Just as Medicare and CMS are cutting reimbursement as much as 75% on Durable Medical Equipment Services and Products U.S. Rep. Bill Cassidy filed legislation to make some weight-loss prescription drugs and treatments available to residents through the federal Medicare...
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Reimbursement
AAHomecare and DME Provider File Suit Against CMS Official Over Competitive Bidding
The American Association for Homecare (AAHomecare), along with a home medical equipment provider from Maryland, announced today the filing of a lawsuit in U.S. District Court in Washington, D.C., asking that the scheduled July 1 expansion of the Medicare competitive...
PAMS Response to Washington Post Editorial on Competitive Bidding
The Washington Post ran an editorial in the paper’s Sunday edition on June 16th encouraging CMS Administrator Marilyn Tavenner to implement the Round 2 program. The Article can be viewed at www.washingtonpost.com. PAMS Executive Director, John Shirvinsky, posted the...
Medicare Panel Urges Cuts to Hospital Payments for Services Doctors Offer for Less
A federal advisory panel said Friday that Congress should move immediately to cut payments to hospitals for many services that can be provided at much lower cost in doctors’ offices. The Medicare Payment Advisory Commission said the current payment disparities had...
H.R. 2375 Calls for Delay and Review of Competitive Bidding
Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, have introduced a bill to delay the implementation of Round 2 of competitive bidding, according to The VGM Group. H.R. 2375, the “Transparency Accountability in Medicare Bidding Act of 2013,” would delay the...
Hawaii Home Health Faces Negative Medicare Margins
Hawaii is one of 10 states where payments will be below cost, and second biggest "loser" in the nation. Hawaii is facing Medicare Home Healthcare payment at least 11.7% below cost, and up to 27.8% below cost if proposed rebasing takes effect. Even without rebasing,...
North Carolina BCBS Network Alert
The deadline to enter into the new North Carolina Blue Cross Blue Sheild network is June 24th 2013. Earlier this month BCBS of NC announced they would be discontinuing thier current "closed" network and replacing it with an opened network. The opened network will have...
Home Healthcare Thanks Congressman Tom Price for Support of Home Health Service Access
The Partnership for Quality Home Healthcare today commended Representative Tom Price (R-GA) and his call for targeted Medicare reforms that achieve savings by putting an end to the occurrence of waste, fraud and abuse in the Medicare program. In a letter sent to his...
Humana Adopts Medicare National Mail Order Pricing
When it comes to the steep cuts Medicare plans to implement as part of Round 2 of competitive bidding, industry stakeholders have been waiting for the other shoe to drop. In the wake of the announcement of the cuts—on average, 45% below the current fee schedule—there...
OIG: CMS Should Establish Transfer Payment Policy for Eary Discharges to Hospice Care
The OIG recently issued a report, found at www.kslaw.com, concerning the potential financial impact to Medicare Part A if CMS established a hospital transfer payment policy for early discharges to hospice care. The OIG explained that it undertook this review because...
7 Insurers Sign on to Participate in Georgia Health Insurance Exchange
Seven health insurers have signed up to offer benefits plans as part of the online insurance exchange that begins enrolling Georgians in October, reports Georgia Health News. The companies that have signed on are: Aetna, Alliant, Blue Cross and Blue Shield of Georgia,...
Senate Takes up Bill to Improve Medicare Audits and Address RAC Concerns
A new Senate bill addresses provider concerns over the Medicare audit process, including the role of Recovery Audit Contractors. The House is also considering a version of the “Medicare Audit Improvement Act of 2013,” which lawmakers originally introduced in October...