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Today’s Hot Topics in Medicare News

Few Medicare Advantage Plans Will Offer New Home Care Benefits in 2019

BY TIM MULLANEY: Medicare Advantage (MA) plans are allowed to cover a range of in-home care services for the first time in 2019, but few insurers are going to do so, according to recent analyses of plan offerings. Experts believe these types of benefits could gain a lot more traction in the next two to three years, however.

In 2019, just 3% of MA plans will offer in-home support services such as personal care and housekeeping, according AARP. The Washington, D.C.-based organization offered an analysis of Medicare Advantage Landscape Source Files from the Centers for Medicare & Medicaid Services (CMS). (read more)

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Medicare for All PAC endorses only seven House Democrat candidates

BY SUSANNAH LUTHI: The new Medicare for All Political Action Committee has endorsed just seven Democratic House candidates—most of them running for toss-up seats in California. 

Progressive Rep. Pramila Jayapal (D-Wash.) launched the Medicare for All Caucus in the House over the summer, and she also chairs the Medicare for All PAC. The caucus now has at least 70 members, although Democratic single-payer critics who don’t want their party to shift that way point out this is far fewer than the 123 House Democrats who opted to co-sponsor the latest “Medicare for all” legislation. (read more)

GOP Revives Medicare Scare Tactics As Election Nears

BY JULIE ROVNER: Once again, Medicare is moving front and center in this fall’s campaigns.

Throughout the election season, Democrats have been criticizing Republicans over votes and lawsuits that would eliminate insurance protections for pre-existing conditions for consumers.

But now Republicans are working to change the health care conversation with a tried-and-true technique used by both parties over the years: telling seniors their Medicare coverage may be in danger. (read more)

Some nonradiologists receive a high percentage of Medicare payments for performing imaging exams

BY MICHAEL WALTER: Nonradiologists are performing more diagnostic and interventional imaging examinations now than ever before. In fact, according to a new study published in Current Problems in Diagnostic Radiology, reimbursements for those services make up a significant proportion of overall Medicare payments for many highly-reimbursed physicians from a variety of specialties.

“Over the years, there have been recurrent concerns in the radiology community over so-called turf wars in which radiologists compete with nonradiologist providers for patients and associated procedures in the same geographic region or institution,” wrote author Andrew J. Degnan, MD, department of radiology at Children’s Hospital of Philadelphia, and colleagues. “More important, however, are concerns regarding appropriateness, quality and costs associated with non-radiologist performed imaging studies. Although these trends in imaging study performance by other specialties began over a decade ago and are well-acknowledged in cardiac imaging and peripheral vascular interventions, there are concerns of ever-growing expansion of non-radiologist performed imaging services including various aspects of diagnostic imaging.” (read more)

Would the IPI Model Reduce Medicare Reimbursement for Providers?

BY JACQUELINE LAPOINTE: Physicians and hospitals would not see Medicare reimbursement drop under the proposed International Pricing Index (IPI) model, the former Senior Advisor to the Secretary for Drug Pricing Reform recently assured providers.

“The model will increase the add-on compensation available for provider costs associated with drugs covered by the IPI model, by undoing a cut to compensation that was imposed by budget sequestration (from 6 percent of ASP [average sales price] to 4.3 percent),” Dan Best wrote in a new Q&A blog post on the HHS website. “Further, ASP will still be used to calculate the overall level of add-on compensation available, so physicians would not see compensation cut because they are included in the model where prices are lower.” (read more)

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