Medicare News
Medicare Pays $36 Million to Doctors, Other Health
Professionals for Quality Reports
CMS says payments go to 56,700 health professionals
in Physician Quality Reporting Initiative
July
15, 2008 – Physicians that treat Medicare patients have been fighting in
Congress to prevent a cut in their pay, but many of them will share in
more than $36 million in bonus payments being paid by the Centers for
Medicare & Medicaid Services to 56,700 health professionals for
reporting quality information to Medicare.
Read
more....
Senior Citizens that Bring Companions to Medical
Visits are More Satisfied with Care
Companions are a valuable quality of care resource
that could enhance the experience for millions of vulnerable Americans
July
14, 2008 – Almost two out of every five Medicare patients age 65 or
older appear for their medical visits accompanied by family members or
companions, which seems to contribute to a greater satisfaction with
their doctor and about everything else associated with the visit. The
report in today’s Archives of Internal Medicine, one of the JAMA/Archives
journals, says this is especially true among those in poor health.
Read more...
Medicare Ties 2009 Pay for Outpatient Services to
Quality Reporting
Amount beneficiaries pay for outpatient services will
decline to provide a gradual transition to 20% coinsurance
July
4, 2008 – Medicare has proposed a new rule increasing the pay rate for
hospital outpatient departments and ambulatory surgical centers by three
percent for calendar year 2009, but, those that do not meet quality
reporting requirements will see that pay rate increase to just one
percent. It is the first time Medicare outpatient pay rates have been
associated with the quality of service.
Read more...
Older Nursing Homes Must Add Sprinkler Systems for
Medicare, Medicaid Patients
‘We now will hold all 16,000 nursing homes in the
nation to this standard.” CMS says
June
20, 2008 – Older nursing homes that have escaped modern regulations that
require wall-to-wall life-saving sprinkler systems to protect residents
from fire, will now have get the systems installed, if they want to
continue to serve Medicare and Medicaid beneficiaries.
Read more...
CMS to Add New Five-Star Quality Rating of
Nursing Homes to Compare Website
Nursing Home Compare continuing to add info to
help consumers make choices
June
19, 2008 - The Centers for Medicare & Medicaid Services today announced
it will soon launch a ground-breaking ranking system of America’s
nursing homes, giving each a “star” rating – one star up to five stars.
The ratings will be posted on the agency’s Nursing Home Compare Website
by the end of this year.
Read more...
Medicare Sending Another $15 Million to Help Counsel
Seniors on Health Care Options
Money to state programs is part of $50 million
commitment for 2008
June
6, 2008 – Senior citizens should find it easier to get help in learning
more about their Medicare health care and health insurance choices after
the State Health Insurance Assistance Programs receive the additional
$15 million promised today from the Centers for Medicare & Medicaid
Services.
Read more...
Medicare Changing Reference Book for Approving
Anti-Cancer Chemotherapy Drugs
National Comprehensive Cancer Network Drugs &
Biologics Compendium is new source
June
5, 2008 – Senior citizen Medicare patients and their cancer care
providers will no longer use the American Medical Association Drug
Evaluations (AMA-DE) book to determine which drugs are covered under
Medicare Part B to treat patients undergoing chemotherapy. The Centers
for Medicare & Medicaid Services says it is no longer being updated and
the agency is switching to a new source to ensure the most
up-to-date information.
Read
more...
End-of-Life Options for Medicare Patients Detailed
in New Regulation
Seniors choosing hospice or palliative care have
right to participate in treatment plan and more
June
5, 2008 - Medicare beneficiaries with terminal illnesses have their
right to determine how they receive end-of-life care outlined for the
first time in a new regulation to be published today by the Centers for
Medicare & Medicaid Services.
Read
more...
Visits by Primary Care Physicians Reduce Medicare
Costs at End of Life
‘Decreasing just one hospital day for each Medicare
beneficiary at the end of life could have saved millions of dollars’
June
5, 2008 – About six percent of the people in Medicare die every year.
Surprisingly, they use up about 30 percent of the money Medicare spends
each year. A new study has found that more visits by the primary care
physician in these final months will significantly lower this cost and
result in fewer deaths in hospitals.
Read more...
Senior Citizens Happy with
Medical Care Regardless of
How Much Medicare Spends on Them
Spending varies widely but perceptions of medical
care quality does not
May 27, 2008 – Many senior citizens would be
surprised by the wide differences in per capita expenditures by Medicare
from area to area across the U.S. A new study has found, however, that
those Medicare beneficiaries in the lowest expenditure areas are just as
happy – if not more so – with their medical care as are those in the
high expenditures areas.
Read
more...
Medicare’s Private Fee-for-Service Plans Not Well
Known to Many Seniors; Mixed Reviews
PFFS plans are the fastest-growing Medicare Advantage
plans on the market
May
27, 2008 – Medicare used to be nice and simple, but it offered less.
Now, there are many options about how to obtain your medical insurance
through Medicare but many are still not well understood. In the analysis
below, ElderLawAnswers.com looks at the private fee-for-service plans.
Some advocacy groups think original Medicare is better.
Read more...
Centers for Medicare and Medicaid Joins with FDA in
New Initiative to Improve Patient Safety
Enables CMS to use Medicare Part D claims data for
research, program oversight and evaluation, care coordination, quality
improvement, and performance measurement initiatives
May 22, 2008 - The Centers for Medicare & Medicaid
Services (CMS) will begin sharing data on prescription drug use to help
government agencies and academic researchers improve the safety, quality
and efficiency of health care services, while as part of this new
initiative launched by Health and Human Services, the Food and Drug
Administration will be more proactive in its surveillance of medical
products on the market.
Read more...
Hospital Compare Website to be Promoted Tomorrow in
58 Daily Newspapers
Centers for Medicare & Medicaid Services’ ads
highlight patient ratings for over 1,000 hospitals
May 20, 2008 – Fifty-eight daily newspapers in the
U.S. will be running advertisements tomorrow promoting the Hospital
Compare website managed by the Centers for Medicare & Medicaid Services
(CMS). The ads provide scores from two of the 26 quality and patient
satisfaction measures on the Website for a sample of hospitals in the
community covered by each newspaper.
Read more...
Medicare Drug Program News
CMS Says New Regulations Will Better Protect Seniors
in Advantage and Drug Plans
Proposal tightens marketing rules, protects from
inappropriate cost sharing
May 8, 2008 - The Centers for Medicare & Medicaid
Services (CMS) says in a news release today that it will propose new
regulations and new requirements for Medicare Advantage (MA) health
plans and Medicare prescription drug plans. The CMS statement says the
actions will provide "enhanced protections" for senior citizens enrolled
in these plans.
Read
more...
Medicare to Cover Artificial Hearts When Used in FDA
Approved Clinical Research
Decision revises a long-standing non-coverage policy
May 2, 2008 - Medicare should soon start paying for
artificial hearts, at least when they are implanted as part of a study
that is approved by the Food and Drug Administration (FDA) and that
meets CMS’ Coverage with Evidence Development (CED) clinical research
criteria. Read
more...
HHS Secretary Leavitt Urges Lawmakers, Public to
'Start Now' To Make Changes to Medicare
Congress has only three methods -- raising taxes,
reducing benefits or lowering payments to providers
April 30, 2008 - Health and Human Services
Secretary Mike Leavitt said Tuesday that it is "simply unreasonable" to
think Medicare can maintain its solvency without changes to the program
and that if "we start now, the change can be made over time and with
genuine fairness,"
CQ HealthBeat reports.
Read
more...
Senators Compliment CMS on Nursing Website but Push
Bi-Partisan Bill for More Info
Democrat Kohl, Republican Grassley push bill to
expand transparency
April 28, 2008 – Two U.S. Senators from different
parties came together last Friday to compliment the Centers for Medicare
and Medicaid Services for increasing the information available on their
Website, Nursing Home Compare, but they say the agency has a ways to go
to achieve the transparency and information for consumers called for in
the Senate bill they have crafted.
Read
more...
Health Care System Unprepared for Millions of Baby
Boomers About To Become Eligible for Medicare
U.S. would need 36,000 geriatricians by 2030 to meet
the need
April 16, 2008 -The U.S. health care work force is
"too small and woefully unprepared" to meet the geriatric care needs of
the 78 million aging baby boomers, according to a report released on
Monday by the
Institute of
Medicine, the Wall Street Journal reports (Francis/Fuhrmans,
Wall Street Journal, 4/15). The report, titled "Retooling for an Aging
America: Building the Health Care Workforce," estimates that currently
there is one certified geriatrician for every 2,500 seniors.
Read more...
CMS Proposal Says Medicare Won't Pay Hospitals for
Mistakes Like Cutting Off Wrong Leg
Adding 43 new quality measures on which hospitals
have to report data in order to receive full payment for services
April
15, 2008 - The screws are being significantly tightened to improve the
care of Medicare patients in the hospital and to save millions of
dollars for Medicare by not paying for certain conditions - such as
having the wrong leg cut off - that are caused in the hospital. The
Centers for Medicare & Medicaid Services (CMS) on Monday proposed these
additional steps to strengthen this tie between the quality of care
provided to Medicare beneficiaries and payment for the services. Read
more...
Medicare Advantage Plans to Get More Subsidy, Drug
Plans Get Higher Deductible
CMS to pay 3.6% more to MA plans, drug deductible
goes to $295 from $275 in 2009
|
Read
complete Fact Sheet below news report. |
April 9, 2008 – The subsidy paid by Medicare to
Medicare Advantage Plans will increase by 2.6% next year, despite
consistent opposition by advocacy groups and Democrats to this subsidy,
according to an a Fast Sheet published by the Centers for Medicare and
Medicaid Services on Monday. And, the drug plan providers also got a
small boost in the form of higher deductibles for prescription drug
plans next year.
Read more...
Hospital
Mistakes Kill 270,491 Medicare Patients in 3 Years, Cost $8.8 Billion
HealthGrades says 238,337 deaths preventable, top
hospitals have 43% lower incident rate
April 8, 2008 – Hospital safety incidents caused the
deaths of 270,491 Medicare patients during the years 2004 through 2006,
according to a new report from HealthGrades, which estimates 238,337 of
these deaths were potentially preventable. There were more than a million
safety incidents during the three years studied.
Read more...
End-of-Life Spending Varies Widely for Medicare
Patients with Chronic Conditions
New Jersey spent most, $59,379; North Dakota least,
$32,523; US average $46,412 - Kaiser Network Daily Report
April 7, 2008 - There is wide variation among the
U.S.'s top academic medical centers in spending on care for Medicare
beneficiaries with chronic conditions during the last two years of their
lives, according to the 2008 edition of The Dartmouth Atlas of Health
Care, the
New York Times reports.
Read more...
Medicare Patients Should Expect Better Care at
Dialysis Centers, Says CMS
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5 tips to prevent CKD below |
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CMS issues final rule to update Medicare
‘conditions for coverage’
March 4, 2008 – Senior citizens should expect a
higher quality of care when receiving dialysis, according to an
announcement yesterday from the Centers for Medicare & Medicaid Services
(CMS), that it has released a final rule that will modernize the
Medicare conditions for coverage for the nation’s dialysis centers.
Read more...
Hospital Compare Website Helps Medicare
Beneficiaries Learn More About Local Hospitals
Latest expansion in growing list of consumer Websites
by CMS
March
31, 2008 – For the first time, Medicare consumers have the three
critical elements - quality information, patient satisfaction survey
information, and pricing information for specific procedures - they need
to make effective decisions about the quality and value of the health
care available to them through local hospitals, according to the Centers
for Medicare & Medicaid Services (CMS), which announced changes to the Hospital
Compare Website, one of several by CMS to help consumers make
intelligent health care choices.
Read more...
New Trustees Report Says Medicare Going Broke
Slightly Faster than Expected
‘We need to act quickly and effectively to address
Medicare’s fiscal health’ HHS Secretary
| |
>> Read report by
KaiserNetwork.org below main story. |
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March 26, 2008 – As many have long known, Medicare
is under a great deal more financial stress than the Social Security
program, and this was confirmed yesterday by the annual report of the
Medicare Trustees that says Medicare’s Hospital Insurance (HI) Trust
Fund will become insolvent slightly earlier in 2019 than reported last year.
Read more...
Fraud Grows as Private Managed Care Takes Over More
Medicaid, Medicare Patients
Wall Street Journal looks at new types of fraud; CVS
pays millions for over-billing Medicaid
March 19, 2008 – The Wall Street Journal today
asserts that as the government shoves more Medicaid and Medicare
beneficiaries to private sector managed care plans, new types of fraud
are emerging. This report hits on the same day as the report that the
giant pharmacy chain CVS agreed to pay nearly $37 million to settle
claims that it fraudulently billed Medicaid. The WSJ also examined the
growing practice of hospitals to reuse medical devices that have
designated for one time use.
Read more...
Medicare, Medicaid Veterans Health Care in
Washington Political Spotlight
Republicans want to cut Medicare, Medicaid;
Democrats want to expand VA health care, key report says traditional
Medicare more efficient than Medicare Advantage
March 12, 2008 – Republicans have introduced their
budget proposal for fiscal 2009, which calls for cuts to the critical
senior citizen programs of Medicare and Medicaid, but that was just the
hottest political move in Washington impacting health care for seniors
and veterans. A committee hearing heard a key report saying traditional
Medicare is a more efficient way of delivering benefits than Medicare
Advantage plans, which supports Democratic efforts to end government
subsidies to the MA plans. The comptroller general criticized the
government in an interview for not acting to secure the financial future
of the entitlement programs. KaiserNetwork.org also reports Democrats
trying to expand the veterans’ health care system.
Read
more...
Kohl Wants Action from Medicare Advantage Plans on
Marketing Reform
'We’ve heard pledges and promises from this group
before,' he says to recent statement by insurance trade group
March 10, 2008 - Sen. Herb Kohl (D-WI) reacted
firmly to
the recent proposal from America’s Health Insurance Plans on reforming
the marketing of Medicare Advantage plans. “We can no longer wait for
these companies to clean up their act while seniors continue to be duped
and misled,” said the chairman of the Senate Special Committee on Aging.
Read more...
Medicare Advantage Plans Higher Than Traditional
Medicare for Some Seniors
Medicare Advantage plans to cost Medicare extra $54
billion from 2009 to 2012, GAO reports
Feb. 29, 2008 - Private Medicare Advantage plans
can cost beneficiaries more than traditional Medicare for home health
care, nursing homes and certain hospital stays, according to a report
released on Thursday by the
Government Accountability Office, the
New York Times reports.
Read
more...
Health Care
Spending to Double to $4.3 Trillion by 2017; Boomers Drive Medicare
Increased use to double prescription drug spending as
prices go down, generics grow
Feb.
26, 2008 – The cost of health care in the U.S. is expected to continue to
outpace inflation and gobble up more of the nation’s gross domestic product
(GDP), according to an analysts by the Centers for Medicare and Medicaid
Services. The report published in Health Affairs says health care spending
will double by 2017, from last year, reaching $4.3 trillion. By 2017 it will
also be consuming 19.5 percent of the GDP.
Read more...
Senior Citizens Living with Heart Failure Increase
as New Cases Decline
Survival gains result in more Medicare patients
living with heart failure
Feb. 25, 2008 – The number of senior citizens being
diagnosed with heart failure has declined over the last ten years. And,
the number of elderly that are living with this condition has increased,
which is, of course, bad news for Medicare which bears the cost of care.
Read more...
Black Women Did Not Benefit as Much as White Women
from Medicare-Paid Mammograms
Breast cancer death rates for the two ethnic groups
used to be nearly identical
By Randy Dotinga, Contributing Writer
Health Behavior News Service
Feb. 19, 2008 - When Medicare began paying for
older women to undergo preventive mammograms in 1991, doctors expected
breast cancer mortality rates to drop. And, as expected, breast cancer
deaths did decrease, but new research has unveiled a discrepancy:
African-American women as a group do not benefit as much as white women.
Read more...
LA Times Says Employers Moving Retirees to Medicare
Advantage; Driving Up Cost for Other Seniors
Senate Kent Conrad (D-N.D.) called the program "a
runaway train
Feb. 12, 2008 – The financial viability of
Medicare, already badly strained, is rapidly getting worse as many local
governments, major corporations and others have learned they can shift
the cost of their retiree health care to the federal government. By
moving the retirees to Medicare Advantage they reduce their cost but
also increase the cost to senior citizens in traditional Medicare.
Read more...
Finance Committee Moves from Stimulus Plan to
Medicare Advantage Problems
Sen. Baucus says, ‘There are too many problems and
abuses.’
Feb. 8, 2008 – Fresh from a victory to get
low-income senior citizens included in the economic stimulus payments,
the Senate Finance Committee is looking at the marketing programs of the
Medicare Advantage Plans, which were supposed to have been corrected
last year.
Read more...
Cost of Entitlement Programs Driven by Skyrocketing
Health Care Costs, Aging Population
Since 1960 health care costs have grown 2.7
percentage points faster per year than the economy as a whole
Feb. 4, 2008 – There are two things that drive the
spiraling costs of the entitlement programs – Social Security, Medicare
and Medicaid – the aging population and the cost of health care. The
administration, in the new 2009 budget introduced today, presents a
brief but informational look at the two problems.
Read more...
Health Care Providers to Bear Brunt of Medicare Cost
Over-Runs in Future
Administration adds budget feature automatically reducing
payments when costs exceed 45% of funding
Feb.
4, 2008 – The 2009 budget submitted today by President Bush will reduce
Medicare spending by $556 billion over 10 years and more than $10
trillion over 75 years. Most of this will probably be paid for by
reduced payments to health care providers due a unique provision the
administration has included to require automatic annual reductions in
fees when funding no longer covers 55 percent of the costs.
Read
more...
Senior Citizen Politics
Senior
Citizen Entitlement Programs Take $208 Billion Hit in Bush Budget
President lays out $3.1 trillion budget and again
says Congress must solve financial future of Medicare, Medicaid, Social
Security
Feb.
4, 2008 - Entitlement programs – short for Medicare, Medicaid and Social
Security – will see spending cuts of $208 billion over the next five years,
if the budget proposed today by President George W. Bush is approved. The
cuts in these programs that primarily affect senior citizens are even larger
than earlier estimates. The President, today, repeatedly laid the problem at
the feet of Congress, as he did in the State of the Union address.
Read more...
Bush Budget Coming Monday Cuts Medicare, Medicaid
but Not Advantage Plan Subsidy
Medicare Payment Advisory Commission says extra fees
paid the Medicare Advantage fee-for-service plans should be cut
Jan. 31, 2008 – President Bush will release his
budget for ht 2009 fiscal year on Monday and it is expected to include
spending cuts in Medicare and Medicaid. He is not likely, however, to
take the suggestion of the Medicare Payment Advisory Commission that
extra fees paid the Medicare Advantage fee-for-service plans be
cut. The Senate Finance Committee seemed to like that idea, too,
at a hearing yesterday.
Read more...
Medicare Making Decisions Based on Profiles that Do
Not Match Beneficiaries
Cardiovascular clinical trial participants differ
in age, sex and country of residence
Jan. 30, 2008 – Despite the skyrocketing costs of
Medicare and the demand for informed decisions, Medicare is using
clinical trials with participants that do not match the characteristics
of beneficiaries to make decisions about cardiovascular products and
services. The trial participants differ in age, sex and country of
residence, according to a report in the January 28 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.
Read more...
Medicare in 2008 Has Become Costly and Complicated
for Many Senior Citizens
A brief look at the Medicare program and the costs in
2008
Jan. 21, 2008 - In the beginning Medicare was
pretty simple with few decisions required – no real challenge even for
an aging brain to understand, and a cost too low to worry about. That’s
not the case today. The Medicare program is fraught with complicated
decisions that can be costly, if a senior citizen makes the wrong
choice. Below is a brief explanation of the program and the costs for
2008 prepared by SeniorJournal.com and the Medicare Rights Center.
Read more...
Senior Citizens Need to Know Medicare's Nursing Home Care
is Very Limited
ElderLawAnswers.com says Medicare covers "acute" care as opposed to
custodial care
Jan. 18, 2008 - Many people believe that Medicare
covers nursing home stays. In fact Medicare's coverage of nursing home
care is quite limited. Medicare covers up to 100 days of "skilled
nursing care" per illness, but there are a number of requirements that
must be met before the nursing home stay will be covered. The result of
these requirements is that Medicare recipients are often discharged from
a nursing home before they are ready.
Read more...
Ohio, Pennsylvania Join Federal Effort to Increase
Planning for Long-Term Care
‘There’s a widespread misconception that Medicare
pays for long-term care’
Jan. 16, 2008 - Ohio and Pennsylvania will join a
federal program created to increase the public’s awareness about the
importance of long-term care (LTC) planning. The “Own Your Future”
education effort includes information on various ways senior citizens
can finance long-term care, according to Health and Human Services (HHS).
Read more....
Healthcare Spending Hits $2.1Trillion, Growth
Rate Grows in 2006, Says CMS
Growth slight but more than economic growth,
general inflation
| |
See below:
> Healthcare spending by age
> Report by KaiserNetwork.org on CMS news and
reactions |
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Jan. 8, 2008 - In 2006, U.S. health care
spending reached a total of $2.1 trillion, or $7,026 per person, up
from $6,649 per person in 2005, according to a report by the Centers
for Medicare & Medicaid Services (CMS). The health care spending
growth accelerated slightly in 2006, increasing 6.7 percent compared
to 6.5 percent in 2005, which was the slowest rate of growth since
1999.
Read more...
What to Do When You Realize Your Medicare Drug or
Health Plan Does Not Meet Your Need
Information on drug and health plans provided by Medicare
Rights Center – see links below article
Jan.
4, 2008 – Sometimes, after you picked the Medicare private health or
drug plan that you thought best suited your needs, you discover in the
New Year that the plan you chose doesn’t work for you at all. Perhaps
you’ll find that your doctor or specialist isn’t part of the plan’s
network. Maybe you’ll discover that there are large copays for a
hospital stay or diagnostic procedures. Or maybe when you go to the
pharmacy, you’ll find out that your drug plan doesn’t cover your
medications. Read
more...
Senior Citizens in Medicare Prove Health Improves
with Universal Health Insurance
Those without prior insurance show greatest health
gains after reaching Medicare coverage
Dec. 26, 2007 – As the presidential candidates rush
out their ideas on universal health care, a new study of senior citizens
proves just how valuable it can be to extend health coverage to those
that do not have it. The report published today in the Journal of the
American Medical Association (JAMA) looks at the impact of Medicare,
which provides comprehensive evidence that having health insurance leads
to better health.
Read more...
Medicare Seeks Ways to Get Senior Citizens to Take
Better Care of Their Health
Awards contracts for Senior Risk Reduction
Demonstration as part of Focus on Prevention
Dec. 19, 2007 – Medicare took a big step forward in
its Senior Risk Reduction Demonstration, by awarding contracts to help
find ways to use disease prevention and health programs now used by the
private sector to encourage senior citizens covered by Medicare to do a
better job of managing their health.
Read more...
Medicare, Medicaid Pay Most of 2005 Hospital Bill
that Jumped 90 Percent from 1997
Total bill is $873 billion in 2005 with Medicare
alone paying $411 billion
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Distribution of the national hospital bill by primary payer, 2005 |
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Dec. 12, 2007 – While the presidential candidates
debate new ideas for universal health care, it is sneaking up behind us.
New numbers show U.S. hospitals charged $873 billion in 2005 – almost a
90 percent increase from the $462 billion charged in 1997. The report
also shows that the majority - about two thirds - of this bill was paid
by Medicare and Medicaid, although other government programs also helped pay
the bill.
Read more...
Three of Four Senior Citizens Refuse Medicare’s Free
Colorectal Cancer Screening
American Cancer Society estimates over 147,000 new
cases and 57,000 deaths this year
| |
Read more about
colorectal cancer and testing below article. |
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Dec. 10, 2007 - A stunning three out of four senior citizens are
failing to take advantage of the Medicare funded screening for
colorectal cancer. It is stunning because regular colorectal cancer
screening can, in many cases, prevent colorectal cancer altogether,
according to the study published in the January 15 issue of CANCER, a
peer-reviewed journal of the American Cancer Society.
Read more...
Medicare Spends Billions Annually on Products
Available at Lower Prices
New York Times finds better prices from retail, online stores
Nov 30, 2007 - "Despite enormous buying power,
Medicare pays far more" than individuals for equipment and services that
are "available at far lower prices from retail pharmacies and online
stores," the
New York Times reports.
Read more...
Senior Citizen Politics
Drug Company Wants
to Force $2,000 Cancer Drug to Replace $40 Avastin
Sen. Kohl demands info on Genentech move that could cost
Medicare $3 billion annually for treating of macular degeneration
Nov. 29, 2007 – Sen. Herb Kohl (D-WI) stepped to the
front of the line late yesterday to intervene in a proposed limit by
Genentech in the availability of its cancer drug Avastin to certain
pharmaceutical compounding firms and pharmacies. Some physicians have
charged that Genentech’s intention in limiting Avastin’s availability is to
boost sales of Lucentis, a chemically-similar, yet far more expensive drug
also produced by Genentech and approved to treat macular degeneration.
Read more...
Nov. 29, 2007 – Ouch! The Centers for Medicare &
Medicaid Services (CMS) today released the first ranking of the nation’s
poor-performing nursing homes, which it identifies as “Special Focus
Facilities.” CMS says the purpose is to help people choose nursing homes
for long-term care. Read
more...
Use of hospice by patients with less predictable life
expectancies, such as Alzheimer's disease and dementia, has
'skyrocketed'
Nov. 27, 2007 - The increase in hospice patients
who live longer than expected has led
CMS (Centers for Medicare & Medicaid Services) to demand
hundreds of millions of dollars in repayments from facilities that
exceed Medicare reimbursement limits, the
New York Times
reports. Read
more...
Group says reimbursement for DXA test will save
Medicare $1.14 billion over five years
Nov. 2, 2007 – Physicians will receive a 10 percent
pay cut for treating Medicare patients in 2008, according to an
announcement that had been expected from the Centers for Medicare &
Medicaid Services (CMS) on Thursday. CMA said it issued a final
physician payment rule designed to improve accuracy of Medicare payments
and give physicians and health care professionals additional financial
incentives to provide higher quality and value in the delivery of care.
Read more...
U.S. News & World Report, NCQA release annual
rankings for 500 health plans
Oct. 24, 2007 – Bed sores, pressure ulcers, decubitus ulcers – they are all the same thing – a killer that often
strikes unsuspecting victims in nursing homes. These flesh killers have
been the target the Centers for Medicare & Medicaid Services, which has
just announced a “remarkably effective” effort in preventing them in
nursing homes.
Read more...
Elderly patients not given full range of treatments
and services for their conditions
Oct. 17, 2007 - If the care received by vulnerable
older people concurrently enrolled in Medicare and Medicaid was
evaluated on a grading scale, it would squeak by with a barely passing
mark, a new UCLA study has found. They found that “vulnerable
elderly” patients received only 65 percent of the tests and other
diagnostic evaluations and treatments recommended for a variety of
illnesses and conditions, including diabetes and heart disease.
Read more...
Senior citizens encouraged to use information as
snapshot of the quality of care being delivered
Oct. 11, 2007 – Medicare reported today that the
“vast majority of the nation’s hospitals” are reporting “valuable data”
about the quality of the care they provide to Medicare beneficiaries and
will receive a full payment rate increase of 3.3 percent next year.
Read more...
Oct. 11, 2007 - The Centers for Medicare & Medicaid
Services (CMS) today announced plans for a home health
pay-for-performance demonstration, an important new step in its drive to
become a more effective purchaser of quality healthcare.
Read more...
Oct. 9, 2007 - Social Security, Medicare and
Medicaid, programs primarily serving senior citizens, accounted for more
than $1 trillion of the $2.3 trillion the federal government spent in
2005, according to the U.S. Census Bureau, which publishes the only
consolidated source of data on the geographic distribution of federal
expenditures.
Read more...
Oct. 2, 2007 – Everyone enrolled in a Medicare
private health plan should review their health coverage options for next
year, since most private plans will change their costs and benefits,
according to the Medicare Rights Center (MRC).
Read more...
CMS hails it as the smallest premium increase in six
years but partially due to accounting change
Oct. 2, 2007 – The monthly charge for Medicare’s
Part B in 2008 will be $96.40. This 3.1 percent increase over this year
is heralded as the smallest rate increase in six years, but how it got
there is partially due to an accounting error that was corrected by the
Centers for Medicare & Medicaid Services (CMS).
Read more...
Enrollment change period opens Nov. 15, ends Dec. 31
with chance to lower drug plan cost
Oct.
1, 2007 – When the open enrollment period opens for Medicare on Nov. 15,
over 90 percent of senior citizens with stand-alone Part D prescription
drug plans (PDP) will be able to choose at least one plan for 2008 with
monthly premiums lower than they are paying now.
Read more...
Sept. 26, 2007 – Even though Medicare pays for it,
senior citizens are terrible about following through with cardiac
rehabilitation after a heart attack or coronary bypass surgery. Fewer
than 20 percent – less than one out of five – take advantage of this
free benefit despite strong evidence that it reduces disability and
prolongs life.
Read more...
Nov. 26, 2007 – The National Osteoporosis
Foundation has issued a news release in support of a House bill (H.R.
4206), which the group says calls for the reversal of drastic cuts in
Medicare reimbursement for Dual Energy X-ray Absorptiometry, DXA, the
imaging procedure "accepted as the gold standard" for diagnosing
osteoporosis.
Oct. 27, 2007 – A ranking for U.S. health
maintenance organizations and point-of-service plans was released today,
which includes plans that serve Medicare and Medicaid. The U.S. News &
World Report listing, however, may not be of much help to those who
don’t live in the northeast – since that is where all but one of the top
ten plans serving those in the government programs are located.
Medicare Rights Center outlines things senior
citizens should consider