Noteworthy News

Archive for July, 2018

 

GAO Looks at Medicaid Managed Care Spending

The federal government should do more to help states ensure the accuracy and integrity of their payments to Medicaid managed care organizations and the payments those Medicaid managed care organizations make to health care providers. This is the conclusion reached in a new study of Medicaid managed care performed by the U.S. Government Accountability Office at the request of the Permanent Subcommittee on Investigations of the Senate Committee on Homeland Security and Government Affairs. The GAO study identified six payment risks among various transactions between state governments, Medicaid managed care organizations, and health care providers.  The two biggest risks, the [&hellip

New Reg Pushes Medicare Toward Site-Neutral Outpatient Payments

Medicare would make more payments for outpatient services on a site-neutral basis under a newly proposed regulation just released by the Centers for Medicare & Medicaid Services. The 2019 Medicare outpatient prospective payment system regulation, published in proposal form, calls for: paying physician fee schedule rates rather than hospital outpatient rates at excepted off-campus provider-based departments; slashing payments for office visits; extending this year’s 340B prescription drug discount payments, already cut nearly 30 percent this year, to additional providers; and raising ambulatory surgical center rates and expanding the list of procedures that can be performed in such facilities so they [&hellip

Pay Raise Didn’t Lead More Docs to Participate in Medicaid

The temporary rate increase that the Affordable Care Act provided as means of encouraging more doctors to serve Medicaid patients did not work, according to two new studies published in the journal Health Affairs. According to the studies, the increase in the number of physicians who decided to begin serving Medicaid patients as a result of the fee increase was negligible. Among the reasons the studies’ authors offer for the lack of growth in the participation of doctors are the limited nature of the pay raise and the documentation required to receive it. Despite this, the authors note, access to [&hellip

CMS: Not Done With Medicaid Work Requirements

Despite the ruling of a federal court that Kentucky’s new Medicaid work requirement violates federal law, the Centers for Medicare & Medicaid Services has not ruled out approving future requests from state governments to impose work requirements on Medicaid recipients. Or so asserted CMS administrator Seema Verma at a recent health care event in Washington, D.C. The Washington Examiner reports that at that event, Verma said that We are looking at what the court said.  We want to be respectful of the court’s decision while trying to push ahead with our policy and our goals. CMS currently has applications from [&hellip

CMS Proposes Changes in Medicare Physician Payments

The Centers for Medicare & Medicaid Services has published a proposed regulation that it says …proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their electronic health records (EHRs) to document clinically meaningful information instead of information that is only for billing purposes. Among the policy changes offered in the proposed 1743-page regulation governing Medicare physician [&hellip

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