Policy and Legislation
The re-election of Republican governors in closely contested races in Florida, Georgia, Wisconsin, Maine and Kansas dims the chances of Medicaid expansion in those states.
The CY 2015 final rule for the home health prospective payment system updates Medicare payment rates to home health agencies, and implements the second year of the four-year phase in of the rebasing of the payment system.
Eight family-physician-related groups, including the American Academy of Family Physicians, have formed Family Medicine for America's Health, a coalition to improve the public perception of what they do and advance their interests through state and federal policies.
Last week the HHS Office of Inspector General and the Centers for Medicare & Medicaid Services published a joint notice continuing the effectiveness of fraud and abuse law waivers granted in 2011 in connection with the Medicare Shared Savings Program.
The Centers for Medicare & Medicaid Services recent 10-year projection of national health expenditures includes retail spending on prescription drugs, but a more complete picture of pharma spending would include the nonretail segment.
With an improving fiscal climate, some states are paying their Medicaid providers more. More states are increasing fees to specialists, nursing homes and managed care organizations, but 31 states were cutting or freezing Medicaid hospital rates, compared to 19 that were increasing them.
The medical tourism industry must respond to the problems found in surrogacy tourism. The first is the need for medical tourism companies, brokers, clinics and even hospitals to hold patient funds in escrow. Abuse of patient trust by misappropriating funds should no longer be an issue.
Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.
This week the Centers for Medicare & Medicaid Services expanded the agency's Five Star Quality Rating System for Nursing Homes, and proposed new conditions of participation for home health agencies.
The U.S. Supreme Court has agreed to hear a case brought by Idaho providers over an issue that has split many lower courts: whether Medicaid providers have a Constitutional right to sue states to enforce Medicaid funding regulations.