AHA ASKS CMS FOR HOSPITAL INPUT ON MAC SELECTION
The American Hospital Association is asking the Centers for Medicare & Medicaid Services to allow hospitals and other providers to participate in the process to select Medicare Administrative Contractors and renew or terminate their contracts. MACs process Medicare claims and perform other functions in the place of fiscal intermediaries and carriers. Hospitals need to be involved because “a significant proportion of hospital revenue will depend on these contractors operating in a timely and judicious manner,” the AHA said in a letter to Leslie Norwalk, acting administrator of CMS. The AHA is also concerned about MACs’ abilities to engage in transition activities while filling regular Medicare contractor functions such as enrolling providers in Medicare and processing hospital cost reports.
IOWA MEDICAID PROGRAM GETS OK TO EXPAND SERVICES
Iowa is the first state to receive federal approval to add home and community-based services as a permanent feature of its Medicaid plan, eliminating the need for repeated requests for time-limited waivers. The move portends that other states will be able to make adjustments to their Medicaid benefit plans. Under section 6086 of the Deficit Reduction Act of 2005, states may now permanently alter their standard Medicaid benefit package, eliminating the need to get previous statutory requirements “waived.” Iowa’s new benefit will provide statewide HCBS case management services and “habilitation services” at home or in day-treatment programs that can include such things as support in the workplace. Services approved under this option will help individuals to delay or avoid institutional stays or other high-cost out-of-home placements.
CCA SETS STANDARDS FOR QUALITY AND SAFETY
The Convenient Care Association, a Philadelphia-based not-for-profit organization, has issued 10 mandatory standards for members that operate clinics, often in retail drugstores or other settings open to the general public. Under these standards, patients are assured timely, accurate treatment from qualified healthcare professionals, the CCA said. The trade group estimates that more than 300 clinics are in operation, and it estimates that it could attract business from as much as 50 percent of all emergency department patients, who could more appropriately be treated in a lower-cost, less-intensive setting such as a clinic.