Here are 12 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.
1. Health insurers Molina Healthcare and Centene won back contracts from Ohio's Medicaid program after they filed appeals in April challenging how the state awarded the contracts.
2. An audit from the Arizona Auditor General's Office found the state Medicaid program is paying up to $50 million annually to provide care for ineligible Medicaid beneficiaries.
3. The American Hospital Association urged CMS to withdraw a final rule that revised critical access hospitals' conditions of participation in Medicare and Medicaid, saying CMS did not propose the rules before making them final.
4. Colorado Gov. John Hickenlooper signed House Bill 1281 into law, which would establish a pilot program to create new payment methods in the state Medicaid program.
5. In fiscal year 2011, hospitals and other providers appealed 56,620 claims, or 6.3 percent, of the 903,372 that had overpayment determinations from Medicare Recovery Auditors (RACs), and of those appealed claims, 43.4 percent received a ruling in the provider's favor.
6. CMS announced agreements with 44 insurers representing markets in eight states — Arkansas, Colorado, New Jersey, New York, Ohio and Kentucky, Oregon and Oklahoma — that will participate in the Comprehensive Primary Care initiative, in which Medicare will collaborate with both commercial and state health insurance plans on primary care.
7. The Congressional Budget Office released a report on the long-term outlook of the U.S. budget, and Medicare, Medicaid and Social Security are expected to grow from 10 percent of gross domestic product today to almost 16 percent of GDP in 25 years — or a total of $850 billion.
8. A study in Health Affairs found the ratio of observation stays to inpatient admissions for Medicare beneficiaries increased 34 percent from 2007 to 2009.
9. Payment and provider reform is needed to cover the 9 million people who are eligible for both Medicare and Medicaid benefits, but policymakers need to take a careful approach when developing new payment and care models for dual eligibles.
10. CMS sent a letter, dated May 23, to the New Hampshire Department of Health and Human Services, asking the agency to provide data showing the state's recent Medicaid cuts to do not hinder access to beneficiaries' access to physician and hospital services.
11. Georgia may expand managed care for Medicaid beneficiaries with more for-profit health insurers as the state braces for a Medicaid deficit of $600 million within the next three years.
12. An Alabama decision to cut $68 million in Medicaid funding will impact not only the nearly 1 million beneficiaries who rely on state-funded healthcare, but also physicians and emergency rooms caring for those patients.
1. Health insurers Molina Healthcare and Centene won back contracts from Ohio's Medicaid program after they filed appeals in April challenging how the state awarded the contracts.
2. An audit from the Arizona Auditor General's Office found the state Medicaid program is paying up to $50 million annually to provide care for ineligible Medicaid beneficiaries.
3. The American Hospital Association urged CMS to withdraw a final rule that revised critical access hospitals' conditions of participation in Medicare and Medicaid, saying CMS did not propose the rules before making them final.
4. Colorado Gov. John Hickenlooper signed House Bill 1281 into law, which would establish a pilot program to create new payment methods in the state Medicaid program.
5. In fiscal year 2011, hospitals and other providers appealed 56,620 claims, or 6.3 percent, of the 903,372 that had overpayment determinations from Medicare Recovery Auditors (RACs), and of those appealed claims, 43.4 percent received a ruling in the provider's favor.
6. CMS announced agreements with 44 insurers representing markets in eight states — Arkansas, Colorado, New Jersey, New York, Ohio and Kentucky, Oregon and Oklahoma — that will participate in the Comprehensive Primary Care initiative, in which Medicare will collaborate with both commercial and state health insurance plans on primary care.
7. The Congressional Budget Office released a report on the long-term outlook of the U.S. budget, and Medicare, Medicaid and Social Security are expected to grow from 10 percent of gross domestic product today to almost 16 percent of GDP in 25 years — or a total of $850 billion.
8. A study in Health Affairs found the ratio of observation stays to inpatient admissions for Medicare beneficiaries increased 34 percent from 2007 to 2009.
9. Payment and provider reform is needed to cover the 9 million people who are eligible for both Medicare and Medicaid benefits, but policymakers need to take a careful approach when developing new payment and care models for dual eligibles.
10. CMS sent a letter, dated May 23, to the New Hampshire Department of Health and Human Services, asking the agency to provide data showing the state's recent Medicaid cuts to do not hinder access to beneficiaries' access to physician and hospital services.
11. Georgia may expand managed care for Medicaid beneficiaries with more for-profit health insurers as the state braces for a Medicaid deficit of $600 million within the next three years.
12. An Alabama decision to cut $68 million in Medicaid funding will impact not only the nearly 1 million beneficiaries who rely on state-funded healthcare, but also physicians and emergency rooms caring for those patients.
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