Noteworthy News

Archive for September, 2014


New Study: Geography Doesn’t Explain Variations in Medicare Spending

Socioeconomic factors play a much greater role than geography in explaining variations in Medicare spending. According to a new report from the Brookings Institution, Underlying socioeconomic and demographic characteristics have important implications for the geographic patterns in Medicare spending.  The findings contradict prior research claiming that most of the variation in Medicare spending can be attributed to geographic differences in medical “practice styles.” As a result, according to the study, “…geographic variation in health care spending does not provide a useful measure of inefficiency and waste in the system” because, among other reasons, “…cross-state variation in Medicare spending is tightly [&hellip

GAO Questions Cost of Private Market Medicaid Expansion

Permitting states to use Medicaid money to enable newly eligible Medicaid recipients to purchase health insurance on the private market may cost more than expansion of traditional state Medicaid programs. Or so says the U.S. Government Accountability Office (GAO). Writing in response to a request from the chairman of the House Energy and Commerce Committee and the ranking minority member of the Senate Finance Committee to look at the approved federal waiver that will permit Arkansas to expand its Medicaid program through the purchase of private insurance for newly eligible recipients, the GAO concluded that the federal government may spend [&hellip

Feds Provide More Info on Short Stay Settlement Offer

The Centers for Medicare & Medicaid Services (CMS) has posted more information about its offer to settle hospital appeals of Medicare denials of payments for short hospital stays. The offer, made last week, seeks to help CMS with an 18-month backlog of hundreds of thousands of appeals from acute-care and critical access hospitals.  Hospitals willing to drop their appeals are eligible to receive 68 cents on the dollar for the value of the cases in dispute.  The offer is available only for cases in which Medicare’s auditors rejected hospital claims for inpatient reimbursement for short hospital stays and then categorized [&hellip

MedPAC Launches New Voices

The independent agency that advises Congress on Medicare payment issues has upgraded its tools for communicating with Congress and the health care community. The Medicare Payment Advisory Commission (MedPAC) has launched a blog and a Twitter feed. According to MedPAC, the blog …will be a mechanism for sharing information about MedPAC’s work and activities in a quicker, less formal, and more wired format than our traditional reports to Congress.  The blog – written by MedPAC staff – is intended to be a resource for Congressional staff and other consumers of our work and will complement our public meetings and formal [&hellip

Medicare Offers Hospitals a Deal

Faced with an 18-month backlog of hundreds of thousands of appeals on cases in which auditors say hospitals billed Medicare for inpatient services that should have been billed at outpatient rates, the Centers for Medicare & Medicaid Services (CMS) is offering hospitals a deal:  drop your appeals and accept a payment of 68 percent of the amount in dispute. Under the offer, acute-care and critical access hospitals have until October 31 to accept CMS’s terms, and once the paperwork is completed, they should receive their payments within 60 days.  Hospitals must be willing to relinquish all of their short stay-related [&hellip

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