Seventeen of the 18 members of Pennsylvania’s U.S. House delegation have sent a joint, bipartisan letter to House Speaker John Boehner and minority leader Nancy Pelosi asking them make a priority of repealing – before the current session of Congress ends – the sustainable growth rate formula (SGR) used to determine how doctors are paid to serve Medicare patients.
See their letter here.
The independent federal agency that advises Congress on Medicare payment issues met last week in Washington and addressed a number of issues of importance to hospitals.
Among the issues discussed by the Medicare Payment Advisory Commission (MedPAC) were:
Find links to the presentations offered by MedPAC staff on these issues here, on MedPAC’s web site.
The Mcare assessments of Pennsylvania hospitals and doctors will decrease 48 percent in 2015.
Pennsylvania’s Medicare Care Available and Reduction of Error Fund, or Mcare, provides supplemental medical malpractice liability insurance for Pennsylvania health care providers. Pennsylvania requires hospitals and doctors to have a minimum level of liability coverage and they obtain half of that minimum amount from the Mcare Fund.
Next year’s assessment is smaller because of reduced claims against the Mcare Fund and leftover money from previous years that a court ordered to be used for this purpose.
To learn more about the fund and the decrease, see this news release on the state Insurance Department’s web site.
Hospital groups are suing the Centers for Medicare & Medicaid Services (CMS) over the 0.2 percent rate cut in Medicare inpatient payments during the 2014 fiscal year.
According to the hospital groups, CMS failed to provide a rationale for the rate cut and denied interested parties access to the data and analysis underlying its rate cut decision.
At the heart of the cut was CMS’s expectation that implementation of Medicare’s controversial “two-midnight rule” would result in an increase in admissions. The rule was never fully implemented.
CMS has asked the court to dismiss the suit.
Learn more about the suit and find links to the hospitals’ and CMS’s legal briefs in this Fierce Healthcare article.
One of the issues in almost any major election is health care, and this year’s gubernatorial race in Pennsylvania is no exception.
With this in mind, the Central Penn Business Journal has published excerpts of Pennsylvania Physician magazine interviews with the candidates in next month’s election, Republican Governor Tom Corbett and his Democratic challenger, Tom Wolf. In the article, the candidates share their views on some of this year’s more important health care issues, including Medicaid expansion, emergency care, the challenge of attracting more doctors to Pennsylvania, and more.
Find the article here.
Pennsylvania Governor Tom Corbett has signed into law a bill that requires hospitals to inform patients when their stay in a hospital has been classified as observation status and not an inpatient admission.
The new law calls for hospitals to provide such notification when patients are under a hospital’s care for more than 23 consecutive hours; when they are in a bed and receiving meals outside of the emergency room; and when they have not formally been admitted.
Observation status poses considerable financial challenges to patients, leaving them vulnerable for charges for tests, medicine, and post-discharge nursing and rehabilitation care that would be covered by their insurance if they were inpatients but are not covered to the same degree if their stay has been classified as observation status (because insurers pay lower outpatient rates only for observation services). Most people have been unaware of this distinction and have neither been told of their observation status nor apprised of the difference between that status and inpatient hospitalization. This has especially been a problem for Medicare beneficiaries.
The bill was sponsored by Pennsylvania state representative Stan Saylor (R-York County). See Rep. Saylor’s memo to his House colleagues outlining the rationale for his bill here and find the bill itself here.
Congressman James Renacci (R-OH) is again asking his House colleagues to support his proposal to adjust Medicare’s hospital readmissions reduction program – a program he maintains is especially harmful to safety-net hospitals.
Noting that in its current form the program penalizes hospitals that care for larger numbers of poorer, sicker patients and that this “jeopardizes the viability of hospitals that service this vulnerable population,” the congressman urges his colleagues to support his bill, H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmissions Program Act.
This bill calls for adjusting the program’s approach “to account for certain disparities in patient population…”
See Representative Renacci’s letter to House colleagues here.
With the country facing a physician shortage and the number of medical residencies capped by the 1997 Balanced Budget Act (because Medicare and Medicaid provide the primary funding for the residencies), teaching hospitals need an additional 4000 residency slots a year.
This was the message conveyed recently to a gathering of congressional aides co-sponsored by the Association of American Medical Colleges.
This issue is of interest to Pennsylvania’s safety-net hospitals, some of which are teaching hospitals.
Such an increase would cost $10 billion over the next ten years.
Learn more about the case for more residency slots in this Kaiser Health News article.
A new report suggests that education is more important to an individual’s overall health than access to health care.
According to the Virginia Commonwealth University’s Center on Society and Health,
More education means better health – in part because more education brings better jobs, improved access to health insurance, and higher earnings that can help pay for medical expenses and a healthier lifestyle. Conversely, people with less education tend to have more challenges accessing health services – lower rates of health insurance coverage and less money to afford copayments and prescription drugs; they are also more likely to live in low-income neighborhoods with limited access to primary care providers.
Improved access to health care may improve overall health but it will not necessarily compensate for the entire difference in health status between those with more and those with less education. In fact, the disparity even exists, the report notes, in countries like Great Britain where the entire population has access to the same national health care system.
Learn more about the possible effects of education on health status here, in the Virginia Commonwealth University Center on Society and Health policy brief “Health Care: Necessary But Not Sufficient.”
The Pennsylvania Department of Public Welfare is no more.
The state executive branch agency whose Office of Medical Assistance Programs has overseen Pennsylvania’s Medicaid program since its inception has officially been renamed the Department of Human Services.
The legislation requiring the name change takes effect in November and the department will phase-in its new name over time.
Read the press release from the governor’s office announcing the name change here.