As a result of intense lobbying the CMS is giving SNF’s, nursing homes that provide nursing and rehab to Medicare beneficiaries recovering from a hospital stay, a rate increase worth more than 1.5 bn USD next year.
There are no strings attached to this windfall that skilled nursing facilities are receiving. Nursing home residents may or may not receive a better quality or care or life as a result of this windfall.
The Center for Medicare Advocacy called upon the CMS to recalibrate skilled nursing facilities rates as well as to take steps to make sure that the dollars are used as the CMS and Congress intended.
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The New York State Health Department will issue a decision in the coming weeks about whether to switch Medicaid beneficiaries who are afflicted with HIV/AIDs to managed care plans from fee for service plans. The 65000 people living with HIV/AIDs in the state who are enrolled in the Medicaid program have been exempt from an enrollment drive to place them in managed care plans. About 10000 HIV positive beneficiaries were enrolled in Medicaid managed care plans since late last year.
According to some HIV/AIDS advocates this means lower quality care and interrupted services for some patients. Some say this is being done just to save state money. According to Claudia Hutton, a health department spokesperson, it was not about saving money but using the money better.
Kentucky has 93,000 uninsured kids, 60,000 of whom are eligible for KCHIP. Even so these children are not enrolled. This report was recently released by Kentucky Voices for Health. Families whose average income is lower than 200 percent of the federal poverty level are eligible for KCHIP for their kids. Families who have incomes less than 150 percent of the poverty level receive KCHIP without cost and children in families with higher incomes contribute $20 per month.
A CMS Report says that medicare durable equipment fraud had been reduced to about 700 mn USD. The New York Times however reports that the claims were based on improper auditing and were incorrect.
The issue is the auditing on which CMS fraud reduction claims are based. Based on a Times report AdvanceMed, a Computer Sciences Corporation subsidiary had been hired to audit medicare DME spending. Apparently AdvanceMed was told to ignore an auditing programe –CERT or Comprehensive Error Rate Testing. This program is required by law. AdvanceMed was apparently told by CMS officials to only examine DME supplier invoices.
David Paterson, Governor of New York has proposed a cut in the state budget by one percent. $506 mn in Medicaid cuts is part of this proposal. This is being done to avoid a budget deficit that is casting it’s shadow on the financials of New York. State lawmakers have been asked to return to Albany in order to find a solution. This would involve reopening the budget, considering the cuts Paterson has proposed or finding solutions to tackle a deficit in the budget of upto %6.4 bn next year.
A recent Wall Street editorial talks about the financing of health care by taxing smokers. The pool of smokers is getting lesser by the day and the propriety of such a tax on this section of the populace is discussed in this editorial. Maryland is one state that proves how erroneous it is to finance health care by taxing smokers.
The editorial goes on to say that last year lawmakers from Maryland increased the state cigarette tax to $2 per pack to fund health care. Today they are realizing the mistake. After this increase in cigarette tax, there has been a 25% decrease in cigarette sales. The reason for the decrease is not a decrease in smoking.
Recently, a survey released by The Commonwealth Fund showed that majority of Americans are unhappy with the US health care system and 82 percent expressed a desire that the system be fundamentally changed or be re-built completely. A report outlining what an ideal US health care system should look like, what its strategies should be etc. has been released by The Commonwealth Fund Commission and is titled A High Performance Health System. It emphasizes on how to improve care and cut costs.
Harris Interactive conducted the survey in May of 2008 on more than 1000 adults. A sizeable majority of those surveyed, nine out of ten, felt that the current Presidential nominees come up with reform plans that promise to improve health care quality, ensure that health care and insurance is reasonable and accessible to all and also decrease the number of the uninsured. One out of every three adults said that their doctors had asked for a test that had previously been done or had been recommended unnecessary in the past two years. All income groups complained of receiving inefficient care. Read more…
The AP/San Francisco Chronicle reports that according to a GAO report obtained by the Associated Press, in the past one year CMS has sanctioned Medicare billing rights for two fictitious medical equipment suppliers that the GAO had established in order to test the system. The two fictitious suppliers were in Maryland and Virginia. They had provided CMS with incomplete and false information regarding their legitimacy and had no clients or inventory.
The report said that had there been real fraudsters in charge of the companies, the government would have ended up shelling out millions of dollars for nonexistent supplies that these companies would have billed them for. Something really needs to be done by the CMS in order to deal with this problem. Only solution is that those responsible for ensuring compliance exercise caution and diligence when conducting inspections and screenings.
On the 43rd anniversary of Medicare and Medicaid, the AARP issued a statement in its honor. Executive Vice President of AARP, Nancy LeaMond was the one who issued the statement.
LeaMond began by emphasizing the significance of the passage of Medicare and Medicaid in 1965 as a part of American history. She underlined how the administration and the Congress came together to deal with the national crisis and provided health care to those who needed it the most. She then went on to say, that a generation since the country is again facing a crisis situation. The exponential rise in health care costs is making quality health care inaccessible to employers, families, state and the federal government. She said that the current health crisis threatens to make everyone vulnerable.