Hospitals care for patients before, during, after Hurricane Sandy   10/31/2012
Hurricane Sandy this week forced a few hospitals in New York and New Jersey to evacuate patients to other nearby facilities due to power or flooding concerns. In addition, many New Jersey hospitals and several Pennsylvania and Maryland hospitals experienced power outages but were able to operate on back-up generators, and some Delaware hospitals reported flooding. Other health care facilities in impacted states, including New York and Delaware, discharged or transferred patients or cancelled elective procedures in advance of the storm. Most Connecticut hospitals closed their outpatient clinics and canceled elective surgeries, but reported no major problems. AHA President and CEO Rich Umbdenstock praised hospitals saying, "People turned to hospitals in their time of need and hospitals turned to each other to help meet the greater needs of their community. The dedication and hard work of the men and women working in America's hospitals once again makes us all enormously proud."
AHA ads: Medicare cut threatens health care jobs   10/31/2012
Two AHA ads appearing this week in Politico's Playbook focus on the more than 766,000 health care and other jobs that could be lost by 2021 as a result of the 2% reduction in Medicare spending mandated by the Budget Control Act of 2011. "One out of 5 new jobs created this year was in health care," one ad notes. "America's hospitals stand ready to care 24 hours a day, seven days a week, 365 days a year ... ensuring that patients have access to the care they need at the right time, in the right setting. But hospitals' ability to maintain the kind of access to services that their communities have come to expect is threatened." The ads point to a report detailing potential job losses by state, prepared for the AHA, American Medical Association and American Nurses Association in September by Tripp Umbach, a firm specializing in economic impact studies.
MedPAC urged to consider unique role of hospitals   10/31/2012
The total payment for a service provided in a hospital setting should not be the same as when that service is provided in a physician's office because of the added cost of hospitals' unique standby role - 24/7 service, safety net and disaster preparedness, AHA told the Medicare Payment Advisory Commission Friday. "Without explicit funding, the standby role is built into the cost structure of full-service hospitals and supported by revenue from direct patient care - a situation that does not exist for physician offices or any other type of provider," AHA Executive Vice President Rick Pollack wrote. "…It is critical that MedPAC consider this unique role of hospitals before making additional recommendations to cut payment for HOPD services." MedPAC last year proposed a "site neutral" payment policy for 10 hospital evaluation and management services and is considering whether to expand the proposal to other HOPD services. "Together, these two proposals would cut payment for HOPD services by more than $2 billion in a single year and represent deep cuts to routine outpatient services that are integral to the service mission of hospitals," AHA wrote.
GAO finds higher use of advanced imaging by providers who self-refer   10/31/2012
Providers who self-refer likely made 400,000 more referrals for advanced imaging services in 2010 than they would have if they were not self-referring, according to a report released today by the Government Accountability Office. These additional referrals cost Medicare about $109 million, GAO estimates. Self-referral occurs when a provider refers patients to entities in which the provider or the provider's family members have a financial interest. The report recommends that the Centers for Medicare & Medicaid Services improve its ability to identify self-referral of advanced imaging services and address increases in these services.
Report looks at factors to consider in Medicare payment bundling   10/31/2012
A new report from the AHA and Association of American Medical Colleges looks at factors to consider when bundling Medicare payment for certain physician, hospital and post-acute services as an "episode of care" to encourage evidence-based processes and lower costs. "In order to promote Medicare payment bundling as a more comprehensive population-based model, policy makers will need to design a complete framework that carefully considers the ways to define and price the bundles, with adequate safeguards to protect the quality of patient care and the financial stability of providers," the report states. "Providers, in turn, will need to understand how to manage episode costs under a new payment system that has markedly different incentives from fee-for-service, and holds them accountable for the costs and quality of services delivered by other providers (factors often outside their immediate control)." AHA members are invited to attend a free Nov. 12 webinar on findings from the study. The webinar, from 2-3:30 p.m. Eastern Time, was rescheduled from Oct. 29 due to Hurricane Sandy; those who registered for the Oct. 29 event do not need to reregister. Additional participants may register at www.aha.org/bundlingwebinar.
FDA reports voluntary recall of all Ameridose drug products   10/31/2012
Ameridose LLC in Westborough, MA, has voluntarily recalled all of its unexpired products in circulation, the Food and Drug Administration announced today. The recall is not based on reports of patients with infections associated with any of Ameridose's products, but was recommended by FDA "out of an abundance of caution" after preliminary findings from an inspection of Ameridose's facility raised concerns about a lack of sterility assurance for products produced at and distributed by the facility, the agency said. Health care professionals currently do not need to follow up with patients who received Ameridose products, but should stop using the products and return them to the firm, FDA said. A list of the company's products is available at www.ameridose.com. Under a voluntary agreement with the Massachusetts Board of Registration in Pharmacy, the company agreed to cease all pharmacy and manufacturing operations on Oct. 10. Ameridose is a sister company to the New England Compounding Center, which was closed following a nationwide outbreak of fungal meningitis related to three lots of injectable epidural steroid medication. The Center for Medicaid and CHIP Services today issued an informational bulletin in response to the interim treatment guidance for certain infections and septic arthritis associated with the contaminated steroid products.
Medicare issues meningitis outbreak coverage guidance   10/31/2012
The Centers for Medicare & Medicaid Services has issued Medicare coverage guidance for health care providers who diagnose and treat patients who received contaminated medications produced by the New England Compounding Center. CMS "believes that, aside from oral drugs, items and services to diagnose and treat patients who have received contaminated medications qualify for the Medicare Part A or Part B benefit," the guidance states. The agency urges Medicare contractors to review the Centers for Disease Control and Prevention website regularly "for updates and specific actions they should take to ensure timely access to CDC recommended items and services. Due to the severity of this situation, CMS advises providers that Medicare contractors are expected to expedite all coverage determination requests for these items and services to include antifungal medication."
CMS approves WA state Medicaid-Medicare project   10/31/2012
The Centers for Medicare & Medicaid Services last week approved the first phase of a Washington state initiative to better coordinate care for people enrolled in both Medicare and Medicaid. The HealthPathWashington project will integrate services and establish "health homes" for 30,000 of the state's 1.2 million dually eligible beneficiaries. Washington was one of 15 states to receive Patient Protection and Affordable Care Act grants to design new approaches to better coordinate care for dual-eligible beneficiaries, and is the second state (after Massachusetts) chosen to implement its plan.