AHA: 'Wasnt $716 billion in Medicare cuts enough?'   12/18/2012
Congress should pursue real reform and stability for Medicare and Medicaid - not blunt cuts to hospital payments that hurt patients' access to care, an AHA ad launched today in Politico and National Journal states. Congress already cut Medicare funding by $716 billion, and Medicaid support to hospitals for care for low-income patients by $18 billion, the ad notes. "Now, some in Congress would cut Medicare and Medicaid payments again - hundreds of billions in cuts that would hurt patients' access to care," the ad states. "Blunt cuts do not equal real reform. They will do nothing to improve the long-term strength of Medicare and Medicaid...Oppose Hospital Cuts. Protect Patient Care."
GAO asks CMS to check for potential duplication in HEN, QIO programs   12/18/2012
The Center for Medicare and Medicaid Innovation should review services provided by Hospital Engagement Networks and Quality Improvement Organizations and eliminate any unnecessary duplication, the Government Accountability Office said in a report released yesterday. In the report, the Department of Health and Human Services agreed with the recommendation and identified steps already underway to identify and eliminate any duplication of effort. According to the report, the center's Partnership for Patients and QIO programs both contract with HENs and QIOs to disseminate successful patient safety interventions in hospitals. However, HENs target more hospital-acquired conditions, focus on a broader population, and reinforce and expand on work being done by QIOs. They also focus exclusively on hospitals whereas QIOs are responsible for implementing improvement projects across all settings of care, GAO said. Requested by Sens. Orrin Hatch (R-UT), Michael Enzi (R-WY) and Tom Coburn (R-OK), the report examines CMMI activities and whether they overlap with those of other Centers for Medicare & Medicaid Services offices.
CMS reports on first year of Medicare Fraud Prevention System   12/18/2012
The Centers for Medicare & Medicaid Services Friday issued its first annual report to Congress on the Fraud Prevention System, which uses predictive algorithms to analyze Medicare fee-for-service claims prior to payment to identify potential errors or fraud. The Small Business Jobs Act of 2010 called for phasing in the technology in the 10 highest fraud states by July 1, 2011, and nationwide by 2014. Instead, CMS implemented the system in one step and began running the analytics against all Medicare fee-for-service claims by July 2011. CMS said it plans to better integrate the FPS and Medicare claims processing systems in the second year of the program; improve and expand the FPS models and data; and identify and share FPS algorithms relevant to Medicaid. In September, the Department of Health and Human Services' Office of Inspector General recommended that CMS revise the methodology used to calculate actual and projected savings from the FPS. Among other changes, CMS said it is evaluating the application of a corrective factor that would systematically account for legitimate services and claims overturned on appeal.
OH high court upholds states medical liability time limit   12/18/2012
The Ohio Supreme Court last week upheld the constitutionality of a state law that prevents medical liability cases from being filed more than four years after the date of an alleged incident. The state's General Assembly "has the right to determine what causes of action the law will recognize and to alter the common law by abolishing the action, by defining the action, or by placing a time limit after which an injury is no longer a legal injury," the court said. In a friend-of-the-court brief filed last year, the AHA, Ohio Hospital Association and others urged the court to uphold the law to protect medical providers from litigation 10, 20 or even 50 years after an alleged medical negligence incident.