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The killer sofa and chronic disease
I’d just come from a news conference on the medical and economic impact of chronic health care conditions, many of them caused by our lifestyles, when I stepped into a Metrorail car and came face-to-face with the poster.
It showed an overweight teenager sprawled on a couch, clutching a video game controller — a giant bag of potato chips and a liter bottle of soda at his feet. Big black letters dubbed the couch the “killer sofa.”
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Nursing homes say Florida could lose $62 million
Florida nursing homes would lose an estimated $62 million next year under proposed rules designed to recoup “forecasting errors” in Medicare payments, according to a study released today by the American Health Care Association and the Alliance for Quality Nursing Home Care.
The nursing home groups have been slugging away at the proposed rules, which they say will trim $770 million nationwide from nursing homes.
“Florida seniors are facing the second-highest Medicare funding reduction in the nation (behind New York) on top of the state Medicaid cuts passed into state law in recent weeks,” Tony Marshall, senior vice president and chief operating officer of the Florida Health Care Association, said in a statement.
“Medicare and Medicaid funding are inextricably linked,” Marshall said. “The combination of cuts to both programs squeezes facilities in a manner harmful to older residents’ rising care needs, as well as to our local economy and caregiver jobs base.”
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Medicare announces new protections
Medicare announced a series of new changes to crack down on high-pressure Medicare Advantage sales techniques and to make it easier for low-income beneficiaries to obtain benefits.
“The Medicare Advantage program is a valuable source of enhanced benefits and coordinated care for beneficiaries, and it should not be undermined by the actions of a limited number of unscrupulous sales agents,” said Kerry Weems, acting administrator of the Center for Medicare and Medicaid Services.
According to Medicare, the proposed marketing standards for Medicare Advantage (MA) plans would:
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AARP: Don’t raise doctor pay on backs of beneficiaries
AARP is launching a major advertising and lobbying blitz on the Senate aimed at averting a huge jump in Medicare Part B premiums next year.
“Taking money out of the pockets of older Americans to pay for skyrocketing health care costs just isn’t fair,” the ad says, while the green line on a medical monitor climbs higher and higher.
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Medicare to cover artificial heart tests
“Our decision revises a long-standing non-coverage policy and allows beneficiary access to this advanced technology,” said Kerry Weems, Medicare’s acting administrator. “Our decision also encourages the completion of FDA post-approval studies.”
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Nursing home industry predicts cuts could jeopardize jobs, wages and tax revenues
Touting an analysis from the Lewin Group, the nursing home industry warns that an anticipated $720 million cut in Medicare nursing home payments would have a huge economic ripple effect on the economy.
Bruce Yarwood, the American Health Care Association president and CEO, said a projected Medicare rule would “not only threaten seniors’ access to quality care nationwide, but will also negatively impact the economy and employment base.
“From our perspective, and as the data confirms, the CMS-driven ‘Forecast Error’ Medicare cuts represent a ‘lose-lose’ proposition for seniors’ care needs as well as the U.S. and local economies,” Yarwood said. Medicare annually adjusts payment rates to reflect what it calls forecast errors.
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Competitive bid program to get congressional look
Medicare’s competitive bidding program for durable medical equipment will be questioned at a House Ways and Means health subcommittee hearing next week.
Medicare officials have touted the program as a major way to save money and reduce fraud in sale and rental of equipment, prosthetics, orthotics and supplies. According to Medicare officials, the first round of bids resulted in a roughly one-quarter drop in the price of equipment.
Equipment dealers have argued that the bid process was flawed and that it will put many longtime small dealers out of business because they will be shut out of the program.
“We have heard from both suppliers and beneficiary advocates that the DMEPOS competitive bidding program is not working as well as it is supposed to,” Rep. Pete Stark, D-Calif., the panel’s chairman, said in a statement. “I look forward to hearing their concerns, as well as from CMS, as we consider whether changes need to be made before the program is further expanded.”
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Leavitt’s cut-the-cake Medicare solution
Everyone familiar with Medicare’s financial situation knows something must be done. Starting in October, the federal government will begin selling its Medicare trust fund bonds to keep the hospital portion of the program solvent. By around 2019, those bonds will be exhausted.
HHS Secretary Michael O. Leavitt keynoted a forum on Medicare today and met with health reporters to give his views on Medicare’s future. Without a change in course, he says, Medicare is “drifting toward disaster.”
Three things are needed to change course, Leavitt says:
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Leavitt: ‘How much for that knee replacement?’
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| Photo by Kimberly Smith/AJC |
At a briefing with reporters this morning, Leavitt noted that Medicare pays for about 255,000 knee replacement surgeries a year but there is no set price on how much it costs, nor is there any competition in terms of cost or quality. He’d like to see that changed.
What if everyone involved in a knee replacement surgery received a lump sum for the procedure and then divided that payment among themselves? The surgeon would get so much, the anesthesiologist would get so much, the radiologist would get so much, the hospital would get so much….
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‘Medicare: Drifting towards disaster’
That’s the topic of a forum of think tanks convening Tuesday to hear from Health and Human Services Secretary Michael O. Leavitt.
The forum skews conservative headed by the Heritage Foundation, The Galen Institute and the American Enterprise Institute
“Medicare is indeed drifting toward disaster,” says the e-mail announcing the forum. “HHS Secretary Michael Leavitt will provide new insights and information on the disastrous fiscal path that Medicare is on, threatening access to health care and the health of the U.S. economy.”
