Noteworthy News

Archive for February, 2016


GAO Suggests Changes in Federal Medicaid Funding Formula

The U.S. Government Accountability Office has recommended changes in how the federal government matches state Medicaid funding for its share of overall Medicaid spending. In testimony submitted to the House Energy and Commerce Committee’s Health Subcommittee, GAO reminded Congress that in the past …GAO has examined multiple concerns regarding how the FMAP [federal medical assistance formula] allocates funds among states, including during times of economic downturn, and has suggested improvements. In particular, the GAO is concerned about how the FMAP formula’s use of per capita income in targeting federal Medicaid matching funds may not accurate reflect economic conditions at the [&hellip

DSH/340B Hospitals Have Lower Medicare Drug Costs

Medicare disproportionate share (Medicare DSH) hospitals that qualify for the federal 340B prescription drug discount program have lower Medicare Part B drug costs than other Medicare providers. So concludes a new study performed for 340B Health, an association that represents more 1100 public and non-profit hospitals and health systems that participate in the 340B drug pricing program. According to the organization 340B Health, Medicare pays disproportionate share hospitals in the 340B drug discount program on average 13 percent less for separately payable drugs reimbursed through Medicare Part B. This is in comparison to what it pays other hospitals and physician [&hellip

Court to Hear RAC Audit Suit

A federal appeals court has overturned a lower court decision and ordered that court to consider a lawsuit against the U.S. Department of Health and Human Services over its nearly two-year backlog in hearing appeals of Medicare Recovery Audit Contractor decisions. Under HHS procedures, hospitals that disagree with RAC audit findings may appeal those findings through various administrative processes. So many hospitals were appealing those findings, though, that HHS suspended approving requests for hearings until it could address the backlog. As of February 15, decisions on those appeals were backlogged an average of 572 days. To learn more about the [&hellip

President Proposes FY 2017 Budget

That budget proposal calls for numerous cuts in Medicare payments to hospitals, including significant reductions in Medicare bad debt reimbursement, medical education payments, and payments for inpatient rehabilitation services. It also calls for restoring the Medicaid primary care payment increase through calendar year 2017. NAUH has prepared a detailed memo outlining the potential implications of the proposed FY 2017 budget for urban safety-net hospitals. Representatives of private urban safety-net hospitals may request a copy of this memo by using the “contact us” link at the top of this screen

Congress Open to Revisiting Medicare Site-Neutral Outpatient Payments?

Conceding that Congress “…has received a large amount of feedback” since including in a 2015 law a provision that compels Medicare to pay for outpatient care on a site-neutral basis, the House Energy and Commerce Committee and its Health Subcommittee have invited members of the health care community “…to provide feedback to the Committee related to the enactment of Section 603 of the Bipartisan Budget Act of 2015.” While noting the differences between Medicare outpatient payments for services provide in hospital-based facilities, private doctors’ offices, and other sites and pointing out that the Medicare Payment Advisory Commission (MedPAC) had urged [&hellip

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