Medicine & Health articles from September 2008

Medicine & Health archives from September 2008

Feds focus on healthcare providers who refuse to perform abortions: HHS releases proposed 'Conscientious Objections' rule to protect providers.(Social Issues)
September 5, 2008... While the abortion issue is again taking center stage this election season, the Department of Health and Human Services is wasting no time implementing policies of its own. HHS Secretary Mike Leavitt announced plans on Aug. 21 to implement...

Employers' healthcare cost growth sees relief ahead: and it's not due to a string of good luck.(Spending)
September 5, 2008... Not that the dragon of healthcare cost for employers in the United States has finally been slayed, but researchers have noted a positive trend in that costs are expected to increase only by 10.6 percent into next year--the smallest increase in...

Congress wants to chip in to help small businesses: small businesses could form health insurance purchasing pools.(Capitol Hill News)
September 5, 2008... Rep. Don Cazayoux (D-LA) promoted a bill (HR 6210) Aug. 7 that would allow the establishment of statewide or nationwide health insurance purchasing pools for small businesses and self-employed individuals, according to an Aug. 8...

CMS boasts smooth transition to MACs: but DME suppliers aren't as happy.(Medicare Contractors)
September 5, 2008... The Centers for Medicare & Medicaid Services appears so far to be smoothly sailing in its transition from fiscal intermediaries and carriers to Medicare Administrative Contractors. Medicare healthcare providers continue to be satisfied with...

State Medicaid agencies not as sharp as they could be: agencies don't bother to notify federal authorities when they sanction providers.(Medicaid News)
September 5, 2008... It is the same old story of bureaucratic straitjackets. But it might be helping con artists stay in business longer than they would if states were smarter. States regularly fail to notify the HHS Office of Inspector General when they have...

CMS lacking in oversight of private Medicare drug plans, report says: congressional caps for agency audit programs might backfire.(Medicare Part D)
September 5, 2008... In what could be a case of being "penny wise and pound foolish," the Centers for Medicare & Medicaid Services has failed to conduct audits on Medicare prescription drug plans due to budgetary constraints. The audits were to ensure that the drug...

Uninsured bear the brunt of healthcare cost: think uninsured are free riders? Think again.(Insurance)
September 5, 2008... Uncle Sam doesn't pick up the tab when the uninsured incur healthcare costs. This is one of the findings of a research study reported Aug. 25 on Health Affairs. People who are uninsured for any part of 2008 will spend about $30 billion out of...

Part B therapy goes under the microscope with DOTPA: rehab community brings a plethora of concerns to CMS Open Door Forum.(Rehabilitation)
September 5, 2008... Yearning for the day when the Medicare outpatient therapy caps are no longer plaguing the industry and lawmakers? In 18 months, everyone will be back at square one with the exceptions process expiring once again. The good news: The Centers...

Working-age Americans in dire straits with mounting medical debt: 79 million adults facing some sort of problem paying their medical bills.(Medical Debt)
September 5, 2008... Families across the United States are faced with difficult choices over their healthcare concerns. With deteriorating health insurance coverage over the past six years, more families are experiencing medical bill problems or cost-related...

WHO report offers valuable insight to U.S. policymakers: widespread health inequities still persist around the world, and on a smaller scale, within America.(Global Perspective)(Report)
September 5, 2008... Those who think that the forces of globalization or the thawing of the Cold War has done wonders to lessen the world's healthcare disparities may be in for a rude shock. The cold, hard facts: A woman in Lesotho has a life span that is 42...

Correction.(Global Perspective)(Correction notice)
September 5, 2008... In the Part D story on Page 2 of MHH Volume 62, No. 32, a sentence reads, "The 10-year cost of the drug benefit initially was forecasted at $634 billion; however, new estimates put it at about $3955 billion..." The correct figure is $395...

Supreme Court favors employees in ERISA case: says federal courts should consider conflict of interest plan administrators face.(Insurance Law)
September 12, 2008... In a landscape where healthcare expenses are a major worry for most citizens and employers, questions regarding the conflicts of interest plan administrators face recently fell into the Supreme Court's lap. In its June 2008 MetLife v....

Hospital cost-cutting programs go under Senator s scanner: 'public service' by hospitals once again comes to the fore.(Hospital News)
September 12, 2008... Health Systems beware: Congress may have its eye on your facility next. Sen. Chuck Grassley (R-IA) has requested that two public hospitals submit information On programs and practices that he suggests could lead to unequal treatment of patients...

Rhode Island plan causes a stir among some Congressmen: RI Gov. plans to cap Medicaid spending.(Medicaid News)
September 12, 2008... Some might consider Rhode Island's request for Medicaid cuts a "canary in a coal mine" for the rest of the United States. As healthcare expenditures spiral out of control nationwide, Rhode Island Gov. Donald Carcieri made a request to the...

Experts question whether MA plans are serving their purpose: government hand-outs to MA plans--$8.5 billion in payments in 2008.(Medicare Advantage)
September 12, 2008... Medicare Advantage plans were devised to control the exploding costs of traditional fee-for-service plans. However, the cost effectiveness of MA plans has come in for questioning with continued increases in government payments to them. ...

CMS delays new ABN deadline for providers: March is the new target date for the revamped patient notice.(Regulations)
September 12, 2008... Providers who haven't started using the new advance beneficiary notice form need not worry--they've still got months to comply. The Centers for Medicare & Medicaid Services allowed providers to start using the new ABN-G (CMS R-131) in...

Public health programs to get a boost? Not likely, report says: but greater enrollment in public health programs still expected.(Statistics)
September 12, 2008... Good news: The number of uninsured in America has declined marginally with greater enrollment in public health programs. However, experts say this data's unlikely to make the case for expanding those programs in broader healthcare...

SCHIP advocacy loses steam on the hill but not for long: Democrats opt to wait until Bush administration is over.(Capitol Hill)
September 12, 2008... One could say Democrats are choosing their battles wisely. While they are hoping to usher in an Obama administration in January and increase their majorities in Congress, they have decided to refrain from challenging Republicans on SCHIP...

Prescription drug plan marketing materials miss requirements by a long shot: insurers' marketing materials fall short of Medicare guidelines 85 percent of the time.(OIG Reports)
September 12, 2008... This is perhaps an example of a 'public-private' collaboration that should not be emulated. Nearly 85 percent of the marketing materials private prescription drug plans have used to reach Medicare beneficiaries do not fully meet CMS guidelines,...

California, Kentucky get busy tackling healthcare legislation: California still working out bugs, while Kentucky moves full-throttle with KCHIP.(States)
September 12, 2008... As lawmakers in Washington anticipate major healthcare legislation under a new administration come Jan. 09, states aren't waiting--and continue to tackle their unique healthcare challenges in different ways. Lawmakers in the Golden State...

House committee discusses permanent overhaul of Medicare physician payment system: with a possible crisis looming 16 months from now, Congress tries to stay on top.(House News)
September 19, 2008... Although Congress was once again able to postpone Medicare physician tee cuts this year, it has only postponed the inevitable. And now Congress is trying to find ways to deal with a possible 20 percent payment reduction scheduled for Jail. 1,...

CMS declares tough guidelines for MA plan marketers: prohibits telemarketing and other 'aggressive marketing practices'.(Medicare Advantage)
September 19, 2008... If you're an MA plan administrator, take heed and if you're a provider who treats Medicare Advantage beneficiaries, get ready for some relief. The Centers for Medicare & Medicaid Services released final regulations that will "protect Medicare...

Lawmakers take serious action against Medicaid funding lows: House dems consider increasing Medicaid reimbursements as economic stimulus.(Medicaid)
September 19, 2008... While the government is busy spending billions rescuing one Wall St. finn after another, lawmakers in Congress want to provide state Medicaid programs with an additional chunk of change. This would be part of a second economic stimulus package...

Suppliers singled out for accreditation requirements: but physicians, therapists exempted from Medicare rules.(DMEPOS)
September 19, 2008... About a year from now, durable medical equipment suppliers who bill Medicare must be accredited--that is, unless they're non-traditional DME suppliers. The Centers for Medicare & Medicaid Services "has issued an exemption for virtually...

Indian heart hospitals offer creative insights on affordable healthcare: case study on Indian hospitals shows new possibilities for state-of-the-art medical treatment.(Medical Innovation)
September 19, 2008... As U.S. policymakers face financial crises in the healthcare sector--and the high cost of medical treatment, promising solutions may be just around the corner... of the world, that is. The mantle of innovation has fallen into the hands of...

Senators point out glaring inadequacies with 1-800-Medicare: demand improvements before upcoming annual enrollment period.(Customer Service)
September 19, 2008... The Centers for Medicare and Medicaid Services may need to learn a few tricks from the corporate world on improving its customer care. The agency is failing to provide satisfactory customer service, advocates for seniors and lawmakers alleged,...

Reverse medical tourism market offers lucrative opportunity for hospitals: medical tourism is more than just Americans going abroad for treatment.(Healthcare Marketplace)
September 19, 2008... Health systems across the nation are losing business to medical tourism, and it's no surprise as to why. The global healthcare industry is seeing innovation across the board--but not without a hefty increase in the cost of treatment. Add to...

Senate responds to Supreme Court decisions with changes to ADA: bill will expand protections for Americans with disabilities.(Legislation)(Americans with Disabilities Act of 1990)
September 19, 2008... The Americans with Disabilities Act has been a landmark bill in many ways, but Congress felt some Supreme Court judgments had somewhat limited the scope of ADA. The Senate responded by approving a bill (S. 3406) by voice vote, said a Sept....

Congress gives Mental Health 'Parity' with physical health: insurers prohibited from discriminating against mental ailments.(Legislation)
September 26, 2008... Compared to physical issues, mental issues often get second-tier attention from healthcare providers, insurers, and society in general. But that's about to change. Congress passed Mental Health Parity legislation on Sept. 23 that will remove...

A most welcome Medicare cost relief to surface in 2009: Part B out-of-pocket expenses for beneficiaries not to rise next year.(Medicare)
September 26, 2008... In an environment of rapid increases in the cost of healthcare, it'll come as a pleasant surprise to Medicare beneficiaries that their out-of-pocket expenses for doctor visits and other outpatient services won't rise next year. The...

Coding experts foresee major problems with 2011 implementation of ICD-10: AAPC advises staggered approach to changeover.(Coding)(American Academy of Professional Coders )(international classification of diseases)
September 26, 2008... There's little unanimity from industry players regarding the ICD-10 coding system going live in 2011. Although the Department of Health and Human Services is upbeat about the transition, coding professionals aren't sure that it's advisable or...

CMS goes full speed ahead with Personal Health Record program: South Carolina pilot expanded to include TRICARE data.(Technology)
September 26, 2008... The Centers for Medicare & Medicaid Services is giving some extra attention to the Personal Health Record program. The agency announced an expansion of the South Carolina PHR pilot to include TRICARE health data in a Sept. 23 press release. ...

Veterans with Lou Gehrig's disease to get federal help: VA acknowledges link between military service and this disease.(Funding)
September 26, 2008... Veterans suffering from a serious neurodegenerative disease will soon receive much-needed support for themselves and their families. The Department of Veterans Affairs announced Sept. 23 that Lou Gehrig's disease is grounds for federal...

CMS provides a helping hand to caregivers: 'Ask Medicare' site will provide information, tools, and materials to caregivers.(Outreach)(Website overview)
September 26, 2008... Medical providers can now turn stressed family caregivers to a new Web site for support. The Centers for Medicare & Medicaid Services recently launched Ask Medicare, a new initiative to help family caregivers--those who are family members or...

Lawmakers consider ways to fight the AIDS battle at home: CDC hits up Congress for doubling HIV prevention spends.(Clinical Funding)
September 26, 2008... The battle against HIV/AIDS is being fought on many fronts--and one of those battlefronts is in Congress. The United States should spend $1.6 billion per year on HIV prevention activities, more than double the current total, according to...

Providers who owe the IRS should expect a dip in Medicare reimbursement: CMS reminds practices that the government can place a levy on Medicare pay if you owe taxes.(Reimbursement)
September 26, 2008... Providers who owe back taxes should expect the IRS to come calling in non-traditional ways--in fact, they might just garnish some of their Medicare reimbursement until they've paid back what they owe. According to a recent Centers for...

3 simple solutions for low PQRI pay: PQRI vendors actually interested in helping providers maximize their return.(Incentives)(physician quality reporting initiative )
September 26, 2008... PQRI participants who scoffed at their $600 check shouldn't lose heart. According to a July 15 CMS press release, the average individual incentive amount for the 2007 reporting period was approximately $630, while the average incentive payment...

Communication with clinicians substandard in Alzheimer's cases: lawmakers push for better treatment and prevention initiatives.(Research & Studies)
September 26, 2008... If geriatric patients aren't talking to their doctors about memory issues, perhaps doctors should be asking about them. The Alzheimer's Foundation of America (AFA) recently released survey results that revealed an overwhelming number of...

Payment cuts pose challenges for insurers across states: Florida and Georgia take steps to sweeten the bitter pill.(Stateside)
September 26, 2008... A reduction in payments by 5 percent was just too much for many HMOs, and many had simply said that they would stop participation in a "Medicare Reform" plan being conducted by the Agency for Health Care Administration. The Agency had to relent...