Kaiser Daily Health Policy Report, March 7, 2011
Politico: Sources: Democrats Giving Up On Donald Berwick
Senate Democrats have given up on confirming Don Berwick as CMS administrator in the wake of a letter from 42 Republican senators opposing the nomination, sources tell POLITICO. Citing the GOP letter, a person familiar with the situation said Senate Democrats and the White House “can do the arithmetic” and now see that there’s no way for Berwick to get the 60 votes needed to clear the Senate. At a meeting with health care lobbyists Friday, Democratic Senate Finance Committee staffers indicated that the nomination is dead, that there will be no confirmation hearing, and that they’ll soon be discussing “next steps” for CMS, sources said (Coughlin, 3/4).
Healthcare Finance NewsWeek, March 8, 2011
Roughly $48 billion of Medicare’s $507 billion budget in 2010 went to fraudulent or improper payments, according to a report from the Government Accountability Office.
Kaiser Daily Health Policy Report, March 8, 2011
The Boston Globe: Medical Bankruptcies A Continuing Problem, Study Finds
The 2006 Massachusetts law that required nearly everyone to buy health insurance has not significantly staunched residents’ pain from medical bankruptcies, according to a new study. A survey of Massachusetts residents who filed bankruptcy in July 2009 found that 53 percent cited a medical cause, down from 59 percent who blamed a medical cause in a survey done in early 2007, before the state law had been fully implemented. But because of the small number of people surveyed, the difference was not statistically significant, according to the study in today’s American Journal of Medicine (Lazar, 3/8).
The Wall Street Journal: Medicaid Is Worse Than No Coverage At All
Kaiser Daily Health Policy Report, March 10, 2011
Patients would be better off if states were able to tailor the benefits that Medicaid covers – targeting resources to sicker people and giving healthy adults cheaper, basic coverage. But federal rules say that everyone has to get the same package of benefits. … These rules reflect the ambition of liberal lawmakers who cling to the dogma that Medicaid should be a “comprehensive” benefit. … Because states are forced to offer everyone everything, the actual payment rates are driven so low that beneficiaries often end up with nothing in practice (Dr. Scott Gottlieb, 3/10).
Get to Know Your Program-Integrity Contractors (excerpt)
www.aishealth.com, February 22, 2011
The Medicare watchdog role has been outsourced at a magnitude never seen before, and it’s important to know exactly who is scrutinizing you. It’s not enough to know that your organization’s claims are, or will be, reviewed by a RAC, MAC, ZPIC, MIC and, soon enough, Medicaid RAC. Organizations should know the names of all the vendors who won CMS contracts to identify overpayments (and perhaps underpayments) or conduct fraud investigations for your jurisdiction, says Atlanta attorney Sara Kay Wheeler. “It is critical to understand who the players are and to know them by name,” she says.
Can you rattle off the names of vendors that hold all these contracts in your jurisdiction?