Medicare

Raising the Medicare age to 67 would shift costs onto 65- and 66-year-olds, according to a Kaiser Family Foundation report.

A Florida mother and her two daughters were charged with Medicare fraud, the Miami Herald reports.

Wisconsin has started charging state employees more for their healthcare, the Milwaukee Journal Sentinel reports.

The liberal Mother Jones looks at a new tactic deployed by the Tea Party to derail healthcare reform.

A new study finds that doctors with financial conflicts of interest have recently played a huge role in writing guidelines on cardiovascular health, The New York Times writes.

Clinical laboratories are anxiously waiting to see if federal regulators will end up nixing a proposal they say would drive healthcare costs up for little apparent gain.

A new Medicare regulation requiring laboratories to show a physician's signature if they want to be reimbursed is set to take effect Friday. The American Clinical Laboratory Association (ACLA) has already successfully lobbied for a three-month delay and hopes a yet-to-be-published regulation pending before the Office of Management and Budget will rescind the requirement.

Requesting a physician signature had been seen as a way to prevent fraud and abuse, but the ACLA argues there's no evidence that's the case. Earlier this year the trade association helped secure bipartisan letters signed by 89 House members and 34 senators raising concerns about the new requirement.

Rising Medicare premiums could wipe out another cost-of-living adjustment for Social Security benefits, The Associated Press reports.

The Wall Street Journal looks at the future of accountable-care organizations.

Former insurance company executive Wendell Potter writes in the Huffington Post about waivers the Obama administration have given to “mini-med” plans.

Cash-strapped states are eyeing Medicaid cuts, CNNMoney writes.

Kentucky is considering restrictions on Medicaid payments for certain cancer drugs, the Lexington Herald-Leader reports.

Ways and Means Committee panels to haul seniors lobbying group in for a hearing on how it stands to benefit.

Top members of the Senate Finance Committee want frequent progress reports from the Obama administration about its effort to crack down on fraud, waste and abuse in federal health programs.

Chairman Max Baucus (D-Mont.) and ranking member Orrin Hatch (R-Utah) want detailed quarterly updates from the health department’s Office of the Inspector General and the Centers for Medicare and Medicaid Services (CMS) about progress on fighting waste, fraud and abuse in Medicare and Medicaid.

Healthcare reform included provisions that allow CMS to take a more proactive approach to rooting out improper payments before they are made. The Department of Health and Human Services estimates fraud at about $60 billion each year.

The senators in a Thursday letter requested updates on investigations, enforcement actions, recovery efforts and how the offices are spending their fraud, waste and abuse budgets.

Opponents of the healthcare reform law are appealing a federal judge’s ruling that seniors cannot opt out of a Medicare program without losing their Social Security benefits.

The 2008 suit was brought by three retirees who wanted to refuse Medicare Part A coverage for hospital stays while retaining their Social Security benefits. Former House Majority Leader Dick Armey (R-Texas) later joined the suit.

“The Medicare Act is very clear that persons entitled to Social Security retirement benefits, i.e., of an age and work history and application therefore, are immediately and automatically entitled to Medicare Part A benefits upon their 65th birthdays,” District Judge Rosemary Collyer wrote last week.

Congress should re-examine how Medicare pays for hospice, home health and nursing home stays, the panel that recommends reimbursement rates said Tuesday.

The panel recommended that federal regulators tackle fraud in the home health industry while ensuring that patients' admission and length of stay in hospice is based on their care needs and not financial incentives. It also suggested creating quality incentives for nursing homes — for example, by requiring the Department of Health and Human Services to publicly report risk-adjusted rates of potentially avoidable rehospitalizations and community discharge.

In total, the Medicare Payment Advisory Commission's annual report to Congress made payment policy recommendations for 10 payment systems. MedPAC comes up with its update recommendations by weighing beneficiary access to care, the quality of care, providers' access to capital and provider costs and Medicare payments.

Medicare is supposed to reject erectile dysfunction drugs under a ban on sexual or erectile-dysfunction treatments.

The nonpartisan Congressional Budget Office released a list of deficit-cutting options Thursday that includes hundreds of billions in cuts to Medicare and Medicaid.

The two programs account for 38 percent of mandatory spending — more than Social Security — and face a visit to the chopping block as Americans across the political spectrum clamor for the government to keep its spending under control.

In its report, CBO says giving states a block grant (indexed to annual increases in the employment cost index) to cover long-term care services in Medicaid — something conservative state leaders have been clamoring for — would shave $287.4 billion off the deficit over 10 years. The next biggest saver, increasing the basic Medicare premium for doctor's visits to 35 percent, would save $241.2 billion.

Physicians will see a 29.5 percent cut in their Medicare reimbursements come Jan. 1 unless Congress acts, Medicare officials said.

The new figure represents an increase over the 28.3 percent "cliff" the Obama administration had relied on when crafting its proposed 2012 budget. That budget, unveiled last month, sets aside $62 billion to keep Medicare payments flat for the next two years; the new estimate means doing so could in fact cost a billion dollars more.

Likewise, the 10-year cost of repealing the payment formula is likely to significantly surpass the $369.8 billion estimated in the president's budget. 

Doctors have been clamoring for years for Congress to repeal the Sustainable Growth Rate formula and its annual reimbursement cuts, but the ever-growing cost of doing so makes it increasingly unlikely Democrats and Republicans will agree on how to pay for it — or whether to add its cost to the ballooning national deficit.

The new figures are included in a letter that surfaced Thursday from Center for Medicare Management Director Jonathan Blum to Glenn Hackbarth, the chairman of the Medicare Payment Advisory Commission.