20 Recent Medicare, Medicaid Issues

Here are 20 issues dealing with Medicare or Medicaid that occurred in the past two weeks, starting with the most recent.

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1. The S&P Hospital Medicare Index increased 2.04 percent in the year ended April 2012, up from the 1.8 percent recorded in March.

2. New York's Medicaid program has saved billions of dollars in its recent redesign, and now the state asked the federal government to keep those savings to reinvest in Medicaid.

3. Compared with non-rural settings, per-capita hospital service payments are 2 percent lower for Medicare beneficiaries in rural settings.

4. A federal judge issued an injunction, requiring CoventryCares of Kentucky — one of three Medicaid managed care companies in the state — to pay for the Medicaid services of patients at Appalachian Regional Healthcare until November 1.

5. The American Hospital Association recently submitted comments to CMS regarding the fiscal year 2013 Inpatient Prospective Payment System proposed rule, urging several changes — especially regarding documentation and coding.

6. As Kansas shifts from a fee-for-service Medicaid program to managed care, a Kansas Health Institute News Service report delved into the effectiveness of Medicaid managed care by gaining perspectives from five states and the national level.

7. CMS and ONC announced that the Medicare and Medicaid Electronic Health Record Incentive Programs have paid more than 110,000 eligible professionals and 2,400 eligible hospitals a total of more than $5.7 billion.

8. North Carolina's Department of Health and Human Services fired Craigan Gray, MD, as Medicaid director as it looked to reorganize the division and "bring in someone with a different perspective and experience."

9. The American Medical Association released its fifth annual National Health Insurer Report Card, which compared the accuracy, timeliness and other metrics among different payors, including Medicare and commercial insurers.

10. Upset over a new agreement regarding Medicaid Disproportionate Share Hospital payments for fiscal year 2012, five CEOs of the largest private health systems in Texas wrote a letter to Gov. Rick Perry and asked for a meeting to voice their concerns over the new model.

11. CMS said it will delay implementation of a new requirement that hospital boards include a medical staff member but will reconsider the requirement in future rulemaking. CMS has been "reconsidering the policy in light of the numerous comments" it has received since it published the final rule, which revised hospitals' conditions of participation in Medicare and Medicaid.

12. The Medicaid and Children's Health Insurance Program Payment and Access Commission, or MACPAC, submitted its June 2012 report to Congress, covering a wide array of topics from Medicaid access to the latest Medicaid and CHIP statistics on spending and enrollment.

13. The Medicare Payment Advisory Commission, better known as MedPAC, released its June 2012 report to Congress, and the main theme of the report was to reform Medicare's benefit design and focus on Medicare beneficiaries.

14. Gov. Pat Quinn signed a slew of bills into law, including reforms that will restructure the Illinois Medicaid program and lay out guidelines for hospital property tax exemptions.

15. The American Hospital Association urged members of Congress to extend expiring Medicare programs that benefit rural hospitals, including the Medicare-dependent hospital program and the enhanced Medicare low-volume adjustment.

16. A report from the Government Accountability Office found the cost of Medicaid fraud audits is five times more than the amount of overpayments they identify.

17. The Medicaid Recovery Auditor program officially started this past January, and according to a recent blog post from Paul Spencer, compliance officer for Fi-Med Management and author of The RAConteur, there has been little recognition of the Medicaid RACs' progress mostly because there hasn't been much to report.

18. Total Medicaid spending, the single largest portion of total state spending, is expected to rise by 3.4 percent in the 2013 fiscal year after Medicaid spending came to a near halt this year, according to the spring 2012 report from the National Governors Association and the National Association of State Budget Officers.

19. CMS announced the Patient Protection and Affordable Care Act helped 14.3 million Medicare beneficiaries obtain at least one free preventive service so far in 2012.

20. Nine hospital groups, including the American Hospital Association and the Association of American Medical Colleges, sent a letter to Congress asking that Medicaid cuts not be used as a means to pay for the student loan bill.

More Articles on Medicare and Medicaid:

What Supreme Court Decision? 4 Hospital Strategies Independent of the Fate of the PPACA

Report: ACOs Don't Hinge on Supreme Court's Healthcare Law Ruling

Finding Financial Control: Q&A With Robert Wood Johnson University Hospital CFO Paul D. Storiale

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