New CMS rules address rebilling   03/13/2013
In two rules released today, the Centers for Medicare & Medicaid Services proposes to revise its position on rebilling for claims denied by Medicare contractors, including recovery audit contractors. Based on a preliminary review of the regulations, it appears that hospitals will generally be eligible for Part B payment following the denial of a Medicare Part A claim, for those services that would have been reasonable and necessary had the beneficiary been treated as a hospital outpatient. “We view this proposed rule as a positive development and will continue to work with CMS to ensure that hospitals are fully reimbursed for the care they provide to our nation’s seniors,” said AHA President and CEO Rich Umbdenstock. Last year AHA filed suit against the government on the rebilling issue. AHA staff is reviewing the rules to determine whether they resolve the issues raised in the lawsuit. AHA members will receive a Special Bulletin with further details tomorrow.
Senate Democrats release budget resolution   03/13/2013
Senate Budget Committee Chairwoman Patty Murray (D-WA) today unveiled a budget resolution for fiscal year 2014 that includes $1.85 trillion in savings over 10 years through an equal combination of tax revenue increases and spending cuts. Murray’s proposal calls for $975 billion in additional revenue, primarily through closing tax loopholes. The budget also proposes $500 billion in domestic cuts, including $275 billion in unspecified health care reductions; $240 in defense spending cuts; and $242 in reduced interest payments. The savings would replace the sequestration cuts that went into effect March 1. The proposed health care savings would be achieved by building on the delivery system reforms included in the Patient Protection and Affordable Care Act and “further realigning incentives throughout the system, cutting waste and fraud, and seeking greater engagement across the health care system.” In addition, the budget calls for $100 billion in economic stimulus measures. The Senate Budget Committee is expected to vote on the resolution and amendments tomorrow.
Health care price growth lowest since December 1997   03/13/2013
Health care prices in January were 1.5% higher than a year ago, two-tenths below the December level and the lowest reading since December 1997, according to the latest economic indicators from Altarum Institute's Center for Sustainable Health Spending. Hospital prices for Medicare and Medicaid patients grew by 1.7% and negative 0.8%, respectively. National health expenditures in January grew at an annual rate of 4.1%, a level that would signify the fifth consecutive year of moderate spending growth, Altarum said. Health care employment rose by 32,000 in February, well above the 24-month average of 24,000, with hospitals adding 8,900 jobs.
NLRB to seek Supreme Court review of ruling on recess appointments   03/13/2013
The National Labor Relations Board intends to ask the U.S. Supreme Court to review a January ruling by the D.C. Circuit Court of Appeals that found three NLRB members were not validly appointed. At issue was whether President Obama validly used his recess appointment authority to appoint three members to the board on Jan. 4, 2012 without Senate approval. In a unanimous decision, the court held that the president can only make recess appointments for vacancies that arise during an official recess, which it defined as the break between sessions of Congress. If the ruling stands, it could invalidate all NLRB decisions made since the appointees joined the board due to lack of a legally required quorum for doing business. If the Court takes the case, it likely would be heard in the term beginning October 2013.
CMS to host call Monday on Health Insurance Marketplace   03/13/2013
The Centers for Medicare & Medicaid Services will host a national conference call March 18 on the Health Insurance Marketplace, which will be followed by quarterly calls through 2013 in each state with a federally-facilitated or state partnership exchange. To register for the national call, go to
AHA Town Hall webcast tomorrow   03/13/2013
Tune in for the next AHA members-only Town Hall Interactive webcast – tomorrow at 4 p.m. Eastern Time. AHA Senior Vice President of Federal Relations Tom Nickels and political consultant Stacey Hughes, founding partner of The Nickels Group, will discuss the latest activity on Capitol Hill. Hosted by AHA leaders, members-only Town Hall Interactive webcasts focus on advocacy and other important developments in the hospital and health care field. To participate in the 2013 webcasts, register here. For more information, call (800) 424-4301.
KY hospitals contribute $1.96 billion in community benefits   03/13/2013
Kentucky hospitals provided community benefit programs and services valued at more than $1.96 billion in 2011, according to a new report by the Kentucky Hospital Association. That's up from $1.67 billion in 2010 and 85% more than in 2008. The total includes $451 million in financial assistance/charity care, which has more than doubled in two years; and other costs such as community health improvement services, health professions education, research, bad debt (health care services for which a hospital expected but did not receive payment), and the unpaid costs of Medicaid and Medicare. The report highlights how hospitals routinely go beyond their core mission to meet other community needs while contributing to the economic strength of their communities. "Kentucky's 131 hospitals continue to provide an important medical safety net for health services and programs at a time when economic turmoil and reform of our country's health care system are affecting all aspects of our society," said KHA President Michael Rust.