16 Recent Medicare, Medicaid Issues

Here are 16 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. The Medicare Payment Advisory Commission released draft recommendations to Congress, including a proposed 1 percent increase to inpatient and outpatient hospital payments in fiscal year 2014.

2. On Nov. 15, CMS posted its FY 2012 financial report. CMS CFO Deborah Taylor, a certified public accountant, prepared the 202-page document, which is required by law every year. These were 10 of the biggest takeaways from the report.

3. Medicare Recovery Auditors' (RACs) rate of claims denials to hospitals continued to grow, as the number of denials was up 23 percent in the most recent quarter.

4. Also in RAC news, during the federal government's 2012 fiscal year, Medicare RACs collected $2.29 billion in overpayments from providers — a record that nearly tripled last year's total overpayment collections.

5. CMS released an interim final rule with comment that made several changes to the Medicare and Medicaid Electronic Health Record Incentive Program.

6. In a bipartisan effort, 30 U.S. senators sent a letter to Max Baucus (D-Mont.) and the Senate Finance Committee advocating for the extension of the Medicare Dependent Hospital and Low-Volume Hospital programs.

7. From January 2009 through the end of the 2012 fiscal year, the Department of Justice used the False Claims Act to recover more than $9.5 billion in federal healthcare dollars, mostly Medicare and Medicaid.

8. A report by the Dartmouth Atlas Project showed wide variation in the rate of elective procedures among Medicare patients in different regions, suggesting patients may not play a large role in the decision-making process.

9. Sen. Sheldon Whitehouse (D-R.I.) wrote a letter to President Barack Obama, urging him to leave Medicare and Medicaid cuts off the table in fiscal cliff talks and redirect cost-saving strategies to healthcare delivery systems. That came as House Republicans sent a counterproposal to the White House that would avoid the "fiscal cliff" with $4.6 trillion in deficit reductions. Included in the proposal was an increase in the eligibility age for Medicare beneficiaries.

10. Between 2003 and 2009, Medicare Advantage beneficiaries utilized fewer services in emergency department visits and ambulatory surgeries than those enrolled in traditional Medicare.

11. The National Association of Public Hospitals and Health Systems launched a campaign featuring advertisements and educational materials emphasizing the importance of Medicaid funding.

13. The Government Accountability Office found national Medicaid expenditures in two government databases, the Medicaid Statistical Information System and CMS-64, did not match up for fiscal years 2007 through 2009.

14. Missouri Gov. Jay Nixon (D) announced the state planned to expand the Medicaid program, under the Patient Protection and Affordable Care Act, which will provide healthcare coverage to an additional 300,000 state residents.

15. CMS ruled that, effective Jan. 1, 22 hospital outpatient therapeutic services will have reduced supervision requirements.

16. CMS extended the deadline for Medicare Electronic Health Record Incentive Program attestation for hospitals in the New York and New Jersey areas that were adversely affected by Hurricane Sandy.

More Articles on Medicare and Medicaid:

Health Care Reform Going Forward: What's the Impact on Providers?

How Aspen Valley Hospital Increased Days Cash on Hand More Than 100-Fold

14 Recent Lawsuits and Settlements Involving Hospitals

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