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Centers for Medicare and Medicaid Services (CMS)

Latest Headlines

Latest Headlines

CMS seeks rural hospitals for gainsharing program

CMS has begun recruiting rural hospitals for a demonstration project which will examine the impact of gainsharing projects on such hospitals. (Gainsharing refers to programs under which hospitals pay physicians a share of any savings generated by mutual quality and efficiency-improvement efforts.) Under the gainsharing program, the hospitals will be asked to provide their own measures of whether they've managed to improve quality and efficiency of care for Medicare beneficiaries. The …

SPOTLIGHT: Sutter responds to dicey federal heart stats

So if your facility came out badly in CMS's new batch of stats on heart failure, what do you do?  That's the problem facing Sacramento, CA-based Sutter Medical Center. Article

ALSO NOTED: Changes in Medicaid drug rates; More chiropractors in Washington state; and much more...

> CMS has announced controversial new Medicaid rules that will change the way it pays for prescription drugs. Release > Washington state has passed a new law requiring health plans to contract with more chiropractors. …

Three more heart transplant programs in jeopardy

Continuing its ongoing investigation of heart transplant programs, CMS has threatened three more programs with decertification. CMS has given San Antonio, Texas-based Christus Santa Rosa Hospital-Medical Center, Abbott Northwestern Hospital in Minneapolis and St. Vincent Indianapolis Hospital 30 days to submit corrective action plans. Meanwhile, a fourth heart transplant program at the University of Kentucky Chandler Hospital has agreed to give up Medicare funding entirely, at least for …

ALSO NOTED: Connecticut boosts hospital fund; HMO premiums to jump in '08; and much more...

> Connecticut approved a plan that should almost triple the state's Hospital Hardship Fund for 2008. The new fund should include $30 million, up from $11 million for fiscal 2007. Article > HMOs could boost monthly premiums 14.1 percent in 2008, the biggest rate increase in four years. …

New HHS program targets Medicare fraud

HHS has launched a new pilot program hoping to catch dishonest medical equipment suppliers in the Los Angeles area and South Florida. If the pilot is successful, CMS plans to role out the program across the United States. The two-year effort, designed to ferret out Medicare fraud, will search for falsified bills and overcharges from suppliers of prosthetics, orthotics, diabetic supplies …

Officials make case for Los Angeles hospital closure

California regulators laid out their case this week for closing Martin Luther King Jr.-Harbor Hospital, arguing it continues to provide substandard care and is putting patients at risk. In a 32-page report, the California Department of Health Services cited findings from inspections between October 2004 and June 2007, that suggest the hospital hasn't made sure nurses are competent or …

ALSO NOTED: States work to offset Medicaid drug cuts; Biotechnology generics bill progressing; and much more...

> States are hoping to offset the effects of a proposed CMS rule that would cut Medicaid reimbursements to pharmacies for generic drugs. Article > A Senate committee has approved pending legislation that would help the FDA approve generic versions of biotechnology drugs. Article > Charlotte, North …

St. Barnabas racketeering suit dismissed

Despite its having engaged in a massive Medicare scam costing the federal government at least $630 million, St. Barnabas Health Care System did not prevent other hospitals from getting fair reimbursement. That's the conclusion of a federal judge, who ruled that despite the fraud, St. Barnabas had not engaged in racketeering. Two small hospitals in Maine and Colorado filed the suit, alleging St. Barnabas' over billing was so extreme it distorted CMS's Medicare reimbursement …

UConn Health Center settles Medicare charges

The University of Connecticut Health Center will pay more than $475,000 to settle Medicare over-billing charges. The hospital was accused of overcharging Medicare for cancer treatments, including chemotherapy and infusion therapy, from 2002 to 2004. The feds had charged that instead of billing Medicare on a per-patient basis, the Center's John Dempsey Hospital charged Medicare for the hours it spent in patient care, resulting in bills that were two- to seven-times larger than allowed. The …