White House: Cutting Medicare Will Only Shift Costs

Addressing the nation’s budget deficit by cutting Medicare will simply shift health care costs to the private sector and not address underlying issues, Obama administration officials said yesterday at a White House briefing. Health and Human Services (HHS) Secretary Kathleen Sebelius said Medicare and Medicaid are not the reason health costs are going up.

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DOJ, HHS Recovered $4.2 Billion In FY 2012

HMS Healthcare Management SolutionsEarlier this week, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This reflects the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse Control (HCFAC) Program.

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Obama Administration Sends Upcoding Warning

HMS Healthcare Management SolutionsA letter signed by U.S. Attorney General, Eric H. Holder Jr., and Secretary of Health & Human Services, Kathleen Sebelius warns providers against using electronic records to abusively bill for Medicare and Medicaid reimbursement.

The letter expresses great concern the adoption of electronic health records could lead to inappropriate coding and addresses the use of electronic health records to facilitate ‘upcoding’ of the intensity of care or severity of patients’ condition.

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AHA Seeks Clarification On Medicaid Expansion

The American Hospital Association (AHA)  is asking U.S. Department of Health & Human Services (HHS) to clarify how the Supreme Court ruling upholding healthcare reform will affect Medicaid payments to hospitals. In a letter sent earlier this week, the AHA asked for clarification in a several areas, including:

  • Whether patients with incomes between 100% and 138% of the federal poverty level are eligible for subsidies through an insurance exchange.
  • Whether states can expand Medicaid coverage to certain individuals or phase in coverage over several years.
  • Whether HHS will consider ways to help states manage patients currently eligible for but not enrolled in Medicaid who might be enrolled under the new mandate.
  • How to minimize the administrative burden of patients “churning” between Medicaid and exchanges
  • When CMS will issue regulations related to reduced Medicare disproportionate share hospital (DSH) payments.

HMS Healthcare Management Solutions will monitor the response from Secretary of HHS, Kathleen Sebelius.

No Contingency Plan For Health Refrom

Health & Human Services (HHS) Secretary Kathleen Sebelius reiterated the administration’s position that it does not have a contingency plan ready should the U.S. Supreme Court rule this summer that the 2010 healthcare-reform law is unconstitutional.

“We’re confident that the law is constitutional and we are moving forward with implementation,” said Sebelius. “In the event that there is a different ruling, we’ll be ready, but at this point, our energy is really focused on continuing to make sure that people know about the benefits and take advantage of what’s out there.”

Planning currently centers on making sure states are prepared when most of the law’s provisions take effect in 2014.

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Lawmakers Query Sebelius On Reform, Budget

Delayed regulations, implementation costs of the healthcare reform law, and mandated contraception coverage in health plans were among the top issues at a congressional hearing featuring Health & Human Services (HHS) Secretary Kathleen Sebelius as the sole witness.

Appearing before the House Energy and Commerce Health Subcommittee to testify about the Obama administration’s fiscal 2013 budget, Sebelius fielded a range of other questions about the Patient Protection and Affordable Care Act (PPACA). Rep. Questions included why Congress appropriated $1 billion to implement the healthcare law and the administration has requested another $1 billion in its most recent budget.

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