Healthcare

Subscribe to Healthcare via RSS

SENATE PASSES TEMPORARY “DOC FIX”; HOUSE ACTION AWAITED

On December 17, the U.S. Senate voted 89-10 to pass the “Temporary Payroll Tax Cut Continuation Act of 2011,” which included a two-month delay in implementing the Medicare Physician Fee Schedule for calendar year 2012. As we reported in our Healthcare Update on November 7, the new Fee Schedule calls for an overall 27.4% reduction in payment rates for physicians, nurse practitioners and physical therapists. …
Read More Healthcare Update: Senate Passes Temporary “Doc Fix”; MedPAC Issues Draft Recommendations for 2013; CMS Issues “Essential Health Benefits” Bulletin; Home Care Worker Wage Protection Proposed

Several healthcare consumer advocacy groups are signatories to a letter (the “Letter”) that was sent to members of Congress in response to a letter that was sent to Congress by the National Association of Insurance Commissioners (the “NAIC”), as discussed in our previous post here.  The NAIC letter urged Congress to exempt fees and commissions paid to health insurance producers from the medical loss ratio (“MLR”) calculation under the Patient Protection and Affordable Care Act (“PPACA”) in order to preserve consumer access to agents and brokers. …
Read More Consumer Advocate Groups Issue Letter to Members of Congress Imploring Them Not to Amend the Medical Loss Ratio in the Patient Protection and Affordable Care Act

CMS ISSUES MEDICAL LOSS RATIO REGULATIONS

Background. Among the most hotly debated provisions of the Patient Protection and Affordable Care Act (PPACA) have been the medical loss ratio (MLR) requirements, which were intended to lower healthcare costs by requiring health insurance companies to spend less on marketing and overhead expenses and more on care. …
Read More Healthcare Update: CMS Issues Medical Loss Ratio Regulations; HHS Rejects Two State MLR Waiver Requests

HHS ANNOUNCES AWARDS FOR COMMUNITY HEALTH CENTERS

The Department of Health and Human Services (HHS) recently announced that 904 community health centers have been awarded $47 million in grants to enhance the coordination and quality of healthcare nationwide. …
Read More Healthcare Update: HHS Announces Community Health Center Awards; CMS Report Addresses Recovery Audit Contractors; Super Committee Hears from Healthcare Providers

MEDPAC PROPOSES PLAN TO FIX MEDICARE PHYSICIAN PAYMENT FORMULA
The Medicare Payment Advisory Commission (MedPAC) recently unveiled a new approach to overhaul the complicated Medicare physician payment formula. Every year, that formula – known as the sustainable growth rate (SGR) – calculates larger and larger mandated cuts to doctors’ Medicare reimbursements, and each year, Congress acts to temporarily halt the cuts via short-term patches. …
Read More Healthcare Update: MedPAC Proposes Medicare Physician Payment Overhaul; CMS Releases Notice for Using Identifiable Data in Accountable Care Organizations; President Proposes Medicare Changes In Deficit Reduction Package

CMS UNVEILS FINAL RULE ON ELECTRONIC PRESCRIBING PROGRAM

The Centers for Medicare and Medicaid Services (CMS) recently released its final rule to amend the Medicare electronic prescribing incentive program. Established in 2008, the Medicare e-prescribing incentive program allows eligible providers to earn incentives related to their e-prescribing actions, and also includes penalties beginning in 2012 if they do not meet e-prescribing thresholds. …
Read More Healthcare Update: CMS Unveils Final Rule on E-Prescribing; Appeals Court Throws Out Two Challenges to Healthcare Law; Ways and Means Committee Democrats Begin to Discuss Medicare Cuts

In its August 2011 letter to the U.S. Office of Personnel Management (“OPM”), the National Association of Insurance Commissioners (“NAIC”) raised concerns over OPM’s proposed guidelines for Multi-State Plans promulgated pursuant to the Patient Protection and Affordable Care Act (“PPACA”).1  These guidelines were drafted in response to OPM’s charge under PPACA that it contract with at least two health plans which must be automatically sold on all state Exchanges. …
Read More NAIC Comments on OPM’s Proposed Guidelines for Multi-State Plans under PPACA Exchanges

HHS AWARDS GRANTS TO COMMUNITY HEALTH CENTERS

The Department of Health and Human Services (HHS) recently announced more than $28 million in grant funding geared toward the development and expansion of community health centers. …
Read More Healthcare Update: Community Health Center Grants Announced; PPACA Individual Mandate Ruled Unconstitutional; Skilled Nursing Facilities Will See Rate Cuts