Noteworthy News

Archive for March, 2013


MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress. The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report. First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid. And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than [&hellip

IOM Questions Desirability of Medicare Payments Based on Geography

Adjusting Medicare payments to hospitals based on where they are located is not necessarily a good idea, according to the Institute of Medicine (IOM). While some states unquestionably have higher costs, a new IOM preliminary report notes that providers, not states, make health care decisions and that financial incentives to manage costs more effectively should be directed at individual providers, not at geographic areas. The IOM study of the potential of adjusting Medicare payments based on geography was undertaken at the request of Health and Human Services Secretary Kathleen Sebelius in 2010. The National Association of Urban Hospitals (NAUH) has [&hellip

Feds Offer New Carrot to Promote Medicaid Expansion

In their desire to persuade states to expand their Medicaid programs as called for in the Affordable Care Act, federal officials are now suggesting that states could use new federal Medicaid funds to enable Medicaid-eligible people to purchase private insurance. Even though this was not envisioned in the  health reform law, the prospect of making greater use of the private sector appears to be appealing to many Republican governors who have otherwise been reluctant to commit their states to expanding their Medicaid programs. The nation’s private urban safety-net hospitals care for many patients who currently are uninsured but would benefit [&hellip

Immigrants Muddy Reform Calculus for Safety-Net Hospitals

Immigrants to the U.S. – legal and not – pose a special challenge in the health care environment of the future. Legal immigrants will not be able to benefit from many of the Affordable Care Act’s provisions until they have resided in the U.S. for five years while undocumented residents will not benefit from the reform law’s Medicaid expansion at all.  Meanwhile, many of these individuals will continue to turn to health care providers, and especially to hospitals, when they are sick or injured. But is this is a problem?  And if it is, how great a problem is it?  [&hellip

MedPAC Makes Rate Recommendations to Congress

The independent federal agency charged with advising Congress on Medicaid payment issues has issued its Medicare rate recommendations for FY 2014. The Medicare Payment Advisory Commission (MedPAC) has recommended a one percent increase in Medicare inpatient rates in FY 2014 and no updates for ambulatory surgical centers, skilled nursing facilities, inpatient rehabilitation facilities, long-term-care hospitals, and hospices. It also has called on Congress to repeal the sustainable growth rate formula (SGR) that governs Medicare payments to physicians. Proposed changes in Medicare payments should be released next month as part of Medicare’s annual inpatient prospective payment system regulation. See a fact [&hellip

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