AHA urges HHS Inspector General to examine inaccuracy of RACs   10/25/2012
Recovery audit contractors are "often wrong but not penalized for their numerous inaccuracies," AHA told the Department of Health and Human Services' Office of the Inspector General yesterday. In a letter to HHS Inspector General Daniel Levinson, AHA Executive Vice President Rick Pollack recommended halting inappropriate payment denials by RACs; streamlining the Centers for Medicare & Medicaid Services' integrity programs and eliminating duplicative audits; and investing in provider education and payment system fixes to prevent payment mistakes. Pollack urged that "OIG's review of the effectiveness of the RACs and CMS-related oversight efforts pay particular attention to the extent to which RAC determinations result in inappropriate denials of payment for services that are medically necessary and reasonable for the care of patients, not solely on whether these contractors are identifying improper payments and referring potential fraud cases to law enforcement." The letter shares relevant data from the AHA's RACTrac quarterly survey of hospitals, which consistently shows that 75% of appealed RAC decisions are ultimately reversed.
Growth in Medicaid spending, enrollment slow in FY 2012   10/25/2012
Total Medicaid spending grew by an average 2% in fiscal year 2012, according to the latest annual survey of state Medicaid officials by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates. That's down from 9.7% in FY 2011 and the smallest increase since 2006. Officials attribute the slowdown to an improving economy, which slowed growth in Medicaid enrollment to 3.2% from 4.4% the prior year, and efforts to control costs after the enhanced federal matching rate expired in June 2011. Forty-five states restricted provider rates in FY 2012, and 42 plan to do so in FY 2013. All but six states report new care coordination efforts for FY 2012 or 2013, while 34 are developing new payment or delivery system options for beneficiaries eligible for both Medicaid and Medicare. States authorized 3.8% average growth in total Medicaid spending for FY 2013, which includes state and federal shares, and expect enrollment to grow 2.7% for the year.
ACIP recommends Tdap vaccine during each pregnancy   10/25/2012
The Centers for Disease Control and Prevention's Advisory Committee for Immunization Practices yesterday recommended that prenatal care providers implement a Tdap (Tetanus-Diphtheria-Pertussis) immunization program for all pregnant women to help protect mothers and newborns from whooping cough. The recommendation calls for health care personnel to administer a dose of Tdap during each pregnancy, or immediately postpartum before leaving the hospital or birthing center. CDC currently recommends the vaccine during pregnancy only for women who have not previously received it. With more than 32,000 cases of whooping cough so far this year, the U.S. is on track to have the most reported cases since 1959, according to CDC. ACIP recommendations are not official until approved by the CDC director and published in CDC's Morbidity and Mortality Weekly Report.
NJ hospitals contribute $19.5 billion to economy   10/25/2012
New Jersey hospitals contributed $19.5 billion to the state's economy in 2011, according to a new report by the New Jersey Hospital Association. That's $900 million more than the previous year, including increases in employee salaries, state income taxes paid by employees, and goods and services purchased from other businesses. Hospital jobs in the state held steady at about 140,000, including 114,000 full-time jobs. "New Jersey communities rely on hospitals for health care services, but it's important to remember that hospitals also are bedrocks of state and local economies," said NJHA President and CEO Betsy Ryan.