California Healthline: Medicare Drug Benefit Jul 29 2008 Federal Report Finds Drop in Complaints on Medicare Drug Plans
The rate of complaints about Medicare drug coverage dropped significantly over an 18-month period, and CMS is taking less time to resolve most complaints, according to a report. However, serious problems about access to medications still take too long to resolve, the report said. AP/Las Vegas Sun.
Jul 25 2008 Report: Rx Costs Higher Under Medicare Drug Benefit Than Medicaid
A House committee headed by California Rep. Henry Waxman released a report projecting that Medicare paid as much as 30% more for medications than Medicaid would have paid for the same prescriptions. The report focused on people eligible for both Medicare and Medicaid. Los Angeles Times et al.
Jul 22 2008 Proposal Targets Practice That Raises Costs Under Medicare Drug Plans
A proposal by CMS seeks to limit pharmacy benefit managers' use of "locked-in pricing," a practice that can result in Medicare drug plan beneficiaries falling into the so-called "doughnut hole" coverage gap more quickly. PBMs defend the practice. Wall Street Journal.
Jul 17 2008 New Medicare Law Has Wider Implications Than Payments to Physicians
This week, Congress overrode President Bush's veto of a wide-ranging Medicare bill. Most attention was paid to a payment fix for doctors, but the law also deals with Medicare drug coverage, electronic prescribing, competitive bidding programs and preventive care. Wall Street Journal, Miami Herald.
California Healthline: Medicare Aug 4 2008 CMS' Lack of Supplier Oversight Puts Funds at Risk
The government's limited review of Medicare equipment vendors' reimbursement claims is putting millions of dollars at risk, according to a Government Accountability Office report. CMS acknowledged that there were problems with its enrollment procedures and said it recently implemented new standar...
Aug 1 2008 More Preventable Conditions Won't Be Covered by Medicare
CMS initially had planned to add seven more conditions to its list of preventable conditions that it would not pay hospitals to treat but cut that down to two new conditions after hearing concerns from hospitals. Federal officials are urging states to adopt similar policies in their Medicaid prog...
Jul 31 2008 Draft Regulation Could Limit Access to Birth Control
HHS is reviewing a draft regulation proposed by the Bush administration that would deny federal funding to any health care entity that does not allow employees to opt out of providing care that conflicts with their personal beliefs, such as providing birth control pills or Plan B emergency contra...
Jul 30 2008 Sharp Grossmont Files Plan To Keep Medicare, Medi-Cal Funding
Hospital officials say they have taken disciplinary action against workers and launched education efforts to correct problems that could lead to the facility losing federal funds. Medicare and Medi-Cal account for about half of patient revenue at Sharp Grossmont. San Diego Union-Tribune.
California Healthline: Health Plans Aug 5 2008 Market Volatility Takes Toll on Kaiser Numbers Despite Jump in Revenue
A leader for Kaiser Permanente's health plan and hospitals said that "turbulence in the financial markets" weakened Kaiser's financial results for the second quarter. Net income was down by almost 70% from the previous year. East Bay Business Times.
Aug 5 2008 Health Care Reform Talks Moving Along in California
Gov. Schwarzenegger and legislative leaders are negotiating over a series of bills that aim to rein in the cost of individual health insurance and tighten rules on health insurers. Elements of the bills were included in the governor's health care reform proposal. KPCC's "Air Talk."
Aug 5 2008 Humana Reports Slight Decrease in Profits
On Monday, Humana reported a Q2 profit of $209.9 million, or $1.24 per share, down 3% from the $216.8 million, or $1.28 per share, it earned in the same quarter a year ago. However, the health plan's earnings beat its own projection of $1.15 to $1.20 per share. AP/San Francisco Chronicle.
Aug 4 2008 Schwarzenegger, Democrats Negotiating Health Care Actions
Gov. Schwarzenegger is working with lawmakers on legislation that aims to tighten rules on health insurers. The governor's health care reform proposal addressed many of the same issues, including insurer profits. Meanwhile, Schwarzenegger vetoed a bill aimed at expanding state regulators' abilit...
The Health Care Blog Aug 6 2008 Dear Medicare: Happy birthday! By Richard Propp Since I first met you on July 31, 1965, I have been smitten with your looks, your fairness, your support of the elderly without regard to social or economic status, skin color, ethnicity, intellectual IQ, emotional IQ,...
The Health Care Blog Aug 5 2008 Health 2.0 User-Generated Healthcare How are Web 2.0 technologies like social networks, wikis and online communities changing the face of the health care industry? How are hospital systems and physician practices evolving as a result of rapid technological change? How can health plans evolve...
The Health Care Blog Aug 4 2008 Dilemma of declining revenues and patient care By Jane Sarasohn-Kahn Health providers want to provide quality care and improve patient satisfaction. Really, they do. It's just that pesky problem of declining reimbursements getting in the way of meeting those two key business objectives. This dilemma comes to...
Piper Report on Health Care Feb 29 2008 Medicare Payment Policy: MedPAC Recommendations to Congress The Medicare Payment Advisory Commission (MedPAC) - the influential independent Congressional agency charged with advising Congress on a wide range of Medicare policy issues - has released its Medicare payment policy recommendations for 2009. The 355-page report includes a weath of information fo...
Piper Report on Health Care Jan 20 2008 Diabetes: Opportunities to Improve Outcomes and Reduce Costs The latest issue of the American Journal of Managed Care has several interesting articles on diabetes, demonstrating several opportunities to improve outcomes and reduce costs: How Managed Care Organizations Contribute to Improved Diabetes Outcomes: Patricia Salber, MD, chief medical officer and ...
- The California Department of Managed Health Care fined Health Net for withholding information from state regulators in their investigation of the company's p...
- Small-business workers are increasingly opting out of employer-based health care plans as rising health care costs have shifted more of the financial burden ...
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