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CMS Press Release: Medicare Advantage Program is projected to remain strong with an increase of 11% for 2013
Enrollment in the Medicare Advantage (MA) program is projected to increase by 11 percent in the next year and premiums will remain steady, Health and Human Services Secretary Kathleen Sebelius announced today. Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has risen by 28 percent.
“Thanks to the Affordable Care Act, the Medicare Advantage and Prescription Drug programs have been strengthened and continue to improve for beneficiaries,” said Secretary Sebelius. “Since the law was enacted in 2010, average premiums have gone down, enrollment has gone up, and new benefits and lower drug costs continue to help millions of seniors and people with disabilities.”
For the third year in a row, the Centers for Medicare & Medicaid Services (CMS) used authority provided by the Affordable Care Act to protect beneficiaries from significant increases in costs or cuts in benefits. Access to supplemental benefits remains steady and beneficiaries’ average out-of-pocket spending remains constant.
The average MA premium in 2013 is projected to increase by only $1.47 from last year, coming to $32.59. However, if beneficiaries choose lower cost plans at the same rate in 2013, as they did in 2012, the average premium is expected to increase by only 57 cents. Access to the Medicare Advantage program will remain strong, with 99.6 percent of beneficiaries having access to a plan. Additionally, the number of plan choices will increase by 7 percent in 2013.
Last month, CMS announced that the average estimated basic Medicare prescription drug plan premium was projected to be $30 in 2013, holding steady from last year. Today’s projections show that access to a Medicare prescription drug plan will remain strong in 2013. Everyone with Medicare will have access to a wide range of plan choices.
The Annual Open Enrollment Period for health and drug plans begins on October 15 and ends December 7.
See on www.cms.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
When Data Makes You Look Bad – HealthLeaders Media
With the launch of an updated Hospital Compare site, and growing interest among the media, healthcare leaders need to face the fact that sometimes the data makes them look bad.
CMS now publicly posts hospital-specific results for 84 measures, with more expected in the next two years. Along with each measure, the public can download spreadsheets showing data for each hospital all in one file; one can see who’s better or worse even within a region, state, county, or ZIP code.
These rating systems alert employers, community leaders, and health plans, for example, whether your patients got the right antibiotic at the right time, how long the hospital made patients wait in the ED, and the rate of central line bloodstream infections, or numbers of foreign objects left inside body cavities during surgery. Even the hospital’s cost for an episode of care is held up for public view.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
In quality push, hospitals face Medicare penalty over readmissions – Tampa Bay Times
RAISING THE STAKES: Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year. The cost to Medicare? $17.5 billion in additional hospital bills.
See on www.tampabay.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
CMS Launches Electronic Quality Reporting Pilot For Hospitals – InformationWeek
The Centers for Medicare and Medicaid Services (CMS) has inaugurated an electronic quality reporting pilot for hospitals participating in its Medicare electronic health record (EHR) incentive program.
According to an announcement on CMS’s QualityNet site, hospitals and critical access hospitals registered for the Medicare incentive program can begin testing their ability to send quality data directly from their EHRs to CMS. From Oct. 1 to Nov. 30, the last two months in which hospitals can attest to Meaningful Use and receive 2012 payments under the Medicare program, they can transmit this data to CMS on a “production basis” to meet the quality reporting criteria.
See on www.informationweek.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Hot Topics in Health Care Law — Saturday July 7, 2012
Today’s edition of Hot Topics in Health Care Law is available. This topic aggregator/newspaper contains articles that I think are on the cutting edge of health law.
HHS launches new Affordable Care Act Initiative to Strengthen Primary Care
Last week, HHS announced a new initiative under the Affordable Care Act. The initiative is intended “to help primary care practices deliver higher quality, more coordinated and patient-centered care.” If you follow this link, you will come to CMS’s new Comprehensive Primary Care initiative web site. A summary of the initiative is available in a CMS “FactSheet.”
The initiative is a limited demonstration project, and will be available in five to seven markets across the country, based on where a preponderance of health care payers apply. CMS intends to partner with commercial and public health insurers to promote community-wide investments in comprehensive primary care. Payers can be private insurers, Medicare Advantage Plans, states (e.g., Medicaid program or state employee health plans), high risk pools, etc.
CMS will provide resources to primary care practices that choose to participate in the initiative that will help primary care physicians work with patients to ensure that the physicians:
- Manage Care for Patients with High Health Care Needs
- Ensure Access to Care
- Deliver Preventive Care
- Engage Patients and Caregivers to participate in their own care
- Coordinate Care Across the Medical Neighborhood
CMS will pay primary care providers for improved and comprehensive care management, and after two years offer them the chance to share in any savings they generate. Equally important, CMS will look to collaborate with other payers in local markets who will commit to similar approaches to how they engage and compensate primary care practices.
Predictive Modeling Technology from HHS Could Enhance Payor Compliance Programs
My partner, Rob Slavkin, recently authored an Akerman Healthcare Practice Update about the Department of Health and Human Services’ “introduction of predictive modeling technology as part of the government’s fraud investigation arsenal, as well as a new collaborative tool that enables private payors to enhance their own monitoring and auditing programs.” The Practice Update can be found here.
This is part of the government’s ongoing efforts to root out healthcare fraud.
For a reminder at how serious the government is about this, look at what the OIG has been posting on its website.
The adoption and implementation of compliance programs continue to be one of the most valuable tools to protect healthcare providers, including medical billing companies and DME suppliers, from purposeful or accidental employee activities that may cause exposure to fines, penalties, or possible exclusion from the Medicare and Medicaid programs. Having and following a compliance can also mitigate criminal penalties.
There is much enforcement activity going on, and it too late to adopt a compliance program when the barbarians are at the gate.
CMS Podcasts for 2011 ICD-10 Implementation
On January 12, 2011, CMS held a national provider call on “Preparing for ICD-10 Implementation in 2011.” From the audio of that event, CMS has created the following four podcasts:
- Welcome and ICD-10 Overview – Pat Brooks, CMS
- Implementation Strategies for 2011 – Sue Bowman, AHIMA
- Question and Answer Session, part 1
- Question and Answer Session, part 2
These podcasts are now available here in the downloads section.
Joseph Rugg's Health Law Blog 