Medicare Compliance & Reimbursement
DOLLARS FOR QUALITY
Hospitals could soon collect bonuses from Medicare for delivering high-quality care. The Centers for Medicare & Medicaid Services hopes to soon announce a demonstration that would pay more to hospitals that provide better quality care. As reported in the Wall Street Journal and confirmed by CMS sources, hospitals with high quality marks would get a one or two percent bonus added to their regular reimbursements. The measures would focus on patients with eight medical conditions, including stroke, heart attack, hip surgery, and pneumonia. According to the Journal, a hospital might report how quickly pneumonia patients received antibiotics, or how many heart attack patients got beta blockers at discharge. CMS chief Tom Scully told the Journal that the demonstration could save money, offsetting the extra payments, by promoting better quality care that would reduce complications and hospital readmissions. However, the more skeptical Office of Management and Budget is insisting that poorly performing hospitals suffer a financial penalty in the third year of the demonstration. This could be a problem, since the demo depends on a database run by Premier, an alliance of over 200 health care systems and independent hospitals, and convincing Premier Inc. to accept OMB's position is likely to be difficult.
Medicare Compliance & Reimbursement
- Medicare:
SENATE FINANCE APPROVES
After an all-day June 12 mark-up, the Senate Finance Committee approved a bill that would [...] - Hospitals:
HOSPITALS BRACE FOR NEW OUTLIER POLICIES
Only a small number of hospitals will have to go through the onerous process of [...] - Long-Term Care:
LONG-TERM CARE PROPOSAL COULD PROVIDE SHORT-TERM HELP
But a new CMS SNF payment policy cut both ways.
Skilled nursing facilities would get a [...] - Enforcement :
AN EVEN TOUGHER WHISTLEBLOWER LAW?
A move is afoot to up the stakes yet again in the ongoing campaign against [...] - Ambulance:
KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS
The HHS Office of Inspector General has its eye on ambulance providers who submit Medicaid [...] - Medicare+Choice:
WATERED-DOWN Rx PROPOSAL STILL STRONG ENOUGH TO HELP M+COs
Medicare+Choice plans that have been holding on in hopes of being saved by a prescription [...] - Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk [...] - People:
GAO LETS LOOSE PARTING BLOW AGAINST EX-OIG CHIEF
The General Accounting Office gave former HHS Office of Inspector General chief Janet Rehnquist a [...] - Quality of Care:
DOLLARS FOR QUALITY
Hospitals could soon collect bonuses from Medicare for delivering high-quality care. The Centers for Medicare [...] - Labs:
SUMMER SURVEYS MAY OFFER SLIMMER CITATIONS
What Will CLIA Inspecions Look Like This Season?
Who says there ain't no cure for the [...] - Pharmaceuticals:
BALDACCI INTRODUCES REVISED MAINE Rx
Maine Governor John Baldacci has proposed a revised version of the state's Maine Rx initiative, [...] - Pharmaceuticals:
WYDEN: NIH IGNORED PATIENT, TAXPAYER COSTS FOR TAXOL
The National Institutes of Health had the authority to get a better deal for taxpayers [...] - Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk [...] - DME:
PAY A BENEFICIARY, PAY THE PRICE
Mult-million-dollar fraud case keeps DME suppliers in the enforcement cross hairs. Paying patients for their [...] - Bill Watch
The following bills were introduced in the House: H.R. 2423. A bill to amend title [...] - PROGRAM MEMO ROUNDUP
Starting Oct. 1, if you don't include an ICD-9-CM diagnosis code on your Part B [...] - Register Watch
The Centers for Medicare & Medicaid Services asked for comments on extension of two information [...]
