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Monday, August 3, 2009

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Daily news & Analysis


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Six Physician Groups Launch Viral Campaign for Universal Coverage

By: Cheryl Clark, July 31, 2009

Setting itself apart from the American Medical Association, a coalition of 450,000 doctors in six physician groups is touting its new campaign, "Heal Health Care Now," to strongly back health reform and to urge their patients to do likewise.

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Health Card Companies Defrauding Hospitals and Patients Shut Down

By: Cheryl Clark, for HealthLeaders Media, August 3, 2009

Lisa Truong's $28,000 bill from a San Francisco hospital is just one reason the California Department of Managed Health Care ordered two unlicensed companies offering fraudulent "discount health cards" to shut down and a third company selling health coverage to apply for a license or stop operating. Additionally, the state plans to make a plea to hospitals, physicians, and clinics to have their intake workers report those instances when patients appear with such cards expecting they are covered, instead of letting the incidents slide unreported.

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CMS' IPPS Final Rule Includes 2.1% Increase

By: Lisa Eramo, for HealthLeaders Media, August 3, 2009

Though many hospitals had feared a 1.9% reduction in payment for 2010, they will actually see a 2.1% increase, according to the fiscal year 2010 IPPS final rule that CMS released on Friday. CMS had originally proposed a documentation and coding adjustment to account for the "effect of increases in aggregate payments due to changes in hospital coding practices that do not reflect increases in patient's severity of illness," according to CMS.

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Patient Deportation Case Highlights Issues with Illegal Alien Healthcare

By: John Commins, for HealthLeaders Media, July 31, 2009

A medical ethicist says people who are angry at a South Florida hospital for repatriating a brain-damaged patient to his native Guatemala should instead push Congress to expand emergency healthcare coverage to illegal aliens.

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Bariatric Study Raises Larger Issues of Healthcare Costs, Quality, and Consumerism

By: John Commins, for HealthLeaders Media, August 3, 2009

The author of a new study of bariatric surgery says the wild disparity in cost and quality for the procedures provide a good example of the "twisted market" that often drives elective medicine. The study of 153,355 bariatric surgeries in 19 states found that, even though the majority of bariatric surgeries are elective, there is little evidence that consumers are demanding a better product at a lower price.

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CMS Announces Payment Rate Cuts for Skilled Nursing Facilities

By: Les Masterson, for HealthLeaders Media, August 3, 2009

CMS announced adjustments to fiscal year 2010 payment rates Friday that the agency said will help "better reflect the cost of caring for Medicare beneficiaries in nursing homes." The final rule calls for Medicare payments to skilled nursing facilities to drop by $360 million, or 1.1% lower than payments for 2009. CMS said the adjustment is a way to "rebalance an earlier adjustment to the case-mix indexes (CMIs) and better align Medicare payments with costs."

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Providers May Need Four Years to Implement ICD-10

By: Lisa Eramo, for HealthLeaders Media, July 31, 2009

Industry experts have repeatedly said that ICD-10 implementation must begin immediately in order for hospitals, health plans, and vendors to meet the October 1, 2013 compliance deadline. But now there is detailed evidence to prove it.

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Minimum Wage Increase May Threaten Financial Stability of LTC Facilities

By: MacKenzie Kimball , for HealthLeaders Media, August 3, 2009

The federal minimum wage, which Congress set at $6.55 an hour two years ago, jumped to $7.25 an hour on July 24. The 70-cent increase is the third such rise in as many years thanks to the Fair Labor Standards Act amendment of 2007, which brought the minimum wage up to $5.85 that year.

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Are We Missing Gawande's Point?

By: Philip Betbeze, for HealthLeaders Media, July 31, 2009

We've known about vast waste in healthcare spending for more than 20 years now. When are we going to actually do something about it?

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