Six states and the District of Columbia. will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors. The pay raise stems from a provision of the Affordable Care Act (ACA) that expands Medicaid fees for primary care to the same amount paid under Medicare. The states are Maryland, Colorado, New Mexico, Iowa, Alabama, and Mississippi. Interestingly, Mississippi and Alabama did not participate in the Medicaid expansion under the ACA.
An expert panel recommended Tuesday completely overhauling the way government pays for the training of doctors, saying the current $15 billion system is failing to produce the medical workforce the nation needs.
Medicare’s Hospital Insurance Trust Fund, which finances about half the health program for seniors and the disabled, won’t run out of money until 2030, the program’s trustees said Monday. That’s four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.
And speaking of MedPAC, each year the Commission releases a June report advising Congress on issues affecting the Medicare program including broader changes in health care delivery and the market for health care services. The latest June report focuses on making the Medicare program more consistent by reforming Medicare payment models, risk adjustment payments, primary care service payments, and select condition payments.
Eligible professionals participating in the Medicare EHR Incentive Program may be subject to payment adjustments beginning on January 1, 2015. Payment adjustments will depend on program participation and start year.
This month the Centers for Medicare and Medicaid Services (CMS) issued final regulations for the Medicare Advantage and prescription drug benefit (Part D) programs. The proposed new requirements largely aim to improve the integrity and efficiency of Medicare Part C and Part D, the prescription drug program. CMS projects that the rule will save an estimated $1.615 billion over the next ten years 2015-2024.
Department of Health and Human Services announced to a Washington, D.C. forum this month that they are committed to more public releases of Medicare claims data and that they recognize that data transparency is a key aspect of transformation of the health care delivery system.
On April 30th, the House Committee on Ways and Means Subcommittee on Health held a hearing to solicit input from the HHS Inspector General’s office (OIG), CMS and the Government Accountability Office (GAO) on ways to improve Medicare oversight and reduce waste, fraud and abuse. Gloria Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, testified on behalf of HHS; Shantanu Agrawal, M.D., Deputy Administrator and Director, Center for Program Integrity, testified on behalf of CMS; and Kathy King, Director, Health Care testified on behalf of GAO.
Under the Medicare Recovery Audit Contractor (RAC) program, the Contractors get paid a percentage of the” inappropriate” payments they identify and recover. Some have compared this to a Medicare “bounty hunter” program.
This week the Centers for Medicare and Medicaid Services (CMS) released raw data on how individual medical providers treat America’s seniors. This is a historical publication into how Medicare expenditures are distributed because access has been denied since 1979, when a Florida court issued a permanent injunction barring the government form releasing information about Medicare Part B payments to individual physicians in any manner that would allow the doctor to be identified. However, in 2011, the parent company of The Wall Street Journal successfully sued to overturn the injunction.
