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Tag Archive | "Medicare"

Medicare Trustees Release 2011 Report

On May 13, the Medicare Board of Trustees released its 2011 Report on the financial status of Medicare. The Board noted that the financial picture may be understated in the report because certain assumptions are not likely to be carried out. For example, the calculation of Medicare’s solvency is based on the assumption that Congress will not intercede to prevent the Medicare physician payment cuts scheduled to go into effect on January 1, 2012.

The Medicare Trustees issued their sixth “funding warning,” meaning that for Medicare is projected to draw more than 45 percent of its funding from general government revenue. Under the Medicare Modernization Act (MMA), as a result of the warning, the President is required to submit to Congress a legislative proposal to reduce Medicare. However, the White House has not historically issued such a proposal.

The report indicated that the reforms included in the Affordable Care Act (ACA) extend Medicare’s solvency by eight years. The Trustees project that the Medicare Trust Fund will be solvent until 2024.

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Rep. Allyson Schwartz Proposal to Repeal SGR

Rep. Allyson Schwartz (D-PA) has proposed to repeal the SGR and freeze the current Medicare physician payment rates through 2012. She proposes to provide primary care physicians with a 2.5 percent annual rate increase and specialists with a 0.5 percent increase from 2013-2016. Her proposal calls on CMS to test and evaluate physician payment models and identify at least four models from which physicians could select to be paid beginning in 2016. If physicians elected to remain in the fee-for-service system, reimbursement rates would decrease annually to encourage providers to move away from the FFS system.

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HHS Outlines Regulatory Review

Earlier this year, President Obama issued an Executive Order directing Department and Agency heads to submit a plan for retrospective review of regulations that may be obsolete or burdensome to businesses. Federal Departments submitted preliminary plans in the spring and just this week issued their final plans.

HHS’s plan notes that the goal of the retrospective review of the regulations is to improve patient care and outcomes and reduce system costs by removing obsolete or burdensome requirements.  The Centers for Medicare and Medicaid Services will publish a rule in September related to this regulatory review and estimates that the changes outlined in the plan will result in savings of $600 million annually and $3 billion over five years.

HHS plans to revisit regulations a number of issues including the following:

  • Use of telemedicine to increase access to improve the ability of rural and critical access hospitals to provide care more broadly and reduce provider burden by removing credentialing requirements;
  • Increase use of electronic reports and submissions at the FDA and the Administration for Children and Families;
  • Align reporting for electronic prescribing requirements and the EHR incentive program in Medicare;
  • Improve pre-market review for medical devices;
  • Reduce certain burdens imposed by the FDA’s medical device regulations;
  • Continue to review the FDA’s Good Manufacturing Practices regulations for foods and drugs and establish preventive controls for food facilities, as well as accommodate advances in technology relating to pharmaceuticals;
  • Revise and update labeling regulations for food and drugs at the FDA;
  • Develop a CMS work plan to better align Medicare and Medicaid; and
  • Review quality reporting requirements.

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Sen. Coburn Proposes Deficit Reduction Plan

Yesterday, Sen. Tom Coburn (R-OK) proposed a deficit reduction plan, “Back in Black,” which would achieve $106.7 billion/10 years in savings from the Department of Health and Human Services (HHS).  His proposal:

  • Reduces Medicare and Medicaid fraud, waste, and abuse
  • Repeals the Affordable Care Act
  • Repeals the Independent Payment Advisory Board (IPAB)
  • Repeals the Community Living Assistance Services and Supports program (CLASS)
  • Repeals policies that increase the cost of health care insurance for individuals – the medical device and pharmaceutical drugs fees and the health insurance excise tax
  • Repeals Medicaid expansion
  • Repeals individual mandate
  • Eliminates Children’s Hospital GME
  • Reduces improper payments, modernizes HHS’ systems, controls unnecessary costs, and improves management of resources
  • Cuts administrative budget
  • Allows American to purchase health insurance across state lines
  • Adopts medical malpractice reform

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Lieberman/Coburn Bipartisan Plan to Save Medicare and Reduce Debt

On June 28, 2011, Sen. Joe Lieberman (I-CT) and Sen. Tom Coburn (R-OK) presented a proposal– the Lieberman/Coburn Bipartisan Plan to Save Medicare and Reduce Debt – that would reform Medicare in order to save at least $500 billion over 10 years. The reforms include:

• Eliminating the variation in beneficiaries’ deductibles depending on the services provided and, instead, establishing an annual deductible of $550 for both Medicare Part A and Part B services;

• Establishing an “out-of-pocket maximum” of $7,500 for Medicare beneficiaries with higher income Americans having a higher out-of-pocket maximum;

• Increasing beneficiary cost-sharing in Medigap by requiring the enrollee to pay the first $550 in cost-sharing and limiting the coverage to half of the remaining coinsurance up to $7,500 of the new out-of-pocket maximum;

• Increasing the Medicare eligibility age to 67 by 2025;

• Accelerating the implementation of the productivity adjustments and rebasing for home health payments;

• Phasing out the Medicare payments for bad hospital debt;

• Requiring higher income Americans to pay more for Medicare Part B services;

• Increasing the Medicare Part B premium until enrollees premium level reaches a minimum of 35 percent of the program’s costs in 2019; and

• Requiring individuals 65 years of age and older who are making more than $150,000 annually ($300,000 for couples) to pay the full premium costs for their Medicare Part D coverage.

The plan would include provisions focused on preventing fraud, waste, and abuse from the “Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars (FAST) Act” (S.1251), which was introduced by Sen. Tom Carper (D-DE) and Sen. Coburn. The Senators propose to use the cost savings generated from the above changes to pay for a three-year Medicare physician fee fix.

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Deficit Reduction Debate Quick Links

The Kaiser Family Foundation prepared a comparison chart of Medicare changes that have been recommended in various deficit reduction proposals.

As the bipartisan, bicameral negotiations lead by Vice President Biden continue, the Committee for a Responsible Federal Budget has identified areas of agreement among the deficit reduction plans, which amount to $1 trillion in savings.

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CMS Proposed Rule on Provider and Supplier Enrollment

CMS released the Proposed Rule: “Medicare, Medicaid, and Children’s Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers.” The Proposed Rule will be published in the September 23 Federal Register.

The Affordable Care Act made statutory changes to the Medicare and Medicaid programs and CHIP to enhance provider and supplier enrollment and to reduce fraud, waste, and abuse.

The Proposed Rule will have implications for both new and existing providers and suppliers. For example, the Proposed Rule would establish new screening procedures for newly enrolling providers and suppliers beginning on March 23, 2011. The new procedures would apply to current Medicare, Medicaid, and CHIP providers beginning on March 23, 2012.

Comments on the Proposed Rule are due to the Agency by November 16, 2010 at 5:00 pm.

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