BY KELLY GOOCH: CMS is offering more settlement options for inpatient rehabilitation facilities to resolve disputes over denied Medicare claims.
The voluntary appeals settlement options are a result of two years of negotiations between the agency and the American Rehabilitation Providers Association, the Fund for Access to Inpatient Rehabilitation and the Federation of American Hospitals.
Under this voluntary global settlement, rehabilitation hospitals or units will be able to settle denied Medicare claims at any administrative appeal level, the AMRPA stated via news release. (read more)
Medicare Direct, A Blueprint For Public Option Waivers, Part 2: Benefit Design, Provider Networks, And Reimbursement
BY BILLY WYNNE: In all of the discussion and debate regarding Medicare for All and public option proposals, three essential considerations often get short shrift: the benefits enrollees will receive, the network of providers they will have access to; and the rates providers will be paid for delivering these services. These elements, however, really are the guts of any meaningful initiative of this scope.
In my first post of this series, I outlined the rationale, administration, and financing terms for a state-initiated, Medicare-based public option waiver program that I call Medicare Direct. In this post, I will address the core design components identified above. In the final post, I will present the key elements and legal basis for the combination of waivers that would allow states to proceed with the program without the need for congressional action. (read more)
BY DAN DIAMOND: Where Mick Mulvaney’s dismissal for an Oval Office coughing fit is nothing compared to Anthony Scaramucci being ordered to get a pencillin shot (in a sensitive spot) because President Donald Trump was worried about his hoarse voice. (read more)
BY MARKOVITZ AA: Medicare Shared Savings Program participation was not tied to improvements in spending, quality of care or outcomes, according to study results published in the Annals of Internal Medicine.
“Evidence suggests that [Medicare Shared Savings Program accountable care organizations] are associated with modest improvements in spending and quality,” Adam A. Markovitz, BS, from the University of Michigan Medical School and School of Public Health, and colleagues wrote. “However, [Medicare Shared Savings Program] evaluations may be subject to confounding from nonrandom participation or attrition within [accountable care organizations].” (read more)
BY JONATHAN COHN: A new poll about “Medicare for All” should make you think twice before trusting polls on Medicare for All.
Yes, that sounds a little weird. But it’s the biggest takeaway from the new survey, one designed specifically to measure the public’s understanding of how Medicare for All would actually work. (read more)