Policy and Legislation

A report released Nov. 29 by the Office of Inspector General calls for random audits of doctors and hospitals prior to payout through the meaningful use EHR incentive program, to ensure they have qualified. It is also calling for EHR certification changes to allow for reporting of yes/no measures.

In a new study published in the Journal of General Internal Medicine, it was found that after examining patients suffering from pneumonia and heart failure, a broad range of social factors affect the risk of post-discharge readmission and mortality.

The message that home- and community-based care is more cost effective than institutional care has been touted by federal and local governments and those within the healthcare community, but a new comparative effectiveness review of long-term care of older adults receiving home- and community-based services versus care in institutions concludes that there is not enough evidence in the literature to determine cost effectiveness.

BayCare Health System in Clearwater, Fla., has agreed to pay over $10.1 million to the federal government to resolve allegations that the health system violated the False Claims Act announced the U.S. Justice Department (DOJ) last week.

A new consumer survey of more than 1,200 voters conducted by PwC Health Research Institute (HRI) found that 69 percent want President Obama to make reducing costs his top healthcare priority in his second term.

States that expand their Medicaid program eligibility under the health reform law will incur only modestly higher state costs, about 3 percent, compared with significant increases in federal funds, according to a new report from the Kaiser Family Foundation.

As many as 31 million Americans now receive healthcare through an accountable care organization (ACO) according to a recent report from industry consulting company Oliver Wyman.

A new report from the Government Accountability Office (GAO) found that less than 4 percent of Medicaid beneficiaries who had coverage for at least a year reported difficulty obtaining medical care in 2008 and 2009, this despite more than two-thirds of states reporting they faced challenges in ensuring there are enough Medicaid providers to serve the growing number of beneficiaries.

A South Carolina-based hospice company has agreed to settle false claims allegations for $1.287 million, the Department of Justice announced last week.

Nearly a year after providing guidance that broadly defined essential health benefits (EHBs), the U.S. Department of Health and Human Services on Tuesday put some meat on the bones with a detailed set of proposed rules that will determine the required components that must be offered beginning in 2014 through all non-grandfathered health plans.