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Medicare to expand 'no-pay' list

April 15, 2008 — 6:59am ET
Medicare has officially announced plans to expand the list of conditions it won't cover if acquired at a hospital. In new rules proposed Monday, it said that it plans to add nine conditions to its... Read more...

Study: Percent of ED charges paid is decreasing

November 12, 2007 — 7:59am ET
With hospital emergency departments already taxed enough, the following isn't reassuring. A new study concludes that the proportion of outpatient ED charges paid by both government and private... Read more...

SPOTLIGHT: Providers beef up "culturally competent" care skills

October 24, 2007 — 6:59am ET
Hoping to do better with helping minority groups manage their care, particularly for chronic disease like diabetes, providers are beginning to work harder at addressing patients' cultural needs.... Read more...

Aetna limits anemia drug payments

October 22, 2007 — 6:59am ET
Anemia drug sales have taken a beating since Medicare tightened rules to limit when it would pay for them. Now, Aetna has set limits on anemia drug reimbursements too, issuing new rules that follow... Read more...

MN hospitals won't charge for major errors

September 19, 2007 — 6:59am ET
Minnesota hospitals have decided to get on the 'no pay' bandwagon. The facilities have announced that they'll stop billing both public and private insurers for 27 preventable adverse events,... Read more...

MN hospitals won't charge for major errors

September 19, 2007 — 6:59am ET
Minnesota hospitals have decided to get on the 'no pay' bandwagon. The facilities have announced that they'll stop billing both public and private insurers for 27 preventable adverse events,... Read more...

PET scan rates climbing dramatically

May 14, 2007 — 8:01pm ET

While positiron emission tomography (PET) scans weren't used much in clinical medicine 10 years ago, today they've become far more common. The number of PET scans performed has climbed dramatically as Medicare and private insurers have agreed to pay for them. Over the past five years, the number of PET scans performed has climbed 400 percent, with more than a million scans being performed per year, according to consulting firm IMV Limited. This surge tracks with increases in MRI and CT …

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NJ charity care program faces fraud, waste

April 19, 2007 — 8:01pm ET

According to a new report by state investigators, a New Jersey program designed to help the poor and uninsured get emergency care is being sapped by waste and fraud due to poor oversight by hospitals and state officials. The state currently pays hospitals a portion of the cost of emergency care for some 300,000 poor state residents with no health coverage. This year, the program should spend $583.4 million on charity care, partly drawing on funds from federal sources. The problem is that …

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Dems pitch 12%cut to Medicare insurers

March 1, 2007 — 8:01pm ET

Democrats looking for ways to expand children's healthcare funding are considering a new option. A commission that advises Congress, the Medicare Payment Advisory Commission, has suggested that CMS stop paying private insurers more than Medicare spends when it pays for patients directly. Right now, Medicare spends about 12 percent more for Medicare managed care plans than it does when it pays providers itself, a difference of about $65 billion. Among other things, Democratic legislators …

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Critics question Democrats' Part D plans

January 7, 2007 — 8:01pm ET

Under the original Medicare law, the private insurers who offer Medicare Part D coverage negotiated prices with drug companies; the federal government was not allowed to bring its considerable bargaining power to the table in order to push down the cost of prescription drugs. Opponents have strenuously objected to this arrangement, saying that drug companies are reaping billions in profit because the federal government isn't forcing them to lower their prices. Many critics felt that …

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