12 Recent Medicare, Medicaid Issues

Here are 12 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. Tennessee hospital executives are questioning a Medicaid "enhanced coverage fee" after finding out some insurance contractors for the state's Medicaid program pay some hospitals more than four times as much as other hospitals for outpatient procedures.

2. The House Ways and Means Committee agreed in a voice vote to repeal the Independent Payment Advisory Board, the second House committee to do so this week. The IPAB is a 15-member panel that would find savings in the Medicare program.

3. A recent report from The Commonwealth Fund says because safety-net hospitals play a critical role in providing care to vulnerable populations, they should receive higher Medicaid reimbursements to sustain their financial operations and stimulate high performance.

4. Every for-profit hospital company in the Fitch-rated group received a cash incentive payment from CMS' Medicare Electronic Health Record incentive program in 2011, and all except one company saw a consequential boost to their EBITDA as a result.

5. In a recent article in the New England Journal of Medicine, two members of the Center for Studying Health System Change contend the recent slowdown in Medicare spending growth is not a fluke and is indicative of the future.

6. Maine Health and Human Services Commissioner Mary Mayhew believes the state will have to repay CMS for providing Medicaid coverage to 19,000 eligible beneficiaries between September 2010 and January 2012.

7. CMS redesigned the Medicare Summary Notice to make it easier for seniors to spot fraud.

8. Roughly 74 percent of hospitals between Oct. 1, 2011, and Dec. 31, 2011, were successful in the appeals process of a Medicare RAC denial.

9. The South Carolina House is considering a budget proposal that would spend an extra $29 million next year to add roughly 70,000 children to Medicaid rolls.

10. U.S. District Judge Steven McAuliffe ordered New Hampshire to issue a notice and hold hearings regarding the Medicaid reimbursement rates that were lowered to hospitals.

11. Members of the Florida House and Senate agreed to $303.9 million in Medicaid cuts to hospitals as part of a final spending plan for next year.

12. Hospital Compare, Medicare's seven-year public reporting initiative for hospitals, had no impact on reducing mortality rates for heart attacks and pneumonia, according to research published in Health Affairs.

More Articles on Medicare and Medicaid:

How Should Hospitals Work Around Medicaid Payment Cuts This Year?

Which States, Specialties Contributed Most to the SGR Deficit?

6 Ways Hospitals Can Survive the Onslaught of Medicare Cuts

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