Medicare & Medicaid

Issues include contractors' desire to protect their competitive advantage by not sharing certain innovations or other operational improvements with other contractors.

The top 100 inpatient stays are associated with approximately $62 billion in Medicare payments and over 7 million hospital discharges, according to data the department just made public as part of its transparency push.

Infections treatments lead to millions in medical charges.

Family caregivers can receive grief and loss counseling for up to a year following the beneficiary's death.

Among the major changes proposed for Medicaid plans are new provider adequacy standards, new mandates for capitated rate setting, beneficiary protections in long-term care, forthcoming quality ratings, and an 85 percent medical cost administrative ratio.

Dr. Aria O. Sabit profited by convincing patients to undergo spinal fusion surgeries with instrumentation that he never used.

The Urban Institute says expansion of Medicaid coverage to adults with incomes over the poverty line was key to reducing the uninsured rate among 50- to 64-year-olds from nearly 12 to 8 percent in 2014.

Since Medicaid expansion coverage began last year, emergency room visits by the uninsured dropped by 22 percent this year, compared to 17 percent in 2014.

“Not all readmissions can or should be prevented; indeed, some are planned as part of sound clinical care,” AHA says.

The bill proposes to increase payment accuracy, encourage physicians to adopt proven practices, supply doctors with data to improve care, and, for patients, to make Medicare more transparent by them more access to information.