D.C. CIRCUIT SAYS CMS DOESN’T KNOW WHAT’S NEW

On Tuesday of last week the D.C. Circuit Court ruled that the Provider Review Reimbursement Board doesn’t know what’s new.  It reversed the PRRB’s decision, along with the District Court’s decision that upheld it.  In doing so, it threw up its hands (figuratively speaking), repeatedly complaining that it …

[Read more...]

CMS WANTS TO SHINE LIGHT ON CME PAYMENTS TO PHYSICIANS

Should drug and device manufacturers be required to report payments to physicians who speak at CME (continuing medical education) programs? It’s a question CMS has been wrestling with since the enactment of the Sunshine Act (sometimes called the Open Payments Program) as part of the Affordable Care Act.  The …

[Read more...]

New CMS Rule a Mixed Bag for Home Health Agencies

The Centers for Medicare and Medicaid Services (CMS)  proposed a new rule last week that will result in home health agencies (HHAs) netting $58 million less in FY 2015 reimbursements. The proposed rule changes the payment rates and wage index of Medicare’s Home Health Prospective Payment System (HH PPS) by …

[Read more...]

Dems Call for Hearing on Costs of Hep C Drug Sovaldi

Dialing up the issue of high-cost medications, Rep. Henry Waxman, the lead Democrat on the House Energy & Commerce Committee and Rep. Diana DeGette of Colorado are calling today for a hearing into the impact Sovaldi will have on Medicare spending. The letter references new data out of Georgetown University …

[Read more...]

COMING SOON TO A HOSPITAL NEAR YOU: THE FIVE-STAR RATING SYSTEM

You choose your movies, restaurants and hotels based on a five-star system: one star for the worst, five for the best.  Why not choose your hospital the same way?  That seems to be the reasoning behind yesterday’s announcement by CMS. Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality …

[Read more...]

ANOTHER CMS WEAPON: SENIOR SLEUTH SQUAD

She’s seventyish, grandmotherly and unassuming.  She sits patiently in the waiting area of your hospital or medical office, knitting to while away the time.  She couldn’t be any less threatening, right?  Wrong.  She could be part of yet another weapon in the CMS arsenal: the Senior Medicare Patrol. The …

[Read more...]