Policy and Legislation

Nine emergency department health providers have created a consensus statement that lays out metrics to help reduce ED crowding.

A home care advocacy organization says the Office of Inspector General's recent report about the unnecessary provision of powered wheelchairs to Medicare beneficiaries is misleading and that the real problem is a flawed documentation process.

A proposed revision of the "advice" exemption of the Labor-Management Reporting and Disclosure Act (LMRDA) of 1959 will restrict access to legal counsel and forwards an organized labor agenda, opponents say.

Industry research firm IBISWorld has forecast the top 10 sectors that will benefit from the creation of state health insurance exchanges under the new rules released this week by the U.S. Department of Health and Human Services.

A new proposed rule has been released by the Department of Health and Human Services outlining ways that states can design and manage their health insurance marketplaces to allow consumers and businesses to comparison shop for health plans starting in 2014.

In a recent educational memo (SE1121), the Centers for Medicare & Medicaid Services (CMS) advised hospitals, once again, to improve their Medicare documentation in order to avoid unnecessary claims' denials by the Recovery Audit Contractors.

Although CMS made changes to the billing of concurrent therapy and higher levels of therapy at skilled nursing facilities, Medicare payment rates increased by $2.1 billion between the last six months of 2010 to the first half of 2011, said a report from OIG.

The U.S. Department of Health and Human Services has announced three new initiatives to help states improve the quality and lower the cost of care for "dual eligible" - the approximately nine million Americans who are eligible for both Medicare and Medicaid.

Leonard Langman, MD, a neurologist who owned and operated a Brooklyn, N.Y., medical clinic, pleaded guilty Friday for his role in a scheme to defraud Medicare and several other agencies, according to the Departments of Justice and Health and Human Services.

The Centers for Medicare & Medicaid Services released a report this week showing that 10 states lack sufficient authority under current law to review and reject excessive health insurance rate increases as required under the Affordable Care Act. Beginning Sept. 1 CMS will begin review of all rate hikes in excess of 10 percent for these states.