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D.C. Week: Hospital Payment Update Proposed

MedPageToday, 2012

"The rate increase, together with other policies in the proposed rule and projected utilization of inpatient services, would increase Medicare's operating payments to acute care hospitals by approximately 0.9% in fiscal year 2013," raising total Medicare spending for inpatient hospital care by approximately $175 million, a press release from CMS said.
But the same proposal that raises pay rates includes proposed methodology for reducing payments -- also beginning in fiscal 2013 -- to hospitals that have excess readmissions for MI, heart failure, and pneumonia.
In a separate proposal, CMS announced a payment rule for long-term care hospitals (LTCHs) -- facilities such as nursing homes and rehabilitation units that provide healthcare to patients with multiple health problems who stay longer than 25 days.
An $8 billion Medicare demonstration program being carried out by the Obama administration is poorly designed and should be canceled, the nonpartisan said Monday.
The program is designed to reward the highest-quality Medicare Advantage plans, but instead pays out most of its award money to mediocre plans, according to a report released Monday.
Instead of continuing with the ineffective "MA Quality Bonus Payment Demonstration," which began this year, CMS should revert to the Medicare Advantage bonus plan that was passed in the Affordable Care Act, GAO investigators concluded.
Most people who misuse prescription painkillers get their stash from friends and family, according to an updated analysis of data from the .
Sixty-eight percent of new users and 66% of occasional users got their pills from a friend or relative, Gil Kerlikowske, director of the Office of National Drug Control Policy, said during a teleconference on Wednesday.
On the other hand, most chronic users of painkillers were prescribed the drugs by doctors or bought them from a dealer, the Internet, or a friend or relative.
CMS should establish a national payment policy for bevacizumab (Avastin) to treat wet age-related macular degeneration (AMD), according to a study issued Monday by HHS' (OIG).
Although bevacizumab, a cancer drug, is not approved to treat wet AMD, ophthalmologists nonetheless use it off-label to treat the condition, which is a leading cause of vision loss in people ages 60 and older.