Noteworthy News

Archive for Medicare regulations

 

Docs Not Scoring Performance Bonuses

Relatively few physicians will receive Medicare pay-for-performance bonuses under Medicare’s value-based modifier program in 2018. The question now is whether this is because of uninspiring performance or indifference to the program. Of the approximately 1.1 million clinicians who participate in Medicare, only two percent – 22,000 – will receive pay increases in 2018 based on their 2016 performance.  Those raises will range from 6.6 percent to 19.9 percent. Most doctors will receive neither bonuses nor penalties. And roughly 300,000 failed to submit the data required by the program.  In the past they would have been penalized for this failure but [&hellip

E&C Calls for Action on 340B

The section 340B prescription drug program has flaws and needs change, a report by the House Energy and Commerce Committee has concluded. The program, which requires pharmaceutical companies to provide discounts on prescription drugs to be dispensed on an outpatient basis to qualified providers that serve large numbers of low-income patients, has been controversial in recent years.  As the number of providers eligible for the program has grown, pharmaceutical companies have claimed that the program is expensive, is being abused, and is responsible for driving up prescription drug costs while providers insist that 340B is a vital tool in helping [&hellip

Medicare Penalizes Hospitals for Avoidable Injuries, Illnesses

Medicare is reducing payments to 751 hospitals because of the high rate at which their patients have suffered avoidable injuries and illnesses while in the hospital. The penalties come under Medicare’s Hospital-Acquired Condition Reduction Program, which was established by the Affordable Care Act. Among the penalized hospitals, more than half were penalized last year as well 115 are academic medical centers – about one-third of all such facilities more than one-third of all safety-net hospitals were penalized Over the years NAUH has argued that the program is unfair to urban safety-net hospitals because it fails to give any weight to [&hellip

Senators Seek 340B Reprieve

A bipartisan group of senators has written to Senate majority leader Mitch McConnell and Senate minority leader Chuck Schumer expressing concern about cuts in Medicare Medicare prescription drug payments to qualified providers as a result of new regulations governing the section 340B prescription drug discount program.  Those cuts have been adopted by regulation by the Centers for Medicare & Medicaid Services and will take effect beginning on January 1, 2018. Under the regulation adopted by CMS, Medicare payments for prescription drugs dispensed on an outpatient basis to low-income patients will be reduced to qualified providers by $1.6 billion in the [&hellip

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 [&hellip

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