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Archive for December, 2008

MAC Named for Five States

Wednesday, December 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) has named National Heritage Insurance Corp. (NHIC) as the Medicare Administrative Contractor (MAC) for Part A and B claims payment in Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. NHIC will administer Medicare fee-for-service claims processing and payment for hospitals and other health care providers in those states. It is the tenth Part A/B MAC named by CMS under the Medicare Modernization Act’s (MMA) contracting reform provisions.

More information regarding the new MAC, visit http://www.cms.hhs.gov/MedicareContractingReform/ Downloads/J14AwardBackgroundSheet.pdf.

Further details regarding Medicare contracting reform can be accessed at http://www.cms.hhs.gov/MedicareContractingReform/.

Guide Published Explaining E-Prescribing Incentive Program

Wednesday, December 17th, 2008

Medicare has published a new guide that will help explain the e-prescribing incentive program. The guide also discusses how eligible professionals can participate and how they can to choose a qualified e-prescribing system.

To access the guide, go to: http://www.cms.hhs.gov/partnerships/downloads/11399.pdf.

Non-Payment Policy for Surgical Errors Proposed

Wednesday, December 17th, 2008

The Centers for Medicare & Medicaid Services (CMS) has proposed three national coverage policies preventing the program from paying for certain serious surgical errors. The proposed policies would prohibit payment for performing the surgery on the wrong body part, surgery on the wrong patient and wrong surgery performed on a patient. CMS will accept comments on the proposed coverage policies through January 1.

For more information on the proposed NCDs, visit http://www.cms.hhs.gov/mcd/index_list.asp?list_type=ncacomment.

MedPAC Drafts Recommendations for 2010 Hospital Payment Update

Wednesday, December 17th, 2008

The Medicare Payment Advisory Commission (MedPAC) has drafted recommendation to Congress for fiscal year (FY) 2010 hospital inpatient and outpatient payments. The draft recommendation would provide hospitals with a full Medicare payment update based on the rate of change in the market-basket index, concurrent with implementation of a quality incentive program. A second draft recommendation would reduce the indirect medical education (IME) adjustment from 5.5% to 4.5%. Commissioners discussed options for redistributing the resulting savings from the IME adjustment.

The recommendations can be viewed at http://www.medpac.gov/.

Costs of Treating Cardiovascular Conditions Rising

Wednesday, December 17th, 2008

In a recent report released by the Agency for Healthcare Research and Quality (AHRQ), in 2006, treatment for cardiovascular conditions accounted for $57.9 billion of the $329 billion hospitals spent to care for patients, about 40% more than was spent on the same conditions in 1997. AHRQ states that most of the growth in the cost for treating patients with six common cardiovascular conditions occurred between 1997 and 2003. Since 2003, annual growth has been less than 2%, a decline the agency attributes to a decline in cases of heart disease and slower increases in cost per case. Costs associated with treating chest pain with no determined cause increased the most, rising 10% annually between 1997 and 2006, from $1.6 billion to $3.9 billion.

The report can be accessed at http://www.hcup-us.ahrq.gov/reports/factsandfigures/facts_figures_2006.jsp.

Recommendations Issued by IOM

Wednesday, December 17th, 2008

An Institute of Medicine (IOM) committee issued recommendations to Congress on ways to improve the Department of Health and Human Services (DHHS). Among other proposals, the Committee said the department should establish a way to assess the comparative value of medical innovations and procedures, preventive and treatment technologies, and methods of organizing and delivering care. In addition, the DHHS should work with Congress to ensure the department’s programs and reimbursement policies are outcomes-based and create incentives to adopt best practices to improve health care quality and efficiency.

The recommendations can be viewed at http://www.iom.edu/CMS/28312/55311/60704.aspx.

Tom Daschle Nominated to Lead DHHS

Wednesday, December 17th, 2008

President-elect Barack Obama announced that he has chosen former Senator Tom Daschle to head the Department of Health and Human Services (DHHS). Obama also stated that Daschle would also serve as the director of the White House office of health reform. According to the President-elect, in addition to responsibility for implementing the health care plan, Daschle will also be the lead architect of the plan.

Daschle was first elected as a congressman from South Dakota in 1978 and served in the House until he was elected to the Senate in 1986. He served as the Democratic leader in the Senate from 1995 until 2004.