effort to pull a unified Senate bill to the floor by the end of the week. The House and would-be Senate bills rely on hundreds of billions of dollars in cuts to Medicare to keep reform deficit-neutral.
Some specialists will see extra cuts in Medicare pay
Some specialty groups are loudly protesting new Medicare payment policies that will boost some primary care rates starting next year at the expense of rates for certain specialty services. In the 2010 physician fee schedule, the Centers for Medicare & Medicaid Services adopted several major changes to the practice-expense portion of the relative value unit system that determines pay for individual services
Medicare relaunches DME competitive bidding
The Centers for Medicare & Medicaid Services on Oct. 21 began accepting bids from accredited durable medical equipment, prosthetics, orthotics and supply companies in nine metropolitan areas to decide whether they can participate in the Medicare program. The round one rebid for the DMEPOS competitive bidding program will be open for 60 days.
Failed Senate vote clouds future of SGR reform
Advocates of Medicare physician payment reform turned their attention to the House after the late October procedural defeat of a Senate bill that would have repealed the current system and effectively frozen pay rates for the next 10 years. House Democratic leaders restated a commitment to permanent pay reform soon after Senate Democrats failed on Oct. 21 to secure 60 votes to force floor consideration of the Medicare Physician Fairness Act.
Medicare doctor pay plan hits Senate snag
A proposal to boost Medicare payments to doctors ran into trouble in the U.S. Senate on Tuesday as Republicans and some Democrats balked at adding $250 billion to skyrocketing U.S. deficits over the next decade. Senator Richard Durbin said Democratic leaders lack the votes needed to overcome procedural hurdles in the 100 member Senate.
Medicare Backs Off On Order About Lobbying Seniors
The Obama administration is backing away from a ban on insurance company mailings to seniors warning of dire Medicare cuts if health care overhaul legislation is approved. Medicare said Friday it's OK for insurance companies to lobby seniors, provided the Medicare beneficiaries have given advance approval and no federal funds or data are used. Last month, Medicare had ordered a halt to such mailings after a Democratic lawmaker complained about a misleading flyer.
Senate panel's health reform bill OK'd with 0.5% Medicare pay hike
The Senate Finance Committee's approval of a health system reform bill on Oct. 13 set the final stage for a historic Senate floor debate in which lawmakers are expected to revisit the public health insurance option along with some of the other more controversial items proposed so far.
Accountable care organizations: A new idea for managing Medicare
Many physicians who are tuned into the health system reform debate have already heard of several of the methods being discussed for changing the way the federal government delivers care. But one Medicare delivery reform term that has recently caught the attention of Congress may be a new one to most.
Senators span over Medicare
Slogging through a second day of work on legislation intended to overhaul the nation's health-care system, the Senate Finance Committee wrestled Wednesday with politically volatile proposals to squeeze money out of Medicare.
Obama Defends Medicare Advantage Cuts
In his Joint Session speech President Obama promised that no one on Medicare would be forced to lose the coverage they have now. But others, like Florida Democrat Senator Bill Nelson, worry that Obama's reforms will deny seniors coverage they now rely on. When I asked him about Nelson's fear, Obama disagreed, but he didn't rule out endorsing Nelson's effort to shield current Medicare beneficiaries from the cuts.
Half of large practices net bonuses from Medicare P4P demo
The Obama White House has indicated it will continue the move toward more pay-for-performance in Medicare, despite mixed results for physicians in the P4P demonstrations it inherited from the previous administration. On Aug. 17, the Centers for Medicare & Medicaid Services disclosed findings from three ongoing programs --
