(Reuters Health)—The incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients. Hip fracture rates declined each year from 2002–2012, the researchers found. But starting in 2013, hip fracture rates leveled off and were higher than expected….
Medical Lab Trade Group Sues Over U.S. Reimbursement Cuts
(Reuters)—A U.S. trade association representing medical laboratories filed a lawsuit on Monday challenging a new reimbursement system used by the federal government that it said would reduce how much Medicare pays for labs by about $670 million in 2018. The American Clinical Laboratory Association (ACLA) in a lawsuit in federal court in Washington, D.C., said…
Trump Administration Proposes Medicare Rules Aimed at Opioids, Drug Costs
(Reuters)—The Trump administration on Thursday proposed changes to Medicare drug plans including limits on opioid prescriptions and rules aimed at reducing drug costs for seniors, such as requiring health insurers to pass on discounts to consumers. To help combat overprescription and abuse of addictive painkillers, the U.S. Centers for Medicare and Medicaid Services (CMS) said…
Rheumatology Champions Call for Lower Prescription Drug Costs, and More in Meeting with Congressional Legislators
ACR advocates recently returned to Capitol Hill to meet with members of Congress as part of the Advocates for Arthritis fly-in conference on Sept. 26. This annual event brings together rheumatology professionals to advocate on behalf of the rheumatology community. Core issues on which the advocates focused this year include lowering the out-of-pocket cost of…
The Important Role of the AMA RVS Update Committee in Medicare Payments
Believe it or not, change begins with one person willing to lead by example—and you can be that person. All too often, we get caught up with the changes we want. However, instead of talking about what we would like, it’s time to lead. The best way to do this is to show others you’re…
Building on Basics: Why I Am an Advocate for Rheumatology
If you speak to any advocate for rheumatology, each of us will tell you we’ve had an “a-ha” moment where we learned the importance of advocacy; my own came a dozen years ago. I was meeting with a legislative aide to a local Congressional representative who was a senior member of the committee overseeing Medicare….
U.S. Teaching Hospitals Are Expensive, But Have Lower Death Rates
(Reuters Health)—Academic medical centers, increasingly spurned by insurers for being more expensive than community hospitals, appear to have lower death rates for older adults than other facilities, a U.S. study suggests. Researchers reviewed millions of records for patients aged 65 and older and insured by Medicare, the U.S. health program for the elderly. They found…
How MACRA Has Affected Physician Compliance
In recent years, providers and practice groups have been worrying about Meaningful Use (MU) and gaining knowledge on using certified electronic health record (EHR) technology to avoid payment penalties, earn incentives and increase practice efficiency. Now, with the release of the final rule for MACRA payment reform, physicians will have two options for payment paths:…
Aetna CEO Urges Debate on What ‘Single-Payer’ Healthcare Would Be
NEW YORK (Reuters)—Aetna Inc, Chief Executive Officer Mark Bertolini wants a debate about what a single-payer healthcare system in the U.S would look like, but says he does not think the federal government should run it. “I think government-run healthcare would be a bad idea,” Bertolini says during an investor conference on Frida. The government’s…
How to Bill Medicare Patients for Non-Covered Services
What do you do when you are presented with a patient who needs treatment but the patient’s insurance company will not pay for the services? Can you provide the services anyway? Who will pay for them? How do you collect payment for such services? If the patient consents to receive the services in spite of…
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