Medicare & Medicaid

WellCare Health Plans has completed its acquisition of Advicare Corp.'s Medicaid business, which includes the transfer of approximately 30,000 members to WellCare of South Carolina.

Seeking to improve patient safety and reduce hospital readmissions, the Centers for Medicare and Medicaid Services is readying a series of "Hospital Improvement and Innovation Networks" (HIINs).

Steven Lipstein, chief executive of BJC, which includes Barnes-Jewish hospital in St. Louis, said Medicare doesn't play fair because its formula for setting penalties does not factor in patients with socioeconomic disadvantages -- low-income, poor health habits and chronic illnesses for instance -- that contribute to repeated hospitalizations.

To continue progress towards a safer healthcare system, CMS is requesting proposals for the Hospital Improvement and Innovation Networks.

On Tuesday, the House Ways and Means Committee passed the "Helping Hospitals Improve Patient Care Act," a bill that, among other provisions, provides financial relief for hospitals that were in the process of building off-campus outpatient centers in 2015 when the reimbursement policy was changed.

The U.S. Department of Justice on Monday filed a notice to join a whistleblower lawsuit against for-profit provider Prime Healthcare alleging it routinely submitted inpatient claims for patients who should have been treated as outpatients.

A broad proposal by Medicare to change the way it pays for some drugs has drawn intense reaction and lobbying, with much of the debate centering on whether the plan gives too much power over drug prices to government regulators.

Avalere said the cost to beneficiaries could be higher if they bought in at a younger age, mainly because Medicare offers no financial out-of-pocket cap on services.

Survey, conducted by marketing research firm Nielsen, assessed attitudes about the health care system, and possible solutions, in five populous states: Texas, California, Florida, New York and Ohio.

Done right and paid right, house calls could prove to be a better way of treating very sick, elderly patients while they can still live at home, feds say.