Morning Briefing
Summaries of health policy coverage from major news organizations
Auditor Find Issues With Medicare Payments To Nursing Homes, Oversight Of Advantage Plans
The Wall Street Journal: Medicare Overpays For Intensive Therapy, Watchdog Says
Medicare could make changes to its nursing-home payment system that save billions of dollars and stem a shift to higher-cost services that don’t always correspond with patients’ needs, a government watchdog said in a report Wednesday. The report, by the Health and Human Services Department’s Inspector General, found that nursing facilities billed for increasing rates of what Medicare terms “ultra high” therapy, leading to the extra spending. The report said an analysis of claims data found facilities billed for ultrahigh therapy 57% of the days they billed to Medicare in 2013, compared with 49% in 2011. (Weaver, 9/30)
Kaiser Health News: GAO: More Oversight Needed Over Medicare Advantage Provider Networks
The federal government needs to increase its oversight over private Medicare health plans to make sure seniors have adequate access to doctors and hospitals, according to a report released this week by congressional auditors. The General Accountability Office study found the Centers for Medicare & Medicaid Services, which administers Medicare Advantage plans, primarily relies on complaints from consumers to determine if they are having trouble getting appointments with providers. (Galewitz, 9/30)
Also in health care news, a look at how drug price issues are complicating trade talks.
The Wall Street Journal: Rift Over Drug Protections Complicates Trans-Pacific Partnership Trade Talks
A fight over how long to protect certain high-end drugs from lower-cost imitators has emerged as the leading obstacle to negotiations aimed at completing a 12-nation trade agreement spanning the Pacific. While officials from the U.S. and other counties cite some progress on two other thorny issues, the drug debate continues to divide Australia and other countries from America in the high-level talks that began Wednesday in Atlanta. (Mauldin, 10/1)
