December 2012

Medicare News - JAMA Reports Medicare Role and Challenges

In JAMA's recent "Visualizing Health Policy Report", supported by the Kaiser Family Foundation analysis, reviews who is covered by Medicare; what proportion of Medicare beneficiaries use at least one medical service in a year; the balancing act for Medicare in setting fair payments to health care professionals and institutions and in keeping medical care affordable and sustainable; how health care spending per person is growing more slowly for Medicare than for private insurance; and how rising health care costs and a growing population pose fiscal challenges to keeping Medicare solvent in the years ahead.

Click here for the article and additional links from JAMA and the Kaiser Foundation.

Medicare Set Aside News - A New CBO Report

Last month, the Congressional Budget Office (CBO) released some interesting data statistics and cost estimates to show that HR 1063 will reduce Medicare spending by $45 million from 2013 to 2022. As defined, H.R. 1063 would modify the process Medicare is reimbursed when another payer (for example, a liability or workers' compensation insurer) is responsible for a beneficiary's medical costs. In general, the provisions of H.R. 1063 would make it easier for other payers to repay Medicare, thus reducing program costs.

Click here for the article and additional links from the CBO.

The Medicare HEAT Team Reports Successes

Between 2007 and 2011, then Health Care Fraud Prevention and Enforcement Action Team (HEAT) actions led to a 75% increase in individuals charged with criminal health care fraud. Since 2007, Heat's Medicare Strike Force, a multi-agency group of investigators designed to fight Medicare fraud, has charged more than 1,400 defendants who collectively falsely billed the Medicare program more than $4.8 billion.

Click here for the article and additional links from Medicare.