Medicare/Medicaid

While the power dynamics will appear similar in the 113th Congress as it did in the 112th Congress, the environment in which the new Congress operates looks entirely different. Sequestration and other fragments of the "fiscal cliff" must be dealt with over the next several weeks and it would seem probable that Republicans look to use parts of the ACA as bargaining chips to get the bigger deal done.

In this podcast interview, The Advisory Board’s Rob Lazerow, a senior consultant, speaks with Healthcare Informatics Associate Editor Gabriel Perna, at-length about the policy implications of yesterday’s election. Lazerow discusses the effect the re-election of President Barack Obama, the maintaining of the house by the republicans, and the senate by the Democrats, will have on healthcare policy, specifically the Affordable Care Act (ACA).

MGMA senior executives tell members of the media that their association's members are feeling hampered by policy and reimbursement uncertainty, and holding off on becoming involved in accountable care organizations and other innovative arrangements because of that uncertainty.

According to a recent audit by the Department of Health & Human Services' Office of the Inspector General (OIG), the Centers for Medicare and Medicaid Services (CMS) could improve the database in which it lists all of the breaches of protected health information is has had since 2009. Also, while CMS did notify 13,775 Medicare beneficiaries affected by the breaches, it did not meet several American Recovery and Reinvestment Act (ARRA) requirements.

The federal government’s push to curb Medicare fraud continued this week when Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the multi-agency Medicare Fraud Strike Force operations have drawn charges against 91 individuals in seven states – including doctors, nurses and other licensed medical professionals.