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CMS lays out how to appeal meaningful use decisions
The Center for Medicare & Medicaid Services' Office of Clinical Standards and Quality announced the establishment of a two-tier appeals process for physicians who were deemed ineligible for Medicare meaningful use incentive pay, or who thought their pay was too low. There are three types of appeals physicians can file: An eligibility appeal will allow doctors to show that all the requirements to earn an incentive payment were met, but payment was not received due to circumstances outside of his or her control. Eligibility appeals must be filed before March 30 to appeal decisions for payment year 2011. A meaningful use appeal allows physicians to show that they used a certified electronic medical record system and met all meaningful use objectives and measures. These appeals must be filed within 30 days of the physician receiving a demand letter or other finding from the review board. An incentive payment appeal allows physicians to show that they provided claims [Read more]
California tax hike could take pressure off Medicaid
The California Medical Assn. on Jan. 31 endorsed a ballot measure proposed by California Gov. Jerry Brown that would increase certain state income and sales taxes to fund education and public safety programs. In December 2011, Brown proposed two tax increases that would generate nearly $7 billion annually. The first would raise income taxes by 1% to 2% on individuals earning at least $250,000. The second would increase the sales tax by one-half cent. Both tax hikes would expire in 2016. California Medical Assn. CEO Dustin Corcoran said Brown's proposal "is the only viable, balanced plan on the table to address the chronic budget crisis and protect essential health care services." The California Hospital Assn. also supports the measure, said CHA spokeswoman Jan Emerson-Shea. She said the California Hospitals Committee on Issues -- the association's ballot initiative arm -- has contributed $500,000 to the campaign to get Brown's proposal on the ballot. The California Academy of [Read more]
House votes to repeal long-term-care program
The House on Feb. 1 voted to repeal the long-term-care insurance program created by the health system reform law amid Democratic calls to save the coverage plan. House Republicans have been sharply critical of the Community Living Assistance Services and Supports Act, or CLASS Act. Opponents of the provision have called it a broken component of the Democrats' reform law that created the illusion of saving billions of dollars while providing much-needed care for the elderly and disabled. But independent actuarial analysis had determined that the new voluntary insurance program would not be viable over the long term. The House voted 267-159, with some Democratic support, for legislation to repeal the act. "This unsustainable program would have increased federal expenditures and debt and was deemed to be financially insolvent," said Rep. Larry Bucshon, MD (R, Ind.). "Repealing the CLASS Act is important to ensure it is not implemented at a future time, which would have added to t [Read more]
Almost half of preventive services not offered during checkups
The annual checkup is geared toward doing a physical exam, taking a patient's history and using the opportunity to deliver counseling or other preventive services that might be difficult to squeeze in during other office visits. Yet even during these encounters, patients are nearly as likely to miss out as they are to receive guideline-based prevention, says an American Journal of Preventive Medicine study published in February. Researchers audio-recorded 284 annual-checkup visits to 64 Detroit-area general internists and family physicians from 2007 to 2009. They also examined patient records for the preceding five to 10 years and surveyed patients to determine if they were eligible or due for 19 items recommended by the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices. Patients were due for an average of 5.5 preventive services such as cholesterol screening, obesity counseling or pneumococcal vaccination. In all, 54% of the services due [Read more]
Referral rates for physicians nearly double in 10 years
More outpatient visits are ending with the doctor recommending that the patient make an appointment to see another physician. It's a fact that probably is contributing to rising health care costs, says a Jan. 23 study in Archives of Internal Medicine. Between 1999 and 2009, the percentage of ambulatory visits that resulted in a referral nearly doubled from 4.8% to 9.3%, the study said. Researchers evaluated Centers for Disease Control and Prevention data from more than 845,000 patient visits between 1993 and 2009, focusing on the period from 1999 to 2009. They were surprised by the increase in referrals, said Bruce Landon, MD, MSc, study co-author and professor with Harvard Medical School's Dept. of Health Care Policy. "It is not something we would have predicted, particularly given the relative stability up until 10 years ago," he said. Referral rates were high for both specialists and primary care physicians. The number of outpatient visits to specialists that resulted in [Read more]
Kansas Medicaid reform plan wins points with state's medical society
The Kansas Medical Society announced in mid-January that it supports many provisions of KanCare, a proposal by Kansas Gov. Sam Brownback's administration to provide Medicaid enrollees more integrated, higher-quality care and limit Medicaid spending growth. KanCare is both a consolidation of existing state agencies serving the state's 378,000 Medicaid enrollees and an attempt to incentivize managed care organizations to provide comprehensive, coordinated, quality care. It includes a medical home program for Medicaid enrollees who require more complex care. It also would create health savings accounts for enrollees in an attempt to give them a better understanding of and more control over the cost of their care. The state plans to launch KanCare in January 2013. Kansas Medical Society Executive Director Jerry Slaughter said his organization supports the physician-related parts of KanCare and remains neutral on its other provisions. KanCare would not reduce physician Medicaid fees o [Read more]
CDC deflates public health threat of mysterious skin condition
Patients with the unexplained skin condition commonly referred to as Morgellons experience real symptoms that often lead to a diminished quality of life, say the authors of a recent Centers for Disease Control and Prevention study. The condition is characterized by unexplained lesions that contain fibers, threads or other foreign materials accompanied by sensations of crawling, biting and stinging, the CDC says. Although the health problem is not recognized as a distinct clinical disorder with diagnostic criteria, the study authors recommend that physicians keep an open mind when they see such patients and not dismiss the individual's medical concerns as untrue. The study encourages physicians to fully examine these patients and create a treatment plan that addresses co-existing medical conditions. "It is unfair to dismiss [these patients'] complaints as invalid, and that has happened," said Daniel Rutz, MPH, a CDC public health communications specialist who worked on the s [Read more]
Pharmacists say marketing of Medicare drug plans is misleading
Pharmacists have called on the agency overseeing the Medicare program to allow patients to switch their prescription drug plans outside of the normal open enrollment season after beneficiaries say they were misled by insurers. Beneficiaries report that they were promised zero co-pays upon enrolling in Part D drug plans online or using Medicare Plan Finder on the Centers for Medicare & Medicaid Services website. However, some of those patients found out only after enrollment had closed that the discounted rates apply only at pharmacies in certain box stores. "Now seniors are going to the community pharmacy that they have relied on for years, sometimes decades, only to be told that they must travel 20 miles or more to obtain the lowest-advertised co-payments for their medication," said B. Douglas Hoey, CEO of the National Community Pharmacists Assn. in Alexandria, Va. The association has asked CMS to create a special enrollment period that allows for patients who are dissatisfie [Read more]
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