How Medicare Might End Surprise Nursing Care Penalties

By Susan Jaffe for Kaiser Health News Medicare officials have allowed patients at dozens of hospitals participating in pilot projects across the country to be exempted from the controversial requirement that limits nursing home coverage to seniors admitted to a hospital for at least three days. The idea behind these experiments is to find out whether new payment arrangements with the hospitals and other health care providers that drop the three-day rule can reduce costs or keep them the same …

Medicare Overpays $6.7 Billion for Patient Evaluation Services

Medicare spent $6.7 billion too much in 2010 by “inappropriately” paying claims from physicians who had submitted the wrong billing codes or no documentation at all for certain services, according to a new report from the inspector general of the U.S. Department of Health and Human Services (HHS). Although that amount was a small fraction of Medicare’s total spending of more than $525 billion in 2010, it still added up to 21 percent of what Medicare paid for all “evaluation …

Medicare Patients Now Can Do a Check-Up on Doctors

In a major data release this morning, Medicare shared information on $77 billion in payments to more than 880,000 health care providers. Consumers for the first time can look up doctors, find out the number of procedures they have performed and how much Medicare paid. This is one piece of the puzzle for determining the overall value of care being delivered. The information, from 2012 Medicare Part B payments, already has generated some eye-popping articles, with reports of one Florida ophthalmologist receiving …