Medicare Compliance & Reimbursement

Bonus:  Legislators want to model universal health coverage after Medicare.

The growth rate in Medicare spending "slowed considerably" during the period from 1992 to 2003, as compared with the period from 1975-1983, according to a "working paper" by the Congressional Budget Office (CBO).

CBO analyst Chapin White compared "excess" growth per-beneficiary during those two periods and found that Medicare had grown by only 0.9 percent during the more recent period, compared with 5.5 percent in the earlier period. White defined "excess growth" as growth above economic expansion and the growing numbers of elderly people. (Access White's study online at www.cbo.gov/ftpdocs/74xx/doc7453/2006-08.pdf.)

This analysis bucks the conventional wisdom--and it's not an official CBO forecast, White cautions. It certainly won't stop some policymakers from calling for more cuts to Medicare spending.

In other Medicare news:

Stark Kick-Starts Universal Health Coverage Debate. It seems like the sleeping elephant in the room is waking up again, as prominent politicians introduce legislation calling for universal health coverage.

Rep. Pete Stark (D-CA), along with 26 colleagues, just introduced the "AmeriCare Health Care Act" to try and frame the debate that is due to come up again as it has every 10 or 15 years. "As we edge closer to our next discussion, the fundamental question before us is if medical care is a civic and social right like police and fire services, education, and national defense," says Stark in a July 25th press release.

AmeriCare would be directed to those Americans who aren't covered by their employers, and modeled after Medicare. It would capitalize on the economies of scale that Medicare enjoys to contain administrative, marketing and prescription costs. Stark cites support from organized labor and academia for his solution to covering the uninsured.

CMS Tightens Billing Requirement For Hours Of Care. Hospices will have to report more information on their Medicare claims, starting Jan. 1, 2007.
 
A transmittal from the Centers for Medicare & Medicaid Services (CMS) (Change Request 5245) issued on July 28 spells out the policy changes.

Among the key changes: Services at the continuous home care level of care must be billed using separately dated line items that report the number of hours of care provided in 15-minute increments. CMS will no longer permit rounding to the next higher hour.

In addition, claims with less than 32 units for the day will be paid at the routine care payment rate.
 
To view CR 5245, go to www.cms.hhs.gov/transmittals/downloads/R1011CP.pdf.