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Centers for Medicare and Medicaid Services (CMS)

Latest Headlines

Latest Headlines

Study: Uninsured cancer patients diagnosed later

Even when other factors like age and gender are factored out, it seems that under- and uninsured patients with cancer are likely to be diagnosed at a later stage in their disease than patients with private insurance, according to a new pair of studies published in the journal Cancer. The studies, which looked at the breast cancer and oral cancer, found that the availability and type of health insurance could predict the severity of the illness at the point when it was diagnosed. …

Bill would open Medicare data to research

A bill making the rounds in the U.S. Senate would open up Medicare data to private organizations that want to use it for research and analysis. The bill, sponsored by Sens. Hillary Clinton (D-NY) and Judd Gregg (R-NJ), would make claims, enrollment, survey, assessment and other available to private groups hoping to measure care quality, efficiency and effectiveness. Other stakeholders would then have the right to request reports from the research organizations. The research organizations …

King-Harbor could lose federal funding after ED crisis

CMS has run out of patience with Martin Luther King Jr.-Harbor Hospital, which it says has put emergency room patients in "immediate jeopardy" of harm or death. The hospital, formerly known as King/Drew, was already on bad terms with CMS, which had threatened to take away the hospital's federal funding certification after serious care problems emerged. This is part of a larger pattern for King-Harbor, which has been cited more than a dozen times for care problems over the past three and a …

Feds study care effectiveness, practice patterns

The House Ways and Means Health Subcommittee is holding a hearing next week on the need to study variations in care practices. The stated purpose of the hearing is to consider funding new research on the comparative effectiveness of various treatments and procedures paid for under Medicare. However, such research would doubtless be used aggressively by private health plans, which are equally interested in seeing that their reimbursement policies make sense. Rep. Pete Stark (D), who chairs …

AMA fights physician Medicare cuts

The American Medical Association has begun its latest no-holds-barred campaign to make Congress cancel a scheduled Medicare reimbursement cut. As part of its campaign, AMA is publicizing the results of its survey of 9,000 physicians, which found that more than half would to limit the number of Medicare patients they accept if the planned 10 percent cut is implemented. (Sure, there's a bit of grandstanding going on here--but the pain is real, too.) Patients aren't the only ones who would …

Study:Medicare P4P doesn't boost hospital quality

While Medicare's new pay-for-performance program may have some effect on hospital quality, the financial incentives don't have any bigger impact than a hospital's voluntary improvement efforts, according to a new study published in the Journal of the American Medical Association. The study, which looked at data from 54 hospitals in the Medicare P4P program, found that most improved on some important criteria during the test, for example by prescribing aspirin more frequently for …

Humana fights for VA medical dollars

It may be starting as a small division, but it could become something big quickly. Hoping to get its piece of the agency's massive budget, Humana has created a unit which will help the U.S. Department of Veterans Affairs care for veterans who are eligible for its benefits. Humana already gets roughly three quarters of its premium revenue from government sources, largely from CMS. Now it wants more government income. To jump start the new division, Humana Veterans Healthcare Services, it …

Study: Childhood cancer survivors lack follow-up

A new study suggest that the majority of childhood cancer survivors aren't getting adequate follow-up care later in life. While childhood cancer treatments may save lives, they also create problems of their own, including the risk of new cancers created by treatment-related radiation. In particular, as many as 20 percent of young women and girls treated with chest radiation, commonly used for treating Hodgkin's disease, will develop breast cancer. Another risk: as many has half of the …

Teaching hospitals dodge a bullet

President Bush delivered a blessing for medical educational programs this week as part of new legislation. By signing the Iraq war spending bill, which contained language impacting Medicaid reimbursement, Bush also agreed to halt planned changes to federal Medicaid match funding. The Bush administration had previously proposed to eliminate Medicaid payments given directly to hospitals as a state match. Teaching hospitals have been using that money to pay for residency programs, but the …

Physicians question CMS P4P effort

Though it hasn't started yet, physicians are already questioning whether CMS's pay-for-performance program will work over the long term. Physician critics say that many practices won't have the time, resources or staff to begin quality reporting. To get the 1.5 percent bonus, physicians will be asked to report on 74 measures for claims between July 1st and December 31st. To make this happen, it's likely that the practices will have to upgrade their IT infrastructure, a step which can be …