Noteworthy News

Archive for Urban Safety-Net Hospitals

 

Medicaid is Toughest Insurer for Providers

Medicaid is the hardest insurer for providers when it comes to billing. Or so reports a new study published in the journal Health Affairs. According to this analysis, Medicaid claims take longer to file, are more likely to be rejected, more likely to be challenged, and take longer to be paid than Medicare and private insurance claims.  While the biggest problem is Medicaid fee-for-service claims, even Medicaid managed care claims pose more problems than Medicare and private insurance claims. This can pose a special challenge to urban safety-net hospitals because they care for so many more Medicaid patients than the [&hellip

Eat! You’ll Feel Better

And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food:  some received general meal deliveries while others received food tailored to their individual medical conditions.  The purpose:  address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants in the medically tailored meal program also had fewer inpatient [&hellip

Court Rebuffs CMS on Medicaid DSH

A federal court has rejected the manner in which the Centers for Medicare & Medicaid Services collects certain Medicaid data from states in a ruling that has potential implications for eligible hospitals’ Medicaid disproportionate share hospital payments (Medicaid DSH). In a case that challenged how CMS told hospitals to report third-party payments for Medicaid patients, the court ruled against CMS in two different ways:  first, it found that CMS had not interpreted a 2003 law in a manner consistent with congressional intent; and second, it ruled that CMS could not clarify its interpretation through a published FAQ rather than through [&hellip

Senate Committee Looks at 340B Program

The Senate Health, Education, Labor, and Pensions Committee (HELP) held a hearing last week on the 340B prescription drug discount program. The hearing was prompted by complaints from pharmaceutical companies about the discounts they are required to provide to eligible providers and by concern that hospitals are insufficiently accountable for how they use the savings they derive from those discounts to serve their low-income patients.  In addition, the Centers for Medicare & Medicaid Services recently reduced its Medicare payments to participating hospitals. During the hearing, Senate Republicans expressed support for the program but spoke of the need for greater transparency [&hellip

MACPAC Issues Annual Report, Recommendations to Congress

The Medicaid and CHIP Payment and Access Commission has published its annual report and recommendations to Congress. MACPAC’s report addresses three primary areas:  Medicaid managed care, telehealth, and Medicaid disproportionate share payments (Medicaid DSH). With 80 percent of Medicaid beneficiaries now enrolled in managed care plans, MACPAC offers three major recommendations for improving Medicaid managed care efforts: permit states to require all of their Medicaid beneficiaries to enroll in a managed care plan extend Medicaid managed care section 1915(b) waivers from two to five years permit states to obtain waivers to waive freedom of choice and selective contracting restrictions MACPAC [&hellip

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