Noteworthy News

Archive for January, 2012


Utah Considers Medicaid Surcharge for Smokers

Utah is considering a surcharge for Medicaid patients who smoke. Utah state representative Paul Ray claims that Medicaid recipients who smoke cost the state’s Medicaid program an additional $100 million a year and that if they can afford $7 for a pack of cigarettes, they should be able to afford the surcharge. While Rep. Ray concedes that his proposal needs more work, he maintains that the issue merits public discussion. Read about Rep. Ray’s proposal in articles in USA Today and the Salt Lake Tribune

Progress Toward Electronic Health Records, But Slowly

The American health care system is moving toward greater use of health care information technology and electronic health records (EHR), but that progress is slow according to a new study from the Bipartisan Policy Center. The report, Transforming Health Care:  The Role of Health IT, lists six barriers to greater use of health care IT and electronic health records:  misaligned incentives, lack of health information exchange, limited use of consumer engagement using electronic tools, limited levels of EHR adoption, privacy and security concerns, and the need for greater focus and attention for multiple federal priorities. The Bipartisan Policy Center describes [&hellip

Government Still Overpaying Medicare Advantage Plans, GAO Says

A new report by the U.S. Government Accountability Office (GAO) concludes that Medicare is overpaying Medicare Advantage plans for the services they provide to their Medicare patients. According to the GAO study titled CMS Should Improve the Accuracy of Risk Score Adjustments for Diagnostic Coding Practices, the overpayments occur because insurers are overstating their members’ health problems and receiving larger Medicare payments as a result.  While Medicare has adjusted its Medicare Advantage rates to reflect this upcoding, GAO maintains, the adjustment has only reduced the degree of overpayment and not ended it. Based on this report, some House members are [&hellip

CMMI Holds Summit, Summarizes Activities

Created by the Affordable Care Act, the Center for Medicare and Medicaid Innovation (CMMI) shared information about the 14-month-old agency’s agenda and achievements to date at a “Care Innovations Summit” in Washington. The agency is charged with responsibility for pursuing innovation in the delivery of care and payment for care to the Medicare and Medicaid populations as part of the broader health care reform effort.  It pursues its mission by identifying areas in which change is needed and then funding programs designed to test possible improvements.  Because urban safety-net hospitals serve so many Medicare and Medicaid patients, the implications of [&hellip

Senator Targets Medicaid Prescribing Practices

Iowa Senator Charles Grassley has written to Medicaid directors in 34 states asking for information about how they monitor the prescribing practices of physicians who treat Medicaid patients. In particular, Senator Grassley is asking the Medicaid directors how they address physicians who appear to be writing unusual quantities of prescriptions for certain drugs. In Ohio, for example, one physician wrote 18,890 prescriptions for the drug Seroquel, which is used to treat schizophrenia.  The senator’s letter to Ohio’s state Medicaid director notes that the physician in question needed to write 73 such prescriptions every weekday, or nine an hour, to reach [&hellip

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