Free Republic

see, two landslide elections did accomplish something. ... the “doc fix” is simply and end run around the deficit accounting process. What is more unsettling is the way this piece of legislation came about. It seems to signal that the era of the “Hastert Rule,” where the Speaker will not entertain legislation without the consent of the majority of his caucus, is dead. ... The fact that the Speaker went to the Democrats first to get votes on this spending deal shows the extent to which Boehner has been mortally injured as a leader. It also tells us that the...

In a rare display of bipartisanship, House leaders are actively pursuing a deal to permanently change the way Medicare pays doctors and to extend a children’s health program for two years. The estimated $200 billion package could be introduced as soon as this week by House committees responsible for health care policy. Both Speaker John Boehner (R-Ohio) and Democratic Leader Nancy Pelosi (D-Calif.) are personally involved to the point that Pelosi reached out to Senate Minority Leader Harry Reid (D-Nev.), and Boehner has spoken to Senate Majority Leader Mitch McConnell in recent days.

Federal agencies made $125 billion in improper payments last year, including tax credits to people who didn’t qualify, Medicare payments for treatments that might not be necessary and unemployment benefits for people who were actually working, said a government report released Monday. The level of improper payments was a new high after several years of declines. In addition to fraud, the errors included overpayments and underpayments, as well payments made without proper documentation. While the errors were spread among 22 federal agencies, three programs stood out: Medicare, Medicaid and the Earned Income Tax Credit. Together, the three programs accounted for...

Democratic senators would oppose a potential House bipartisan deal preventing cuts in physicians’ Medicare payments if it doesn’t finance a children’s health program for four years, senior Senate Democratic aides said Sunday. […] According to lobbyists and congressional aides, bargainers have discussed including money for the Children’s Health Insurance Program for two more years, costing around $5 billion. Its money is due to expire Oct. 1. […] The overall agreement—eliminating the Medicare reimbursement formula, slightly boosting those payments and adding money for children’s health—would cost roughly $200 billion over 10 years, aides and lobbyists say. …

House leaders are closing in on a deal to permanently avert cuts in payments to physicians under Medicare, two House aides confirmed Friday. The deal would offset only about $70 billion of the more than $200 billion cost of making the permanent fix, however, which would likely draw opposition from conservatives that the agreement would bust the budget.

While speaking with liberal talk-radio host Thom Hartmann last week, Senator Sherrod Brown (D-Ohio) said he agreed with the idea of lowering the Medicare eligibility age from 65 to 0, and essentially establishing a national, government-run health care system, claiming it “would be terrific.” Hartmann, while discussing the King v. Burwell case now before the Supreme Court, which could potentially end federal Obamacare subsidies for people in 34 states, said to Sen. Brown on Mar. 3, "Might it be a good time to start talking about alternatives, like, for example what Robert Ball, the guy who wrote the Medicare bill...

A defiant Sen. Robert Menendez declared, “I am not going anywhere,” Friday night amid reports the Justice Department is preparing to charge the New Jersey Democrat with corruption counts over allegations he used his office to help a Democratic donor. A person familiar with a federal investigation of Menendez told the Associated Press the Justice Department is expected to bring criminal charges against him in the coming weeks. The pending charges were first reported by CNN. Menendez told a press conference about four hours after the reports surfaced that he had “always conducted myself appropriately and in accordance with the...

A few weeks ago, I had an appointment with my dermatologist–an old school guy, well-loved by his patients. He’s straightforward, no-nonsense, and has long office hours. You know the type: The one you hope will never retire. As I was led to the examining room, I noticed something not too common these days–shelf after shelf of medical records in manila folders. When the doc came into the room, I commented that he did not appear to be an early adaptor of electronic health records (EHRs). He replied that it was definitely worth the Medicare reimbursement penalty (starting in 2015) to...

There is unprecedented demand for physician assistants as insurance payment and the Affordable Care Act encourage a team-based approach to managing the care of patient populations. A snapshot of this trend can be seen in a new report by The Medicus Firm, a national physician recruiter, which said physician assistants (PAs) rose to No. 5 among its top 10 most frequently placed medical care providers in 2014, outstripping several categories of medical doctors. Primary care doctors continue to hold the top three spots with family physicians at No. 1, followed by hospitalist doctors and internists at No. 3. Just a...

The Government Accountability Office added two more federal programs to its "high risk" list in a report released this week, bringing the total up to 32. Those high risk programs are ones the GAO deems to be extremely vulnerable to fraud, waste, abuse and mismanagement, putting billions of dollars of taxpayer money at risk.

In his march towards total government control of American lives, President Barack Obama strikes at Medicare Advantage, or Medicare Part D, in his new budget released Feb. 2 for fiscal year 2016. “The Budget proposes to give the Secretary of HHS the authority to negotiate drug prices for biologics and high-cost drugs in Medicare Part D to help ensure access to and affordability of these treatments,” according to “Investing in America's Future,” the White House's FY 2016 budget narrative. “This proposal is one of a range of potential solutions to address these growing costs, and the administration looks forward to...

The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity. Rather than pay more money to Medicare doctors simply for every procedure they perform, the government will also evaluate whether patients are healthier, among other measures. The goal is for half of all Medicare payments to be handled this way by 2018. Monday’s announcement marks the administration’s biggest effort yet to shape how doctors are compensated across the health-care system. As the country's largest payer of health-care services, Medicare influences...

Next year, doctors and hospitals will no longer get paid according to the fee for services model. They will get a fixed salary according to how well patients do. We will see the equivalent of patient report cards. Personalized care is out, government one-size fits all healthcare is in. The more tests, scans, surgeries that hospitals and doctors do, the less they will make. What could possibly go wrong? It will have a devastating effect on patients’ access to care. Patients who come back for the same problem will be included in the one-time bulk rate. Beginning next year, Medicare,...

Lillian Palermo tried to prepare for the worst possibilities of aging. An insurance executive with a Ph.D. in psychology and a love of ballroom dancing, she arranged for her power of attorney and health care proxy to go to her husband, Dino, eight years her junior, if she became incapacitated. And in her 80s, she did... But one day last summer, after he disputed nursing home bills that had suddenly doubled Mrs. Palermo’s copays... Palermo was shocked to find a six-page legal document waiting on her bed. It was a guardianship petition filed by the nursing home, Mary Manning Walsh,...

Nationally, 724 hospitals have had their Medicare funding reduced after the Centers for Medicare and Medicaid Services found that each had high rates of potentially avoidable “hospital-acquired conditions,” including falls, bed sores, and certain infections, including ventilator acquired pneumonia and catheter-associated urinary tract infections. CMS scored hospitals on the prevalence of three risk factors to their Medicare population patients: central line bloodstream infections, catheter-associated urinary tract infections, and serious complications, a catch-all group made up of eight types of injuries, including blood clots, falls, and bed sores. Funding can be reinstated for hospitals whose scores improve in the targeted areas.

I received many interesting comments from readers on Single-Payer "Medicare for All" Proposal; Live and Let Die; Why Does Single-Payer "Work" in Europe? This email is from a US M.D. named Ken. Ken writes ... I agree with everything you wrote, but you omitted a discussion of the variation of demand in relation to the cost. It is approximately correct to state that when the perceived cost to the user approaches zero, the demand for services approaches infinity. This is the crucial flaw in all "government-funded" single-provider programs. The demand for "free" services is impossibly huge. I have read extensively...

HICAGO — Denee Mallon marveled at the view of Lake Michigan from her hospital bed in the Windy City, where she had just made history: the then 74-year-old transgender woman underwent a milestone sex reassignment surgery she'd sought for decades. "Here I am, finally, after all these years," she said. "It happened." Her operation will be one of the first paid for by Medicare after she won a challenge in May to end the government insurance program's ban on covering such procedures for transgender individuals. Mallon's victory opened the door for other seniors to access this care and may influence...

The Obama administration announced new rules under Obamacare on Monday that target nonprofit hospitals’ efforts to get paid by their patients.Nonprofit hospitals, which serve a charitable purpose and are often religiously affiliated, will now be subject to strict rules on when and how they can collect payments from customers, thanks to regulations included in the health-care law. As a condition of their tax-exempt status, these hospitals must “take an active role in improving the health of the communities they serve,” Treasury Department deputy assistant secretary for tax policy Emily McMahon wrote in a blog post Monday. Under the new IRS...

The bullying of the nation’s physicians continues apace, now turning to penalizing doctors who don’t meet the administration’s one-size-fits-all approach to medical records. Bruce Japsen of Forbes reports: More than 250,000 physicians and other health professionals are being notified as early as today that their payments from Medicare and Medicaid will be cut because they aren’t adequately using electronic health records in their practices, the Obama administration confirmed. The Centers for Medicare & Medicaid Services, known as CMS, is telling about 257,000 eligible medical care providers who are largely physicians that they will be paid 1 percent less in reimbursement...

I need to pick something by 12/31.ATT is dumping us retired types to a BS type Exchange.The reps are minimum wagers and don't know squat. Been looking at plans and need, if possible some input on Plan F's "Excess charges"? Its a $70 month dif for me for a plan with it or without which is plan "N" Any one up to speed on this stuff your input would be appreciated. Last year went to the DR one time and the ER 1 time(i am not a roofer) Thanks