Analysis of 2003-2004 Medicare claims data reveals that almost one-fifth (19.6 percent) of Medicare beneficiaries in the FFS program discharged from a hospital were rehospitalized within 30 days, and more than one-third (34 percent) were rehospitalized within 90 days, according to an article in the April 2 issue of the New England Journal of Medicine. […]

Federal Health Architecture Delivers Free, Scalable Solution Helping Organizations Tie Health IT Systems into the NHIN The Federal Health Architecture is making software available as a first step to help public and private health information technology systems communicate to the Nationwide Health Information Network (NHIN), a federal initiative to facilitate the electronic exchange of health […]

CCH® Medicaid – April 1, 2009. In November 2008, CMS issued the first changes in conditions for coverage for ambulatory surgical centers (ASCs) since 1982 (see ¶180,745). The new rules go into effect May 19, 2009. At the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues on March 24th, Claire Miley, of […]

CCH® Medicaid — March 30, 2009. The Fifth Circuit Court of Appeals dismissed a class action by Medicaid recipients to enforce a right to reasonably prompt access to services under federal Medicaid law. The court rejected the recipients’ contention that Soc. Sec. Act §1902(a)(8), stating: [A] state plan for medical assistance must provide … that […]

WTN News, WI – March 16, 2009. In his mind, as similarly presented in the OpEd piece, these EMRs just generate voluminous documentation geared to optimize reimbursement rather than better patient care. In addition, there is no real data supporting the notion that these systems … Obama’s $2 trillion reality

HFMA – March 16, 2009. Medicare spending on home health care–typically following a hospital discharge or for treatment of a chronic condition–totaled $12.9 billion in 2006, up 44 percent from 2002, according to a new report from the Government Accountability Office (GAO).  Click title to read more… The GAO found that upcoding–overstating the severity of […]

MedPAC recommends an increase for most providers in 2010 Wolters Kluwer Editorial Staff – March 13, 2009. Although payment adequacy has been positive, average Medicare margins are expected to fall to 6.9 percent in 2009, according to the Medicare Payment Advisory Commission (MedPAC). An increase in payment rates was recommended for most providers, except for […]

RantRave | Published Opinion – March 13, 2009. A Jill Appleby story in USA Today (Mar 13-15 2009) reveals that “fraud” in medicare costs have driven up health care costs 44%. So, add this to the list of things you tell persons who doubt that this nation needed a nationalized health care system. … Medicare […]