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Centers for Medicare and Medicaid Services (CMS)
Latest Headlines
Latest Headlines
JCAHO to study nursing care quality measures
Funded by a grant from the Robert Wood Johnson Foundation, JCAHO has announced plans to begin testing a comprehensive list of nursing-related performance measures. The idea behind the testing is to see whether the measures make sense, and should be used for national nursing quality improvement efforts. The measures, which are endorsed by the National Quality Forum, focus on hospital-based nursing, address patient outcomes, nursing-centered care interventions and process issues that tend …
Calif. group pays out $55M in P4P incentives
It's always nice to see that there's light at the other end of the pay for performance tunnel, namely, a big fat pile of cash. In this case, a group of seven California health plans has paid big bonuses to high performers on their roster, which includes 35,000 physicians working in 210 medical practices. This year's $55 million payout, as in previous years, went to physician groups who performed best on clinical care, patient satisfaction and smart use of IT during 2005. Among the most …
CA heart transplant program suspends operations
After a warning by CMS that it might lose its certification, UC San Diego Medical Center has decided to shut down its heart transplant program, at least for the time being. The program performed only four transplants last year, down from 10 during the previous year. Both fell under the minimum level of 12 heart transplants CMS requires a center to perform each year; CMS assumes that centers who perform less aren't doing them often enough to stay in practice. The move comes as part of a …
ALSO NOTED: Retail clinic industry maturing; Medicare won't cover new depression treatment; and much more...
> Watch out: the retail clinic industry is maturing, and now it has its own annual conference. Release
> CMS officials have said that they don't plan to let Medicare cover an implanted brain stimulation device for use in treating intractable depression. Article
> The state has stripped a Texas cardiologist of his license for …
Medicare's needy struggle to get drugs
According to some advocacy groups, it looks like pharma companies aren't coming up with free prescription drugs for the needy Medicare recipients, despite a pointed congressional request eight months ago. Several pharma companies had called off their drug assistance programs for Medicare patients once Part D became effective last year. The drug makers said that they were afraid they'd be accused of violating anti-kickback rules if they kept the programs open, though CMS has since said …
Four more transplant centers could lose CMS funds
CMS has let four more heart transplant centers know that they may lose Medicare and Medicaid funding in 30 days due to the low volume of transplants they've done in recent years. The hospitals include Sutter Memorial Hospital, Hartford Hospital (CT), Washington Hospital Center (Washington, DC) and BryanLGH Medical Center East (Lincoln, NE). CMS has been particularly aggressive in threatening low-end programs of late, in part after a recent investigation found that a fifth of 236 heart, …
Medicaid drops Houston's psych hospitals
As of yesterday, Houston's six stand-alone psychiatric hospitals will lose their Medicaid reimbursement, cutting off funding for treating many mentally-ill adults. The hospitals say that the cutoff will bar dozens of mentally-ill people a day from receiving treatment, because the psych wards in the region's acute-care hospitals often don't have space to take them in. "It's going to be a huge issue," said Dr. George Santos, medical director of freestanding psychiatric facility West Oaks …
Gov't: Pharmaco bilked CMS out of $500M
This isn't chump change. According to a suit filed by the U.S. Department of Justice, generic drug maker Boehringer Ingelheim Roxane may have bilked the federal government of $500 million in fraudulent and inflated charges for its products. The DoJ says that BIR reported puffed up prices for several of its products, billed CMS for the higher price, then let hospitals and healthcare providers keep the difference in price. The difference was as much as 1,000 percent at times, the DoJ says. …
MO physician assistants fight for looser restrictions
A bill traveling through the Missouri state legislature is getting vigorous support from physician assistants (PAs), who feel that new rules loosening supervision requirements in rural and inner-city communities could make a big difference for patients in those areas. Right now, in most cases a physician must be physically present in a facility when a PA is providing care, other than some follow-up visits. Another state policy allows PAs to practice in areas where there are a shortage of …
Medicare P4P results show care improvements
The results are in on the latest round of Medicare's 266-hospital, three-year pay-for-performance test. And it appears that, initially, P4P incentives are doing what they're supposed to do--improve adherence to evidence-based care. For example, under the new program, managed by nonprofit hospital alliance Premier, it appears that more heart attack patients are getting aspirin when they come into the ED. The winner in the competition to date was Hackensack University Medical Center, which …
