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Medicare Payments For Durable Medical Equipment Are Higher Than Necessary
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Book Synopsis Medicare Payments for Durable Medical Equipment are Higher Than Necessary by : United States. General Accounting Office
Download or read book Medicare Payments for Durable Medical Equipment are Higher Than Necessary written by United States. General Accounting Office and published by . This book was released on 1982 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Medicare Handbook written by and published by . This book was released on with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare: Issues for Manufacturer-Level Bidding for Durable Medical Equipment by : Kathleen M. King
Download or read book Medicare: Issues for Manufacturer-Level Bidding for Durable Medical Equipment written by Kathleen M. King and published by DIANE Publishing. This book was released on 2012-10-19 with total page 29 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2009, Medicare spent approx. $8.1 billion on durable medical equipment (DME), prosthetics, orthotics, and related supplies for 10.6 million beneficiaries. DME includes items such as wheelchairs, hospital beds, and walkers. Medicare beneficiaries typically obtain DME items from suppliers, who submit claims for payment for these items to Medicare on behalf of beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Dept. of Health and Human Services (HHS), has responsibility for administering the Medicare program. Medicare and its beneficiaries -- through their out-of-pocket costs -- have sometimes paid higher than market rates for various medical equipment and supplies. To achieve Medicare savings for DME and to address DME fraud concerns, Congress required CMS to phase in a competitive bidding program (CBP) for DME suppliers in selected competitive bidding areas (CBA). In CBP, suppliers submit bid prices in the amounts they are willing to accept as payment to provide DME items to Medicare beneficiaries. CMS then enters into contracts with select DME suppliers to provide DME items at the prices determined by CBP. In contrast to CBP's supplier-level approach, some health care purchasers use a manufacturer-level approach to buy DME items directly from DME manufacturers to obtain savings by leveraging their purchasing power. CMS has not been required to develop a manufacturer-level approach. This report provides information on health care purchasers that currently use a manufacturer-level approach and on issues that would need to be addressed if CMS implemented such an approach. It describes (1) efforts used by some non- Medicare purchasers to reduce DME spending by contracting with DME manufacturers or using purchasing intermediaries, and (2) issues that CMS might face if required to implement a DME manufacturer-level approach with broad authority to do so. Figures and tables. This is a print on demand report.
Book Synopsis The Future of Disability in America by : Institute of Medicine
Download or read book The Future of Disability in America written by Institute of Medicine and published by National Academies Press. This book was released on 2007-10-24 with total page 619 pages. Available in PDF, EPUB and Kindle. Book excerpt: The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.
Book Synopsis The Healthcare Imperative by : Institute of Medicine
Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Book Synopsis Medicare Hospice Benefits by : United States. Health Care Financing Administration
Download or read book Medicare Hospice Benefits written by United States. Health Care Financing Administration and published by . This book was released on 1993 with total page 6 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare: Competitive Bidding for Medical Equipment and Supplies Could Reduce Program Payments, But Adequate Oversight Is Critical by : Kathleen M. King
Download or read book Medicare: Competitive Bidding for Medical Equipment and Supplies Could Reduce Program Payments, But Adequate Oversight Is Critical written by Kathleen M. King and published by DIANE Publishing. This book was released on 2008-10 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare has paid higher than market rates for medical equip. and supplies provided to beneficiaries under Medicare Part B. Medicare has used fee schedules based on historical charges to set payment amounts. But this approach lacks flexibility to keep pace with market changes and increases costs to the fed. gov¿t. CMS is required to test competitive bidding as a new way to set payments. CMS did this through a demonstration in two locations in which suppliers could compete on the basis of price and other factors for the right to provide their products. This testimony describes the effects that competitive bidding could have on Medicare program payments and suppliers and the need for adequate oversight to ensure quality and access. Illustrations.
Download or read book Medical and Dental Expenses written by and published by . This book was released on 1990 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781976361845 Total Pages :24 pages Book Rating :4.3/5 (618 download)
Book Synopsis Medicare Durable Medical Equipment by : United States Government Accountability Office
Download or read book Medicare Durable Medical Equipment written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-13 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare fee schedule payments for durable medical equipment (DME) that the Food and Drug Administration (FDA) regulates as class III devices, those that pose the greatest potential risk, increased by 215 percent from 2001 through 2004. From 2004 through 2006, and for 2008, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provided for a payment update for class III DME equal to the increase in the consumer price index for all urban consumers (CPI-U). For 2007, MMA requires the Secretary of Health and Human Services to determine the payment update. MMA also requires that other DME receive a 0 percent update from 2004 through 2008. MMA directed GAO to report on an appropriate payment update for 2007 and 2008 for class III DME. In this report, GAO (1) examined whether class III devices have unique premarketing costs and (2) determined how the fee schedule rate-setting methodology accounts for the premarketing costs of such devices.
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781976399688 Total Pages :34 pages Book Rating :4.3/5 (996 download)
Book Synopsis Medicare by : United States Government Accountability Office
Download or read book Medicare written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-16 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS)-the agency that administers Medicare-estimated that the program made about $700 million in improper payments for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) from April 1, 2005, through March 31, 2006. To protect Medicare from improper DMEPOS payments, CMS relies on three Program Safeguard Contractors (PSC), and four contractors that process Medicare claims, to conduct critical program integrity activities. GAO was requested to examine CMS's and CMS's contractors' activities to prevent and minimize improper payments for DMEPOS, and describe CMS's oversight of PSC program integrity activities. To do this, GAO analyzed DMEPOS claims data by supplier and item to identify atypical, or large, increases in billing; reviewed CMS documents; and conducted interviews with CMS and contractor officials. GAO focused its work on contractors' automated prepayment controls and described related claims analysis functions.
Book Synopsis Extending Medicare Reimbursement in Clinical Trials by : Institute of Medicine
Download or read book Extending Medicare Reimbursement in Clinical Trials written by Institute of Medicine and published by National Academies Press. This book was released on 2000-03-17 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: Increasingly over the past five years, uncertainty about reimbursement for routine patient care has been suspected as contributing to problems enrolling people in clinical trials. Clinical trial investigators cannot guarantee that Medicare will pay for the care required, and they must disclose this uncertainty to potential participants during the informed consent process. Since Medicare does not routinely "preauthorize" care (as do many commercial insurers) the uncertainty cannot be dispelled in advance. Thus, patients considering whether to enter trials must assume that they may have to pay bills that Medicare rejects simply because they have enrolled in the trial. This report recommends an explicit policy for reimbursement of routine patient care costs in clinical trials. It further recommends that HCFA provide additional support for selected clinical trials, and that the government support the establishment of a national clinical trials registry. These policies (1) should assure that beneficiaries would not be denied coverage merely because they have volunteered to participate in a clinical trial; and (2) would not impose excessive administrative burdens on HCFA, its fiscal intermediaries and carriers, or investigators, providers, or participants in clinical trials. Explicit rules would have the added benefit of increasing the uniformity of reimbursement decisions made by Medicare fiscal intermediaries and carriers in different parts of the country. Greater uniformity would, in turn, decrease the uncertainty about reimbursement when providers and patients embark on a clinical trial.
Download or read book Medical Fee Schedule written by and published by . This book was released on 1995 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Role of Human Factors in Home Health Care by : National Research Council
Download or read book The Role of Human Factors in Home Health Care written by National Research Council and published by National Academies Press. This book was released on 2010-11-14 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: The rapid growth of home health care has raised many unsolved issues and will have consequences that are far too broad for any one group to analyze in their entirety. Yet a major influence on the safety, quality, and effectiveness of home health care will be the set of issues encompassed by the field of human factors research-the discipline of applying what is known about human capabilities and limitations to the design of products, processes, systems, and work environments. To address these challenges, the National Research Council began a multidisciplinary study to examine a diverse range of behavioral and human factors issues resulting from the increasing migration of medical devices, technologies, and care practices into the home. Its goal is to lay the groundwork for a thorough integration of human factors research with the design and implementation of home health care devices, technologies, and practices. On October 1 and 2, 2009, a group of human factors and other experts met to consider a diverse range of behavioral and human factors issues associated with the increasing migration of medical devices, technologies, and care practices into the home. This book is a summary of that workshop, representing the culmination of the first phase of the study.
Book Synopsis Medicare Coverage of Diabetes Supplies & Services by :
Download or read book Medicare Coverage of Diabetes Supplies & Services written by and published by . This book was released on 2002 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Competition and Market Power in Option Demand Markets by : Cory Stephen Capps
Download or read book Competition and Market Power in Option Demand Markets written by Cory Stephen Capps and published by . This book was released on 2001 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Procedures for Avoiding Excessive Rental Payments for Durable Medical Equipment Under Medicare Should be Modified by : United States. General Accounting Office
Download or read book Procedures for Avoiding Excessive Rental Payments for Durable Medical Equipment Under Medicare Should be Modified written by United States. General Accounting Office and published by . This book was released on 1985 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare & You written by and published by . This book was released on 2006 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
