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. The House of Representatives voted Thursday to cut Medicaid spending and eliminate the Prevention and Public Health Fund, along with maintaining across-the-board Medicare cuts that are originally part of the Budget Control Act of 2011.

2. CMS issued final rulings for Medicare Conditions of Participation and for the Medicare Regulatory Reform rule, which are expected to create $5 billion in savings over the next five years.

3. CMS posted the names, business phone numbers and business addresses of Medicare eligible professionals, eligible hospitals and critical access hospitals that have successfully demonstrated meaningful use of electronic health records and received Medicare EHR incentive payments as of March 2012.

4. CMS identified hospitals with the highest Medicare spending per beneficiary using data from the new Medicare spending per beneficiary efficiency measure that is now on the Hospital Compare website.

5. Between 2001 and 2010, Medicare payments for evaluation and management services increased 48 percent, from $22.7 billion to $33.5 billion due to their high vulnerability to fraud and abuse from physicians billing higher levels.

6. U.S. Reps. Allyson Schwartz (D-Pa.) and Joe Heck, DO (R-Nev.), released the Medicare Physician Payment Innovation Act of 2012 — a bill that would permanently repeal the sustainable growth rate formula within the Medicare physician fee schedule.

7. HHS issued a proposed rule in which primary care physicians serving Medicaid patients would see their Medicaid payments rise to Medicare levels.

8. U.S. Sens. Charles Schumer (D-N.Y.) and Chuck Grassley (R-Iowa) introduced a bill yesterday that would extend the Medicare-Dependent Hospital Program and the Low-Volume Hospital Program an extra year to September 2013 for rural hospitals.

9. In this year's May issue of Health Affairs, four detailed studies look at different Medicare spending trends and what is driving the variations.

10. Nevada's Health and Human Services director said 150,000 people will be added to state Medicaid rolls at a cost of $574 million between now and 2020 if the federal healthcare law is upheld in the Supreme Court.

11. For fiscal year 2013, Alabama is projected to spend $5.77 billion for Medicaid services, and lawmakers are maneuvering to make sure the program for the poor receives full state and federal funding.

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10 Recent Medicare, Medicaid Issues

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