OIG report looks at Medicare reconciliation of hospital outlier payments   07/20/2012
The Centers for Medicare & Medicaid Services should ensure that Medicare contractors reconcile certain hospital outlier payments as required and perform final cost report settlements, the Department of Health and Human Services' Office of Inspector General concludes in a new report. OIG also recommends that CMS implement an automated system that will recalculate outlier claims to facilitate reconciliations, and work with Medicare contractors to develop and maintain a list of cost reports with outlier payments requiring reconciliation. In the report, CMS said it agrees with the recommendations. Medicare supplements basic prospective payments for inpatient hospital services by making outlier payments for unusually high-cost cases. Outlier payments that rapidly increase charges are subject to reconciliation under CMS regulations.
HRSA awards grants for HIV/AIDS care   07/20/2012
The Health Resources and Services Administration yesterday awarded $80 million in grants to increase access to health care and medications for low-income people with HIV/AIDS. About $69 million will go to 25 states and territories to eliminate waiting lists in the Ryan White AIDS Drug Assistance Program, and the rest will go to Ryan White community-based health clinics. A portion of the funding was provided by the Patient Protection and Affordable Care Act.
Court upholds Colorado's authority to opt out of CRNA supervision   07/20/2012
The Colorado Court of Appeals yesterday upheld the governor's authority to opt out of Medicare's physician supervision requirement for certified registered nurse anesthetists to improve access to care for rural residents. "We conclude the delivery of anesthesia by a CRNA without physician supervision is consistent with state law, and therefore the Governor had authority to opt out of the physician supervision requirement," the decision states. In a statement, Colorado Hospital Association President and CEO Steven Summer said, "As the health care delivery system continues to evolve in this era of reform, the increase in the number of Coloradans with coverage will result in a need to utilize appropriately educated, experienced and licensed non-physician providers to meet the growing demand for health care services. Such providers, including advanced practice nurses and others, are needed to help fill a substantial gap in health care access in underserved regions of our state, and the court has affirmed their right to do so." In December, AHA filed a friend-of-the-court brief in support of the governor's decision.
2012 TRUST Award recipient honored    07/20/2012
Health care leaders last night gathered in San Francisco to honor 2012 TRUST Award recipient Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement, for her dedication to continuous improvement of the health care delivery system to achieve higher quality and safer care for all patients and communities. The annual award by the AHA's Health Research & Educational Trust affiliate recognizes individuals who have made significant and lasting contributions to health care, and who share HRET's vision of creating a society of healthy communities and its mission of transforming health care through research and education. To commemorate the award's 10th anniversary, a new HRET report features essays by past award recipients on topics impacting the future of health care, including team-based and patient-centered care, cost control, quality and end-of-life care. For more information, visit www.hret.org/trust.