HHS Inspector General Outlines 2015 Oversight Agenda
The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has presented its oversight priorities for 2015. Those priorities include the health insurance marketplace, including whether the right people are getting benefits and consumers’ personal information [...]
Insurance Expansion Won’t Hurt Access to Primary Care, Study Finds
Fears that significant increases in the numbers of Americans with health insurance as a result of Affordable Care Act policies would overwhelm the health care system and lead to access to care problems are unfounded, according to a new Commonwealth [...]
States Seek to Reduce ER Use Among Medicaid Patients
Even though the rate at which non-Medicaid recipients inappropriately use hospital emergency rooms exceeds the rate of inappropriate use among Medicaid patients, a number of states are launching efforts to reduce ER overuse among their Medicaid recipients. Medicaid patients currently [...]
Administration Blocks No-Hospitals Insurance Plans
Health insurance plans that do not include hospital benefits fail to meet employers’ obligations under the Affordable Care Act and will leave companies that provide such insurance vulnerable to fines of $3000 a year for every worker covered by such [...]
Proposal for Improving Medicare Physician Payments
Last year, Congress considered shifting Medicare’s payments to physicians from their fee-for-service foundation to a value-based purchasing approach as part of its attempt to address the Medicare sustainable growth rate (SGR) formula problem (the “Medicare doc fix”). With that problem [...]
MedPAC Looks at New Quality Measures
Amid Medicare’s effort to encourage hospitals to improve the quality of the care they deliver, the Medicare Payment Advisory Commission (MedPAC) looked at new possible quality measures to contribute to that effort during a recent meeting in Washington, D.C. Noting [...]
MedPAC Calls for Equalization of Some Post-Acute-Care Payments
The agency that advises Congress on Medicare payment policies has voted to recommend that Medicare equalize payments to skilled nursing facilities and inpatient rehabilitation facilities. At a recent meeting in Washington, D.C., the Medicare Payment Advisory Commission (MedPAC) concluded that [...]
MedPAC Looks at Short Hospital Stays
The independent agency that advises Congress on Medicare payment issues is examining one of the more controversial of those payment issues: Medicare payments for short hospital stays. At its recent public meeting in Washington, D.C., members of the Medicare Payment [...]
Medicare Seeks to Put Pedal to the Metal on Quality-Related Payments and Care
The federal government has unveiled its intention to pursue a significant increase in the proportion of Medicare services for which it pays based on the quality of care delivered than the quantity of care provided. The plan was announced on [...]
MedPAC Mulls Payment Per Beneficiary for Primary Care
At a recent meeting of the Medicare Payment Advisory Commission (MedPAC), commission members discussed the inadequacy of Medicare payments to providers for primary care and considered a proposal to recommend to Congress that primary care physicians receive a “per beneficiary” [...]
