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July 13, 2017
CMS looks to drop payment for off-campus services by half
The CMS wants to drop by half what Medicare pays when patients receive healthcare at medical facilities that are owned by hospitals but located off their campuses.
The Obama administration last year finalized a rule that paid hospital off-campus facilities the same as hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015.
The proposal, outlined in the proposed 2018 physician fee pay rule released Thursday, would drop that rate from 50% to 25% of what they would have been paid under outpatient rates.
"At a time when the nation is moving toward value-based payments, this proposal makes no sense. In essence, it removes all incentives to provide care out in the communities rather than at the hospital, and ultimately will lead to higher overall Medicare spending," said Blair Childs, senior vice president of public affairs for Premier, a consulting firm.
The prioir, more generous payment made to off-campus facilities has led to hospitals acquiring physician practices at a rapid clip. But hospitals say the facilities, while increasing their operating costs, allow them to provide greater access to healthcare, especially in underserved areas.
The Trump administration's proposed changes would save $25 million next year. Among the services affected would include pain management treatment, some x-rays and radiation therapies as well as some behavioral health services.
"The CMS proposal will result in an unsustainable payment rate that will further reduce access for people in chronically underserved communities, health care deserts, and the hospitals on which they rely," Dr. Bruce Siegel CEO of America's Essential Hospitals said in a statement.
Congress passed what's called the site-neutral policy after a 2013 Medicare Payment Advisory Commission report that found Medicare was paying 141% more for a echocardiogram in an outpatient setting than for the same procedure in a doctor's office.
Comments on the proposed rule are due by Sept. 11.
Source: Modern Healthcare
Oklahoma weighs steep cuts to provider pay, Medicaid benefits
By Rachana Pradhan
04/10/2017 03:47 PM EDT
Oklahoma’s Medicaid agency is considering slashing provider reimbursement rates by 25 percent and eliminating several optional benefits amid ongoing budget woes, officials said today.
This is the second straight year that Oklahoma is considering a 25 percent cut to provider rates. Oklahoma ultimately avoided painful cuts to provider rates and benefits last year, but a dire outlook for fiscal year 2018 is forcing the state to reconsider.
Oklahoma will consider eliminating or reducing benefits related to pharmacy, behavioral health treatment, dialysis, adult organ transplants, hospice services and private duty nursing services, among others.
Cutting provider reimbursement rates by 25 percent would put physician payment levels at 65 percent of Medicare rates, officials said. The reductions would affect all provider types, including hospitals, nursing facilities and pharmacy.
“While we don’t know our final appropriation, we must be prepared for a reduction," Oklahoma Medicaid agency CEO Becky Pasternik-Ikard said in a statement. "In order for us to meet our obligations to the federal government, we have to get the process started,”
Oklahoma, one of 19 mostly GOP-led states that has refused Medicaid expansion, last year briefly weighed joining the optional Obamacare program to help fill the state's budget hole.
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New DEA registration renewal policy creates new headaches for doctors
Effective Jan. 1, 2017, the DEA will eliminate the informal grace period for physicians to renew their registration - and doctors who miss their renewal deadline face daunting consequences:
Further, physicians will receive only one renewal notice to their "mail to" addresses.
Click here to read more about this policy change and the AMA's opposition.
Source: FMA News
Signature CEO Jan Vest to Retire; Schwartzkopf, Sackman Get Expanded Roles
ST. LOUIS, Jan. 19, 2017 /PRNewswire/ -- Jan Vest, the longtime CEO and founding member of the Signature Medical Group Board of Directors, is retiring Dec. 31. In addition, two senior executives will be expanding their roles in the company immediately, Vest has announced.
Andrew Schwartzkopf, general counsel, will become chief administrative officer, handling many of Vest's duties, and Chad Sackman, senior vice president of operations, will be chief operating officer. Vest said the remaining executive team members will remain intact.
Vest said he is proud to be leaving Signature in a strong position among healthcare providers in the Midwest.
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Missouri says Aetna-Humana merger is anticompetitive
Missouri insurance officials have issued a preliminary order against the merger between health insurance giants Aetna and Humana, the first state to find a problem with the massive transaction.
Source: Modern Healthcare
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