Reimbursement

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would increase Medicare payment rates under the IRF Prospective Payment System (PPS) by a projected 1.5 percent in fiscal year 2012 - an estimated $120 million nationwide.

Getting a good deal on things we need. These days, it’s not a “nice to have,” it’s a “must have” for managing our personal expenses.

The Centers for Medicare & Medicaid Services has issued its proposed update for Medicare payment policies and rates for hospitals in fiscal year 2012, and as always, its not great news for providers.

A new face-to-face meeting requirement for home healthcare patients receiving Medicare has left some physicians and home healthcare groups disgruntled and industry experts shaking their heads at the idea that it will prevent fraud and waste.

The Congressional Budget Office estimates that the government deficit will exceed one and a half trillion dollars this year, with federal health care annual expenditures expected to hit the trillion dollar mark by 2012. The largest federal health care program is, of course, Medicare, with costs projected to be close to $600 billion in 2012, and growing at around seven percent a year thereafter, although forecast to drop to a mere six percent annual increase if and when the Accountable Care Act is fully implemented.

The House Energy and Commerce Health Subcommittee is looking at ways to move beyond the Sustainable Growth Rate formula, the current method of paying Medicare physicians.

Recovery Audit Contractors (RACs) have identified $365.8 million in improper payments made to Medicare providers from October 2009 through March 2011. The payments were issued as long ago as three years prior to the dates on which they were identified by the RACs, marking the limit of the lookback period in which contractors were allowed to search.

EMD Serono, an affiliate of German drug maker Merck, has agreed to pay $44.3 million to settle a lawsuit alleging false claims submissions to Medicare and Medicaid for the multiple sclerosis drug Rebif.

Nine in 10 American workers either have no idea what their healthcare costs are likely to be in retirement or underestimate those costs, says a new consumer survey from Sun Life Financial.

"Historically, telehealth hasn't received the attention that it's deserved from the federal government," says Neal Neuberger, executive director of the Institute for e-Health Policy and president of Health Tech Strategies.