Archive for Medicare bad debt reimbursement


CBO Targets Health Care in Options for Reducing Deficit

Every year the Congressional Budget Office publishes a menu of options for reducing federal spending and the federal budget deficit.  As in the past, this year’s compendium includes a number of options to reduce federal health care spending and raises federal revenue through health care initiatives.

The cost-cutting options include:

  • establish caps on federal spending for Medicaid
  • limit states’ taxes on health care providers
  • reduce federal Medicaid matching rates
  • change the cost-sharing rules for Medicare and restrict Medigap insurance
  • raise the age of eligibility for Medicare to 67
  • reduce Medicare’s coverage of bad debt
  • consolidate and reduce federal payments for graduate medical education at teaching hospitals
  • use an alternative measure of inflation to index social security and other mandatory programs

Options to raise additional revenue include:

  • increase premiums for Parts B and D of Medicare
  • reduce tax subsidies for employment-based health insurance
  • increase the payroll tax rate for Medicare hospital insurance

Learn more about the CBO’s recommendations, how they might be implemented, and their potential implications in the CBO report Options for Reducing the Deficit: 2019 to 2028.

Senate Committee Talks Entitlement Cuts

Higher Medicare Part B and Part D premiums for wealthier beneficiaries.   Reduced Medicare bad debt reimbursement.  Raising the Medicare eligibility age.  Reducing the scope of Medigap policies.

These were among the entitlement “reforms” discussed when Treasury Secretary Jacob Lew testified recently before the Senate Finance Committee.

Learn more about Mr. Lew’s testimony and the potential Medicare cuts discussed by committee members in this CQ HealthBeat article presented by the Commonwealth Fund.…

Capital Spending May Dip Because of Reimbursement Concerns

Hospitals expect to spend less on capital needs in 2013 because of continuing concern over reduced reimbursement, especially from Medicare.

Hospitals have already been targeted for cuts in Medicare bad debt reimbursement and face $155 billion in additional Medicare cuts as well as a two percent reduction in payments if Congress does not address the fiscal cliff and sequestration cuts take effect on January 1.  In addition, hospitals have experienced Medicare coding adjustments and face further cuts as a result of Medicare’s value-based purchasing program.

These and other cuts, a Premier healthcare alliance survey found, will hurt growth in hospital capital spending in 2013.

Read more about the Premier survey and why hospitals are concerned about their government reimbursement in this Healthcare Finance News article.…

Report Calls for Billions in Hospital Cuts

A report by the Center for American Progress proposes billions of dollars in payment cuts to hospitals as a way of helping to prevent the country from falling off the fiscal cliff.

In its new report “The Senior Protection Plan:  $385 Billion in Health Care Savings Without Harming Beneficiaries,” the Center for American Progress proposes $61 billion in hospital payment cuts over the next ten years – cuts over and above those already enacted in the Affordable Care Act and other legislation of recent years.

Among the proposals:  greatly reduced Medicare inpatient annual payment updates; the elimination of payment differentials between hospital outpatient facilities and physician offices; more expansive penalties for Medicare readmissions; reductions in Medicare bad debt reimbursement and graduate medical education payments; penalties for states that use large provider taxes to fund their Medicaid programs; and more.

These proposals, most of which have been offered by others in recent years, are considered especially important because the Obama administration frequently looks to the Center for American Progress for policy ideas.  The report was issued the same day that President Obama agreed to consider entitlement cuts if significant enhanced revenue was part of the overall approach to addressing the fiscal …

Medicare DSH Cut Looms for Many Hospitals

Hospitals across the country will soon lose important funding that helps them care for many of their low-income and uninsured patients:  their Medicare disproportionate share hospital payments (Medicare DSH).

Come 2014, the Affordable Care Act mandates a significant cut in qualified hospitals’ Medicare DSH payments.  The underlying rationale for this cut is that once the health care reform law’s individual insurance mandate takes effect and states begin greatly expanding Medicaid eligibility (a reform law mandate made optional by this year’s Supreme Court decision), hospitals will have fewer such patients and less need for supplemental DSH funding.

But as a Kaiser Health News article points out, hospital officials are concerned that the funding will phase out before the expanded insurance phases in, leaving them with fewer resources to care for their low-income, still-uninsured patients.

Safety-net hospitals, which care for the greatest numbers of low-income and uninsured patients, figure to suffer the most under such circumstances.

Learn more about the phase-down of Medicare DSH payments and the challenges some hospitals will face in its wake in this Kaiser Health News article.…