Entries in Centers for Medicare and Medicaid (4)


Physicians Fear Medicare Cuts Due to Fiscal Cliff

Ingram Publishing/Thinkstock(WASHINGTON) -- Medicare physicians are preparing for fee hikes for their patients if Congress is unable to resolve the fiscal cliff, according to a statement by the Centers of Medicare and Medicaid Services (CMS).

According to the statement, “Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2012, are unaffected by the 2013 payment cut and will be processed and paid under normal procedures and time frames,” but the CMS will notify Medicare physicians “on or before January 11, 2013” if fees will go up.

The CMS says, “We continue to urge Congress to take action to ensure these cuts do not take effect.”

Copyright 2012 ABC News Radio


Study: Government Should Prepare for Contingencies in Medicaid Expansion

Comstock/Thinksto(WASHINGTON) -- The federal government will bear a heavier financial load when it comes to Medicaid as the number of Americans who receive aid jumps under the Obama administration’s health care plan, according to a new study.

The research, published in Health Affairs, found that the number of additional people enrolling in Medicaid may vary by more than 10 million, which would require federal government to spend an additional $58 billion on the program annually. According to the report, more than 7,000 new doctors could be needed because of the expansion.

“Our results indicate that policy makers should prepare to handle a broad range of contingencies in the Medicaid expansion under health reform,” the report concluded.

The report’s figures vary slightly from those of the Congressional Budget Office, which estimated that 16 million individuals will enroll in Medicaid in 2019, and those of the Centers for Medicare and Medicaid Services, which put the figure at 18 million.

“Research indicates that extending Medicaid coverage to uninsured people increases their access to care,” the report stated. “However, because of low provider reimbursement rates, people who shift from private coverage to Medicaid may actually experience greater difficulty finding providers willing to treat them.”

The Affordable Care Act requires states to expand Medicaid eligibility by 2014 to all Americans whose incomes are at or below 133 percent of the federal poverty line. The federal government will bankroll much of the initial costs.

Another study published in the same journal found that even without the individual mandate -- perhaps the most controversial aspect of the bill -- the health care law would still cover 23 million Americans that wouldn’t have had insurance without the law, and insurance premiums would rise less than projected.

If the mandate was lifted, premiums in the individual market would increase by 12.6 percent, with 7.8 million people losing coverage, according to the study.

The Democrats’ health care law has come under increased scrutiny by critics. Most Republican presidential candidates support repealing the entire law, even Mitt Romney, under whose governorship Massachusetts passed a law that became the model for the national bill.

Several programs in the Affordable Care Act have also run into hurdles. Earlier this month, the Obama administration announced it would drop the provision that would have provided long-term care insurance. The plan would’ve eased the burden on Medicaid but officials said they could not come up with a viable, financially sustainable model for it.

Copyright 2011 ABC News Radio


Medicare to Cover Costly Prostate Cancer Drug

Paul Tearle/Thinkstock(WASHINGTON) -- The Centers for Medicare & Medicaid (CMS) says it will cover the cost of the pricey drug Provenge, recently approved for men with metastatic prostate cancer.

Provenge is said to extend patient survival by an average of four months, but costs about $93,000 per patient.  A CMS administrator said Thursday that the agency wants to assure patients can get the treatment they need according to their wishes.

"We are optimistic that innovative strategies may improve the experience of care for our beneficiaries who have cancer," said Dr. Donald M. Berwick, a CMS administrator. "CMS is dedicated to assuring that these patients can seek the treatments they need in accordance with their wishes."

Although research says that Provenge can lengthen survival time for men with prostate cancer that has spread beyond the prostate, experts note the drug is a therapeutic treatment and not a preventative one.   

Provenge has also reportedly presented fewer side effects in patients, researchers say.

Copyright 2011 ABC News Radio


Most Medicare Patients Not Taking Advantage of Free Care

Brand X Pictures/Thinkstock(WASHINGTON) -- The Obama administration is trying to boost awareness of the free benefits of Medicare now that the Centers for Medicare and Medicaid Services (CMS) on Monday released a report showing that only one in six Americans take advantage of free check-ups offered each year.  

Preventative benefits are now available at no charge to Medicare patients due to the Affordable Care Act.  Part of these preventative benefits allows those on Medicare to take part in an Annual Wellness visit, breast and prostate cancer screenings and bone density screenings, but CMS says people are not taking the free care, likely due to a lack of information.  Now, CMS has launched a public outreach campaign called "Share the News, Share the Health" to inform physicians and patients about the available services.

"The Obama Administration is committed to helping increase the number of Americans who are healthy at every stage of life," CMS administrator Donald Berwick, M.D., said Monday. "…With the new free Annual Wellness Visits and free preventative care, people with Medicare have the tools to take common sense steps to take control of their health."

CMS says these services offered without cost-sharing can help save Americans an estimated two-thirds of the $2 trillion spent on treating long-term illnesses by taking steps to prevent them altogether.  

"Share the News, Share the Health," which will include online ads and community events all over the U.S.. will run throughout the summer.

Copyright 2011 ABC News Radio

ABC News Radio