Hospitals’ Tabs Are Due For Excess Federal Payments To Nursing Schools
A government error resulted in $310 million in overpayments to hospitals that run nursing schools, and federal officials said they would collect that money by taking it out of Medicare reimbursements this summer. In news about a different federal program, Georgia looks to expand Medicaid coverage for new moms, and states brace for confusion when the pandemic ends and millions of people are likely to be pushed out of the health program for people with low-incomes.
Modern Healthcare:
CMS Claws Back Medicare Payments From Hospitals That Own Nursing Schools
For nearly a decade, the federal government has overpaid hospitals that own nursing schools an estimated $310 million, and now the Centers for Medicare and Medicaid Services want that money back. CMS posted a notice online in late 2020 stating that due to an agency error, nursing schools were overpaid by Medicare from 2008 through 2018 and needed to return that money. For many of the providers, that money will come due this summer unless a congressional effort to forgive the debts is successful. (Hellmann, 2/11)
In other news about Medicare —
Modern Healthcare:
Joint Replacement Pay Reform Hasn't Hurt Alzheimer's Patients
Medicare payment reforms for joint replacement didn't increase disparities in use between patients with Alzheimer's and those without, according to a new study in JAMA Health Forum on the first two years of program data. The findings, published Friday, came after previous studies found the value-based payment reform was associated with a decrease in knee replacements for Black beneficiaries and dual-eligible beneficiaries. The relatively equitable treatment for Alzheimer's patients under the reformed model is encouraging, but policymakers should keep evaluating new models to make sure they're offering equitable care to vulnerable populations, the study's authors wrote. (Goldman, 2/11)
CIDRAP:
Medicare Study Puts Spotlight On High-Volume Antibiotic Prescribers
A review of data on outpatient prescriptions for Medicare patients shows that high-volume antibiotic prescribers are responsible for a disproportionate number of antibiotic prescriptions in this group, researchers reported today in Morbidity and Mortality Weekly Reports. The study, led by researchers with the Centers for Disease Control and Prevention (CDC) Division of Healthcare Quality Promotion, found that, among more than 59 million antibiotic prescriptions written for Medicare Part D beneficiaries in 2019, 41% came from the top 10% of prescribers, who prescribed antibiotics at a rate 60% higher than that of lower-volume prescribers. Nearly half of those prescribers were located in southern states. (Dall, 2/11)
Stat:
Drug Company Payments For Consulting, Food, And Drinks Influence Rheumatologists’ Prescribing
In the latest attempt to examine financial ties between physicians and the pharmaceutical industry, a new study finds that payments to rheumatologists by drug makers are associated with an increased likelihood of prescribing and Medicare spending. Between 2013 and 2015, more than 3,700 – or two-thirds – of all rheumatologists in the U.S. received some type of payment from a pharmaceutical company. Depending upon the drug, payments for food and beverages likely increased prescribing anywhere from 1.5% to 4.5%, while such payments boosted annual Medicare spending from 3% to 23%. (Silverman, 2/11)
Modern Healthcare:
Provider Groups Ignite Push To Keep Direct Contracting Model
Federal regulators are considering the future of the Direct Contracting program and an announcement could come soon, unnerving some provider groups. The concerned groups are urging the Centers for Medicare and Medicaid Services to tweak but not toss out the Global and Professional Direct Contracting part of the program. ... The Direct Contracting program is part of CMS' push towards value-based care arrangements. The initiative has taken on new meaning recently, as the agency in October unveiled a goal to bring all Medicare beneficiaries into value-based care by 2030. GPDC builds off CMMI's previous ACO models, offering higher levels of risk and greater opportunities for reward. (Goldman, 2/14)
In Medicaid news —
AP:
Georgia Bill Would Expand Medicaid Coverage For New Moms
A Georgia bill aimed at reducing the state’s high death rate for new mothers is advancing. The state Senate this week unanimously approved legislation that would extend Medicaid coverage for low-income moms in Georgia from six months to a year after they give birth. “Extending Medicaid coverage to new mothers to a full year after birth is a solid step towards improving the lives and health of mothers and babies in Georgia,” Senate Democratic Leader Gloria Butler said Monday. “It will address our shameful maternal mortality rate. We cannot claim to care about women’s health, maternal health and babies without passing this legislation.” (2/12)
KHN:
Why Millions On Medicaid Are At Risk Of Losing Coverage In The Months Ahead
The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition. State Medicaid agencies for months have been preparing for the end of a federal mandate that anyone enrolled in Medicaid cannot lose coverage during the pandemic. (Pradhan, 2/14)
