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Lessons From 10 Years of Medicare Coordinated Care Projects

The authors make 5 practical suggestions for primary care practices implementing care coordination, as learned from the past 10 years of Medicare demonstration projects.  
medscape.com
about 4 years ago
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Fewer Hospitalizations for Diabetics Seen by Nurse Practitioners

Compared with Medicare patients receiving all care from physicians, those receiving care from nurse practitioners had slightly lower odds of potentially preventable hospitalizations.  
medscape.com
about 4 years ago
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Senior citizens were routinely tested for “angel dust” in scam that led to $256m settlement

One of the United States’ largest urine drug testing companies, Millennium Health, has agreed to pay $256m (£167m; €232m) to settle allegations that it fraudulently billed Medicare for hundreds of thousands of unnecessary drug tests on senior citizens and ran a kickback scheme designed to induce doctors to order the tests.  
feeds.bmj.com
about 4 years ago
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Medicare Cut for Physicians Helps Balance New Budget Deal

To help offset an $80 billion spending increase, the bipartisan bill would extend a 2% sequestration cut of Medicare payment rates into fiscal 2025.  
medscape.com
about 4 years ago
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Why Doesn't Congress Have Our Back?

For all of their talk about improving the quality of care in America, federal legislators may let the Medicare bonus for primary care providers expire at the end of the year.  
medscape.com
about 4 years ago
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450+ Hospitals to Pay Big for Defibrillator Claims Violations

The 70 settlements stem from a whistle-blower lawsuit alleging physicians violated Medicare coverage by implanting cardioverter-defibrillators sooner than allowed after MI or coronary procedures.  
medscape.com
about 4 years ago
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Medicare Approves Payment for End-of-Life Counseling

A proposal dropped from the Affordable Care Act after critics associated it with 'death panels' will take effect in 2016.  
medscape.com
about 4 years ago
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Congress Passes Budget Bill That Cuts Medicare Pay in 2025

'It was easier to go after the doctors,' said one veteran executive of organized medicine about lawmakers paying for the 2-year budget deal in part by reducing Medicare reimbursement 10 years from now.  
medscape.com
about 4 years ago
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Physicians Decry Broken Promise of Medicare Raise in 2016

The law that repealed the SGR formula called for a 0.5% hike in Medicare rates next year, but the ACA and other laws trumped it, yielding a 0.3% decrease."'It's a morale breaker," said the president of the AAFP.  
medscape.com
about 4 years ago
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Medicare Extends Deadline to Appeal Two Penalties

The Physician Quality Reporting System will reduce the reimbursement of some clinicians by 2% in 2016. The Value-Based Payment Modifier threatens practices with 100 or more members with another 2% cut.  
medscape.com
about 4 years ago
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Fewer Medicare-Subsidized Drug Plans Means Less Choice for Poor Seniors

The number of Medicare plans that cover medications with a subsidy provided for low-income beneficiaries is declining in 2016 by 20 percent.  
medscape.com
about 4 years ago
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Medicare Penalizes 758 Hospitals for Safety Deficiencies

Hospital-acquired condition program reduces Medicare payments 1%; some improvement seen in HAC prevalence.  
medscape.com
about 4 years ago
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Opioid Overprescribing Not Limited to a Few Bad Apples

The bulk of prescriptions for opioid painkillers are written by the broad swath of general practitioners, not by a limited group of specialists, new Medicare data suggest.  
medscape.com
almost 4 years ago
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Even With Smaller 'Donut Hole,' Medicare Cancer Pill Costs Stay High

Seniors insured by Medicare may still face high out-of-pocket costs for oral cancer medicines even after the government health program scales back a coverage gap known as the donut hole, a U.S. study suggests.  
medscape.com
almost 4 years ago
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Bill Allows Mass Exemptions From EHR Meaningful Use Penalty

The measure, awaiting the president's signature, would make it easier for Medicare to exempt physicians from a 3% penalty because they were not given enough time to meet MU requirements in 2015.  
medscape.com
almost 4 years ago
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CMS' Qualified Entities Program Disseminates More Doctor Data

'Qualified entities' combine Medicare data and other data and can publish performance reports on individual physicians.  
medscape.com
almost 4 years ago
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How Medicare Reimbursement Cuts Are Reshaping Ophthalmology

Medicare reimbursement for common ophthalmology procedures will be cut 19%-68% in 2016 and 2017, in addition to many cuts in 2015. Here's the rationale and how ophthalmologists are likely to respond.  
medscape.com
almost 4 years ago
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GAO Report Points to Need for Medicare Payment Leveling

The rapid increase in hospitals' practice acquisitions is causing Medicare to pay more than it should for evaluation and management services, according to a report.  
medscape.com
almost 4 years ago
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Medicare's NTAP for Blinatumomab Should Be Questioned

The NTAP program was designed to help hospitals offset costs associated with innovative interventions, but a new expensive drug does not meet the criteria, say two experts.  
medscape.com
almost 4 years ago
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Medicare Proposal to Penalize PSA Testing Is Rebuked

The national agency is considering a penalty for clinicians who provide prostate-specific antigen (PSA) testing that is not recommended; the idea got a thumbs down from a surprising source last week.  
medscape.com
almost 4 years ago