Policy and Legislation

The U.S. Food and Drug Administration (FDA) announced Monday that it is part of the first public-private partnership to promote medical device regulatory science. The partnership will focus on speeding up the review and approval processes of new medical devices.

Medicare Advantage (MA) HMO plans may be offering more efficient care than Medicare Part A and B plans, a study published in the journal Health Affairs has found. According to researchers, MA HMO enrollees have fewer hip and knee replacements and use fewer benefits for outpatient surgeries and procedures, inpatient stays and emergency department visits.

Last week New York Attorney General Eric T. Schneiderman announced a $3.1 million settlement with Excellus BlueCross BlueShield requiring the insurer to refund 12,000 plan members who overpaid their healthcare providers as a result of the company's improper accounting of deductibles.

Despite the economic downturn, the number of uninsured children eligible for Medicaid and CHIP programs fell to 4.4 million in 2010, a 10 percent decrease from the 4.9 million who were uninsured in 2008, according to an analysis of government data released recently by the Robert Wood Johnson Foundation.

Bloomberg highlights the challenges many of the newly insured will have in paying for coverage, even with the substantial subsidies available to those with lower incomes.

A report issued Nov. 29 by the Office of Inspector General (OIG) calling for more oversight of the meaningful use program has been mostly well-received by stakeholders. Doctors, however, are concerned about the burden of pre-payment audits.

Hospitals and healthcare systems across the country will soon be facing large cuts in Medicare if the U.S. Congress cannot reach an agreement on an alternative deficit reduction plan in order to avert the so-called fiscal cliff, therefore it's a good idea for these organizations to start being proactive.

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.