AHA urges Congress to extend Medicare rural, outpatient therapy provisions   01/09/2014
The House Energy and Commerce Health Subcommittee today held a hearing to examine how expiring Medicare, Medicaid, Children’s Health Insurance Program and human services provisions should continue under a permanent repeal of the Medicare Sustainable Growth Rate formula for physicians. The Bipartisan Budget Act, enacted by Congress last month, temporarily averted a 20.1% payment cut effective Jan. 1 under the SGR formula by increasing Medicare payment for physicians under the Physician Fee Schedule by 0.5% through March. The legislation also extended through March several AHA-supported Medicare provisions to ensure access to services for patients in rural areas: the adjustment for low-volume hospitals; Medicare-Dependent Hospital program; add-on payments for rural ambulance providers; and the exceptions process for outpatient therapy caps. “Over the years, Congress has enacted several provisions to address the special challenges rural hospitals encounter in delivering health care services to the communities they are committed to serving,” AHA said today in a statement submitted to the subcommittee. “The AHA urges the Committee to recognize that the circumstances that necessitated these provisions continue to exist; therefore, it is appropriate that they be extended.”
OIG recommends changes to CMS monitoring of MAC performance   01/09/2014
The Centers for Medicare & Medicaid Services should require action plans for all quality assurance standards that Medicare Administrative Contractors fail to meet, the Department of Health and Human Services’ Office of Inspector General said in a report issued today. CMS also should ensure that MAC performance informs award fee metrics; seek legislative change to allow more time between contract competitions; meet timeframes for completing quality assurance reports and award fee determinations; and establish reasonable timeframes for issuing contractor performance reports, OIG said. In the report, CMS agreed with the recommendations. The report looked at the extent to which MACs met performance requirements reviewed by CMS between September 2008 and August 2011, and the extent of CMS’ performance assessment and monitoring of MACs. According to the report, MACs did not meet one quarter of the standards reviewed and had not resolved issues with 27% of the unmet standards as of June 2012. Unmet standards without action plans were almost four times more likely to have issues go unresolved. MACs are monitored on eight general performance areas: appeals, audit and reimbursement, claims processing, financial management, medical review, Medicare secondary payer, provider customer service, and provider enrollment. 
Survey: More shoppers visiting health insurance marketplaces   01/09/2014
About 24% of adults who are uninsured or have individual health coverage report visiting the new health insurance marketplaces to shop for a health plan via the Internet, mail, phone or in person, according to a survey released today by the Commonwealth Fund. That’s up from 17% in October, when the Commonwealth Fund initiated the tracking survey. About 38% of adults who visited the marketplaces ended up applying for health insurance by the end of December, the survey found. About 41% of adults visiting a marketplace were under age 35, 77% reported being in good health, and 51% said it was somewhat or very easy to compare premium costs of plans for sale. Thirty-six percent of marketplace visitors said it was very or somewhat easy to find a plan with the type of coverage they needed, while 37% said it was very or somewhat easy to find a plan they could afford. About six in 10 adults who had not yet gone to a marketplace or enrolled said they were very or somewhat likely to enroll in a plan or find out if they are eligible for financial help before the enrollment period ends on March 31.
AHA Section for Maternal and Child Health names 2014 leaders   01/09/2014
Angela Scioscia, M.D., chief medical officer at the University of California San Diego Health System, is the 2014 chair of the AHA's Section for Maternal and Child Health Governing Council. As chair, Scioscia will lead the section's governing council on public policy issues concerning women's and children's health, hospitals serving that patient population and AHA member service strategies. Maribeth McLaughlin, chief nursing officer and vice president of patient care services at Magee-Women’s Hospital at the University of Pittsburgh Medical Center, is the section's chair-elect and will assume the role of chair in 2015. For more on the section's governing council, see the AHA news release.