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Category Archives: Medicaid

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Providers Get Short Reprieve on New CMS Two-Midnight Rule on Hospital Stays

Posted in Hospitals, Medicaid, Regulations

The new CMS “Two-Midnight Rule,” which is intended to provide greater clarity regarding when inpatient hospital admissions are generally appropriate for Medicare Part A payment, goes into effect today. However, in order to address widespread concern among hospitals and doctors about the new rule, CMS officials announced last Thursday that government recovery auditors will delay… Continue Reading

No State-Run Health Insurance Exchange or Medicaid Expansion in Alabama

Posted in Affordable Care Act, Medicaid, Regulations

Governor Bentley told the Birmingham Business Alliance today that he would not set up a state-run health insurance exchange, and he will not expand Medicaid as provided under health care reform. Once established, the health insurance exchanges will be places for individuals and businesses to shop for health insurance plans.  The exchanges are supposed to be… Continue Reading

President Obama’s Reelection Ensures the Path of Health Care Reform

Posted in Affordable Care Act, Medicaid, Regulations

In its front-page story on President Obama’s reelection, the New York Times reports, “For Mr. Obama, the result brings a ratification of his sweeping health care act, which Mr. Romney had vowed to repeal.  The law will now continue on course toward nearly full implementation in 2014, promising to change significantly the way medical services… Continue Reading

An Attempt to Make Audits Less Burdensome for Hospitals

Posted in Administration, Hospitals, Medicaid

“House members look to ease Medicare audit burden on hospitals” is the title of a recent post by Pete Kasperowicz in his The Hill’s Floor Action Blog.  Last week, four House of Representatives members introduced bill H.R. 6575, that endeavors to ease the burden of a hospital during an investigation by a Medicare contractor, such as a… Continue Reading

Two “Pay-For-Performance” Provisions of the Affordable Care Act Go Into Effect Oct. 1, 2012

Posted in Administration, Affordable Care Act, Hospitals, Medicaid, Regulations

Two major but less discussed programs under the Affordable Care Act took effect October 1, 2012, which are part of the government’s effort to deliver better quality health care.  Both programs aim to reward hospitals for providing more efficient and higher quality care and penalize those that don’t. Under the Hospital Value-Based Purchasing Program, Medicare… Continue Reading

Physician-Hospital Integration: “Same Doctor Visit, Double the Cost”

Posted in Accountable Care Act, Hospitals, Medicaid, Physicians and Group Practices

“Same Doctor Visit, Double the Cost” – this is the title of a recent Wall Street Journal article written by Anna Wilde Mathews, which provides a view on the hospital-physician integration phenomenon.  The article describes the higher fees charged by hospitals that result when physicians become employed by hospitals.    It is our experience that… Continue Reading

CMS Launches New Tools to Fight Health Care Fraud

Posted in Hospitals, Medicaid, Physicians and Group Practices

The federal government’s war on healthcare fraud is going high-tech with the opening of a $3.6 million command center.  The Centers for Medicare and Medicaid Services (CMS) pays $750 billion each year to more than 1.5 million healthcare providers, and healthcare fraud is estimated to cost taxpayers more than $60 billion annually (see Health Law… Continue Reading

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