11 Recent Medicare, Medicaid Issues

Here are 11 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. HHS and CMS agreed to settle a dispute with roughly 2,200 hospitals over low reimbursements from the Medicare inpatient prospective payment system, and the total cost of the settlement is expected to cost $3 billion.

2. The world's largest banks responsible for the 2008 financial meltdown led to a massive increase of government debt after they were bailed out, and an article from the New York Times Economix blog said Medicare now faces mounting pressures due to the fiscal irresponsibility of those banks.

3. CMS reminded hospitals, physicians and other providers there are certain steps every provider should take when a beneficiary has Medicare Secondary Payor status.

4. The number of Medicare beneficiaries enrolled in some kind of shared savings program now totals 1.1 million people.

5. As baby boomers reach the golden Medicare age of 65, clinics in the Spokane, Wash.-area are revving up physician hiring to provide care for that population.

6. CMS named the first 27 accountable care organizations to participate in the Medicare Shared Savings Program, effective this month.

7. In a surprising move, Ohio announced five new Medicaid managed care organizations will serve state Medicaid beneficiaries starting Jan. 1, 2013.

8. A Commonwealth Fund research brief suggests increased use of primary care services could dramatically reduce Medicare costs.

9. The Medicare Payment Advisory Commission held policy and recommendation meetings April 5 and 6, covering ground on several proposals ranging from CMS demonstrations for dual-eligible beneficiaries to reforming Medicare's benefit design.

10. The Arizona Health Care Cost Containment System, the state's Medicaid agency, announced CMS has approved two waivers to the state's program.

11. The Utah Department of Technology Services and the Utah Department of Health announced the total number of individuals affected by the Medicaid data breach has grown. They reported 280,000 individuals had their Social Security numbers stolen from a computer server in a data breach last week. Additionally, around 500,000 individuals had less-sensitive personal information stolen.

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