Medicare Compliance & Reimbursement

Women can look forward to a healthier life, thanks to with new rules in the health care law requiring coverage of preventive services taking effect from August 1 according to a statement issued by Health and Human Services (HHS) Secretary Kathleen Sebelius in a July 31 press release.

Approximately 47 million women stand to benefit from these new preventive services at no charge. Earlier they were not covered by their health plans for the care they needed to stay healthy and catch potentially serious conditions at an earlier stage and had to depend on copay or were liable for deductibles.

"President Obama is moving our country forward by giving women control over their health care," Secretary Sebelius said in the press release. "This law puts women and their doctors, not insurance companies or the government, in charge of health care decisions."

The eight new prevention-related services announced in the press release are:

• Well-woman visits.
• Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
• Domestic and interpersonal violence screening and counseling.
• FDA-approved contraceptive methods, and contraceptive education and counseling.
• Breastfeeding support, supplies, and counseling.
• HPV DNA testing, for women 30 or older.
• Sexually transmitted infections counseling for sexually-active women.
• HIV screening and counseling for sexually-active women.

"The Obama administration will continue to work with all employers to give them the flexibility and resources they need to implement the health care law in a way that protects women's health while making common-sense accommodations for values like religious liberty," the release clarified.

Expect to Fight/Prevent Infectious Diseases Better With ACA

Awards of $48.8 million to bolster epidemiology, laboratory and health information systems in health departments in all 50 states were announced by Health and Human Services (HHS) Secretary Kathleen Sebelius, according to an Aug. 16 HHS press release.

"Today's awards support the critical work of public health departments to prevent, track and respond to new and emerging infectious diseases," Secretary Sebelius was quoted as saying.

State, local and territorial health departments can expect to improve disease reporting and monitoring by hiring and training staff, invest in information technology, and buy laboratory equipment and supplies for diagnosing emerging pathogens with support from the Epidemiology and Laboratory Capacity program.

For more information about the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreements, go to www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html

Proposed 2013 Fee Schedule Offers Five Percent Raise for Pediatricians

CMS -- the governing body that oversees Medicare and Medicaid -- is offering an innovative new approach to medicine that offers some good news for pediatricians if it's finalized by the end of this year. On July 6, CMS released its proposed Medicare Physician Fee Schedule for 2013. The 760-page document offers a glimpse into how the agency would calculate Medicare pay rates for the coming year.

Five percent pay raise would benefit pediatricians: CMS is proposing a five percent payment increase for pediatricians and internal medicine physicians, and a seven percent increase for family practitioners. "Helping primary care doctors will help improve patient care and lower health care costs long term," said CMS Acting Administrator, Marilyn B. Tavenner in a July 6 statement.

Proposal would pay for hospital transitions: If your pediatrician spends a significant amount of time providing care following a hospital discharge, you might see extra pay for that service in 2013 if the proposal is finalized.

"The proposal calls for CMS to make a separate payment to a patient's community physician or practitioner to coordinate the patient's care in the 30 days following a hospital," CMS says. "The proposed rule also asks for public comment on how Medicare can better recognize the range of services community physicians and practitioners provide as part of treating patients either through face-to-face services in the office or coordinating care outside the office when the patient does not see the physician."