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 The leading web portal for pharmacy resources, news, education and careers May 26, 2017
Pharmacy Choice - News - Medicare & Medicaid - May 26, 2017

Pharmacy News

 Medicare & Medicaid
Current Articles | 7 - 30 Days Old | 30 - 90 Days Old | Over 90 Days
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5/19/17 - ACHP Shares Support for CHRONIC Care Act of 2017
The Alliance of Community Health Plans has shared support for the CHRONIC Care Act of 2017, being marked up in the Senate Finance Committee today. ACHP members are non-profit organizations that provide coverage and care for more than 18 million Americans across 27 states and the District of Columbia, including 2.4 million Medicare beneficiaries.
5/19/17 - Agency Information Collection Activities: Submission for OMB Review; Comment Request
SUMMARY: The Centers for Medicare& Medicaid Services is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995, federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each pr
5/19/17 - Agendia's MammaPrint Now Included in First Coast Coverage for Medicare Breast Cancer Patients in Florida, Puerto Rico and the Virgin Islands
By a News Reporter-Staff News Editor at Insurance Weekly News Agendia, Inc., a world leader in personalized medicine and molecular cancer diagnostics, announces that First Coast Service Options Inc., the Medicare contractor for Florida, Puerto Rico, and the Virgin Islands, has revised its Local Coverage Determination for gene expression profiling
5/19/17 - Audit: MCO spending 'could erode public trust' 'Unreasonable spending,' executives' pay cited in audit critical of NC agency funded by Medicaid
*$174,454 in "questionable" miscellaneous credit-card expenditures, including $47,987 for hotel charges above the federal hotel rate, $38,177 in transactions that lack sufficient documentation, $10,521 on first-class airline tickets, and $3,281 on alcohol purchases. *$27,751 spent on agency Christmas parties "at high-end locations" or at executive.
5/19/17 - Billing for shoe inserts lands chiropractor in court facing Medicaid fraud charges [Detroit Free Press]
May 19 A chiropractor who owns and operates four clinics in southwest Michigan faces a hearing Friday on two felony charges for allegedly receiving illegal Medicaid reimbursements for two products he prescribed to low-income patients. Ahad Lotfi, 53, of Lawton, Mich., west of Kalamazoo, has been charged with two counts of Medicaid-Fraud False C
5/19/17 - Casey says GOP's Medicaid cuts would devastate Pennsylvania schools [Beaver County Times, Pa.]
May 19 Proposed Medicaid cuts of $880 billion included in U.S. House Republican's health-care reform plan would devastate funding for students, especially those with disabilities, U.S. Sen. During a conference call with reporters, Casey blasted the AHCA for decimating Medicaid while giving "a huge tax cut" to the richest Americans. Casey's office
5/19/17 - Casey slams plan for Medicaid cut
Bob Casey criticized the House-passed American Health Care Act Thursday, saying the resulting reduction of Medicaid funding would be a "totally unnecessary cut" that would "change American life in a very devastating fashion." "Medicaid is a program I am going to defend with everything I have," he said.Casey, an outspoken opponent of the American H
WASHINGTON, D.C.- U.S. Senator Thad Cochran today announced his support for legislation to improve Medicaid coverage for children with serious illnesses and medical conditions. The bipartisan bill would change the Medicaid system to allow health care providers and hospitals to coordinate care for children with complex medical conditions.
5/19/17 - Counting the cuts in Mohs surgery: A way to improve care and reduce costs
By a News Reporter-Staff News Editor at Insurance Weekly News In an analysis of Medicare billing data submitted by more than 2,300 United States physicians, researchers have calculated the average number of surgical slices, or cuts, made during Mohs micrographic surgery, a procedure that progressively removes thin layers of cancerous skin tissue
5/19/17 - ER OVERUSE
Getting the people who overuse emergency services under control has been an uphill battle, but one major health insurer has been teaming with metro-area emergency medical services agencies for over a year to put a dent in the numbers of ER visits by some of its Medicaid members. The Community Paramedicine initiative, launched in January 2016 by Blu
5/19/17 - Federal Register Table of Contents
Table of Contents Office of the Federal Register Agriculture Department See Commodity Credit Corporation See Food and Nutrition Service NOTICES Agency Information Collection Activities; Proposals, Submissions, and Approvals, 22953 Centers for Medicare& Medicaid Services RULES Medicare Program: Advancing Care Coordination Through Episode Payment...
5/19/17 - Finance Committee Approves Sen. Roberts' Amendment Improving Medication Use for Medicare Patients
Pat Roberts, R- Kan., issued the following news release:. In a Finance Committee mark-up on bipartisan legislation improving Medicare for seniors with chronic conditions, U.S. Senator Pat Roberts today introduced an amendment with Sen. The Roberts-Carper amendment directs the Department of Health and Human Services to establish a process by which M
5/19/17 - Genomic Health Announces Favorable Draft Local Coverage Determination LCD on Medicare Coverage for Use of Oncotype DX Genomic Prostate Score in...
By a News Reporter-Staff News Editor at Insurance Weekly News Genomic Health, Inc. announced that Palmetto GBA, a Medicare Administrative Contractor that assesses molecular diagnostic technologies, has issued a draft local coverage determination for the Oncotype DX Genomic Prostate Score?. "This positive draft local coverage determination..
5/19/17 - King, Collins, Durbin, Portman, Brown, Capito Introduce Bipartisan Bill to Expand Access to Substance Abuse Treatment Under Medicaid
U.S. Senators Angus King, Susan Collins, Dick Durbin, Rob Portman, and Shelley Moore Capito have introduced the Medicaid Coverage for Addiction Recovery Expansion Act, bipartisan legislation that would expand access to substance abuse treatment for tens of thousands of Medicaid beneficiaries across the country. The Medicaid CARE Act would increase.
5/19/17 - Medicare and Medicaid Programs: Application From the Joint Commission for Continued CMS-Approval of Its Critical Access Hospital Accreditation Program
SUMMARY: This proposed notice acknowledges the receipt of an application from the Joint Commission for continued recognition as a national accrediting organization for critical access hospitals that wish to participate in the Medicare or Medicaid programs. You may mail written comments to the following address ONLY: Centers for Medicare& Medicaid..
5/19/17 - Medicare Program; Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to...
SUMMARY: This final rule finalizes May 20, 2017 as the effective date of the final rule titled "Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model" originally published in the January 3, 2017 Federal Register. This final rule a
5/19/17 - NEBRASKA MEDICAID MANAGEMENT The system needs stability
Nearly 227,000 low-income or disadvantaged Nebraskans depend on Medicaid funding for health care or mental health services. These supports are vital for many Nebraska households. Nebraska shifted on Jan. 1 to a new system in which companies or nonprofits providing those services can choose among three managed care companies now administering the bu
5/19/17 - PCI could cut ties with two of Iowa's private Medicaid insurers [The Gazette, Cedar Rapids, Iowa]
May 18 CEDAR RAPIDS Payment disputes have pushed Physicians' Clinic of Iowa to threaten to terminate contracts with two of the state's three private Medicaid insurers if the concerns are not soon corrected. About six percent of PCI's patient base is on Medicaid, Dalton said, with about 5,500 patients receiving procedures in the past 13 months t
5/19/17 - Questions To Ask Before Buying Medicare Supplement Insurance
By a News Reporter-Staff News Editor at Insurance Weekly News Asking a few simple questions can help ensure obtaining the right Medicare insurance coverage and potentially saving significant money. "Individuals have choices when it comes to Medicare coverage and that's a good thing but weeding through the choices to find the best plan can be dau
5/19/17 - Rep. Tonko Calls for Raising Mental Health Care Limits on Seniors through Medicare
This legislation would improve care for seniors in need of inpatient mental health care by permanently repealing the Medicare 190- day lifetime limit for inpatient psychiatric care. Congressman Paul D. Tonko: "Even today, Medicare continues to discriminate against seniors with mental illnesses by imposing lifetime caps on the care they need to live
5/19/17 - Reports by D. Pelech and Co-Researchers Describe Recent Advances in Medicare and Medicaid (Dropped out or pushed out? Insurance market exit and...
Reports by D. Pelech and Co-Researchers Describe Recent Advances in Medicare and Medicaid. By a News Reporter-Staff News Editor at Insurance Weekly News A new study on Medicare and Medicaid is now available. A 2011 policy change required that certain private insurance plans in Medicare form provider networks de novo; in response, insurers cancell
5/19/17 - Researchers at American Geriatrics Society Report New Data on Medicare and Medicaid (Medicare Access and CHIP Reauthorization Act: What do Geriatrics...
Researchers at American Geriatrics Society Report New Data on Medicare and Medicaid. By a News Reporter-Staff News Editor at Insurance Weekly News Researchers detail new data in Medicare and Medicaid. According to news reporting out of New York City, New York, by VerticalNews editors, research stated, "Commencing in 2017, the Medicare Access and
5/19/17 - Rising costs & potential savings for generic, topical steroids
In a new study led by investigators at Brigham and Women's Hospital, researchers have found that although most topical steroids prescribed to patients were generic, there was a sharp increase in Medicare Part D and out-of-pocket spending for elderly patients taking these drugs. Medicare Part D is the Medicare prescription drug benefit program for p
5/19/17 - School district Medicaid reimbursements
District FY 2014-15 Proposedreimbursement 30 percent cutAvella Area 31,537 9,461 Belle Vernon 233,675 70,102 Bentworth 41,114 12,334 Bethlehem-Center 11,268 3,380 Burgettstown Area 50,214 15,064 California Area 17,016 5,105 Canon-McMillan 96,659 28,997 Carmichaels Area 50,164 15,049 Central Greene 67,537 20,261 Charleroi Area 48,148 14,444...
5/19/17 - Sen. Casey: Medicaid cuts would hurt special education students [The Times Leader, Wilkes-Barre, Pa.]
May 19 Stressing that school districts use Medicaid money to meet federal special education mandates, U.S. Sen. Bob Casey warned Thursday that cuts proposed by Republicans could mean $40 million less nationwide in federal funding that helps school students. Schools use Medicaid money to pay for things like occupational and physical therapy, devic
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