Archive for Medicare bad debt reimbursement


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.…

Focus on Medicare and Deficit Reduction

Hospitals and other providers have a great deal at stake in Medicare policy changes that may result from the budget deficit reduction process established through the Budget Control Act passed last month.

That process started with $900 billion in future federal spending cuts adopted immediately and another $1.2 trillion to be identified and passed by the end of the year – or, failing that, immediate cuts in various aspects of federal spending, including a two percent cut in Medicare payments to hospitals and other providers.

In an issue brief entitled “The Budget Control Act of 2011:  Implications for Medicare,” the Kaiser Family Foundation presents a broad look at what Congress has already done, the process Congress and its new Joint Select Committee on Deficit Reduction will follow to identify and consider additional future federal spending cuts, and the time-frames for completion of this work.

Hospitals and other health care providers will be watching closely – and undoubtedly weighing in with their own preferences – as this committee and Congress address their deficit reduction responsibilities in the coming months and make vital decisions about Medicare’s future.  Many aspects of Medicare reimbursement that are vital to hospitals – inpatient and outpatient payments, …