Medicare Compliance & Reimbursement
SENATE BILL STILL ON PATH TO PASSAGE
In the Senate, there is still a ways to go before a final product. However, it's looking more and more like the bill authored by Finance chair Charles Grassley (R-IA) and senior panel Democrat Max Baucus (MT), S. 1, will be approved with significant Democratic support. On June 18, for example, the Senate turned back an amendment by Sen. Debbie Stabenow (D-MI) that would have offered every FFS beneficiary the option of obtaining drug coverage through a government-run plan, no matter how many private entities in particular geographic areas were willing to offer drug-only plans on the limited risk-bearing basis envisioned in the Grassley-Baucus bill. The Senate voted 58 to 37 to reject Stabenow's amendment. Republicans unanimously voted no and were joined by independent James Jeffords (VT) and Democrats Max Baucus (MT), John Breaux (LA), Thomas Carper (DE), Mary Landrieu (LA), Zell Miller (GA), and Ben Nelson (NB). Still, Senate passage is not a sure thing. According to CQ Today, 27 GOP Senators sent President Bush a letter urging a narrower, less expensive approach that would focus on providing drugs to low-income seniors and those with high medication expenses. Many conservatives are not happy about what they see as the lack of fundamental reforms in S. 1. For instance, Sen. Jon Kyl (R-AZ) has argued that the bill stacks the deck against PPOs by tying what the government will pay them to FFS costs. Kyl and others would like the government to simply take the lowest-bidding PPOs in a given area, regardless of cost. By an overwhelming 94-1 vote, the Senate amended the Medicare bill with legislation designed to speed the market entry of generic drugs. The bipartisan compromise would revise the landmark legislation authored by Sens. Orrin Hatch (R-UT) and Rep. Henry Waxman (D-CA) that created the modern generic drug industry. One reason for the bipartisan enthusiasm for the generic drug bill: Sponsors estimate it could save about $20 billion over ten years that would be available for use in sweetening the underlying Medicare bill. Last year, however, the House refused to even take up a similar Senate-passed measure, so the provision's fate in a House-Senate conference would be unclear.
Medicare Compliance & Reimbursement
- Medicare Rx:
MEDICARE OVERHAUL ADVANCES IN HOUSE
Medicare beneficiaries would receive 100 percent coverage of drug expenses after spending $3,500 out-of-pocket under [...] - Medicare Rx:
SENATE BILL STILL ON PATH TO PASSAGE
In the Senate, there is still a ways to go before a final product. However, [...] - Medicare Rx:
WHITE HOUSE Key To Medicare Reform
Most Democrats supporting Grassley-Baucus would not support the direct competition between FFS Medicare and private [...] - Medicare Rx:
FINANCIAL ANALYSTS: DRUG-ONLY PLANS A NO-GO
The Medicare prescription-drug legislation being debated in Washington proposes private drug-only insurance plans - presumably [...] - Specialty Hospitals:
CMS CAN'T, CONGRESS MIGHT CAN WHOLE-HOSPITAL EXEMPTION
The rise of specialty hospitals funded mainly by physician investors is a recent phenomenon that [...] - MedPAC:
MEDPAC PUSHES PAY FOR MEDPAC PUSHES PAY FOR
To provide high-quality, cost-effective treatment, Medicare must launch demonstration projects exploring financial-reward systems for top-quality [...] - Enforcement:
WHAT'S TOPPING FRAUD-FIGHTERS' TO-DO LISTS
Perhaps the top activity for state and federal fraud busters these days is following pharmaceutical [...] - SCHIP:
Finance Acts To Preserve SCHIP Funds
The Senate Finance Committee June 12 unanimously approved legislation to prevent states from losing $2.7 [...] - Hospitals:
HOSPITALS OUTCOMES DEMO TO GO FORWARD
Agreement has been reached on terms of a Medicare demonstration project that would give hospitals [...] - Hospitals:
BEEF UP YOUR POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforcement actions [...] - Hospitals:
SMALL FACILITIES HIT HARDEST BY CLOSURES
In rural and urban settings alike, smaller hospitals that treat fewer patients than their peers [...] - Coverage:
CMS Settles Appeals Suit
Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commission [...] - Coverage:
ICD COVERAGE EXPANDS- BUT ONLY SLIGHTLY
Health care providers will soon be able to bill Medicare for implantable cardioverter defibrillators in [...] - Bill Watch
The following House bills were introduced: H.R. 2471. A bill to amend title XVIII of [...] - Register Watch
Looking for continuing education credits? Look to CMS. The Centers for Medicare & Medicaid Services [...]
