Medicine & Health articles from March 2007

Medicine & Health archives from March 2007

National Health-care Quality rises steadily--despite quality variations in different settings: but those who need care most are not getting it.(National Healthcare Quality Report)
March 5, 2007... Health care continues to improve nationally at a median rate of 3.1 percent, according to the Agency for Healthcare Research and Quality's fourth annual National Healthcare Quality Report. The AHRQ produces this report at the behest of the...

Older Americans may not benefit from advances in Health IT: psychological barriers impede the progress of telemedicine.(Health IT)
March 5, 2007... Approximately 45 million Americans aged 60 or older may not be able to take advantage of recent improvements in home health care due to their lack of familiarity with cutting-edge technology, claims a recent report from the New Millennium...

Disturbing find: quality disparities increasing in all aspects of health care: African Americans, Hispanics and low-income patients receive worse care than whites and high-income patients.(Health Policy)
March 5, 2007... Together with the National Healthcare Quality Report, the Agency for Healthcare Research and Quality also released its complementary National Healthcare Disparities Report, a sobering document that suggests many improvements in health care do...

CMS introduces the new Physician Quality Reporting Initiative, but will it work? The AQA Alliance and Institute of Medicine call for more comprehensive quality control standards.(Physicians)
March 5, 2007... The Centers for Medicare and Medicaid Services recently unveiled a new Web page offering further details on the Physician Quality Reporting Initiative authorized by President Bush on Dec. 20, 2006 in the Tax Relief and Health Care Act of 2006....

Hospital rehab therapists need to focus on outpatient therapy policies: hospitals' expectations aren't far from Part B settings', CMS says.(Hospitals)
March 5, 2007... The Centers for Medicare & Medicaid Services announced in Transmittal 65 that hospital inpatient-rehab settings, hospital acute-care settings, critical access hospitals, long-term care hospitals and psychiatric hospitals under Medicare Part A...

Congress re-introduces therapy-cap repeal bill.(Industry Notes)
March 5, 2007... The newly elected 110th Congress hasn't forgotten about therapists' and their patients' cries for help. On Feb. 1, Congress re-introduced legislation S. 450/H.R. 748, the Medicare Access to Rehabilitation Services Act of 2007, according to the...

Ohio couple found not guilty for fraudulent billing.(Industry Notes)
March 5, 2007... What appeared to be a stiff prison sentence on the horizon for radiologist Robert Reither and his wife Judy is now cleared. The Reithers were accused of fraudulently billing Medicare for modified barium swallow tests. A federal grand jury...

Therapists can't lose sight of patients' satisfaction.(Industry Notes)
March 5, 2007... Insurers, employers and others that give therapists business are paying closer attention to their patients' satisfaction--especially as talk of potential pay-for-performance systems spreads. "Patient-satisfaction data is both a valuable...

Innovations in health insurance may slow growth in health-care spending: current cost-sharing measures and HSAs may not curb rising health-care costs efficiently.(Health Plans)
March 12, 2007... Employers and policy-makers have asked employees to share insurance premium costs with growing frequency in an effort to cut rising health care costs, but current cost-sharing methods have not produced significant savings, according to a recent...

SCHIP funding could run out before reauthorization: without a funding increase, 1.3 million children will lose their health insurance.(SCHIP)
March 12, 2007... While Washington's talking heads reaffirm their commitment to extending the State Children's Health Insurance Program's viability, their inaction could leave otherwise uninsured children without medical care as early as May 2007, according to a...

Avian flu may target the young and healthy: lessons from the 1918 Spanish Flu could prepare us for the future.(Pandemics)
March 12, 2007... Ethicists have sounded the depths of moral and medical wisdom recently in a struggle to decide who ought to receive vaccinations first in the event of a flu epidemic, but the answer to that question might lie in the past, according to new...

Will a doctor's notes stand up to EHR audit scrutiny? Physicians' EHRs could soon need an upgrade.(EHRs)
March 12, 2007... RTI International just released a draft version of anti-fraud standards for electronic health records. The standards could put more pressure on physicians to support evaluation & management levels in documentation. RTI convened a panel of...

New ABN form takes providers by storm: providers say goodbye to payment up front for non-covered services.(Coverage)
March 12, 2007... The Centers for Medicare & Medicaid Services proposed a new version of the Advance Beneficiary Notice form in the Feb. 23 Federal Register. The new form includes information about the beneficiary's right to demand that the provider bill...

Americans live longer than ever, but quality of life decreases: one-third of all deaths in the United States could be prevented.(Aging)
March 19, 2007... Modern medicine may not be able to stop you from getting older, but it can remove many of the negative effects of aging. Unfortunately, many older Americans do not receive the preventive care necessary to make their final years fulfilling ones,...

Could rising health-care costs kill the American dream? Current spending-growth rates are not economically sustainable.(Spending)
March 19, 2007... Most policy makers assume that projected growth in entitlement spending will be due to the aging baby boomer population, but "the most important cause is the projected increase in health-care costs," according to a recent statement by Peter...

Democrats promise to right SCHIP: proposals would allocate 10 times the money in Bush's budget.(SCHIP)
March 19, 2007... Undaunted by the alarming consequences of continued health-care spending growth (see story on page 1), Democrats are pushing to extend the State Children's Health Insurance Program to cover all 6 million children currently living without health...

Independent study shows great savings with the PCM model: patient-centered management: the better way to cut costs?(Managed Care)
March 19, 2007... As insurers look to breathe new life into their health plans with initiatives that will both benefit enrollees and cut expenses for their most costly beneficiaries, a study funded by Blue Shield of California and published in The American...

New call services aim to bolster DM programs: call technology focuses on diabetes management--for now.(Disease Management)
March 19, 2007... As every disease-management administrator knows, communication with patients is paramount. Now, a new automated-calling system is on the market that can help them to stay in touch. Silverlink, a provider of health-care-specific automated...

CT proposal seeks to put claims-denial onus on insurers: if insurers' claims processors say no, they must be prepared to justify it.(Health Plans)
March 19, 2007... If some Connecticut lawmakers have their way, insurance companies that deny claims for medically unnecessary health care would have to prove that such treatment isn't necessary. House Bill 7055 now before the state's Insurance and Real...

MA payment rate to slow in CY 2008: plus: Maryland lawmakers consider cash giveaways to keep citizens healthy.(Industry Notes)
March 19, 2007... Congress is eager to scrutinize the effectiveness of Medicare Advantage program, and it's starting to review the payment rate as a result. MA payment rates could increase by a lower percentage in 2008 than in recent years, according to...

NIH funding cuts threaten the future Of U.S. medical research: putting a price on a cure for cancer and other diseases.(Funding)
March 26, 2007... From 1998 to 2003, the National Institutes of Health budget doubled, and NIH funding sparked an almost unprecedented boom in medical research, leading to advances that benefited millions of Americans. Now, NIH funding cuts appear poised to...

AmeriCare could save $60.7 billion, cover all uninsured Americans: Legislative Review compares administration and Congressional health-care reform proposals.(Uninsured)
March 26, 2007... In the last two congressional sessions, legislators introduced 10 health-care plans, and several of those appear to offer a care package superior to the current Administration plan while reducing federal spending, according to a new report...

Will flossing each day keep the doctor away? Insurers might think so: what the big insurers are doing in the dental-care arena.(Dental Care)
March 26, 2007... Recent research points to good dental health as one source for good overall health. As a result, many insurers nationwide are beginning to expand dental coverage to their customers. Big players in health insurance like Aetna and CIGNA are...

Fixing broken physician-payment formula could cost $330 billion: senate hearing results in no answers for physicians.(Reimbursement)
March 26, 2007... The Medicare Payment Advisory Commission delivered its long-awaited report on Medicare physician payments--and couldn't agree on a solution. By law, every year Medicare changes the physician conversion factor based on how fast physician...

CMS gives providers a breather due to incorrect forms: providers can stop rushing to switch over to the new CMS-1500.(Physicians)
March 26, 2007... The Centers for Medicare & Medicaid Services granted providers a respite and will allow the old version (12-90) until around June 1, not April 1 as originally planned. Next month, Medicare contractors were supposed to accept only the revised...

CMS' 'bounty hunters' should focus on hospitals, physician group says; Medicare fraud-hunters expand nationwide.(Fraud & Abuse)
March 26, 2007... The Recovery Audit Contractors will be coming to your town soon. These so-called "bounty hunters" receive more money if they collect overpayments (or uncover underpayments). Until now, they've operated in only three states, but they'll...

Food and Drug Administration.(In Other News ...)
March 26, 2007... CMS is reviewing all Medicare policies on erythropoiesis stimulating agents alter the Food and Drug Administration issued some new warnings regarding their use. CMS also opened a National Coverage Analysis on the use of ESAs for conditions...

NPIs won't replace Medicare numbers; plus: CMS examines ESAs for coverage.(Industry Notes)
March 26, 2007... Think the National Provider Identifier numbers required in May will simplify providers' Medicare paperwork? Think again. After the NPI implementation, the Centers for Medicare & Medicaid Services will continue to issue and use...