medicaid programs news from FierceHealthcare

> In an effort to make sure aging baby boomers get appropriate care, the Institute of Medicine is urging payers to support an increase in pay for geriatric specialists. Read more...

CMS has proposed new rules that would give states more latitude in designing their Medicaid programs. The rules, which address provisions of the Deficit Reduction Act of 2005 and the Tax Relief and Read more...

The U.S. Department of Justice already had let the world know that hospitals run by Community Health Systems had submitted improper claims. Now, the government has attached a number to CHS's alleged Read more...

While President Bush's proposed 2009 budget adds money to the Medicare and Medicaid programs, it also proposes to cut funding by a substantial amount over the next five years, raising protests from Read more...

An Illinois judge has booted an antitrust suit brought against two Chicago-area physician groups, which claimed that they'd conspired to get rid of Medicaid patients in an effort to force the State Read more...

Questions continue to dog the medication monitoring program managed by a contractor for drugmaker Eli Lilly, that has been working to cut costs for psychiatric medications for 20 Medicaid programs. Read more...

While the evidence for cost-savings seems a bit, well, ambiguous, CMS this week is trumpeting the results of the first year of its diabetes care P4P project. CMS has just completed the first year of a three-year demonstration project under which the agency is monitoring diabetes care provided by 10 large medical practices. Diabetes management is being measured by standards drawn from CMS's Doctor's Office Quality project. Under the terms of the demonstration, which was mandated by …

Read more...

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 …

Read more...

It looks like psychiatrists are getting the most love from pharmaceutical companies, a relationship which critics say could be behind the increasing use of costly atypical antipsychotic drugs for children.

As states begin to track pharma gifts to doctors, psychiatrists are increasingly coming up as top beneficiaries for pharma payments. In Vermont, for example, pharma payments to psychiatrists more than doubled last year, hitting $45,692 per individual, up from $20,835 in 2005. …

Read more...

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 …

Read more...