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2012 Annual Report to Congress – Medicare Payment Policy

From: MedPac – 3/15/12

MedPac released the annual report to Congress this week.  This is an important report as the recommendations from this issuance will be strongly considered in the development of the updated Medicare payment rates for all services in FFY 2013 and later years.  I highly recommend looking through the executive summary of this 443 page report as they summarize recommendations for the various Medicare services.  Total Medicare FFS payments for 2009-2010 to PPS and Critical Access Hospital for inpatient and outpatient services totaled $153 billion.

MedPac’s recommendation for Inpatient and Outpatient PPS Medicare service payment rates in 2013 is a 1% increase. 

From: HHS – July 7, 2011 News Release

Here is but another reminder of the vigilance we must maintain relative to our use of protected health information (PHI).

Contents from News Release:

Following an investigation by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), the University of California at Los Angeles Health System (UCLAHS) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules for $865,500 and has committed to a corrective action plan aimed at remedying gaps in its compliance with the rules.

The resolution agreement resolves two separate complaints filed with OCR on behalf of two celebrity patients who received care at UCLAHS. The complaints alleged that UCLAHS employees repeatedly and without permissible reason looked at the electronic protected health information of these patients. OCR’s investigation into the complaints revealed that from 2005-2008, unauthorized employees repeatedly looked at the electronic protected health information of numerous other UCLAHS patients.

Through policies and procedures, entities covered under HIPAA must reasonably restrict access to patient information to only those employees with a valid reason to view the information and must sanction any employee who is found to have violated these policies. (more…)

AAMC Site – July 7, 2011

The Association of American Medical Colleges (AAMC) is pushing back hard against debt-ceiling proposals to cut Medicare spending on graduate medical education.

Excerpt from Site:

America has the world’s best doctors and nurses because we have the best teaching hospitals. However, cuts to graduate medical education (GME) would jeopardize the ability of medical schools and teaching hospitals to train physicians, nurses, and other health care providers, as well as limit critical services to the community.  Cutting the deficit is important, but cutting physician training at a time when our nation faces a critical shortage of doctors would threaten the health of all Americans.

AAMC – Open Letter to President Obama (GME/IME Funding Cuts)

From: Kaiser Health News

An interesting article that profiles Santa Rosa Memorial Hospital and the appeal that now will be decided by the U.S. Supreme Court related to the 10% Medi-Cal payment reduction applied to California non-contract Hospitals.

From: Kaiser Health News

Excerpt from Article:

Facing strong criticism of the proposed regulation for accountable care organizations, the Obama administration announced new options Tuesday to lure hesitant doctors and hospitals. ACOs are a new delivery model created under the health law that offers providers financial incentives to work together to provide high quality care to Medicare beneficiaries while keeping down costs. But hospital and doctor groups are complaining that the proposed regulation creates more financial risks than rewards and imposes onerous reporting requirements. On Monday the American Hospital Association estimated that starting an ACO could cost a hospital $11 million to $26 million in the first year. The proposed regulation put the cost at $1.8 million.