Archive for the ‘Health Care Reform’ Category

Florida Leads Nation in Number of ACOs Formed

June 17, 2013

By David Pittman, MedPage Today

WASHINGTON – More than 40% of accountable care organizations (ACOs) formed under Medicare exist in only five states, leaving many states with one or none, according to an analysis by industry experts.Medicare ACOs are concentrated in states like Florida (32), California (22), and Massachusetts (18) but rural states – like North Dakota, South Dakota, Utah, Wyoming, Oklahoma, and Kansas – are devoid of them, according to the analysis by consulting firm MedeAnalytics in Emeryville, Calif. Others like Montana, Idaho, Mississippi each only have one Medicare ACO. (more…)

Tampa Bay Times: One Month Later, Florida Lawmakers No Closer to Medicaid Deal

June 17, 2013

By Tia Mitchell, Tampa Bay Times

TALLAHASSEE — Two House Republicans unwittingly revived hopes this month that lawmakers could compromise on a proposal to expand Medicaid.

“Lawmakers say Medicaid expansion not dead” read the headline in the Sarasota Herald-Tribune,highlighting comments from Manatee County Reps. Greg Steube and Jim Boyd.

But the reality is no different today than it was when the legislative session ended last month:

Medicaid expansion, or some alternative, remains a long shot.

“All I was simply trying to say was, we all agree it’s an important issue,” Boyd told the Times/Herald about his remarks at a June 6 luncheon. “We thought we had a pretty good plan.”

That plan, championed by House Speaker Will Weatherford, included saying no to $51 billion in federal money over 10 years. Instead, House Republicans proposed using up to $300 million in state funding to subsidize basic coverages for about 130,000 people. (more…)

Projecting Medicare Advantage Enrollment: Expect the Unexpected?

June 12, 2013

By Gretchen JacobsonPatricia Neuman and Jennifer Huang, Kaiser Family Foundation

While much of the health policy world is focused on the health coverage developments in store as the Affordable Care Act of 2010 is implemented, private insurers are also gearing up for the next Medicare Advantage open enrollment season. Four months from now, just as exchange enrollment swings into action, Medicare beneficiaries will have the option to enroll in a Medicare Advantage plan (or switch plans) during the annual open enrollment period. And, earlier this month, each of the insurers participating in the Medicare Advantage program submitted what is known as a “bid” to the federal government that essentially indicates whether they will offer more or fewer Medicare Advantage plans in 2014 than in 2013 and how they will change their plans’ benefits and premiums, which could ultimately affect how many Medicare beneficiaries enroll in Medicare Advantage plans in 2014 and future years. (more…)

New ACO Forms in Brevard County

June 12, 2013

Health Management Associates, Inc. and Florida Blue, Florida’s Blue Cross and Blue Shield company, announced recently the formation of an accountable care model to serve patients in Brevard County.

Health Management’s physicians, as well as its two hospitals in Brevard County (Wuesthoff Medical Center – Melbourne and Wuesthoff Medical Center – Rockledge) will be the provider cornerstones of this new partnership. (more…)

Analysis: Florida Home Health Medicare Margins on Steep Decline

June 6, 2013

The Home Care Association of Florida in coordination with the Partnership for Quality Home Healthcare today released data demonstrating that the rebasing of Medicare home health payments within the proposed Home Health Prospective Payment System (HHPPS) rule for 2014 will negatively impact Florida’s home health sector and the 342,570 vulnerable Medicare beneficiaries receiving home health by driving Medicare margins to an all-time low. Leaders are urging regulators to carefully consider home health sector’s current-law economics when implementing this policy.

Under the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) is directed to rebase home health payments between 2014 and 2017 by a percentage determined appropriate by the Secretary.  This percentage is to be implemented in equal increments during each year from 2014 through 2017. (more…)

Medicare Urges Seniors to Join the Fight Against Fraud

June 6, 2013

In mailboxes across the country, people with Medicare will soon see a redesigned statement of their claims for services and benefits that will help them better spot potential fraud, waste and abuse. These newly redesigned Medicare Summary Notices are just one more way the Obama Administration is making the elimination of fraud, waste and abuse in health care a top priority. Because of actions like these and new tools under the Affordable Care Act, the number of suspect providers and suppliers thrown out of the Medicare program has more than doubled in 35 states. (more…)

Palmetto GBA: Medical Review Requirements for HH Face-to-Face Documentation

May 22, 2013

Palmetto GBA has noticed an increase in overpayments for Home Health Prospective Payment System (HH PPS) claims. The top reason for this increase is attributed to the requirement for a face-to-face encounter with the beneficiary.

Palmetto GBA evaluated its criteria for review of these types of claims. Effective immediately, Palmetto will begin a more comprehensive review using the regulations governing these types of claims. Palmetto GBA encourages all providers to review their internal processes to ensure that all of the criteria for coverage have been met and documented in the medical record. (more…)

Obama Administration Launches $1B Initiative for Health Care Innovation

May 15, 2013

Health and Human Services Secretary Kathleen Sebelius today announced a nearly $1 billion initiative that will fund awards and evaluation to build on the Obama administration’s work to transform the health care system by delivering better care and lowering costs.  This second round of Health Care Innovation Awards will fund applicants that have a high likelihood of driving health care system transformation and delivering better outcomes.

Made possible by the Affordable Care Act, the Health Care Innovation Awards provides another opportunity to improve the quality of health care and bring down costs for taxpayers and patients. The health care law includes many tools to avoid costly mistakes and readmissions, keep patients healthy, reward quality instead of quantity, and create health information technology infrastructure that enables new payment and delivery models to work. The provisions in the Affordable Care Act are already working to reduce costs: Medicare spending per beneficiary increased by just 0.4 percent last year, far below historical averages. (more…)

Partner with CMS on Benefits Outreach and Education

May 8, 2013

The Centers for Medicare & Medicaid Services has asked the association to share the following message with providers about opportunities for providers to partner with CMS by disseminating preventative information to the public. (more…)

Ask the Obama Administration to Exempt Home Care Providers from the PPACA Employer Mandate Requirements

May 3, 2013

Please sign an industry-sponsored petition on The White House website if you feel in-home care services should be exempt from the Employer Mandate portion of the Affordable Care Act. This petition was just created and needs 100,000 signatures within the next 30 days in order to get the attention of the President and Congress. So far just over 1,000 signatures have been received.

Click here to take action by signing the petition now!