House passes 12-month physician fix bill   03/27/2014
The House of Representatives today approved by voice vote a bill that would stave off scheduled cuts to Medicare physician payments through April 1, 2015. Senate action on the bill is expected next week. Medicare physician payments are scheduled to be cut by 24% on April 1 without congressional action. The bill would extend the Medicare-dependent Hospital Program, low-volume adjustment and ambulance add-on payments through April 1, 2015; extend the delay in enforcement of the Centers for Medicare & Medicaid Services’ two-midnight policy for an additional six months, through March 31, 2015; and prohibit recovery audit contractors from auditing inpatient claims spanning less than two midnights for the six-month period. It also would delay implementation of ICD-10 for one year, until Oct. 1, 2015; delay the start of the Medicaid Disproportionate Share Hospital cuts for one year, until 2017; and extend the DSH cuts for an additional year through 2024. AHA members received a Special Bulletin yesterday with more information on the bill and its hospital-related provisions.
CMS to extend EHR attestation for certain Method II EPs   03/27/2014
The Centers for Medicare & Medicaid Services will extend the attestation period for meaningful use of electronic health records for 2013 for any physicians and other eligible professionals who bill for outpatient services provided in critical access hospitals using CAH Method II, and are unable to attest because they are being improperly categorized as hospital-based physicians, the agency said today. All other EPs must attest by 11:59 p.m. ET on March 31, 2014 to receive an incentive for 2013 and avoid future payment penalties. To qualify for the extension, affected EPs must contact the EHR Information Center for the Medicare EHR Incentive Program at (888) 734-6433 to log their complaint and create a helpdesk ticket. The agency will use the ticket numbers to ensure that records for those EPs are reopened for attestation after March 31.
CMS issues FY 2012 report to Congress on Medicare RAC program   03/27/2014
Medicare Recovery Audit Contractors denied $2.4 billion in payments to Medicare providers in fiscal year 2012, according to the Centers for Medicare & Medicaid Services' FY 2012 RAC report to Congress, released this week. More than 90% of denied payments were for inpatient services. When hospitals appeal denied inpatient claims, they are successful in overturning the denial 72% of the time, according to a 2012 report by the Department of Health and Human Services Office of Inspector General. RACs are paid a contingency fee ranging from 9% to 12.5% for each claim they deny and are not penalized for their inaccuracy, which provides incentives to continue to deny accurate inpatient claims. According to the CMS report, RACs received $142.3 million in contingency fees in FY 2012. For more information, visit
House hearing examines impact of fewer inpatient psychiatric beds   03/27/2014
The House Energy and Commerce Oversight and Investigations Subcommittee yesterday held a hearing examining the impact of a national shortage of inpatient psychiatric beds on patients and communities. Among other topics, the hearing focused on deinstitutionalization and the lack of federal and state funding for community-based resources and support services. “It is counterintuitive that the solution to a perceived inpatient bed shortage is to build a strong community-based service system,” said Arthur Evans, commissioner of the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. “But experience consistently shows this to be the case.” Participants agreed that emergency departments generally should not be the first treatment setting for people with serious mental conditions, and stressed the importance of Medicaid funding for community-based resources and services, noting that the program excludes enrollees aged 21-64 from accessing short-term acute care in freestanding psychiatric hospitals.
Payment cuts have consequences, MO hospital survey finds   03/27/2014
Federal funding cuts and high uncompensated care costs are contributing to workforce and service reductions and delayed and canceled capital investments at Missouri hospitals, according to a survey released yesterday by the Missouri Hospital Association and Missouri Chamber of Commerce and Industry. Nearly half of the 84 hospitals surveyed had laid off staff members in the past six months, for a total of nearly 1,000 fewer employees, and more than half of the hospitals had implemented a hiring freeze. In addition, 37 hospitals reported delaying or canceling building projects, reducing capital investment by more than $100 million, and 40 hospitals were considering reducing service lines. “Medicaid reform matters,” said MHA President and CEO Herb Kuhn. “Without it, financial constraints will continue to limit hospitals’ ability to deliver services to Missouri communities and support local economies.”
PA hospitals urge payment stability to protect access to care   03/27/2014
Hospital jobs, services and capital projects are at risk in Pennsylvania if payment cuts continue, The Hospital & Healthsystem Association of Pennsylvania (HAP) reports. Many hospitals have or plan to freeze hiring (67%), lay off staff (49%), cancel or delay building projects (51%) or cut health care services (41%), according to a HAP survey of general acute care hospitals last month. The Pennsylvania Department of Labor & Industry reports that hospitals in the state shed 3,900 jobs in the past 12 months. “As hospitals work to transform the delivery system, they need stability in federal Medicare and Medicaid payments in order to make needed improvements without jeopardizing Pennsylvanians’ access to health care,” said HAP President and CEO Andy Carter. He also urged the federal government to approve the state’s application for a Medicaid demonstration waiver to increase access to health insurance for low-income, uninsured residents.