Noteworthy News

Archive for February, 2012


The Medicare Doc Fix: The Problem That Won’t Go Away

While Congress recently “solved” the Medicare physician payment problem, its solution was only a temporary fix to a long-running challenge. The latest solution will last only until the end of 2012, which means Congress will need to tackle the problem again in November, in its lame-duck session after the presidential election. Why does this problem arise so frequently and why can’t it be solved once and for all?  Kaiser Health News considers this and more in “FAQ:  The ‘Doc Fix’ Dilemma,” which can he found here

Hospitals Seeking Upfront Payment for Non-Emergency ER Care

A growing number of hospitals are requiring emergency room patients with non-emergency medical problems to pay upfront for their services, according to a report from Kaiser Health News. Hospitals say this helps reduce ER waiting times and prevent unnecessary bad debt.  Critics believe that once patients come to the hospital, they should not be turned away if they cannot afford the upfront payment. While for-profit hospitals appear to be leading the way in using this approach, some non-profit hospitals are using it as well. Learn more about this latest trend in hospital ER practice in this Kaiser Health News report

Court Clarifies Use of Dual Eligible Days in Medicare DSH Calculation

A federal court has ruled that Medicare must use dual eligible days in its calculation of hospitals’ Medicare disproportionate share (Medicare DSH) payments. Read about the ruling and its implications in this report from the Ober|Kaler law firm

NAUH Endorses CMS Redefinition of “Uninsured Care”

NAUH has conveyed to the Centers for Medicare & Medicaid Services (CMS) its support for a proposed regulation that changes how the agency defines “uninsured care” for the purpose of calculating hospitals’ Medicaid disproportionate share (Medicaid DSH) payments. The refinement in the definition extends “uninsured care” to include services not covered by insured patients’ health plans.  NAUH has long advocated this change because urban safety-net hospitals care for many patients who are under-insured and whose plans do not always cover the services they need. Read NAUH’s letter to CMS here

Illinois Defies Feds on Medicaid Maintenance-of-Effort Requirement

The state of Illinois has imposed new Medicaid eligibility requirements despite federal rejection of its application to do so. Federal approval is needed because of the maintenance-of-effort requirement in the Affordable Care Act. The new Illinois requirement calls for more documentation from applications for Medicaid eligibility. Read more about the new Illinois approach and why it was rejected by the federal government in this Stateline report

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