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Medicare/Medicaid News – 07/21/14

Some Seniors To Be Exempt From Medicare Three-Day Rule As Part Of Pilot Study.

The Washington Post (7/20, Jaffe) reported that some seniors will be exempt from the “controversial requirement that seniors be admitted to the hospital for at least three days to qualify for follow-up skilled nursing home care.” This waiver of the three-day rule, which is part of a pilot program aiming to test ways in which to develop better care at a lower cost, “applies even to patients kept for observation, which is considered an outpatient service. 77 more words

Medicare/Medicaid

Medicare/Medicaid News - 07/16/14

States Respond To CMS Letter About Medicaid Enrollment Backlogs.
The Los Angeles Times (7/15, Brown) reports that California state health officials have responded to CMS’s June 27 request for a plan to address Medicaid enrollment issues and have pledged to “reduce the number of Medi-Cal applications it has pending under Obamacare by nearly half within six weeks.” The letter detailing the state’s plan to clear the backlog “focuses on fixing the computer troubles that have made it difficult for county eligibility workers to interface with CalHEERS, the state’s new healthcare enrollment system” as well as plans to “‘proactively inform consumers’ caught in the backlog by sending them letters with instructions on how to obtain care while they await their Medi-Cal cards.” 109 more words

Medicare/Medicaid

Senate Committee Blasts CMS For Failing To Prevent Improper Medicare Payments.

 The Hill (7/10, Al-faruque) reports that the Senate Special Committee on Aging on Wednesday “blasted” CMS “for failing to prevent record-high improper payments and for putting undue burden on falsely accused providers.” Committee chairman Bill Nelson (D-FL), said, “The bottom line is, despite doing more audits than ever before, Medicare just isn’t getting the job done when it comes to preventing payment errors. 36 more words

Medicare/Medicaid

CMS Proposes Rule Change for Home Health Services.

The Hill (7/2, Al-faruque) reports that in an effort for the Centers for Medicare and Medicaid Services (CMS) to save money, the agency plans on “toughening requirements for eligibility for home health services setting a minimum requirement on home health agencies to prove their effectiveness and revising how much CMS pays for certain services.” The Hill notes that the agency predicts this rule change will reduce costs by 0.30%, or $58 million, by 2015.

Medicare/Medicaid

Omnicare Agrees to $124.24 Million Settlement to Resolve Anti-Kickback Allegations 

Nursing home pharmacy company Omnicare Inc. agreed to pay $124.24 million to settle allegations it submitted false claims to Medicare and Medicaid by entering into below-cost contracts to supply prescription medication and other pharmaceutical drugs to skilled nursing facilities to induce them to select Omnicare as their pharmacy provider, the Department of Justice (DOJ)  141 more words

Medicare/Medicaid

Medicare/Medicaid News - 06/19/14

Tool Offers Physicians A Way To Affirm Hope While Offering Accurate Medical Info To Patients Hoping For Miracles.
On its website, TIME (6/19) reports that physicians sometimes are unsure of what to do when confronted with “sick patients” who “say they’re hoping for a miracle.” Now, to help physicians “navigate this common situation, a team of physicians at Johns Hopkins Kimmel Cancer Center have created a helpful conversational tool called AMEN (affirm, meet, educate, no matter what), recently published in the Journal of Oncology Practice.” The tool offers physicians a way “to affirm hope while keeping intact their role as the provider of accurate medical information.” 95 more words

Medicare/Medicaid

Home Health Care Group Challenges CMS’ Implementation of ACA Face-to-Face Requirement

The National Association for Home Care & Hospice (NAHC) filed June 5 a lawsuit seeking to block a Centers for Medicare & Medicaid Services (CMS) rule it says requires extensive physician documentation of a patient’s need for homebound care beyond what was contemplated by the Affordable Care Act (ACA) face-to-face encounter requirement. 52 more words

Medicare/Medicaid