Medicare

The agency that governs Medicare is considering adjusting its payment rates to take back nearly $4 billion in unexpected payments to nursing homes.

The Centers for Medicare and Medicaid Services (CMS) said in a proposed regulation Thursday that payments under a new classification system have "differed significantly" from the agency's earlier estimates. As a result, CMS is considering an 11 percent cut in next year's payment rates to make up for the extra spending this year.

"The CMS proposed rule is extremely complicated, but one thing is already clear — it will have a dramatic impact on the lives of nursing home residents and patients," American Health Care Association President and CEO Mark Parkinson said in a statement. "AHCA will spend the coming days and weeks examining all of the elements of this rule to ensure that our members' daily experiences are used to help guide CMS in creating the best possible environment for residents."

Senate Majority Leader Reid will hold a vote on Rep. Ryan's budget in an effort to split Senate Republicans.

Center for Economic and Policy Research extrapolated costs from data over the program's 75-year planning period.

The liberal Campaign for America's Future (CAF) is urging Senate Majority Leader Harry Reid (D-Nev.) to hold a vote on the House Republican budget, which includes Rep. Paul Ryan's (R-Wis.) plan to replace Medicare with subsidies to buy private insurance. 

The House passed the Ryan budget along party lines, 235-193, just before the spring recess. Democrats have spent the past two weeks hammering away at it, especially its Medicare proposal, which the Congressional Budget Office says would raise healthcare costs on seniors.

"This Republican budget plan is an outrage. The more Americans learn about it, the angrier they get," CAF co-director Robert Borosage said in a statement. "Bring it to a vote. Force a debate on it. Let Americans know exactly where their senators stand."

For the second time in less than two weeks, House Speaker John Boehner (R-Ohio) raised eyebrows Tuesday with a tepid endorsement of Rep. Paul Ryan's (R-Wis.) Medicare reform plan.

Ryan's proposal to replace Medicare with subsidies to buy private insurance was a central part of the GOP's 2012 budget blueprint, which sailed through the Republican-controlled House on April 15 on a party-line vote of 235-193. But in an interview with ABC News this week, Boehner called the Ryan Medicare plan "an idea … worthy of consideration;" two weeks ago, the Speaker called it "an option worth considering."

"I'm for it," Boehner told the news channel. "It's our idea. Right? It's Paul's idea. Other people have other ideas. I'm not wedded to one single idea, but I think it's — we have a plan."

Democrats have been hammering away at the Ryan Medicare proposal's growing unpopularity throughout the spring recess. The liberal group Americans United for Change immediately blasted out Boehner's latest comments under the headline "Say what??"

The Medicare agency could cut its annual bill for physician-administered drugs by $4.4 million by adopting a government watchdog's recommendations, a new report says.

The Inspector General for the Department of Health and Human Services recommends that the agency lower its reimbursements for drugs under certain conditions. The report addresses Part B drugs, a subset of Medicare's prescription drug coverage that deals mostly with infused and injected medicines that are not usually self-administered.

Medicare officials rejected most of the report's conclusions, saying the savings aren't worth the effort and that their hands are tied by the courts.

"Given that annual Medicare spending is approximately $450 billion, of which roughly $15 billion on part B drugs, we respectfully suggest … redeploying those resources to activities that may have higher potential rates of return," Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick wrote to Inspector General Daniel Levinson.

Kaiser Health News has a rundown of news coverage about the reactions to Republicans' Medicare reform proposal. 

Republicans are finding they have some explaining to do at their town halls, reports McClatchy.

Democrats are fueling some of that anger, Daniel Strauss and Emily Cahn write in The Hill.

Americans United for Change is running ads this week blasting the GOP budget in the districts of Reps. Paul Ryan (R-Wis.), Chip Cravaack (R-Minn.), Sean Duffy (R-Wis.) and Steve King (R-Iowa).

The New York Times previews Tuesday's Supreme Court case on the use of prescription drug records for marketing. 

Former Obama budget director Peter Orszag said the GOP Medicare plan would raise national healthcare spending overall.

The chairmen of two powerful House committees want President Obama to detail how exactly he plans to cut federal healthcare spending by $480 billion over the next 12 years, as he promised during last week's deficit speech.

Reps. Dave Camp (R-Mich.) and Fred Upton (R-Mich.), the chairmen of the Ways and Means and Energy and Commerce panels, wrote to Obama on Wednesday asking him for a detailed explanation of how he plans to meet those savings targets. The president announced his proposals after House Republicans unveiled their own proposal to transform Medicare into a voucher-like system.

"(I)t is unclear from where or how those reductions in spending are achieved," the letter states. "In order to meet our shared goal of keeping Medicare solvent for future generations by controlling spending, we intend to examine all proposals. We ask that you provide this additional clarification so that we can fully understand and evaluate the new Medicare proposals you have put forward."

The American Hospital Association said Tuesday it was "deeply disappointed" by an Obama administration proposal to cut Medicare payments for acute-care hospitals by 0.5 percent next year.

The trade group says a new proposed rule penalizes hospitals because it wrongly assumes that per-patient spending has increased as a result of coding changes rather than hospitals' treatment of more complex and severely ill patients. The rule also increases Medicare payments for long-term-care hospitals by 1.9 percent.

"America's hospitals are deeply disappointed that today's proposal puts further stress on vital care on which seniors depend on," AHA President and CEO Rich Umbdenstock said in a statement. "Medicare already fails to covers the cost of hospital services and these reductions ultimately make hospitals' ability to care for patients and communities even more challenging."