The CMS proposed to increase Medicare payments for outpatient services with a 3% inflation update to more than 4,000 hospitals and other facilities next year under the outpatient prospective payment system. The CMS projects it will pay the providers $28.7 billion in 2009, up 6.7% from projected payments of $26.9 billion this year. In addition, the CMS projects it will pay $3.9 billion to ambulatory surgery centers, up 11.4% from the $3.5 billion projected for 2008. The agency recently began tying outpatient payments to quality of care. For 2009, the CMS is proposing to add four measures on imaging efficiency to seven measures that hospital outpatient departments must report data on in 2008 to get full payment in 2009. The agency is seeking comment on 18 quality measures that could be added to this list. Beth Feldpush, senior associate director for policy with the American Hospital Association, said the AHA had concerns that none of the new measures has been endorsed by quality organizations. To promote efficiency in paying for imaging services, the CMS is proposing to make just one payment for multiple services of a particular type conducted during a single hospital session. The public comment period on the proposed regulations ends Sept. 2.
Michigans attorney general filed a civil lawsuit against Blue Cross and Blue Shield of Michigan, alleging that the not-for-profit insurer illegally used subscriber funds to purchase a for-profit subsidiary. Michigan Attorney General Mike Cox says that the Michigan Blues transferred $125 million to its Accident Fund subsidiary in November 2007, and then used those funds to purchase CompWest Insurance Co., a for-profit workers compensation firm in California, that same month for $127 million. Michigan Blues spokeswoman Helen Stojic said the insurer strongly disagrees with the lawsuit, adding that Accident Fund obtained prior regulatory approval for the transaction and that the Blues subsidiaries are a stabilizing influence on members health insurance rates. The attorney general said state law prohibits the Michigan Blues from using its own revenue toward the Accident Funds activities. Cox is asking the court to require the Blues, the states largest insurer, to divest the California firm or recover the $125 million.
UnitedHealth Group, Minnetonka, Minn., said it is settling a federal securities class-action lawsuit brought by major shareholders for $895 million, and is slashing 4,000 jobs and warning of weaker profits because of the poor economy and higher Medicare costs. The California Public Employees Retirement System brought the lawsuit in U.S. District Court in Minnesota over the insurers stock-option grant practices. UnitedHealths previous chief executive officer, William McGuire, resigned from the company in December 2006 over the stock-backdating scandal. UnitedHealth said neither the company nor any of the individuals admit any wrongdoing as part of the proposed settlement agreement. CalPERS said the proposed settlement, which is subject to approval by the board of directors of both parties as well as the court, also provides shareholder protections such as a mandated holding period for option shares acquired by executives, shareowner approval of any stock option re-pricing, and that incentive compensation take into consideration UnitedHealths performance as compared to its peer group.
HCA, Nashville, sold another hospital to a not-for-profit system, this time in Georgia. The company sold 100-bed Hughston Orthopedic Hospital, Columbus, to the Medical Center Hospital Authority, which leases its facilities to Columbus (Ga.) Regional Healthcare System, for $59 million, effective July 2. Last week, HCA agreed to sell 339-bed West Florida Hospital, Pensacola, to Baptist Health Care Corp., Pensacola, for $245 million. That deal is pending financing and regulatory compliance. In February, HCA sold 171-bed Doctors Hospital of Columbus to the authority for $89.5 million. Meanwhile, HCA also has expressed interest in acquiring a sizable not-for-profit system should one become available. Tenet Healthcare Corp. last week also agreed to shed some hospitals (See p. 12).
The National Quality Forum is asking for input on a new list of priorities and goals it developed through its National Priorities Partnership effort to reform healthcare in the next five years. The standards-development group established seven broad priority areas with specific goals within each. The goals would reduce harm and waste in the healthcare system, improve patient-centered care and eliminate health disparities, said Janet Corrigan, president and chief executive officer of the NQF, in a written statement. The priority areas are: patient and family engagement, population health, safety, palliative care, care coordination, patient-focused care and overuse of care. Feedback is due to the NQF by July 30 through an online form.
Send us a letter