Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
September 1, 2014

Posts in "Medicare"

August 14, 2014

Medicare Reward and Ambulance Payment Rules Await White House Approval

The White House Office of Management and Budget  is the last stop prior to final approval of most agency rule proposals. This week, the Centers for Medicare and Medicaid Services sent to OMB a final rule revising several Medicare provider enrollment conditions, designed to block fraudulent suppliers. The proposal also adjusts an incentive reward for reporting potential fraudulent providers. Initial proposed rules, unveiled in 2013, suggested an increase of the reward from 10 percent of over-payments recovered to 15 percent.

Also, the original draft included a provision limiting the ability of an ambulance service to “back bill” for transportation services provided prior to a new Medicare provider enrollment application. However, ambulance providers commented that back billing is sometimes necessary to provide emergency coverage in a service region following the abrupt withdrawal of another ambulance service, when there isn’t enough time to process a new  application.

The timetable for White House handling of rules and the final components of the new regulations can vary. Approval can be processed within days of receipt or a proposal can linger at OMB for months due to internal discussion and debate.

By Paul Jenks Posted at 12:31 p.m.
Medicare

August 12, 2014

Anti-Fraud Bill Presses CMS to Nix Social Security Numbers on Medicare Cards

Medicare identification cards would no longer display beneficiaries’ Social Security numbers under a new bill outlined recently by the chairman of the House Ways and Means Subcommittee on Health. Rep. Kevin Brady, R-Texas, released the draft text of a measure that compiles a wide range of suggestions to thwart Medicare and Medicaid payment fraud and abuse. The proposals– collected from a bipartisan suggestions offered by committee members — range from halting payments for health services provided to deceased beneficiaries to enhanced fraud abuse monitoring of various specific provider payments, such as those for medical equipment, vacuum erection systems and ambulance services.

The aim of ending the printing of Social Security numbers on Medicare cards is to protect against possible fraud against Medicare beneficiaries, rather than to save the program’s money. The Medicare card is one of the few remaining federal documents that still display the full Social Security number, opening up the possibility for identity theft if the card is lost or stolen.

Eliminating Social Security numbers on the card is a long-running bipartisan congressional objective that has not been taken up by the Centers for Medicare and Medicaid Services. HealthBeat’s John Reichard reported in April on questions about the ID card posed to CMS official at a panel hearing on Medicare fraud. The Medicare agency insists that it lacks the resources to make the change.

The Government Accountability Office in 2012 reviewed several options offered to CMS to change the Medicare card. The suggestions included replacing the number, only partially displaying it, or denoting it in a machine readable bar code.

 

July 31, 2014

Medicare Payment Quirk Grabs Senate Panel’s Attention

Senators on Wednesday mulled the impact of a restriction in Medicare payment policies that has riled both hospitals and patients. When a Medicare patient stays in a hospital under “observation status” the person does not qualify for certain Medicare coverage in a subsequent stay in a nursing home or rehabilitation facility — and may end up paying more in co-payments and drug costs.

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By Paul Jenks Posted at 10:10 a.m.
Hospitals, Medicare

July 30, 2014

Powered Wheelchairs: CMS Expands Payment Scrutiny

A trial program that requires prior-authorization before payment for power mobility devices, or powered wheelchairs, will be expanded by the Centers for Medicare and Medicaid Services.

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By Paul Jenks Posted at 10:05 a.m.
Medicaid, Medicare

July 29, 2014

Medicare Trustees Report Extends Trust Fund Solvency

The trustees of the Social Security and Medicare trust funds on Monday released their annual report. The trustees projected that due to lower health care spending the Medicare hospital inpatient trust fund will be depleted in 2030, four years later than estimated last year.

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July 17, 2014

Final Medicare Payment Rules Loom

The Centers for Medicare and Medicaid Services has sent the White House the final payment rule proposals for fiscal 2015 Medicare provider payments for skilled nursing, psychiatric and inpatient rehabilitation facilities.

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July 11, 2014

Senate Highway Fund Fix Eyes Delinquent Medicare Providers

The long-reach of health care spending came into play Thursday as the Senate Finance Committee advanced a compromise bill to shore up the highway trust fund.

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July 10, 2014

Federal Auditors Question Lab Fees

The HHS inspector general has released a report on Medicare Part B spending for clinical laboratory services. HHS auditors examined lab payments from 2005-10, and despite a 10 percent increase in Medicare enrollment, lab payments increased by 29 percent.

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