Medicare Sets Final Rule To Pay Doctors For Consultations On ‘End-of-Life’ Care
The new rule did not ignite the fierce fight that a similar measure did during the health law debate. Medicare officials also turned down requests from hospitals to change their plans for a controversial rule to determine which patients are considered out-patient status, and the Wall Street Journal examines how the federal government is curbing the auditors who check those hospital decisions.
The New York Times:
New Medicare Rule Authorizes ‘End-Of-Life’ Consultations
Six years after legislation to encourage end-of-life planning touched off a furor over “death panels,” the Obama administration issued a final rule on Friday that authorizes Medicare to pay doctors for consultations with patients on how they would like to be cared for as they are dying. The administration proposed the payments in July, touching off none of the rancor that first accompanied the idea during debate on the Affordable Care Act in 2009. (Pear, 10/30)
The Wall Street Journal:
End-Of-Life Discussions Will Be Reimbursed By Medicare
The rule announced Friday by the Centers for Medicare and Medicaid Services will reimburse, starting Jan. 1, health-care providers if they choose to have conversations with Medicare patients about advance care planning—also known as end-of-life discussions. The decision affects about 50 million beneficiaries and could ripple through the health-care industry. Private insurers often follow payment practices adopted by Medicare, the national insurance program for seniors and the disabled. (Armour, 10/30)
The Associated Press:
Medicare To Cover End-Of-Life Counseling
The policy change was urged by numerous physician and health groups. Some doctors provide this "advance care planning" to their patients without getting paid for the counseling time, and some private insurers already reimburse for it. But the Obama administration's policy change could make the talks more common among about 55 million Medicare beneficiaries. The rule, proposed last summer and finalized Friday as part of broader doctor-payment regulations, takes effect Jan. 1. The counseling is entirely voluntary, and could take place during seniors' annual wellness visit or during regular office visits. (Neergaard, 10/30)
The Wall Street Journal:
Medicare Cuts Back Work Of Auditors Probing Improper Payments To Hospitals
The federal Medicare agency is sharply cutting back the work of auditors that review hospital claims and seek to recoup improper payments for the government, according to a letter reviewed by The Wall Street Journal. Recovery audit contractors, as they are known, recouped $2.4 billion in improper payments in 2014, down from $3.7 billion in 2013 before the agency scaled back other audit activities and temporarily suspended the program for several months, according to a Medicare report. Starting in January, the auditors will be able to review only 0.5% of the claims the agency pays to each hospital or provider every 45 days, according to an Oct. 28 letter to the contractors. That is a quarter of the prior threshold: 2% of claims. (Weaver, 10/30)
Modern Healthcare:
Final Two-Midnight Rule Dismisses Suggestions On 'Physician Judgment'
The CMS is standing by the controversial two-midnight rule and will not implement changes proposed by industry stakeholders, including a popular suggestion to create a one-midnight rule. The agency will also allow physicians to exercise judgment in admitting patients for short hospital stays. The CMS finalized its two-midnight policy in the 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System payment rule released Friday. ... The two-midnight rule, which was initially created in 2013, calls for Medicare's payment and audit contractors to assume a hospital admission was legitimate if it spans two midnights. Shorter stays are assumed to be more appropriately billed as outpatient observation care. (Dickson, 10/30)
In other Medicare news -
USA Today:
How To Navigate Medicare Open Enrollment Season
April might be the cruelest month, but Oct. 15 through Dec. 7 have to be the cruelest days of the year. That’s when Uncle Sam asks millions of Medicare beneficiaries to review and change, if need be, their Medicare health plans and prescription drug coverage for the following year. Here’s what you need to know to survive this year’s season. (Powell, 10/30)
The Washington Post:
Watchdog: Cash Benefit Program Overpaid Disabled Workers By $11 Billion Over Nine Years
One of the largest federal programs that provides cash benefits to disabled workers overpaid $11 billion during the past nine years to people who returned to work and made too much money, a new study says. The Social Security Administration, which runs the Disability Insurance program, gave up on recovering $1.4 billion of the excess payments because they were found to be the agency’s fault, not the workers’, the Government Accountability Office found. (Rein, 11/2)