Medicare Auditor Finds Some Treatments Cost More For Outpatients Than Inpatients
The inspector general's report shows that beneficiaries getting heart stents in the hospital pay on average $645 less than those getting them in outpatient facilities. It says Medicare needs to review how its billing rules distinguish between inpatient and outpatient hospital stays. Also, an analysis of Medicare's decision to kill a controversial test to lower the payments for drugs administered by doctors in outpatient settings and one senator hears from constituents about concerns over Medicare funding.
The Associated Press:
Medicare Outpatients Risk Higher Bills For Some Procedures
You pay less for outpatient treatment than for a hospital admission, right? Not necessarily in the topsy-turvy world of Medicare billing, according to a government report. People entitled to benefits under Medicare who had heart stents inserted as outpatients faced hospital bills that were $645 higher on average than those who had the same kind of procedure as inpatients, the Health and Human Services inspector general has found. (Alonso-Zaldivar, 12/19)
Modern Healthcare:
Mandatory Participation Killed The Part B Demo
Experts say the cancellation of a pilot program whose goal was to drop drug prices doesn't mean the fight is over, and future efforts should simply take lessons from the experience. The Obama administration Thursday evening announced it was killing a five-year Medicare initiative that would test new ways of paying for outpatient drugs in an effort to bring those prices down. ... the mandatory program has served as an example for opponents of what's wrong with the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act to find ways to reform how healthcare is delivered and paid for. The center itself is in the crosshairs of some Republicans, who say the pilot programs created by the Innovation Center overstep its authority because they require physicians and patients to participate without creating legislation to support the efforts. Providers also said they weren't consulted or asked for input before the model was unveiled. (Dickson, 12/16)
Billings (Mont.) Gazette:
Tester Gets Feedback On Medicare, Medicaid At Seniors Town Hall Meeting
Sen. Jon Tester met with senior health care representatives across the state on Thursday to hear concerns on Medicare, Medicaid and the Affordable Care Act. ... “Medicare is a bedrock program for seniors and to do away with that would be criminal. To voucher it would be very very bad,” Tester said. Representatives from AARP Montana, The Montana Health Coop and Montana’s Area Agencies on Aging echoed Tester’s concerns, and called on him to protect Montanans with Medicare and Medicaid. They also came with suggestions for improvements to existing services and areas where Montanans need additional benefits. (Loranger, 12/17)