Medicare Issues Final Rule For Controversial Plan To Bundle Some Payments For Heart Care
However, Rep. Tom Price, who has been nominated to be the secretary of Health and Human Services in the Trump administration, is expected to weigh in on this issue, too. Also in Medicare news, a look at a new payment rule designed to reward doctors for coordinating care, an anomaly in coverage of kidney transplants, a nursing home company in Maryland draws scrutiny and new hospital payment details.
Modern Healthcare:
Obama Administration Sticks With New Mandatory Bundled-Pay Demo, But Tom Price Likely To Intervene
The CMS is moving forward with a new mandatory initiative that would make hospitals in 98 markets financially accountable for the cost and quality of all care associated with bypass surgery and heart attacks. The final regulations issued Tuesday came just days after the agency announced it was junking a proposed mandatory demonstration that would have tested new ways of paying for outpatient drugs under Medicare Part B in an effort to bring those prices down. Both models have drawn criticism that the Center for Medicare & Medicaid Innovation is overreaching its mandate by compelling participation, including from President-elect Donald Trump's nominee for HHS secretary, Rep. Tom Price (R-Ga.). (Dickson, 12/20)
Kaiser Health News:
New Medicare Rules Should Help ‘High Need’ Patients Get Better Treatment
Doctors have complained for years that they’re not paid adequately for time-consuming work associated with managing care for seriously ill older patients: consulting with other specialists, talking to families and caregivers, interacting with pharmacists and more. That will change on Jan. 1, as a new set of Medicare regulations go into effect. (Graham, 12/22)
NPR:
Government Pays For Kidney Transplants But Not The Anti-Rejection Drugs
The federal government will pay more than $100,000 to give someone a kidney transplant, but after three years, the government will often stop paying for the drugs needed to keep that transplanted kidney alive. Constance Creasey is one of the thousands of people who find themselves caught up by this peculiar feature of the federal kidney program. (Harris, 12/22)
The Washington Post:
Md. Attorney General Says Nursing Homes Kicked Out Patients To Boost Medicare Payments
A nursing home operator in Maryland aggressively and illegally booted residents from its facilities to maximize payments it collected from public health plans and in many cases dropped the residents off at homeless shelters or inadequate living facilities, the state’s attorney general alleged in a sweeping lawsuit filed Wednesday in Montgomery County Circuit Court. (Morse, 12/21)
Kaiser Health News:
Latest Hospital Injury Penalties Include Crackdown On Antibiotic Resistant Germs
The federal government has cut payments to 769 hospitals with high rates of patient injuries, for the first time counting the spread of antibiotic-resistant germs in assessing penalties. The punishments come in the third year of Medicare penalties for hospitals with patients most frequently suffering from potentially avoidable complications, including various types of infections, blood clots, bed sores and falls. This year the government also examined the prevalence of two types of bacteria resistant to drugs. (Rau, 12/21)