Medicare

The House Budget Committee's chairman said the administration is violating the law by not proposing ways to shore up Medicare.

A group of Democratic senators are asking the health department’s top investigator to examine Medicare contractors’ possible conflicts of interest.

Democratic Sens. Max Baucus (Mont.), Tom Carper (Del.) and Claire McCaskill (Mo.) on Tuesday called on the Health and Human Services Department’s inspector general to review Medicare contractors and their subsidiary relationships.

A survey conducted by staffers of several Senate committees raised concerns about the relationships between firms that approve and process Medicare reimbursement claims and those hired by the government to ensure the accuracy of the claims, the senators wrote. For example, in some cases, an oversight contractor was found to be the subsidiary of a company with a Medicare claims processing contract, the senators said.

“There would clearly be questions of impaired objectivity, or the appearance of impaired objectivity, when related companies are charged with both the administration of Medicare-related programs and oversight of that administration,” the letter read.
 
“We recognize that a conflict of interest does not necessarily mean fraudulent or improper activity is occurring,” the senators wrote. “However, this survey by our respective committee staffs strongly underscores the need for a more extensive review of relevant contracts to ensure compliance with federal regulations, and to promote a more efficient and transparent federal government.”

The Senate Finance Committee, chaired by Baucus, is one of three congressional panels to hold a hearing Wednesday on reducing fraud, waste and abuse in the Medicare program. HHS Inspector General Daniel Levinson will be at the Senate Finance hearing.

The Centers for Medicare and Medicaid Services is touting early interest in new programs offering bonuses to healthcare providers for using electronic health records (EHR).

More than 21,000 providers have already signaled their intent to apply for Medicare and Medicaid incentives, and 11 states have launched Medicaid EHR programs, CMS announced Wednesday. Four Medicaid programs have already paid out $20 million in incentives.

The programs, which opened for registration Jan. 3, are funded by nearly $30 billion included in the 2009 stimulus for the adoption and implementation of EHR technology. To receive the funding, doctors and hospitals must meet certain clinical and administration benchmarks intended to boost patient safety and quality of care.

Doctors can receive up to $44,000 or $63,000 in the Medicare and Medicaid programs, respectively, for the “meaningful use” of EHR technology, and hospitals stand to earn millions for either program. The bonuses will eventually turn into penalties for providers who don’t adopt.

The man who helped create the “doughnut hole” in Medicare prescription drug coverage defended the program’s original design Friday morning.

The new healthcare reform law will gradually close the doughnut hole over 10 years, and more than 3 million seniors who fell in the coverage gap have already received $250 checks.

But former Ways and Means Chairman Bill Thomas (R-Calif.) said the doughnut hole was an intentional design.

“We were limited by money, but I didn’t want any more money because we had the opportunity to create a structure that was basically actuarial equivalent,” Thomas said during an event at the conservative American Enterprise Institute.

A bipartisan pair of senior senators reintroduced a bill that would lift a cap on Medicare services for mentally ill patients.

The bill, introduced by Sens. John Kerry (D-Mass.) and Olympia Snowe (R-Maine), would eliminate a lifetime cap of 190 days on inpatient psychiatric hospital care.

“There is no good reason why Medicare should randomly shut down benefits and force mentally ill seniors to go without treatment," Kerry said.

"Eliminating the lifetime cap on inpatient psychiatric hospital care takes another critical step in ending the unfair distinction between physical and mental disorder," Snowe said.

The bill was first introduced last year with the support of the AARP and the American Psychological Association.

Mental health issues have taken on a new level of importance in the aftermath of the Arizona shooting tragedy last month that left six dead and Rep. Gabrielle Giffords (D-Ariz.) seriously wounded.

Meanwhile, Rep. Grace Napolitano (D-Calif.) was trying to build support Thursday for a bill that would boost federal funding for therapists and mental health services in schools.

President Obama, responding to GOP criticism that his budget doesn’t tackle entitlement spending, said Tuesday he prefers to hammer out a deal with lawmakers to fix Medicare and Medicaid spending.

“If you look at the history of how these deals get done, it’s typically not because there’s an Obama plan out there,” Obama said during a Tuesday morning press conference. “It’s because Democrats and Republicans are committed to tackling the issue in a serious way.”

Obama said the healthcare reform law enacted last year set the stage for reforming healthcare entitlement spending. The Affordable Care Act slows the growth of Medicare spending by about $500 billion over 10 years.

House Speaker John Boehner (R-Ohio) on Tuesday vowed that Republicans “will not punt” on entitlement reform in their budget proposal this spring. Republicans are still mum, however, on the details of their plan.

The White House on Monday unveiled a budget proposal that prevents cuts in Medicare payments to doctors while leaving other healthcare providers largely unscathed.

The budget's two-year "doc fix" is seen as vital for building physician support for the healthcare reform law. One of the doctors' top priorities is the permanent repeal of Medicare's Sustainable Growth Rate, which mandates payment cuts that lawmakers regularly scramble to postpone.

"The administration's in a political battle with Republicans who are basically telling docs, if you support our goal of repealing (healthcare reform), we'll use the money (from the law's subsidies) for a doc fix," said healthcare analyst Alexander Vachon, a former Republican Senate aide. "The minimum bid here was a two-year doc fix."

President Obama's 2012 budget proposal squeezes healthcare payments for a broad cross-section of medical providers.

President Obama’s Medicare chief, appearing before a House committee for the first time since his recess appointment in July, strongly denied Republican claims that he supports rationing healthcare.

A 2008 quote from Centers for Medicare and Medicaid Services Administrator Don Berwick about his love for the British national health system raised some Republicans’ eyebrows after his nomination last year. Thursday morning, Berwick fought back against the Republican accusations, saying that they have “no substance.”

"My entire life has been spent fighting rationing," Berwick, a pediatrician by trade, told the House Ways and Means Committee Thursday morning.

The healthcare law has strengthened the privately-run Medicare Advantage program, Medicare's chief testified Thursday.