Boehner
The New York Times ran a quietly subversive news story Wednesday about how members of Congress and their aides will receive health coverage under the Office of Personnel Management's new proposed rule interpreting a controversial Obamacare provision.
During the drafting of the Patient Protection and Affordable Care Act, Sen. Charles Grassley (R-Iowa), an opponent of the legislation, insisted that members of Congress and their staffers should have to buy their coverage from the state health insurance exchanges the same way millions of other Americans would get it—rather than getting it through the Federal Employees Health Benefit Program as they do now. It was a commendable idea that few members of Congress probably thought through.
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Stark
The healthcare world is populated by scores of legal experts who strive to keep up with the sprawling compendium of statutes, regulations and legal advisories known collectively as the “Stark law.” But the law's father, Fortney “Pete” Stark, is not one of them.
Stark, in fact, says he would favor repealing the law as it currently exists and getting back to the law's initial intent.
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It's Christmas in July for Medicare-participating physicians—though the gift is far from being delivered. On Wednesday, the House Energy and Commerce Committee unanimously passed bipartisan legislation to repeal Medicare's sustainable growth-rate formula and replace it with a stable system of payments to the nation's physicians.
For years, Congress has waited until the end of the calendar year to stave off a steep Medicare payment cut to physicians with a temporary fix.
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The American Nurses Association wants the federal government to require insurers selling plans on state insurance exchanges to have at least a certain percentage of advanced practice registered nurses in their provider networks.
The ANA proposed the minimum level would be equal to 10% of the number of APRNs who independently bill Medicare Part B in a state.
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Greater proportions of not-for-profit and government hospitals than for-profit hospitals qualified for at least one category of Medicare payment adjustments last year, according to new findings from the Government Accountability Office.
About 97% of government-owned hospitals and 90% of not-for-profit hospitals paid by the Medicare program received at least one form of increased payment to the standard inpatient prospective-payment system last year.
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A bipartisan House bill has been introduced that would require disclosure of Medicare payment information on individual physicians and other healthcare providers and suppliers, to enable the public to compare providers of services.
A companion bill has been pending in the Senate since June, and one Senate spokesperson says the final proposal may be added to the upcoming “doc fix” legislation to come later this year that would change how Medicare doctors are paid under the sustainable growth-rate formula.
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Eight out of 10 eligible hospitals and 58% of eligible physicians and other medical professionals have received payments totaling $15.5 billion under the federal electronic health record incentive payment program, according to the latest CMS data.
Through June, 4,024 hospitals have shared nearly $9.2 billion dollars to adopt, implement, upgrade and/or meaningfully use certified EHRs under the Medicaid and Medicare EHR incentive payment programs created by the American Recovery and Reinvestment Act of 2009.
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Doctors asked to assess options for reducing healthcare costs were not exactly enthusiastic about replacing the system that pays them based on the volume of tests, exams and procedures they perform.
Granted, cuts to Medicare physician pay proved even less popular among the nearly 3,000 doctors surveyed on their opinions for strategies to blunt the nation's high and rising healthcare costs. Just 1% of the polled physicians described their attitude toward this option as “very enthusiastic.”
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The American Medical Association has responded sharply to a July 20 Washington Post investigative article that found that the AMA/Specialty Society RVS Update Committee (RUC) has overvalued many procedures by overstating the amount of physicians' time required to perform them. Washington Monthly published a critical article about the RUC earlier this month, similarly charging that the RUC is essentially a secret cabal of specialty physicians that overvalues services and fixes prices.
The Post reporters counted the number of Medicare procedures that gastroenterologists, ophthalmologists, orthopedists and other specialists performed at surgery centers in Florida and Pennsylvania. They found that if the physicians had taken the amount of time estimated by the RUC to do each procedure, they would have had to work an average of more than 12 hours a day, when the surgery centers typically were open only 10 hours.
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Stepped-up federal funding resulted in more seniors receiving training in how to stop Medicare fraud in 2012, but the latest annual survey of the $20 million program shows it produced $134,000 in actual savings.
Many illegal schemes rely on seniors who aren't savvy in how fraudsters and opportunists can use Medicare numbers to bill for care and equipment that is unneeded or never delivered. The Obama administration greatly increased the funding in 2010, 2011 and 2012 to bolster the so-called Senior Medicare Patrol program, which educates them with a branch in each U.S. state, plus Washington, D.C. and three territories.
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Stepped-up federal funding resulted in more seniors receiving training in how to stop Medicare fraud in 2012, but the latest annual survey of the $20 million program shows it produced $134,000 in actual savings.
Many illegal schemes rely on seniors who aren't savvy in how fraudsters and opportunists can use Medicare numbers to bill for care and equipment that is unneeded or never delivered. The Obama administration greatly increased the funding in 2010, 2011 and 2012 to bolster the so-called Senior Medicare Patrol program, which educates them with a branch in each U.S. state, plus Washington, D.C. and three territories.
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