Heart doctor: Six initial reactions to the Medicare payment data dump

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Heart doctor: Six initial reactions to the Medicare payment data dump

April 9, 2014 6:50 pm by | 0 Comments

What a day it was for medical news. After much legal wrangling, specifically by the Wall Street Journal, the Centers for Medicare and Medicaid Services (CMS) released detailed data on…


Outside The Four Walls – It’s Where Medicine Is Going

Outside The Four Walls – It’s Where Medicine Is Going

December 3, 2013 12:52 pm by | 0 Comments

In 2-3 years, 50% of the reimbursement a hospital receives for most Medicare patient stays may be based on what happens outside the four walls of the hospital.  Yet most…


Dialysis operators dodge proposed 9.4% rate cut from CMS

Dialysis operators dodge proposed 9.4% rate cut from CMS

November 22, 2013 6:08 pm by | 0 Comments

(Reuters) – Medicare, the U.S. government healthcare program for elderly and disabled people, will leave its overall reimbursement rates for kidney dialysis treatment unchanged for next year, and said it will take three to four years to implement a man…



Hospital readmission rates under review by CMS

Hospital readmission rates under review by CMS

October 7, 2013 5:00 am by | 0 Comments

Under new federal health reform laws, hospitals will face penalties for high readmission rates of certain conditions.
The Centers for Medicaid and Medicare Services’ program officially began in 2012. However, the CMS will go back and review the last th…


Medicare pushes start date of bonus/penalty plan to 2016 for mid-size doctor groups

Medicare pushes start date of bonus/penalty plan to 2016 for mid-size doctor groups

July 22, 2013 5:51 am by | 1 Comments

Medicare is accelerating plans to peg a portion of doctors’ pay to the quality of their care.
The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or…


MedPAC: Medicare’s re-admission penalties too harsh for hospitals serving the poor

MedPAC: Medicare’s re-admission penalties too harsh for hospitals serving the poor

June 14, 2013 1:21 pm by | 0 Comments

The financial penalties that Medicare imposes on hospitals with high rates of patient readmissions are too harsh for hospitals serving the poor and should be changed, according to a congressional advisory agency.
Since last fall, Medicare has been red…


Lawsuit aims to overturn Medicare rules for “observation” care

Lawsuit aims to overturn Medicare rules for “observation” care

May 3, 2013 5:52 am by | 1 Comments

Hospitals don’t have to tell patients they are under “observation” care and Medicare will not cover the costs of that care if the patient is not admitted. Patients who are not admitted for at least three consecutive days do not qualify Medicare’s nursing home coverage. Advocates have filed a lawsuit to change these rules.


Proposed 2014 Medicare Advantage rates cut insurer payments

Proposed 2014 Medicare Advantage rates cut insurer payments

February 19, 2013 10:10 am by | 0 Comments

(Reuters) – Proposed reductions in government payments for Medicare Advantage insurance plans – estimated at $11 billion by an insurance industry trade group – sent health insurer shares lower on Tuesday.
Humana Inc said that the planned cuts would af…



U.S. top court rejects hospitals’ Medicare claims suit

U.S. top court rejects hospitals’ Medicare claims suit

January 23, 2013 10:03 am by | 0 Comments

(Reuters) – The U.S. Supreme Court rejected on Tuesday a bid by a group of 18 hospitals to reopen a specialized group of Medicare reimbursement claims that are up to 25 years old.
The hospitals, which are entitled to extra compensation for treating a …


The “right” to healthcare does not require a doctor to work for free

The “right” to healthcare does not require a doctor to work for free

November 23, 2012 1:25 pm by | 326 Comments

After the election, a lot of people are excited that they can now get healthcare. Or maybe not quite yet, but by 2014, when ObamaCare is fully implemented. The only…


AHA sues Medicare over audit program aimed at trimming improper payments

AHA sues Medicare over audit program aimed at trimming improper payments

November 3, 2012 8:00 am by | 0 Comments

The American Hospital Association sued the agency that oversees Medicare, saying an audit program is depriving hospitals of reimbursements for care they provide.


Analyst: Edwards Lifesciences’ missed TAVI sales akin to U.S Ryder Cup loss

Analyst: Edwards Lifesciences’ missed TAVI sales akin to U.S Ryder Cup loss

October 9, 2012 2:55 pm by | 0 Comments

Losing the Ryder Cup this year to the Europeans was every bit unexpected. Almost as unexpected as Edwards Lifesciences suddenly pre-announcing late Monday that it would miss its 3rd quarter…


What’s the best way to avoid Medicare readmission penalties? Stop trying

What’s the best way to avoid Medicare readmission penalties? Stop trying

September 17, 2012 7:17 am by | 2 Comments

As a cardiac electrophysiologist, I’m pretty far removed from public policy.  But I have to admit that I was interested in the latest move by CMS to cut their Medicare…


Mayo, S.F. startup launch health IT tool to track data around cardiology patient readmits

Mayo, S.F. startup launch health IT tool to track data around cardiology patient readmits

September 10, 2012 10:30 am by | 0 Comments

The Mayo Clinic announced Monday that it is partnering with a California startup that aims to provide unparalleled insight into a hospital’s performance data with the goal to improve healthcare…


Questcor gets approval for 77% cut in Medicaid rebate for MS drug Acthar Gel

Questcor gets approval for 77% cut in Medicaid rebate for MS drug Acthar Gel

September 4, 2012 8:35 am by | 0 Comments

(Reuters) – Questcor Pharmaceuticals Inc said it is now eligible to provide lower Medicaid rebates on its flagship multiple sclerosis drug, Acthar Gel, allowing for improved financial results in the future.


New Tool to Help Physicians Get Maximum Reimbursement

New Tool to Help Physicians Get Maximum Reimbursement

January 19, 2012 2:46 pm by | 1 Comments

The U.S. health care industry has evolved and changed rapidly over the past several decades. This evolution took place in response to a number of environmental influences including, technological advances, demographic shifts, and economic and political changes.