WEEKLY E-BULLETIN


Dec. 28, 2011


Congress Passes 2-Month Doc Fix, Medicare Extenders

It’s not a lengthy extension, but it is the best they could do for now AND have the votes to pass it.  There were NO changes to the health care provisions in the final bill from what the Senate had passed two weeks ago.

Medicare Physician Payment: Provides for a 0 percent update in reimbursement levels for January and February 2012. Provides that the payment update shall not be considered when calculating the Sustainable Growth Rate (SGR) reimbursement levels in future periods.

Extenders:  Extends for two months a series of Medicare and health-related provisions, all of which would expire at the end of the calendar year unless otherwise noted:

  • Section 508 hospital reclassifications;
  • Geographic floor for work;
  • Therapy caps exception process;
  • Technical component of certain physician pathology services;
  • Reimbursement raises for ambulance services;
  • Mental health reimbursements (5% increase);
  • Outpatient hold harmless provision;
  • Minimum payment for bone mass measurement;
  • Qualifying Individual (QI) program, assistance to low-income seniors in paying Medicare premiums; and
  • Transitional Medical Assistance, which provides Medicaid benefits for low-income families transitioning from welfare to work.

Click here to see a summary of the Senate passed bill.  Changes made in the final version were minor modifications to the way in which businesses would calculate the payroll tax payments.  Click here for the full 33-page text of the final version passed by Congress.  Click here if you want to see the final Congressional Budget Office score.


CMS Announces Independence at Home Demonstration

Up to 10,000 Medicare patients with chronic conditions will now be able to get most of the care they need at home under a new demonstration announced last week by CMS.  The new Independence at Home Demonstration greatly expands the scope of in-home services Medicare beneficiaries can receive. The demo will provide chronically ill patients with a complete range of primary care services.  Applications are due February 6.  Click here for details.

32 Pioneer ACOs Announced by CMS

32 health systems have signed agreements with CMS to become Pioneer Accountable Care Organizations, as defined by the federal government.  The announcement was made in Washington last week with representatives from CMS and each of the new ACOs.  Click here to see the list of Pioneer ACOs.  Click here for the CMS announcement.

Growing Numbers of Americans Have Difficulty Paying Medical Bill:  New Study

More than one in five Americans are in families that had problems paying medical bills in 2010 — some of them were insured — according to a new study released last week. This is about the same level as 2007, when the economy was healthier. The share of Americans reporting problems rose to 20.9 percent in 2010, up from 15.1 percent in 2003. Clickhere to see the report.


Nurses Want Public Posting, Evaluation of Staffing Plans

The American Nurses Association last week expressed its support for revisions to the CMS’ Medicare and Medicaid Conditions of Participation for hospitals. In addition to advocating proposals that would expand the roles of advanced practice registered nurses, the group has backed the public posting and annual evaluation of staffing plans that base the appropriate number of nurses per unit on patients’ needs. Click here for details.

Study Supports Children with Medical Home

According to a new study, researchers found children with a medical homemade fewer trips to the emergency department and had fewer sick visits with the doctor.  Click here to see a media summary.  Click here to see the study.


Supreme Court Schedules Health Care Law Arguments for March

The Supreme Court announced last week that it will use an unprecedented week’s worth of argument time in late March to decide the constitutionality of the nation’s historic health care overhaul before the 2012 presidential elections.  Clickhere for a good Washington Post article on the issue.

New Survey: Most Docs Are Stressed Daily

Almost 90 percent of physicians feel stressed everyday, according to a new survey.  Almost 40% cited administrative demands as a key stress point, while 33% named long hours and 26% said schedules and expectations.  Click here to see the story.


NQF Identifies 29 Preventable Errors to Measure National Performance

The National Quality Forum, a voluntary consensus standards-setting organization, issued a report last week that identifies 29 preventable medical errors that can be used by national and state health care groups to measure performance by providers.  The report endorses a set of serious reportable events—including such mistakes as wrong-site surgery, patient falls, and medication errors—that were published for public comment in June.  Click hereto download the 46-page report.

FDA to Relax Regs for Certain Radiology and Diagnostic Devices

The FDA last week released a guidance that will relax the agency’s requirements for 510(k) clearance for some medical devices including certain class I and class II in vitro diagnostic (IVD) and radiology devices that have established safety and effectiveness profiles and for which it intends to exempt from the 510(k) process. Radiology devices on the list include certain collimators, film cassettes, film processors, and digitizers. Click here to see the FDA guidance.

Fewer Young Women Getting Less Reproductive Healthcare

Fewer U.S. women ages 15 to 24 are receiving reproductive healthcare, according to a new study out last week. This includes services such as Pap tests, pregnancy tests, contraception prescriptions, tests for sexually transmitted diseases and other gynecological and obstetric care.  Click here for more.