Medicare Update

CMS to Hold Town Hall Meeting on New Medical Services and Technologies

The Centers for Medicare & Medicaid Services (CMS) recently published a Notice in the Federal Register announcing a Town Hall Meeting to discuss fiscal year 2009 applications for add-on payments for new medical services and technologies under the Medicare hospital inpatient prosp …

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CMS to Post Worksheets for 2008 Physician Quality Reporting Initiative

On January 1, 2008, reporting for the 2008 Physician Quality Reporting Initiative (PQRI) began.

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Study: Health of Uninsured Adults Improved After Obtaining Medicare Coverage

A recent study suggests that expanding health coverage to uninsured adults improves their health.

President Bush Signs Medicare, Medicaid and SCHIP Extension Act of 2007

On December 29, 2007, President Bush signed the Medicare, Medicaid and SCHIP Extension Act of 2007 (Act) into law, extending the State Children's Health Insurance Program (SCHIP) and temporarily addressing a number of Medicare program issues.

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CMS Delays Revised Anti-Markup Provisions for Certain Services

On December 28, 2007, the Centers for Medicare & Medicaid Services (CMS) released a display copy of a final rule (Final Rule), delaying until January 1, 2009, the applicability of the anti-markup provisions in 42 C.F.R.

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OIG Solicits New Safe Harbors and Special Fraud Alerts

On December 19, 2007, the Department of Health & Human Services' Office of Inspector General (OIG) published a Notice in the Federal Register soliciting proposals and recommendations for developing new and modifying existing safe harbor regulations under the Federal anti-kickback …

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GAO Audit Reveals $90 Million in Questionable Medicare Payments

In a recently released report to Congress, the Government Accountability Office reports that the Centers for Medicare & Medicaid Services made approximately $90 million in questionable payments to contractors.

UPDATE: House Passes Medicare, Medicaid and SCHIP Extension Act of 2007

Today, the U.S. House of Representatives passed the Medicare, Medicaid and SCHIP Extension Act of 2007 (S.2499) in a 411-3 vote.

UPDATE: Senate Passes Medicare, Medicaid and SCHIP Extension Act of 2007

On December 18, 2007, the U.S. Senate passed the Medicare, Medicaid and SCHIP Extension Act of 2007 (S.2499), which would prevent the 10.1 percent cut to Medicare physician payments beginning January 1, 2008.

Congress to Consider Medicare Legislation Blocking Physician Payment Cuts

Today, Senate Finance Committee Chairman Max Baucus announced that Congress will consider the Medicare, Medicaid and SCHIP Extension Act of 2007 this week.

Medicare Part D Plans Not Meeting Requirements for Tracking TrOOP Costs

On December 17, 2007, the Department of Health and Human Services' Office of Inspector General released a report indicating that Medicare Part D plans have not met all requirements for tracking beneficiaries' true out-of-pocket costs.

OIG Issues Advisory Opinion No. 07-16

On December 14, 2007, the Department of Health and Human Services' Office of Inspector General released OIG Advisory Opinion No. 07-16.

Quality Measures Proposed for Medicare Special Needs Plans

On December 14, 2007, the Centers for Medicare & Medicaid Services and the National Committee for Quality Assurance announced that they are seeking public comment on a set of proposed quality measures for Medicare Special Needs Plans.

OIG Releases Semi-Annual Report to Congress

On December 14, 2007, the Department of Health and Human Services' Office of Inspector General released its Semi-Annual Report to Congress, which reports savings and expected recoveries of over $43 billion for fiscal year 2007.

CMS to Direct Review of Recovery Audit Contractor Decisions

In a December 10, 2007 article, The Sacramento Bee reports that Medicare officials recently informed Congress that policy inconsistencies were found in approximately 40 percent of one Medicare recovery audit contractor's decisions.

HHS Publishes Semi-Annual Regulatory Agenda

On December 10, 2007, the Department of Health and Human Services (HHS) published its Semi-Annual Regulatory Agenda identifying the rulemaking activities that HHS expects to undertake in the next 12 months.

Senator Baucus Cancels Mark Up of Medicare Legislation

On December 5, 2007, Senate Finance Committee Chairman Max Baucus announced that he will speed up efforts to craft Medicare legislation this year by moving directly to negotiations with the House of Representatives.

HHS Secretary Sets Parameters for Medicare Physician Payment Legislation

On December 4, 2007, the Secretary of the Department of Health and Human Services wrote to Senator Max Baucus regarding draft legislation that the Senate Finance Committee may consider to block the 10.1 percent reduction in the payment rates for physician services in 2008.

CMS Extends Enrollment Period for Medicare Home Health P4P Demonstration

The Centers for Medicare & Medicaid Services recently posted an announcement extending the enrollment period for the Medicare home health pay-for-performance demonstration project.

CMS Establishes Therapy Caps for Calendar Year 2008

In the Final Rule updating the Medicare Physician Fee Schedule for calendar year 2008, the Centers for Medicare & Medicaid Services establishes therapy caps for outpatient physical therapy, speech language pathology, and occupational therapy services.

CMS Releases List of Poor Performing Nursing Homes

On November 29, 2007, the Centers for Medicare & Medicaid Services released a list of 54 poor performing nursing homes as part of the "Special Focus Facility" initiative.

CMS Releases Report to Congress on Medicare Hospital Value Based Purchasing

On November 21, 2007, the Centers for Medicare & Medicaid Services released its Report to Congress: Plan to Implement a Medicare Hospital Value-Based Purchasing Program.

CMS Gives Survey of New Medicare Providers Lower Priority

In a November 5, 2007 memorandum to State Survey Agency Directors, the Centers for Medicare & Medicaid Services (CMS) recently addressed CMS's Medicare survey and certification priorities.

CMS to Host Conference Call on 2008 Physician Quality Reporting Initiative

The Centers for Medicare & Medicaid Services recently announced that it will host a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI).

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mapolskis

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Michael Apolskis is an attorney and the author of the Medicare Update blog. In the course of his practice, he works with health care providers, suppli …

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