“The federal Centers for Medicare & Medicaid Services released a potential treasure trove of 2012 Medicare physician claim information. The release, which makes the data public for the first time since 1979, is “a huge step to making the Medicare system more transparent,” CMS says.”
“A tiny fraction of the 880,000 doctors and other health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out to them under the federal program, receiving millions of dollars each in some cases in a single year, according to the most detailed data ever released in Medicare’s nearly 50-year history.”
ProPublica reports that Medicare has issued a proposed rule that would give the agency the “authority to kick out physicians and other providers who engage in abusive prescribing. It could also take such action if providers’ licenses have been suspended or revoked by state regulators or if they were restricted from prescribing painkillers and other controlled substances.”
ProPublica identified scores of doctors whose prescribing in Medicare’s drug program bore the hallmarks of fraud
“New data posted today and gathered through the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN) gives patients a first look at how their local hospitals are doing at preventing Clostridium difficile infections (deadly diarrhea) and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.”
Senator Grassley sent letters to all 50 states this week asking if they alert the federal government when they do. This information could be used by Medicare to help identify fraud.
The Public Policy Institute brought together leading experts to discuss promising approaches to improving care and lowering Medicare costs. Panel included Lisa McGiffert, Director, Safe Patient Project, Consumers Union
ProPublica’s “The Prescribers” series: “Prescription data obtained by ProPublica shows widespread use of antipsychotics, narcotics and other drugs dangerous for older adults, but Medicare officials say it’s not their job to look for unsafe prescribing or weed out doctors with troubled backgrounds.”
Op-ed by Dr. Kevin Kavanagh: “As more physicians become employees of hospitals, more hospital outpatient services will be provided, which produces an ever increasing cash trove for facilities, while increasing costs for patients and draining Medicare’s financial reserves.”
KHN: Last fall, seeking to improve care and save money, Medicare announced penalties to hospitals to which too many patients returned within a month. Both payment changes are applied to payments for every hospital stay of a Medicare patient. This chart shows the effect of each of those programs on hospitals’ Medicare reimbursements per hospital stay, and the combined effect for the federal spending year that runs from last October through September 2013. Hospitals could gain up to 1 percent in payments or lose as much as 2 percent from the two programs combined.